Invisible Women, Invisible Shackles
Tuesday, July 20, 2010 at 12:10PM
by Courtroom Mama
Here’s another for the “things I should care more about” files: shackling of pregnant inmates during labor.
State by state, prison reform activists have been chipping away at the practice, and now, according to this NPR report that came out last Friday, 10 states have ended the practice in most circumstances. This is a fantastic victory, it’s about damned time this issue was brought to light by the major media outlets, and I’m sending a virtual fist pump to the people who have worked to make this happen.
Nevertheless, there are two aspects of this that I find depressing:
- Do we really have to prove on a state-by-state basis that this clearly cruel and unusual practice runs afoul of the Eighth Amendment—not to mention any standards of human decency? For the nerds out there, there is actually an Eighth Circuit decision on the matter, ruling in favor of the pregnant woman, but I’d like to see the doors slammed shut a little more quickly and completely on this practice.
- Responses to the issue show just how absolutely clueless people are. Both good clueless (“I had no idea this terrible thing is happening!”) and bad clueless (“Who cares, men get shackled, durp durp.”).
Look, I get it. Do the crime, do the time. Tough on crime. Win one for the Gipper… ad nauseam. But anyone who thinks that giving birth completely confined to a bed by shackles is a suitable punishment for the drug or property offenses for which the majority of women inmates are in prison (pdf) clearly has never given birth, and/or is a total sadist. While this is an issue that doulas instinctively understand, some people just don’t understand the importance of movement in making labor bearable, while others are just left behind on some Biblical “labor pain = punishment” fetish. Hello! The sentence is for incarceration, not physical punishment!
This has implications for those of us on the outside, too. If it has taken this long for people to see the cruelties visited on the invisible women we hide in our prisons at an ever increasing pace, how long will it take them to see the commonplace evil of the invisible shackles so common in labor? I wonder how many people who heard the NPR segment thought immediately to their own experiences of being restrained during a cesarean (or even during a vaginal birth in the Bad Old Days), or being told that they must be hooked to internal monitors that prevent them from moving. If legislatures are increasingly willing to recognize that preventing a woman from moving during labor is tantamount to torture, when are we going to start demanding that the monitors and restraints only be used when absolutely indicated, and never against the will of the pregnant woman? I think the time is now.
In my perfect world, legislators in these 10 states would get a follow-up visit from birth activists proposing legislation to ensure that no woman is deprived of her human rights by being unnecessarily or unwillingly restrained during labor, and that medical procedures that have the effect of restraint be done only with proper informed consent, including information about how positioning affects pain and progress in labor.
Lastly, just writing this out raises a serious question in my mind: what does it say about gender equality in the U.S. if we need to follow every guarantee of the Bill of Rights with legislation or litigation that says “and this applies to women too!”
Reader Comments (21)
I listened to that NPR segment on my commute. That one prison director who commented a couple times, I hope all the women in his life gave him a good slapping around when they heard him on the radio. His attempt to evade responsibility was honestly one of the most weaselly, pathetic things I've heard in a long time. "Well, the problem is how you define 'active labor', that's up to the doctors. we aren't medical professionals who can determine labor accurately, so it's not our fault women are still shackled when pushing babies out of their vaginas." WTF?
Also Jill, I agree with you that part of the reason why this isn't regarded with more outrage)is that society's perception of birth is not one in which moving around is required. If every birth you see takes place entirely in a hospital bed from start to finish, why would you see anything wrong with being shackled to a bedrail? Is that why the nurses and doctors attending these births don't protest the practice more?
Courtroom Mama wrote this post. I haven't listened to the NPR segment yet, but I will now after reading your comment.
Hi Megan, thanks for your comment - and I agree, that sort of evasion of responsibility is deplorable.
I think that you are responding to me (the author of this post) but if you are responding to something Jill said elsewhere I apologize. Anyhow, I think that actually L&D nurses and other healthcare professionals are the ones who stand up on behalf of shackled patients more than most because they recognize exactly how excruciating labor can be if you, say, have a posterior presentation and can't move to alleviate back labor. A nurse actually just made a really poignant comment on the FB page about how they sometimes refuse to unshackle patients who are dying and need to be defibrillated.
