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Invisible Women, Invisible Shackles

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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:

  1. 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.  
  2. 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!”

Photo credit: Mark Allen Johnson/ZUMA Press

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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?

July 20, 2010 | Unregistered CommenterMegan

Courtroom Mama wrote this post. I haven't listened to the NPR segment yet, but I will now after reading your comment.

July 20, 2010 | Registered CommenterJill

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.

July 20, 2010 | Registered CommenterCourtroom Mama

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.

July 20, 2010 | Unregistered CommenterLouise

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?

July 21, 2010 | Unregistered CommenterAugusta

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.

July 21, 2010 | Unregistered CommenterR.S.

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.

July 21, 2010 | Unregistered CommenterKK

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?

July 21, 2010 | Unregistered Commenteremjaybee

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.

July 21, 2010 | Unregistered CommenterSaanenMother

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.

July 21, 2010 | Registered CommenterCourtroom Mama
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