At seven months pregnant, inmate Sophia Casias recounts her experience of being assaulted by female guards. Not only did they pull her hair, they also dragged her in chains and verbally abused her. [1] Unfortunately, this story is an all too familiar experience endured by many pregnant prisoners who are deprived of their fundamental human rights. Although handcuffing pregnant prisoners can be perceived as a safety measure for guards and medical professionals, it opens up opportunities for human rights abuse and misconduct.
83% of hospital nurses reported that pregnant prisoner patients were shackled, and 12.3% reported that their patients were always shackled [2]. The First Step Act, which was passed in 2018, prohibits extreme punitive measures against prisoners which includes the shackling of pregnant women. However, there are massive problematic loopholes that allow for the abuse of pregnant prisoners [3].
The First Step Act states that correctional facilities are not permitted to use any restraints on inmates in labor, unless they are deemed a threat to themselves or others, or are at risk for fleeing law enforcement or imprisonment. Therefore, this opens up opportunities for corrections officers to be the determinants of the level of restraint implemented on these women with a lack of oversight. It was reported that 61% of these women are handcuffed not due to any posed risk, but because there are protocols supporting shackling—23 states currently do not have laws that restrict the shackling of pregnant prisoners. Consequently, the laws that intended to restrict prisoner shackling present discrepancies between states and loopholes to selectively ignore the protection of the bodily autonomy of pregnant women.
One could argue that shackling patients is vital to protecting hospital and correctional staff that may be exposed to physical harm. By restraining patients who are imprisoned for violent crimes, it would prevent potential assaults on hospital staff or other patrol officers.
Despite the risk of prisoner retaliation, shackling pregnant women poses incredibly dire risks—both physical and psychological—that outweigh the risks that hospital and correctional staff may receive from not shackling pregnant women.
Handcuffing pregnant prisoners that are in labor or giving birth opens them up to a variety of physical dangers. With their hands clasped behind their backs, or even in front of them, they face an increased risk of falling, encounter difficulties in receiving epidurals, are less likely to change positions necessary for alleviating labor pains, and have a higher susceptibility to blood clots if their movement is restricted [4]. Additionally, shackling pregnant patients makes it more difficult for physicians to test and treat pregnancy related complications including hypertension, pre-eclampsia, kidney infections, preterm labor, and vaginal bleeding. Patients have also reported accidents caused by severe shackling that include bruising, stomach muscle tears, and umbilical hernias that go overlooked and untreated as a result of severe restraint [4]. These consequences can be life threatening to both the fetus and the mother. Furthermore, emergency procedures such as C-sections may be impeded if they require a corrections officer’s consent for their temporary release [4]. Leaving these important medical decisions up to a corrections officer with no medical training can open doors to abuse. Pregnancy related risks can be severely exacerbated as attempts for prisoners to voice their pain could be perceived as attempts to escape or exploit their circumstantial freedom.
African American women are three times as likely, and Latina women are 69% more likely to be imprisoned than white women. Therefore, this issue may extend into racial and class-based biases that POC women have a higher pain threshold, or are less deserving of adequate medical treatment [5]. This exacerbates these systemic inequalities that invalidate the pain experienced by POC women. Within this same framework, the failure to provide patients with quality prenatal care and labor monitoring not only increases the already pressing maternal mortality rates that POC women face [5], but also communicates to them that their lives as well as their child’s life is not valuable enough to be protected. Pregnant prisoners should not only exercise their right to an empowering birthing process, but have access to prenatal vitamins, frequent OBGYN appointments, and comprehensive monitoring and treatment of those with high-risk pregnancy related conditions like gestational diabetes or preeclampsia [6]. Many states do not have protocols in place for prenatal care including standards on nutrition and education [6] which broadens this issue as evidence of the human rights abuses embedded in the prison system.
Restricting pregnant women in this way can also lead to psychological harm. Physical constraint practices can be incredibly dehumanizing, and lead to depression and trauma [7]. Additionally, if women are shackled, they are unable to properly bond with their child. Nursing not only allows mothers and their children to bond, but breast milk provides the child with antibodies to build their immune system. Infant attachment to a mother is crucial to understanding their child’s body cues, and for the development of their child’s relationship with others [8].
Without the opportunity to properly bond with their children and engage in skin-to-skin contact, mothers and their infants may both experience distress. Infants face potential developmental challenges both socially and immunologically [8]. Being deprived of building meaningful relationships with their newborn children conveys to prisoners that they are not considered legitimate mothers. This begs the question of how we define motherhood and how we decide who is unworthy of this role? Who is at liberty to decide that imprisoned mothers are not deserving of motherhood? Systematically this dehumanizes imprisoned women as they are unable to experience an integral part of womanhood based on their legal status, which is determined by the government.
In conclusion, stories just like Casias’ need to be heard to reduce the systematic oppression and devaluation of imprisoned women. In addition to the physical and physiological consequences for both the mother and child, being pregnant and imprisoned opens up opportunities for human rights abuse from correctional officers. Regardless of the potential risks that may come with unshackling prisoners for medical professionals and their caregivers, it does not outweigh the dangerous consequences from the negligence and poor healthcare that these pregnant women may face.
1. Yearwood, Lori Teresa. “Pregnant and Shackled: Why Inmates Are Still Giving Birth Cuffed and Bound.” The Guardian, 24 Jan. 2020. The Guardian, https://www.theguardian.com/us-news/2020/jan/24/shackled-pregnant-women-prisoners-birth.
2. Hernandez, J. (2022, April 22). More states are restricting the shackling of pregnant inmates, but it still occurs. NPR. https://www.npr.org/2022/04/22/1093836514/shackle-pregnant-inmates-tennessee.
3. Federal Bureau of Prisons. BOP. (n.d.). https://www.bop.gov/inmates/fsa/overview.jsp#:~:text=Correctional%20Reforms, and%20the%20U.S.%20Marshals%20Service.
4. Dufresne, L. (n.d.). Pregnant prisoners in Shackles. Voices in Bioethics. https://journals.library.columbia.edu/index.php/bioethics/article/view/11638.
5. The truth about women of color behind bars. Logikcull. (n.d.). https://www.logikcull.com/blog/women-color-behind-bars.
6. Initiative, P. P. (n.d.). Prisons neglect pregnant women in their healthcare policies. Prison Policy Initiative. https://www.prisonpolicy.org/blog/2019/12/05/pregnancy/.
7. Urell, A. (2022, June 3). Shackling of pregnant women in jails and prisons continues in the United States. Equal Justice Initiative. https://eji.org/news/shackling-of-pregnant-women-in-jails-and-prisons-continues/.
8. UC Davis Health, P. A. and M. (n.d.). The importance of infant bonding: UC Davis Medical Center. https://health.ucdavis.edu/medicalcenter/healthtips/20100114_infant-bonding.html#:~:text=Bonding%20is%20essential%20for%20normal%20infant%20development&text=Often%20within%20just%20hours%20of,enter%20into%20a%20bonding%20relationship.