I do agree that it has a lot to do with society's perception: if all people (judges? legislators? prison guards?) see is women on A Baby Story screaming bloody murder, the idea that childbirth can be torturous is totally unimportant. Like "yeah, it's torture, and you hate the man that did this to you, yadda yadda." The idea of "manageable pain" versus "out of control" pain is totally lost.
After having worked with prisoners, and after having given birth myself, this is insane. It's not like they'd run off during labour or shortly thereafter!!! Next day maybe. Some of these women are pretty strong and determined, so why not extra security afterwards. But during??? That's MAD.
I have some questions about this, actually. On the surface, I know it seems completely ridiculous. And you are right--labor can be excruciating for women who are shackled and unable to use movement or positioning for relief or to encourage progress. Since most of the women who are in prison for non-violent offenses, shouldn't they just be summarily unshackled?
Well, I am not totally sure. Perhaps I am too cynical, but the reason these laws are in place is to protect medical staff, civilians, etc. who are near the women while giving birth, as well as preventing her from escaping. It seems extreme, I know.
My husband worked as an firefighter/EMT in a somewhat rural suburb of Kansas City. They were called to the county jail on a regular (probably two times a week) basis for prisoners who used medical excuses for reasons to get unshackled. They would fake heart attacks, diabetic problems or even try to overdose on pills (thus losing heart rhythm and needing to be defibrillated)--all with the purpose of getting out of lockdown so they could escape. This happened ALL the time. These people were ALSO typically non-violent offenders! It really DOES happen. And my guess is that if it happens in small town Missouri, it happens with greater frequency in areas where there are larger prisons, more violent offenders, etc. If people would do this, then there is nothing that says labor (or even faked labor) prevents a female offender from trying a similar tactic.
As much as I personally feel very committed to birth activism and rights of women in prison to be treated humanely and fairly during birth, the laws are in place because they don't want female offenders to escape or assault anybody. I personally think that women with a history of non-violent offenses should be given some sort of provision to be unshackled during labor. But I'm not convinced that violent offenders should be as well. It would only take a moment for somebody bent on escaping or harming others to do so. Give them some pain relieving narcotics and the behavior could potentially increase.
Here is the quote from the original post:
"In my perfect world, legislators in these 10 states would get a follow-up visit from birth activists proposing legislation to ensure that no woman is deprived of her human rights by being unnecessarily or unwillingly restrained during labor, and that medical procedures that have the effect of restraint be done only with proper informed consent, including information about how positioning affects pain and progress in labor."
I agree for the most part. But when people violate laws, certain liberties or freedoms that are available to the average citizen are essentially revoked. Serving prison time would be the number one example, I think. It is otherwise illegal to incarcerate somebody against their will. In these cases, the women in question are not the average jane in labor at MegaHospital. They are still offenders of the law of some sort. While I think confining them to their hospital bed should not be allowed in all cases. I do not think it is fair to say that it is a violation of their rights. Is it a violation of male prisoner's rights when they are shackled to a gurney for medical treatment in an ambulance or hospital bed? Are they not sometimes in pain that could be alleviated by movement?
Thanks for bringing attention to the issue of shackling laboring inmates. I used to work as a hospital-employed doula and I will never forget the day I was called in to support an incarcerated women. I came in to find her shackled to her bed, two armed guards in the room. Sounds like a violent felon, right? I later found out that her crime was prostitution and she had been jailed on a bench warrant. She was being induced for a fetal death in utero at 37 weeks and was sitting in her bed, crying. Thankfully one of her guards had the compassion to take the shackles off once she was in labor.
The weirdest thing about it was that halfway through her labor, the order came through to release her. So the guards just left her alone with the nurse and me. One minute she is too violent to be trusted without shackles and two armed guards; the next moment she is no different from any other patient. It was very surreal. I also remember that as soon as her baby was delivered, the hospital doctors could not get out of that room fast enough. They left the nurse by herself to clean everything up and tend to this woman, which I never saw happen in any other delivery. As another doula put it, "they treat them differently, don't they?"
I'm very happy to hear that more states are ending this ludicrous practice.
As a sort of side bar, I know I have seen research showing that prisoners who give birth and are allowed to raise their babies in a sort of prison nursery setting (instead of having their babies taken away) do much better with rehabilitation and are better parents. I wonder if more humane birth practices could segue into something like that.
