The number of female prisoners in Scotland has doubled in the past 10 years, a prison inspection has found.
Inmate numbers at Cornton Vale have risen significantly
Chief inspector Dr Andrew McLellan said this made it hard to meet inmates' needs at Cornton Vale, Stirling.
He also said questions surrounded the practice of routinely "double-cuffing" and pointed to two cases where pregnant inmates were handcuffed during labour.
However, Dr McLellan praised improved living conditions and the arrangements for maintaining family contact.
The findings in his report were based on an inspection of Cornton Vale prison and young offenders institution in February.
During the inspection the number of prisoners was 326, half of whom were convicted of violent offences.
Dr McLellan said in 1998 prison and social work chiefs had called for a joint strategy to reduce the daily female population at Cornton Vale from more than 170 to 100 or less by the end of 2000.
"Today that sounds fanciful," he said.
His report found that boredom was a major problem and the time inmates spent in cells was increasing.
He also noted that there had been a reduction in psychology services.
"Many of these women arrive at the prison gate in a desperate state, suffering from a combination of mental and physical ill health," Dr McLellan said.
"For most prisoners in Cornton Vale their time of imprisonment is unlikely to heal the desperate things that are wrong with them in body, mind and spirit when they are admitted."
The report said the greatest concern raised by prisoners and staff was double-cuffing.
Prisoners leaving Cornton Vale for any reason, except for a work placement, have their wrists handcuffed together and then handcuffed to a custody officer.
Prison staff told inspectors of cases where no mother was present at a children's hearing because prisoners could not bring themselves to be double-cuffed in front of their children.
Dr Andrew McLellan raised questions over "double-cuffing"
Staff also told of women refusing to go to hospital for medical treatment when they learned that they would be double-cuffed and women being handcuffed during labour.
Dr McLellan said: "There is always a balance to be found between security and humanity, but in the case of women giving birth the security considerations would need to be extraordinarily high to justify this practice."
The report pointed to some good work with addictions and mental health and said there had been a significant reduction in the number of women harming themselves.
It also praised the living conditions in the new residential accommodation and better living arrangements for offenders under the age of 21.
Dr McLellan's predecessor Clive Fairweather, who was chief inspector between 1994 and 2002, said the figures were "very disappointing".
He said large numbers of women were still being sent to jail for petty offending.
These were often "desperate individuals" rather than people from whom the public needed protection.
"There could be a lot more done in terms of funding community sentences," he said.
Scottish Conservative justice spokeswoman Margaret Mitchell described the number of female prisoners as "truly shocking" and said the vast majority had committed drug-related crimes.
"Rather than focusing on details to do with the management of prisoners, Dr McLellan should be pressing to ensure that the time spent in prison is used to give prisoners the opportunity to become drug free and to end the addiction and cycle of abuse which resulted in them being imprisoned in the first place," she said.