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AMA Passes Resolution Prohibiting Shackling of Pregnant Prisoners in Labor

On June 15, 2010, the American Medical Association (AMA) adopted a resolution prohibiting the use of restraints on a female prisoner “in labor, delivering her baby or recuperating from the delivery,” absent compelling grounds to believe that she poses a threat of harm to herself or others or poses a “substantial” escape risk and “cannot be reasonably contained by other means.” The resolution also urges jail and prison officials to use “the least restrictive restraints necessary” on female prisoners during the 2nd and 3rd trimester of pregnancy.

While not binding or enforceable, the AMA resolution lends moral, ethical and medical force to a growing body of opinion that the practice of shackling pregnant prisoners, particularly during labor, is, in the words of Erin Tracy, MD, an Ob/Gyn from Massachusetts, “dehumanizing” and “counter to our values” as a society. The resolution may lead hospital administers to develop anti-restraint policies, which in turn would put pressure on prison and jail officials to adopt practices consistent with those hospital policies.

The AMA itself plans to write draft legislation that states can se as a model to develop anti-shackling laws. Only eight states – New York, California, Texas, Illinois, New Mexico, Vermont, Washington and Colorado – have laws barring or discouraging the shackling of pregnant prisoners during labor. Those states, according to Cynthia Geto, MD, an Ob/Gyn from Hawaii, have not reported any safety issues arising from the practice of not restraining pregnant prisoners. Understating the obvious, Geto observed that women in labor are unlikely to be able to overcome guards or escape from the delivery room.

The AMA resolution referred to a New York Times editorial that, in the AMA’s view, “highlighted the need for an end to the barbaric and medically hazardous practice of shackling female patients in labor.” That practice, the resolution observed, was contrary to AMA Policy H-430.997, “Standards of Care for Inmates of Correctional Facilities,” which calls on correctional and detention facilities to “provide medical care that meets prevailing community standards.”

Sources:, AMA Resolution 203(A-10)

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