'It was fully ignored': This woman's medical emergency in Ontario jail reflects broader health-care crisis

Ashley smitty stevens has scars interior and come out from her clip in an Ontario clink.

It’s not because she was involved in violent confrontations with other inmates, but because she suffered a miscarriage and then an unrelated infection.

“I got sepsis,” said Stevens, who was treated at an Ottawa-area hospital. “The doctor even said if I didn't come in when I did, I would have been dead.”

Earlier this year, Stevens, 30, spent four months at the Ottawa-Carleton Detention Centre for crimes related to domestic violence — uttering threats, mischief and assault. She was initially granted bail, but ended up in jail after breaching her conditions.

The day she was sent to jail, she found out she was pregnant. It would be her fourth baby.

Weeks into her incarceration, she knew something was wrong.

“I kept telling the nurses I'm still bleeding a lot,” she said.

Stevens said she bled for five days before she was sent to the hospital, where it was confirmed she’d lost the baby.

Former inmate says she miscarried, got a severe infection while incarcerated in Ontario jail

When she returned to jail, she noticed a wound on her left buttock that was painful and swollen.

“I was just feeling really sick, but not, like, pregnancy sick. I felt like I was dying, and I ended up passing out,” said Stevens.

She was taken back to hospital and had surgery to remove the failed pregnancy from her uterus. While there, Stevens said a doctor told her the wound on her buttocks had gone septic.

“It was fully ignored… I was pulling my pants down, showing [correctional officers] my infection," said Stevens, to which the officers replied, “‘Don’t worry, just stay off of it and if it gets worse, just let us know.'”

She said she had little contact with jail medical staff because “to see the doctor, you're only allowed to see him once a month, and you get to see him for a few seconds.”

More than a third of the complaints received between January and June 2025 were related to health care — primarily access to doctors and nurses and issues around medication.

“People with health issues and with mental health issues often end up behind bars. When they end up there, they still require care, but it's in short supply," he said. "They don't have enough staff … enough resources for that, and the prison is not a hospital.”

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When accounting for the significant increase in prisoner population, complaints have gone from the equivalent of nine complaints for every 100 inmates in 2019 to 17 per 100 inmates in 2024.

The Ontario Ministry of the Solicitor General, which is responsible for provincial correctional facilities that house prisoners with sentences of less than two years and those on remand, said it could not comment on Stevens's case because it involved personal medical information.

“Each facility has primary care practitioners responsible for the provision of primary medical services," the ministry said. "Inmates have access to health care practitioners, such as nurses, nurse practitioners and physicians.” 

The figures suggest jails employed hundreds more medical staff before and during the height of the COVID-19 pandemic. In 2019, more than 1,000 medical professionals were considered “active staff”; by 2025, that had dropped to around 550.

The statistics are not surprising to Piché. “If you talk to nurses or doctors, they're already finding it extremely difficult to work in hospitals. They're going to go and work in a prison?”

Adam Cygler, co-chair of the occupational stress and injury subcommittee for the Ontario Public Service Employees Union (OPSEU), said nurses contracted through agencies have been brought in to boost staff levels, but it’s not enough.

“Everybody is just being run off their feet, because there's 30 per cent more people to provide services to, and we don't have the staff alongside to be able to continue to do that,” said Cygler, who is also a social worker at the Ontario Correctional Institute in Brampton.

Dr. Louisa Marion-Bellemare, who works in an Ontario jail, said access to health care isn't just a corrections problem.

“If we're in a health-care crisis outside of jails or provincial corrections, then there's also a crisis for health-care providers within provincial corrections,” said Marion-Bellemare, a physician with a focus in addictions and Indigenous health.

Before building more jails as a solution to overcrowding, Marion-Bellemare said leaders should take a step back and look at who’s currently detained. For example, she estimates more than 95 per cent of the patients she assesses in jail have substance-use disorders and are significantly sicker than 20 years ago.

“They do cocaine, drink alcohol, do crystal meth and fentanyl. It's a much more complex patient,” she said.

With limited resources, she said jail staff have to triage problems.

“As health-care professionals, that is the ethical thing to do," said Marion-Bellemare. "Because we have limited health-care resources, we must see the sickest people first.”

She also said more programs and transitional housing are needed to support people suffering from addiction and mental health problems before they land in jail.

“What's going to solve this problem is keeping people out of jail in the first place,” she said.

Piché says the way society perceives the most vulnerable is also an issue. “When we see public drug use, people living with mental health issues ... People who are unhoused or encampments, it makes us uncomfortable,” said Piché. “They’re not going to find care in cages.”

In April, Ashley Stevens pleaded guilty to some of the charges against her and was sentenced to another 30 days in jail.

“The judge had seen everything that I had went through,” said Stevens, who has now recovered from the infection, but is still coming to terms with the miscarriage.

Judges have already stayed cases or given shorter sentences, citing a variety of conditions for detainees in Ontario jails.

“I think judges are becoming much more aware of it,” said Ontario Sen. Kim Pate, who is also the former executive director of the Canadian Association of Elizabeth Fry Societies.

“The waits and the conditions of confinement to which they're subjected means that oftentimes, judges are trying to compensate for that."

Inmate complaints over the first six months of 2025 were compared to the Jan. 1-June 30 period of each previous calendar year (2019–2024) to ensure accurate year-over-year trends. To account for changes in the jail population, a complaint rate was calculated by dividing the total number of complaints filed in a given year by the average number of inmates, then multiplying by 100 (complaints per 100 inmates). The data did not specify the outcome of complaints or if the same person filed multiple complaints.

Originally, more than 800 different reasons were cited for complaints. To facilitate analysis and visualization, complaints were divided into two main subcategories: complaints related to “Health care” and complaints related to “Jail operations.” All complaints related to the day-to-day operation of the jail (e.g., mail, hygiene, diet, telephone) were grouped together as "Daily operations." All complaints related to medication (e.g., availability, dosage, dispensing, diverting, method, timing) were grouped in one "Medication" category.

Estimates for the average number of prisoners were calculated by dividing the monthly total number of incarceration days (“Days stay”) by the number of days in that month, a method later confirmed to be accurate by the government.

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