About a week after U.S. Marshals transferred Andrea Circle Bear from a jail in South Dakota to a federal prison in Fort Worth, the pregnant inmate was sent to a nearby hospital with a high fever.

On March 28, doctors sent Circle Bear, who was serving a two-year sentence on a drug-related charge, back to Federal Medical Center Carswell, a federal prison equipped to provide medical care to incarcerated women, KXAS reported. Three days later, prison medical staff saw that she had developed a fever, dry cough and other covid-19-like symptoms, the Bureau of Prisons said in a statement Tuesday.

She returned that day to the hospital, where she was placed on a ventilator. On April 1, doctors performed an emergency Caesarean section to deliver her premature baby, the bureau said. She tested positive for the novel coronavirus on April 4.

The 30-year-old struggled for air in the hospital for four weeks, before her body succumbed to complications of the viral infection on Tuesday. Federal officials said she had a preexisting condition that made her a high-risk patient but did not say what conditions may have contributed to her death.

A relative confirmed to The Washington Post that Circle Bear’s newborn daughter has been returned to the family in South Dakota.

She was the 29th federal inmate to die in the pandemic and appears to be the first woman to die while in a federal prison’s custody, based on details the Bureau of Prisons has released on each of the 30 deaths it has reported. Her death is just one in a swell of serious illnesses and deaths caused by the novel coronavirus inside jails and prisons.

Circle Bear had been at FMC Carswell since March 20, after pleading guilty to a charge related to methamphetamine in January. Court records said she rented a home on the Cheyenne River Sioux Reservation, where a confidential informant arranged two drug deals with her in April 2018, but she did not live at the residence. Her formal charge was “Maintaining a Drug Involved Premises,” and she was sentenced to 26 months in federal prison on Jan. 14.

The bureau did not immediately respond to questions Tuesday night to explain why Circle Bear was transferred across state lines to the medical prison in Texas amid the coronavirus pandemic.

Before her incarceration, Circle Bear lived in Eagle Butte, S.D., an area of the state that has so far been largely untouched by the coronavirus pandemic. Neither the city nor the surrounding county has reported a covid-19 case. The Cheyenne River Sioux Tribe erected roadblocks at entrances to its nearby reservation in early April to screen for people who might have the virus, and many tribes fear that a coronavirus outbreak could overwhelm the federal Indian Health Services.

But on the other side of the state, Sioux Falls is home to one of the nation’s largest outbreaks, which spread inside a pork-processing plant.

According to data published by federal officials, Circle Bear was the only inmate to contract covid-19 at FMC Carswell, which currently holds 1,625 women. As of Tuesday night, 1,313 federal inmates have tested positive for coronavirus, and 30 have died, according to the Bureau of Prisons. More than 300 prison staff have also contracted the virus.

The spread of the coronavirus inside prisons and jails has been an increasing concern for weeks. Social distancing measures are nearly impossible in facilities where people share cells or sleep in beds just feet apart. Soap, hand sanitizer and face masks can also be hard to obtain behind bars. Many state prisons have released inmates facing short sentences for nonviolent crimes, and jails around the country have let out many people held on misdemeanors and nonviolent felonies.

The federal prisons have also been reviewing cases to remove high-risk individuals from facilities where social distancing and proper hygiene to disinfect surfaces and hands can be difficult to maintain.

On March 26, Attorney General William P. Barr wrote a memo to the Bureau of Prisons instructing officials to opt for home confinement for at-risk inmates whenever possible.

“Given the surge in positive cases at select sites and in response to the Attorney General Barr’s directives, the BOP began immediately reviewing all inmates who have COVID-19 risk factors, as described by the CDC, to determine which inmates are suitable for home confinement,” the bureau said in a statement on its website.

The agency has transferred 1,751 people into home confinement in recent weeks. Because of growing outbreaks in some facilities, the agency has repeatedly expanded the pool of inmates eligible for release to home confinement. But the releases have come in fits and starts, as bureau officials have changed the rules and the process to send people home.