Congress should ban the use of restraints on pregnant women in all corrections institutions, barring “substantial security or safety concern[s],” argue Sierra Wollen and Angelique Day of the University of Washington School of Social Work.
In an online paper posted in Academia Letters, Wollen and Day maintain that shackles and other restraints on pregnant women in custody pose health and development risks to both mothers and babies.
Several thousand pregnant women are currently held in federal and state prisons, the authors said―many of whom are restrained during transport or when receiving medical treatment.
Corrections authorities typically justify the use of restraints — handcuffs, ankle cuffs, belly chains and convex shields — by asserting that they protect staff from incarcerated people deemed violent and prevent incarcerated people from escaping.
But corrections institutions have yet to report a case of an incarcerated woman attempting to escape during childbirth, Wollen and Day write.
Prominent health organizations, including The American College of Obstetrics and Gynecologists, have previously condemned the use of restraints on pregnant women.
“Restraints increase pregnancy risk by impeding a medical team’s ability to diagnose and treat life-threatening conditions the mother or fetus may be experiencing,” says the paper.
“Giving birth in restraints can also be humiliating and traumatic. Furthermore, restraints prevent new mothers from bonding with their infants, which can have negative long-term developmental consequences for the child.”
Other organizations — from the American Medical Association to the Black Maternal Health Caucus to the American Civil Liberties Union — have recommended that restraining pregnant incarcerated women during the labor, delivery, and post-partum period be banned outright.
Only in cases of documented “safety or security risks” should “least restrictive” restraints be used, advocates say.
Prominent legal organizations have also identified the restraint of pregnant and incarcerated women as a violation of their Eighth Amendment right to be free from cruel and unusual punishment.
In 2009, the Eighth Circuit Court of Appeals ruled that, based on prior court rulings, there had been a “clearly established” right not to be shackled during labor since September 2003.
Internationally, the United Nations Standard Minimum Rules for the Treatment of Prisoners prohibits the use of restraints on pregnant prisoners, with the UN repeatedly calling upon the U.S. government to comply with human rights standards by banning use of restraints on pregnant women.
The restraint of pregnant incarcerated women also reproduces racial disparities, the paper said.
“Black activists have advocated for investments in Black maternal health for years,” Wollen and Day wrote. “Compared to white women, Black women are 1.7 times more likely to be incarcerated and three to four times more likely to die due to pregnancy related complications.”
Some corrections institutions and states have adopted policies that limit or ban the use of restraints on pregnant incarcerated women. The U.S. Department of Justice’s Bureau of Justice Assistance (BJA), which remains the leading institution governing corrections staff, recommends that restraints be used “only when necessary” to prevent an imminent risk of escape or harm.
The BJA urges the banning of all restraints during labor and delivery.
In January, the U.S. Government Accountability Office (GAO) recommended that the U.S. Marshal’s Service and the U.S. Bureau of Prisons “should better align policies[ on pregnant women in DOJ custody] with national guidelines.”
The Bureau of Prisons, which incarcerates over 175,000 federal offenders, ended the use of restraints on pregnant women in labor, delivery or post-partum recovery in 2008. The District of Columbia and 31 U.S. states have laws prohibiting or limiting the use of restraints on pregnant incarcerated women.
Based on the detrimental implications of restraint, the existing policies of institutions and states, and proposed federal legislation from the Black Maternal Health Caucus — whose proposed Black Maternal Health “Momnibus” Act of 2021 requires states to pass legislation banning the use of restraints on pregnant people in prisons or face a reduction in federal funding — Wollen and Day recommend a federal ban on this form of restraint.
“Given the known and documented risks, the federal government has a responsibility for any harm restraints cause to mothers and babies,” the report reads.
“Federal legislation regulating the use of restraints is a logical next step to impose a national standard of care for pregnant women in custody.”
To access the full paper, please click here.
Eva Herscowitz is a TCR contributing writer.