The female prison population has risen significantly in recent years, with in increase of 800% since the 1970s- twice the rate of males. The War on Drugs in particular has led to more women being incarcerated, especially women of color.(1) The American Public Health Association states that 6-8% of incarcerated women in the US are pregnant.(2)
In 2007, the US Marshal Service published policies and procedures for authorized use of restraining devices, including the use of these devices on women in labor, delivery, and postpartum recovery. This practice, often called “shackling,” is a common occurrence in US prisons despite outcry from human rights groups. In 2010, the National Commission on Corrective Healthcare, which accredits correctional facilities, changed their standards to say women should not be in shackles during childbirth. However, these standards are voluntary, so this does not guarantee that the practice will stop. Despite the fact that several states have enacted anti-shackling policies, 36 states, as well as the Immigration Customs Enforcement Agency have taken no measures towards limiting the use of shackling pregnant inmates during transportation, labor, delivery, and recovery. (3)
There is compelling medical evidence against the use of shackles for pregnant inmates. The use of these restraints can compromise health care, hinder medical exams, tests, and treatments. Shackling pregnant inmates increases the risk of falls and decreases the ability to break falls. Limited mobility can compromise the health of both the mother and the baby. Restraints interfere with labor and delivery, especially if something goes wrong, such as hemorrhaging or the need for a cesarean. Post-delivery, ACOG recommends the infant and mother are kept together for important bonding time. Shackles can interfere with this and not allow the infant to be held safely. Many of the women who give birth in shackles are non-violent offenders, and there is no reason to believe they would become violent. No escape attempts have ever been reported during an inmate’s childbirth.(3)
Additionally, the American College of Obstetricians and Gynecologists stresses the importance of not separating an infant and their mother as well the importance of accommodations for breastfeeding. If for some reason the mother and child must be separated, adequate visiting times should be provided. If breastfeeding is not possible, mothers should be allowed to pump their milk and have it brought to their infant.
Despite the unique issues presented by the incarceration of pregnant women, according to ACOG, 38 states have inadequate policies, or no policies, regarding pregnant inmates. 41 states don’t require prenatal nutrition counseling or appropriate nutrition to pregnant women in prison.(3)
A Better Way
Nine states currently have prison nurseries for women with young children in jail. Women have to qualify for the “privilege” of having their children with them. (1)
The oldest prison nursery was opened in 1901 at Bedford Hills Correctional facility in New York.(2) The children and mothers live in a separate building than the rest of the other inmates. Many of the nursery participants have older children at home. The program allows the women time to bond with their babies- time that they might not have in their daily lives outside of prison as a result of poverty. The program allows inmates to adjust to motherhood and give solid thought to how their lives will be after they are released. Mothers can get support, structure, and guidance while in prison.(1)
Though the idea of a prison nursery may seem like a novelty to Americans, it may not seem strange to those outside the states. In other countries, infants are often allowed to stay with their incarcerated mothers. In Frankfurt, Germany children can live on the prison grounds until they go to school. Women with older children can go home during the day and check back into the prison at night. In one 1987 survey, the United States was one of five UN Countries that did not generally provide accommodations to mothers in women’s prisons.(1)
Prison nurseries have proven beneficial for women and children. When a prison nursery opened in Nebraska, there was a 13% drop in misconduct among women with children in the nursery. A 2009 study showed that half of the women whose babies had been taken away from them would be reincarcerated, versus 17% of women with children in a nursery. In one study, babies in prison nurseries were as likely to have a secure attachment to their mothers as children in a stable middle class background, despite one third of the mothers in the study not being securely attached to their own parents. The children most likely to be securely attached were the ones who had been in the nursery for a year.(1) ACOG reports that prison nurseries are beneficial to a young child’s development. Pre-school age children who are separated from their incarcerated mothers are more likely to experience anxiety and depression than children in prison nursery pre-school programs (2).
It is crucial to care for children born to incarcerated mothers like any other children, starting before they are born. It is necessary to treat all inmates with basic human rights, including the access to the healthcare they need. This includes quality healthcare during pregnancy, delivery, and postpartum. The state and correctional facilities need to take into account what is best for the humans in their care, and their children, when making policies. Transforming our justice system into a human-centered model must include protections for incarcerated mothers and their children.
(1 )Yager, Sarah, “Prison Born”, 2015, The Atlantic, https://www.theatlantic.com/magazine/archive/2015/07/prison-born/395297/
(2) Stavola, Michael, “Pregnant in prison: what it’s like for women expecting behind bars in Kansas”,
2018, The Topeka Capital-Journal, http://www.cjonline.com/news/20180528/pregnant-in-prison-what-its-like-for-women-expecting-behind-bars-in-kansas
(3) Committee on Healthcare for Underserved Women, “Healthcare for Pregnant and Postpartum Incarcerated Women and Adolescent Females”, 2011, The American College of American Obstetritions and Gynecologists”, https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Health-Care-for-Pregnant-and-Postpartum-Incarcerated-Women-and-Adolescent-Females