If we're really worried about women escaping before/during/after labor, then why not put a freaking ankle monitor on them and leave it at that? A woman in labor, unless she's some kind of Ocean's 11 master criminal, is not going to have a getaway fake ambulance revving in the hospital parking lot to let her escape while birthing. And if she is, then she could probably get out of shackles too.
Even if some particularly determined woman were to make it out of the hospital mid-labor--she won't be moving fast. Follow her signal and get her back to the hospital.
As for violent women, well, what are we talking about here? Women who are mentally ill and prone to episodes of violence? Women who fought with other women in prison gangs? Psychopaths? Women who defended themselves against someone hurting them? All of those matter. And even a serial killer could probably be deterred from just killing a nurse for the hell of it mid labor by having a prison guard standing right there, but if not, maybe there could be some sort of humane way to help that woman birth without putting anyone in danger. Put her in a padded room, perhaps, with nothing for her to use as a weapon and a guard standing right there while the nurse helped her.
But how many members of the prison population are pregnant women who have uncontrollable urges to kill everyone around them? And don't we generally know which ones those are? And should we subject all pregnant prisoners to safeguards designed for that tiny number?
Listening again right now- listening to Jennifer Ferrera's story, her crime bad checks...
Random thoughts to add to comments here:
"they don't deserve to be treated with full human rights." most important quote.
ACOG condemns it - let's give them a C+ for effort now unshackle the rest of us.
The person answering the question of when a woman is a labor- is the spokesperson for the Cook county Sherrif not a doctor. Steve Patterson.... can't put the blame on him for slippery evasiveness/ bad doc talk. He is media weasel for the sherriff's office.
"It hadn't really OCCURRED to these two wardens that it could be a health problem." (YIKES, they are in mind prison I guess)
Okay here's a really logical conclusion:
Outfit the prison infirmary with a birth unit. How f-ing stupid are these people? have trained personnel in delivering babies in every state prison only transporting to county/public hospitals when a c-section would be deemed necessary. Don't law enforcement personnel always end up on the evening news getting mad praise for when they attend a precipitous roadside birth? Does this mean that UNTRAINED medical professionals are taking care of the health of inmates. How about one of those tracking GPS anklets and guard outside the door- or female law enforcement matron in the room in case the inmate decides to commit and act of assault.
I think it is also just "the man's" way of slut shaming women in a different way- taking crime and punishment to the most vulnerable psychological and important moment of a woman's life and maligning it making her fully aware that she is not free even in that moment, shackling her so she will never forget what she did under the guise of protecting the public from a criminal. I guess this returns us to the time of Hester Prynne. barbaric, unnecessary, disgraceful.
Thanks for your comment, Augusta. The thing about torture is that it’s not about having justification, it’s about the act of torture itself being wrong. Sure, prisons have an interest in making sure people don’t escape, but that doesn’t justify hanging them all from their arms or breaking their ankles. There are levels of restraint commensurate to the level of threat posed by a particular offender, and I think that the mere fact that someone might try to run in some alternate universe where laboring women can haul ass down the hall does not justify this level of restraint for all incarcerated women.
People certainly lose some rights upon being convicted of a crime, but not all rights. If a person is in jail, they lose the right to go to their kids graduation and go to their knitting circle or wear their favorite jeans, because those are incidental to being outside of a prison. Making a woman endure labor while shackled is in no way related to her crime, or even her sentence. Simply put, if a person thinks that the added pain of shackled labor should be a part of the rights that a woman loses upon incarceration, they are supporting torture and cruel, inhuman, and degrading treatment. There are a lot of problems around people of all genders being denied proper medical attention, and these are human rights violations, not just part and parcel of being in jail. The days of dungeons where people rot without nourishment or medical care are (or should be…) over – prisoners have rights, this is just not controvertible in any serious way.
Furthermore, if you believe in natural birth, you believe that birth in a normal physiological process that requires movement to happen. I feel like I don’t understand, are you saying that natural birth is something that female inmates should be stripped of? Should they all just be given cesarean sections, because knocking them out and cutting their babies out would also maximize safety of everyone around them and minimize flight risk. I think that we have a major fundamental difference in that you see them as “still criminal offenders of some sort” and I see them as “people needing medical care of some sort.” Setting aside the issue of whether or not I think that anyone should be shackled during major medical care at all, I think that there are few, if any, medical issues that men would have that require them to move (my dad had a kidney stone and he said the meds they gave him didn’t do a thing and he was pacing the halls almost involuntarily, but that’s anecdata). What makes this situation particularly cruel is that it is “equal treatment” in a way that is particularly, specifically detrimental to women.
