An Etowah County woman who claimed she was forced to give birth without any medical help in a jail shower settled a federal civil rights lawsuit against the county, jail officials and doctors this week.

Ashley Caswell was two months into her high-risk pregnancy when she was arrested in March 2021 for using drugs while pregnant. When her water broke in October, her lawyers said she was not taken to the hospital and eventually delivered alone in the shower, where she experienced a life-threatening placental abruption.

“I delivered my own son and had to beg for help,” Caswell told AL.com in 2023.

According to the lawsuit, jail staff looked on as she bled and took pictures of Caswell and her baby, who was still attached to the umbilical cord, before calling for medical help.

Though both Caswell and her baby survived, the lawsuit claimed the jail denied Caswell prenatal care and her physician-prescribed Ibuprofen to manage the pain from her delivery.

“I felt they treated me like I was less than nothing, and I was terrified my baby and I would die. I decided I had to speak up by filing the lawsuit,” said Caswell in a press release.

The lawsuit was filed in October 2023 against Etowah County and officials at the Etowah County Jail, jail medical contractors Doctors’ Care Physicians and some of its employees and CED Mental Health Services.

All defendants entered into settlements, according to Caswell’s lawyers. The terms of the settlements are confidential.

“It wasn’t easy standing up for myself, but reaching this point today lets me know I made the right decision to sue. I hope they’ll take steps to make sure this doesn’t happen to another woman again,” Caswell said.

For years, law enforcement officials in Etowah County kept pregnant women accused of drug use behind bars for months until they could be released to rehab. The practice ended after AL.com reported on legal challenges filed in 2022.

AL.com has written about the county’s abnormally high number of chemical endangerment cases against pregnant women. County officials have said they are trying to protect babies from exposure to drugs, however attorneys from Pregnancy Justice and former inmates have described deplorable conditions and inadequate care for high-risk pregnancies.

Between 2015 and 2023, Etowah County arrested at least 257 pregnant women and new mothers, according to the lawsuit.

Alabama leads the nation in pregnancy-related prosecutions, according to the Pregnancy Justice Center, who represented Caswell in the case, along with co-counsel Southern Poverty Law Center and Sullivan & Cromwell LLP.

“This settlement sends a clear message: A person’s carceral status doesn’t make them any less human or less deserving of civil rights,” said Pregnancy Justice Senior Staff Attorney Emma Roth.