West Indies won the toss and batted first, posting 223 for six, and England were looking strong at 133 for one in their reply before collapsing to 181 all out.
The series decider will be played at Sabina Park on Wednesday.
England faced an uphill battle and a record run chase target after the West Indies registered 223, helped massively by captain and lynchpin Stafanie Taylor’s 85.
However, openers Tammy Beaumont and Lauren Winfield batted brilliantly to give the visitors a solid platform as they put on 95 for the first wicket, including a 52-ball half-century from Beaumont.
Captain Heather Knight joined Winfield for a stand of 38 after Beaumont was caught and bowled by home skipper Taylor for 57, during which Winfield notched up her fifty.
Progressing nicely at 133 for one in the 29th over, England quickly surrendered momentum and control of the innings as they lost a cluster of vital wickets.
Winfield was run out, Natalie Sciver caught by Stacy-Ann King at midwicket and Danni Wyatt followed in the same fashion as Winfield.
England had lost three wickets for five runs and looked in danger at 137 for four.
Knight chipped away with Georgia Elwiss but the pressure continued to build.
Elwiss became England’s third run-out of the day and a communication issue saw Katherine Brunt depart as the side’s fourth run-out casualty.
Player of the match Taylor – who took 3-22 to cap a quality all-round performance – removed Knight for 36 to leave England eight down.
Jenny Gunn and Laura Marsh were the final two wickets to fall, with Marsh going the same way as Winfield, Wyatt, Elwiss and Brunt.
Four dropped catches earlier in the day had added to England's challenge – West Indies wicketkeeper Merissa Aguilleira benefiting when she was put down twice during her 32.
With the series still up for grabs, England will look to bounce back immediately in the final, winner-takes-all ODI.
