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Shackling Laboring Inmates

In the news recently is the debate about whether pregnant, laboring and postpartum women should be shackled or not. Apparently, it isn't humane to shackle a prisoner during the most wondrous experience of her life. It seems that California has made it illegal to shackle women in labor, delivery and during their recovery. Articles abound decrying the vileness of chains and cuffs around a laboring woman's ankles and/or wrists during labor and birth.

When asked how they felt about women being shackled in labor, by far, the average person was horrified that it still occurred. Words such as "abhorrent," "abominable," and "inhumane" were common utterances.

Initially, I felt the same way.

And then I voiced my concern (disgust!) to my partner who was a Deputy Sheriff at the time. How could they?, I implored!

I was filled in with the inside view of why laboring and birthing inmates are shackled. I don't necessarily expect to change your views on the subject, but mine certainly were.

- The Deputy/Officer's job isn't just to keep the prisoner in custody. They also have the responsibility to keep those around her safe. No one knows who might be coming to get the woman... either out of the hospital or to hurt/kill her. Gangs know no limitations and will do anything if someone gets in the way. The Deputy is the sole protection for the birth team. If she (most prisoner escorts are female, but not always if a female isn't available) has to protect the staff of the hospital, too, how can that be accomplished when she is also chasing down a prisoner?

- Women are shackled with 4 foot chains. All the Deputies I spoke with asked the woman over and over where she wanted the cuff... the ankle or the wrist. All also said they have shackled and unshackled and shackled again when mom needed to move or if an IV was placed or mom said it was uncomfortable in that place. Wherever mom felt it was least intrusive was where the Deputy would place them.

- While we are wont to imagine all birthing mothers as Madonnas who love their babies and who deserve some peace and joy during the process, some of these prisoners have done unspeakable things to their other children. From child porn to slavery to killing them, enough of the women have no compunction to harm the baby they are carrying, especially when it comes to escaping, that it should put everyone on high alert.

- While we're on the subject, some pregnant women do anything to get themselves out of jail/prison so they can go to the hospital. Examples of not-uncommon methods include drinking bleach, suffocating themselves into a faint, purposefully falling hard on their stomachs and other things most of us cannot even imagine.

- Hospitals are the number one place of prisoner escapes. While there hasn't been a case of a woman high-tailing it out of Labor & Deliver (yet), if you were a prisoner planning an escape, where might you choose to go?

- The most violent of the violent are usually tagged in some way so everyone knows they are horribly cruel criminals. Besides bands on their wrists, many times they even wear a different color prison/jail uniform, making them stand out even more. These types of prisoners require two Deputies just to take them to sick-call and they are shackled, before leaving their cells, hands to waist to ankles. One of the most severe beatings my partner witnessed was a 5'2" very pregnant woman who wanted to go to sick-call and whose over-seeing 6'4" Deputy decided she was "just so little!" and opened her cell without anyone else there. This Deputy now has scars all over his face reminding him of the little pregnant girl who kicked his ass. It took 5 Deputies to get the woman into restraints and back into her cell.

- An interesting aspect of the articles is that doctors say the women's freedom to move about in labor is hampered. What? Don't most of these women get epidurals, too? Aren't they strapped down by external/internal monitors? BP cuffs? IVs? If women without restraints aren't permitted to move around, why are prisoners?

- Women having abortions are treated the same as women having a baby (or miscarriage).

- No, Deputies cannot "step out" for the birth. Even for cesareans, they have a duty to protect everyone. One Deputy reminded me that when they go in for cesareans, they cut a hole in the paper gown so they are able to get to their guns if something should happen. It might seem absurd to think of a woman hopping off the table during a cesarean, but desperate women do desperate things - and one never knows who might be lurking right outside the door to take her away as surgery begins or ends. (I'm sure this sounds so "what-if" - but it is that kind of thinking that keeps us safe from situations most of us might never consider.)

- None of this is to say that women are not to be treated without dignity and kindness, but it is to say we need to remember just why the woman is shackled on the way to and from the hospital - she is a threat to others, her baby included.

- The most important part of all of this is that simply by being a prisoner, one gives up the right to many, many things we take for granted. They no longer pee in private, shower in private, eat in private, walk without restraints outside of the cell area, make decisions about medications, telephone calls and even choice of reading material (daily newspapers are edited). If one wants to birth in peace and privacy, perhaps that might be an impetus for not stealing for a fix. It's the way our society is set up. You're in jail? You lose a whole bundle of rights.

Including birthing unshackled.

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Reader Comments (8)

Not the same subject, but when you wrote about being shackled, I immediately thought of my hospital births where I was "forced" to remain in bed with IV, EFM, blood pressure cuff that went off every 15 minutes, etc. Was I a prisoner?