"But when people violate laws, certain liberties or freedoms that are available to the average citizen are essentially revoked."
...and they become less than human. This is also the same line of reasoning behind resistance to the push to really address issues like rape and sexual assault in prison. Believe me, I've heard it a million times in the Contemporary Moral Issues class I've taught. I think I can forgive most of those naive little 19 year-olds who are just parroting what they've heard from their parents. But it also tells me that they've never experienced sexual assault or childbirth, and that they don't take the clause about "cruel and unusual punishment" all that seriously. I'm sorry, but there are just certain freedoms that you can't lose, no matter what crime you commit. Freedom from sexual assault, for instance. And freedom from the infliction of unnecessary physical and emotional pain and trauma during childbirth. That's not really something a civilized nation can compromise on, is it?
On a related note, I have a friend who spent 13 years in prison for property crimes he committed at the age of 17. He vividly remembers the warden rebuking a sadistic guard by saying "they are here as punishment, not for punishment." I think that hits the nail on the head.
Oh, and on the topic of invisible shackles... I had a hospital birth that was supposed to be attended by a midwife, although she was out of town when I went into labor early. But a good friend of mine's mother is also a midwife who has done both home births and hospital births. She gave me some of the best advice I ever got. She said they always want to put an IV on you in the hospital no matter what it says in your birth plan, and that prevents you from being able to move around freely. Her advice was to agree to a hep-lock as a compromise, so they would feel like they were covered in case of an emergency but I would be unrestricted by an actual IV. That was fabulous advice and removed one area of conflict from my birthing experience, anyway.
One thing strikes me which I haven't seen covered yet. Birth affects the baby too. It's reasonable to extrapolate that if it's tougher on the mother, it's tougher on the baby too. If we can agree that restraint makes labour more difficult, then I'd be interested to know what crime the baby is supposed to have committed...
CM, you raise an excellent and important question about why we must CONSTANTLY remind our lawmakers that women are equal citizens entitled to constitutional rights. Our protections shouldn't be revoked by pregnancy OR incarceration. And I agree- I don't buy it for a minute to say that both of those conditions are optional and women must pay the price with physical punishment.
I understand what you are saying, Courtroom Mama. And I have to say that I agree with the overall message of the original post, along with the idea that women in labor should not be shackled merely because they *are* prisoners. I do not think, however, that women who are known to be violent offenders or flight risks should necessarily go unmonitored. To me, it is not torture and it is not wrong if it is in accordance with the law and in the interests of public safety (and within reason). You may feel that this idea is a justification, but I can't imagine they will be doing away with the idea of handcuffs for male prisoners being transferred any time soon.
Of course, in the event that some a-hole wants to use this specifically as a punishment or as something that all female prisoners have to endure, then I do think that is wrong and torture. But I think railing against monitoring and confining (if need be) prisoners during labor misses the point to some degree. After reading some of the other comments, I can see that there would be better ways of accomplishing this. A GPS monitor or ankle bracelet for potential flight risks would be more appropriate for sure. Additionally, female guards or guards posted OUTSIDE instead of inside the room would be better as well. But what, then, should be done for women who are known violent offenders? To say that it would just never happen that a woman in labor would attack somebody or try to escape, I think is equally short-sighted. I am not trying to vilify women who are incarcerated, but neither am I going to say that all women in labor become saints.
And for the record, I have experienced both childbirth and sexual assault. I do take "cruel and unusual punishment" very seriously. I also strongly believe in prisoners' rights and the rights of laboring women. And NO, I absolutely DON'T believe that incarcerated women should be stripped of natural birth. I think the percentage of women I'm talking about this being a potential need for would be miniscule. I agree that there should be some major reforms when it comes to this issue. But to do away with it entirely? I'm not so sure.
Hmm. If you think that the point is "railing against monitoring and confining," I'm afraid you didn't fully understand the piece. It's not about saying that inmates should be "unmonitored" -- I don't propose that anywhere. I definitely don't say anything about "doing away with handcuffs for male inmates being transferred" (although I do question the idea of shackling during major medical care because of an RN on the FB page who talked about having someone nearly die because the guards wouldn't unshackle him so they could use the defibrillator).
