Safe Pregnancy for Incarcerated Women

The United States has the world’s highest incarceration rate with 724 people per 100,000. Louisiana has the highest incarceration rate in the US, earning the title of ‘The World’s Prison Capital.’

Historically, correctional institutions have been disproportionately populated by male inmates. Correctional policies and procedures have been designed to ensure safety and security in a predominately male setting. However, over the past few years there has been a growing amount of women and girls in prison populations. There are about 2,044 women incarcerated in LA. An estimated 5% of women coming into prisons and jails are pregnant and will likely deliver in prison. There is however a lack of data available in relation to pregnant inmates. Federal regulations do not require prisons or jails to collect data on
pregnant women and childbirth among female inmates.1

Shackling pregnant women has been widely recognized as a cruel and inhumane. The are numerous negative physical and mental health affects for both mother and child, are borne out by myriad evidence. National medical organizations (ACOG, AMA) and the Women’s Prison Association strongly oppose the shackling of pregnant women because it is both dangerous and wholly unnecessary. There are of course objections to the unshackling of pregnant women, which rely heavily on the potential public safety risk of incarcerated pregnant women. Pregnant women are highly unlikely to pose a flight risk.2 According to a 2011 report by Women’s Prison Association, there is no record of an attempted flight risk or public safety risk for an incarcerated female who was not shackled during labor.3

Physical and Mental Health Affects

Incarcerated women and girls are among the most vulnerable members of our society. Shackling during pregnancy, labor, and recovery presents this group with an additional unnecessary risk.

  • Shackling can cause extreme physical pain and complication due to the mother’s inability to move.
  • Shackling increases the chances of life threatening embolic complications.
  • Shackling obstructs detection of pregnancy complications (e.g. preterm labor, hemorrhage).
  • Shackling impedes the range of movement necessary for emergency caesarian section.
  • Shackling increases the likelihood of falling. 
  • Medical experts have reported not being able to administer epidural due to shackling.
  • Reports from women and girls shackled during childbirth include accounts of severe mental distress, depression, anguish, and trauma. The use of shackles during labor and immediately after can cause, and often increases, pregnancy-related mental health problems.

Infant-Mother bonding

The use of restraints following delivery still pose undue risk on the mother. Restraining new mothers can prevent them from holding and bonding with their babies, which negatively affects the health of the infant. Women who are shackled are significantly less likely to initiate breastfeeding after the birth of their child than those who were not restrained.4

In 2012, the Louisiana Legislature passed the Safe Pregnancy for Incarcerated Women Act. Finding that, freedom from physical restraints is especially critical during labor,delivery, and postpartum recovery after delivery. The act limits the use of restraints during the 2nd and 3rd trimester and calls for the least restrictive form of restraint possible.5

The use of restraints on a pregnant prisoner during labor and delivery is prohibited by Louisiana statute unless:

A. Member of the medical staff orders therapeutic restraints for an inmate, due to a psychiatric or medical issue, creates a danger to herself or others6

B. The inmate presents a serious threat to herself and others or a substantial flight risk

The Louisiana Department of Corrections updated its policy to comply with the statute. The DOC policy states7:

  • Female offenders should be restrained in the least restrictive method possible when it is reasonable known that they are pregnant, to provide for the safety of the offender and unborn fetus.
  • Pregnant offenders shall never be handcuffed behind the back or restrained utilized leg irons. The electronic restraint belt shall never be used on a pregnant offender.
  • Restraints shall not be used on a pregnant offender during labor and delivery.
  • Pregnant offenders shall not be placed in a face down position.


Medical Providers Decide

According to the Statute:

  • Restraints shall not be used on a pregnant prisoner while she is in labor and during delivery unless a member of the medical staff orders therapeutic restraints for a prisoner who, due to a psychiatric or medical disorder, is a danger to herself, her child, her unborn child, or other persons.
  • If the doctor, nurse, or other health professional treating the prisoner requests, based on his or her professional medical judgment, that restraints not be used, the prison staff accompanying the prisoner shall immediately remove all restraints.

Medical Experts Agree

The American Medical Association (AMA), American Congress of Obstetricians and Gynecologists (ACOG), National Commission on Correctional Healthcare (NCCHC), and the American Psychological Association (APA) all oppose the use of restraints on pregnant incarcerated women during labor and delivery unless necessary due to serious threat.

Tori DeAngelis, The Restraint of Pregnant Inmates, American Psychological Association, Vol. 46, No. 6, June 2016. 
Women’s Prison Association. (n.d.).Laws banning shackling during childbirth gaining momentum nationwide (Organizational Statement)
 American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. (2015). Screening for perinatal depression Committee Opinion). 
5 La. Rev. Stat. Ann. § 15:744.2
6  La. Rev. Stat. Ann. § 15:744.7​
7  State of Louisiana Department of Public Safety and Corrections. Corrections Services Health Care Policy No. HC-08, 20 January 2012.