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Massachusetts’ Anti-shackling Law Limits Restraints on Pregnant Prisoners but Problems Persist

by Joe Watson and Matt Clarke

Being pregnant is stressful – just ask any woman who has been pregnant. Incarceration adds to that stress and removes support systems, so prisoners face problems during their pregnancy, birthing and postpartum recovery that are difficult for outsiders to imagine.

The situation can be exacerbated by prison and jail staff. Improper use of restraints on pregnant prisoners – especially during labor – and staff indifference can endanger the health and safety of both the mother and unborn child.

According to a 2010 report by the National Women’s Law Center and the Rebecca Project for Human Rights, 5% of women entering state prisons and 6% of women in jails are pregnant. Around 2,000 women give birth each year in U.S. correctional facilities.

A Massachusetts jail prisoner identified as Kenzie W. had experienced five previous pregnancies. She was four months pregnant when incarcerated, and on January 23, 2013 she had her first delivery behind bars, which was a waking nightmare.

“At 7 a.m., when active labor started, the jail medical staff denied that I was actually in the late stage of labor, but from experience, I knew it was time,” said Kenzie. “They kept talking behind my back saying that I was not really that far into labor because I was not hysterical and screaming. It wasn’t until I said that I had the urge to push did they finally decide to take me seriously.”

Taking her seriously meant handcuffing her, placing her in the back seat of a car and driving her to the hospital. That process took over 20 minutes.

“I couldn’t fit into the back of the car because I was way too pregnant,” Kenzie remembered. “I had to sit sideways as I continued to labor. I can’t even buckle my seatbelt, so I’m sliding around. I’m trying to hang on while handcuffed, but I also need to hold on to my stomach. Once at the hospital, I couldn’t even get into the bed or undress because of the cuffs.”

The handcuffs were only briefly removed at the request of hospital medical staff so they could examine her. While on her hands and knees moving from the ER bed to the delivery bed, Kenzie gave birth. She had left the jail a mere 11 minutes earlier.

“When you’re in full-fledged labor with two correctional officers there, where did they expect me to go?” she said. “And then to shackle me immediately after I gave birth, and I can’t even go to the bathroom when I need to. When I took my first shower after giving birth, I had shackles around my ankles and cuffs on my wrist. I had the nurse in the bathroom with me, looking into the shower, and the CO had to stand in the doorway to the bathroom to watch me shower. Why did the CO need to be there? Why did I need to be shackled? I had just given birth! What was I going to do?”

After her release from jail, Kenzie publicized the story of her harrowing experience during delivery and became involved with the Prison Birth Project, a local group advocating for laws to prohibit the shackling of pregnant prisoners.

When then-Massachusetts Governor Deval Patrick signed Senate Bill 2063 into law on May 15, 2014, the legislation limited “the use of restraints, including handcuffs and leg irons, on pregnant inmates,” according to a press release from Patrick’s office.

“It blows my mind that I had to sign a law for that,” the governor said.

The signing of the bill made Massachusetts the 21st state to have an anti-shackling law that “establishes a minimum level of care that must be afforded to pregnant inmates in county correctional facilities.”

The legislation, according to the governor’s office, prohibits prisoners in labor, “or those in post-delivery recuperation,” from being restrained at all, “absent extreme cases.”

The bill also ensures that female prisoners will be screened for pregnancy upon being admitted to a correctional facility; receive counseling, adequate prenatal nutrition and daily exercise; and be transported in vehicles with seat belts. Further, any guards present for a medical examination must be female, if possible, and the prisoner’s privacy will be protected.

“Unless it can be said with certainty that the inmate poses a serious and immediate physical danger to herself or her fellow inmates, she should not be tied down limb-by-limb in the 21st century here in Massachusetts,” Patrick said in a written statement.

Since 2001, longtime state Rep. Kay Khan had filed some version of an anti-shackling bill. In 2013, state Senator Karen Spilka introduced a companion bill in the Senate, prompting Patrick to issue 90-day emergency regulations that immediately prohibited the shackling of pregnant prisoners as a stopgap until the bill was approved by the legislature.

The legislation passed both chambers unanimously.

“We are reducing physical and psychological traumas in both mothers and children by providing all pregnant women with the appropriate medical treatment throughout their pregnancies, during delivery and in post-partum follow-up care,” Khan said.

A number of state lawmakers joined Rep. Khan in thanking Patrick for signing the bill, along with prisoner advocates ranging from the ACLU to NARAL Pro-Choice Massachusetts, but they also warned that the law will not be effective unless the state Department of Correction (DOC) carries through with its implementation.

“The next step is ensuring that this law is enforced,” said Marianne Bullock, founder of the Prison Birth Project.

“Despite the governor’s emergency regulations filed earlier this year, I have heard multiple reports from my clients who have been brought in labor to the hospital in handcuffs and ankle shackles, in the back of a police car, with hard metal seats and no seat belts,” she said. “They undergo exams in labor with a leg or wrist shackled to the bed only to be unrestrained when they are cleared by medical staff to go to the delivery room.” [See: PLN, Dec. 2014, p.30].

Unfortunately, lacking any real oversight or clear methods to enforce the law, little has improved since it was put into effect. According to a report published in May 2016, state and county policies still are not in full compliance, pregnant prisoners continue to be shackled and several counties fail to provide seatbelts or other suitable transportation for pregnant prisoners.

State prisons have been slightly more compliant and consistent than the counties when implementing the anti-shackling law. The DOC, however, appears less enthusiastic about establishing and enforcing statewide standards of care for pregnant prisoners.

The report, jointly authored by the Prison Birth Project and Prisoners’ Legal Services of Massachusetts, concluded that the state had broken its promise to pregnant incarcerated women. The co-authors, Marianne Bullock and Rachel Roth, recommended allocating additional resources towards training corrections staff and implementing mechanisms to ensure enforcement of the law. As passed, there were no penalties for noncompliance.

“The Legislature passed a really comprehensive law to address the use of restraints on pregnant and postpartum women, but it didn’t build in any kind of oversight or reporting or consequences for violating the law,” Roth told in an interview earlier this year.

Outraged by the slow progress, Rep. Khan sponsored a new bill, H.3679, which will improve compliance with the anti-shackling law. The Health Care Financing Committee and the Public Safety Committee approved the legislation earlier this year, and on June 9, 2016 it was read for the second time in the House and ordered to a third reading.

The American Medical Association supports a general ban on shackling pregnant prisoners, as does the federal Bureau of Prisons. [See: PLN, Dec. 2010, p.48; April 2009, p.36]. And numerous court rulings have awarded damages in cases involving that practice, many of which have been reported in PLN.

Although both laws and lawsuits will certainly help pregnant prisoners receive better treatment, a Minnesota group known as Isis Rising is taking another approach – they are training volunteers to provide nonmedical assistance to prisoners in labor. Such care includes a cool washcloth on the forehead, the offer of a massage, birth coaching and moral support. The volunteers are called doulas.

“This is one of the biggest public-health issues of our time and no one wants to look at it,” said Isis Rising coordinator Rae Baker, who noted Minnesota’s cesarean section birth rate for prisoners dropped from 63% to 30% after the doula program started. The program has thus saved taxpayers money and helped babies and their mothers have healthier deliveries. Isis Rising is trying to build a national coalition of prison doulas out of what has been an underfunded grassroots movement.

Sources:,,, Massachusetts Anti-Shackling Coalition,,,,,,

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