U.S. Prison Reform Should Prioritize Pregnant Women

ByStephan Grabner

This piece was co-authored by Laura Barrios.

Congress should prohibit the shackling of female inmates in their third trimester of pregnancy and during active labor in all U.S. correctional facilities. A standardized training program should be created for all correctional officers who work with inmates during labor, delivery, and postnatal recovery. 

In 2006, the UN Human Rights Committee called upon the U.S. to follow the UN Standard Minimum Rules for the Treatment of Prisoners and “prohibit the shackling of detained women during childbirth.” 19 states still allow the practice in their correctional facilities and in doing so act against recommendations from the Federal Bureau of Prisons and the American Medical Association, which in 2010 denounced the practice as “barbaric” and “medically hazardous” to a woman’s health and well being.

Shawanna Nelson was detained for non-violent crimes when six months pregnant. As a result of being shackled during labor, Nelson now suffers from permanent back pain and a damaged sciatic nerve. In the following lawsuit, Nelson v. Correctional Medical Services ADC (2009), the U.S. Court of Appeals for the Eighth Circuit concluded that the shackling of inmates during childbirth is a form of cruel and unusual punishment and as such prohibited by the 8th Amendment. Despite this ruling and mounting pressure from civil rights organizations, many states have no legislation prohibiting the practice.


Women have to be able to freely adjust their position throughout labor and childbirth to relieve pain and accommodate the different stages of delivery. Shackles not only keep them from doing so, but also impede a doctor’s ability to intervene effectively in the case of complications. As American Civil Liberties Union attorney Diana Kasdan put it, “a woman in the throes of labor is really not in a physical condition to overtake [the armed] guards and make a run for it.” Shackling seems even more untenable considering that two-thirds of all female inmates are detained for non-violent offenses.

Protocols for the treatment of inmates were generally written when the percent-age of female inmates was negligible. However, the number of female inmates has increased eightfold in the past 30 years and continues to be the fastest growing segment of the prison population. Although the practice of restraining male inmates at all times while medical care is administered may be permissible, female inmates in active labor keep present an entirely different situation and thus require a different protocol.

Next Steps

Although states should continue to have the ability to administer their correctional facilities in ways they find most effective, this is a constitutional issue of human rights and must be addressed first and foremost. The shackling of inmates during the third trimester of pregnancy, but especially during labor and delivery, should be prohibited for all state correctional facilities through federal legislative action. Exceptions may be made in dealing with maximum security inmates and those with a history of violence or attempted escapes, in which case some kind of restraint may be required. This could be done by permitting the use of longer and softer cuffs, which allow for the necessary movement while addressing the significant  security concerns.

Additionally, states should be compelled to implement mandatory, standardized training programs for all correctional officers working with pregnant inmates in order to prepare the officers for the complex and challenging situations labor and delivery present and to ensure that the rights and safety of the inmates are respected.