July 22, 2006 | Unregistered CommenterHomeJewel

This has definitely given me a new perspective on why pregnant prisoners should be shackled or at least cuffed to the bed while in the hospital. We get our share of prisoners now and then at my hospital, and I've often wondered just WHY do they need to remain cuffed. Well, we don't always know just WHY they are prisoners! Many are incarcerated for drug charges, but that doesn't mean that they too won't try and harm anyone in their way to escape, including nurses/MD's/midwives who are caring for them while they are in labor. Side note - I have also cared for a preterm labor patient for several weeks who was never cuffed or shackled, and never had a guard with her. She never once tried to leave the hospital. We kept in daily contact with the prison nurse as to her status. After she delivered, we called the prison to come pick her back up to finish her jail sentence.

July 23, 2006 | Unregistered CommenterAtYourCervix

As a new nurse, I haven't experienced it yet, but the way I understand it, prisoners do lose the shackles in the event of surgery (cesarean).

Patients can't have any metal on, as they may be burned because of the cautery equipment. But I guess they'd have a pretty hard time running with that heavy epidural/ spinal/ general! LOL

I would assume that sometimes the level of security depends on the level of the crime committed &/or security level of the prison as well.

July 23, 2006 | Unregistered Commentermitchsmom

I was also shocked when I heard of women being shackled during labor, but I talked to a midwife who had been at several inmate births, and echoed many of the things you said.

I hope there is a way to make decisions on an individual basis if a woman is non violent and (rare occasion I am sure) really wants a natural birth.

PS Love your blog - found it via shape of a mother.

July 24, 2006 | Unregistered CommenterHilary

Hmmm. This is an issue I feel passionately about, as I'm sure we all do when we first confront the subject, and I'm glad to have these other perspectives on the problem.

However, I would reiterate what atyourcervix said, that the vast majority of women in prison in the US are in for low-level non-violent crimes, minor drug offences or fraud. This is why the argument that these women are hardened criminals (child-killers?) who are a threat to their own unborn baby sounds a little weak to me.

And I have a hard time with the implication that epidurals should be routine among this population anyway. Why??? Being pregnant is not a crime, and anesthesia is not a disciplinary measure, last time I checked.

While we're on the subject, does anybody know what percentage of pregnancies among female inmates are the result of rape by guards? Pretty high, according to one researcher I've talked to.

It seems to me that this debate is emblematic of a deeper problem with the incarceration system in this country which punishes the victims, and that the reasoning employed by the deputy sheriff in this case only alienates offenders further, making chronic re-offense a self-fulfilling prophecy. He's got a tough job, for sure, but his arguments only make sense if you take the current system as given and unchangeable.

July 29, 2006 | Unregistered Commentergrateful doula

I never said epidurals should be required for these women. Never even implied it. I *did* ask if most of the women don't get one just as the majority of women who are not incarcerated.

My partner worked in the jails, not the prison system, so I don't know the answer to your question about prison rapes. I will tell you, though, that prisoner/Guard relationships (not rape) have been known to occur - not during any of the 4 years where she worked, but knew of it happening in prisons. Good question, though.

Again, I really never even implied that the women should be given medical paralysis. I re-read what I wrote in many ways and it didn't ever say that. I hope that clears it up.

August 7, 2006 | Unregistered CommenterNavelgazing Midwife

My last birth was an inmate birth. Sure she was unable to move, because she had an emerg section. But, not all the inmates will have epidurals, and even non violent criminals make stupid decisions, especially women, in for drugs, who are facing detox when they are sent back to jail afterwards! Even their baby isn't as important sometimes as their "meds" during their time there. This is a time of high stress, high emotions, and they are in an unsecured environment. I think the origional poster made some great points. As my mentor said to us, ever rule is there for a reason. Becuase something has happened before.

July 26, 2008 | Unregistered CommenterAnonymous

I've been reading you for a while, NM, and I was pretty shocked to see you down with the shackling procedure.

My boss is a lawyer. Currently we have a sixteen year old in juvenile custody. Our state has ONE facility for teen mothers in custody...a good three hours from where the girl lives. She is going through the tail end of her first pregnancy ALONE, despite the fact that her family is supportive and relatively functional...they are not financially able to make the trip to see her each week for the limited time such visits would be allowed. We are having a devil of a time even getting the courts to allow her a weekend pass so she can get married and keep the child from also passing into state's custody as soon as it is born, considering that there are three generations of family willing to care for it until their child is released.

This girl is in jail for violation of probation following a truancy charge. She's not a violent felon. She's just a kid who messed up bad...and is now going through pregnancy and, eventually, delivery, without a single person who gives a damn about her being allowed to care for her or provide support. Asking her to give birth in shackles is one more inhumane and ridiculous show of petty authority over her. Making a policy to do this to women who deliver children while in state's custody, instead of looking at the facts of everyone's case and conviction to make determinations as to the level of danger they pose, is doubly stupid. I wouldn't be surprised if eventually the for-profit prisons decide that all women who give birth in state's custody will have automatic c-sections due to costs...would you treat that in a similarly casual fashion?

As a person who has been handcuffed for medical transport without having committed any crime, I know firsthand how humiliating and negative to healing such an experience can be...and that was a fifteen minute car ride, not labor and delivery.

I'm generally impressed with your compassion...but not today.

August 18, 2008 | Unregistered Commenterpopelizbet

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