What I do say is that, under this circumstance, treating men and women the same--regardless of whether you think the treatment for men is right or wrong--causes specific harm and danger to pregnant women. It's probably not great to shackle men by the legs, but pregnant women are particularly unstable and vulnerable to falling, and susceptible to abruption or bad injuries because of the relaxin. It's probably not great to shackle men to the gurney if they're being treated for a knife wound, heart attack, whatever, but the act of holding still isn't going to almost necessarily make it worse and riskier. I'm not saying we should just set anyone who claims to be in labor out to prance among the daisies, but we DO need to figure out a way to deal with laboring inmates that isn't so degrading and dangerous.
Your position seems to have shifted from your first comment to the second, because in your first comment it was pretty clear that you were saying that even petty offenders should be shackled (more specifically, that the interest in confinement justifies shackling) because they try to escape. Now it seems that you are thinking about it more as a possibility for the most violent offenders with the greatest flight risk. I'm glad that your position has become more moderate after you read solutions that other people mentioned. But the truth remains that we are seeing a sevenfold (as I recall) increase in the incarceration of women, with thousands of pregnant women among them. What works for male inmates simply doesn't work for laboring inmates. "Accordance with the law" is really irrelevant if the law is simply not prepared to deal with women (lest we forget that coverture was also in accordance with the law).
I return again to my point about the justification for torture versus the act of torture. I think that for some people (like the current and prior administration) there is some sort of grey area around when torture is justifiable - to me, and I may be alone with the UN in this, I think that there is a moral high ground and that a big part of the reason for NOT committing torture is because we have to decide what sort of society we want to be. Torture does not become "not-torture" just because there is some compelling justification. It doesn't work that way.
People are willing to indulge all these crazy Jack Bauer fantasies about pregnant women pretending to be in labor, stabbing the doctor with the epidural needle, using the umbilical cord to strangle the guard, and jumping out the window with the baby toward freedom, or that we're talking about some sort of psychopaths who just can't control the urge to kill for 5 minutes. Apart from being really problematic and dehumanizing stereotyping, the reality is so much more banal. And even if the woman were deemed dangerous, I'm not sure that I'm willing to say that shackling the way that it is done now, which causes severe pain and suffering is ever justifiable. I think there is a moral obligation to find another solution.
You said:
"Your position seems to have shifted from your first comment to the second, because in your first comment it was pretty clear that you were saying that even petty offenders should be shackled (more specifically, that the interest in confinement justifies shackling) because they try to escape."
But my comment in my original post was:
" I personally think that women with a history of non-violent offenses should be given some sort of provision to be unshackled during labor." And I also said: "While I think confining them to their hospital bed should not be allowed in all cases..." And by "not allowed in all cases" I meant almost never, whether my original post reflects that. I went into more detail in my subsequent post, but I still felt that way from the beginning.
I agree almost entirely with your thoughts and your logic. And I never said or thought that the practice should be allowed and continue without any kind of oversight. I think it would be ridiculous and a very ripe situation for all sorts of abuses--yes, torture. I do agree with you that we SHOULD find a BETTER way of handling this situation. But I still believe that to say that in no cases should a woman ever be shackled or restrained during labor is not taking into account all variables. Perhaps it is a crazy Jack Bauer fantasy and no woman in labor would ever become violent or try to flee, but if it happened even once, they would probably start shackling everybody back to their beds! So in the interests of creating a more complete solution to the situation, shouldn't scenarios like that be taken into account as a possibility (however unlikely)?
I have a doula friend who volunteers for these women during their births. 1) I hadn't even heard of doing that. 2) Hadn't thought of it, which just makes me feel like shit, and amazed at my friend's caring heart.
Are they allowed their family there, or even a friend to help support them? I have no clue how she got into volunteering for it, but she's just the sweetest human being ever.
The thought of shackles during labor makes me sick to my stomach.
Navelgazing Midwife did a post on this topic based on her partner's perspective as a deputy sheriff.
http://navelgazingmidwife.squarespace.com/navelgazing-midwife-blog/2006/7/22/shackling-laboring-inmates.html
I didn't hear the segment on NPR but that picture is making me so sad. That poor woman, shackled to a bed, feeding her baby formula, looking absolutely miserable. Are these women ever encouraged to breastfeed?