Stop Violence Against Women
Re: Use of Restraints on Pregnant Women - Model Policy Guidelines
Using restraints such as belly chains (sometimes called chain belts) and leg irons on pregnant women is in direct violation of international standards, such as the United Nations Standard Minimum Rules for the Treatment of Prisoners. [ *]
Amnesty International believes that there is no sound reason, security or otherwise, for authorities to restrain women in labor or women who have just given birth. While AI acknowledges that it is the responsibility of departments of corrections to implement policies for the protection of inmates, staff and the general public, requiring the use of restraints for pregnant women should not be considered part of this duty. Reports to AI indicate that only a minority of women have a history of violence and only few have ever absconded or attempted to escape, making restraints unnecessary. AI believes that the use of restraints in such circumstances is cruel, inhuman and degrading. According to the European Committee for the Prevention of Torture:
"...from time to time, the CPT encounters examples of pregnant women being shackled or otherwise restrained to beds or other items of furniture during gynecological examinations and/or delivery. Such an approach is completely unacceptable, and could certainly be qualified as inhuman and degrading treatment. Other means of meeting security needs can and should be found." [ * ]
Amnesty International is further concerned that the shackling of women who are about to give birth endangers women and their children. As described by physician Patricia Garcia:
Women in labor need to be mobile so that they can assume various positions as needed and so they can quickly be moved to an operating room. Having the woman in shackles compromises the ability to manipulate her legs into the proper position for necessary treatment. The mother and baby's health could be compromised if there were complications during delivery, such as hemorrhage or decrease in fetal heart tones. If there were a need for a C-section (caesarian delivery), the mother needs to be moved to an operating room immediately, and a delay of even five minutes could result in permanent brain damage for the baby. The use of restraints creates a hazardous situation for the mother and the baby, compromises the mother's ability postpartum to care for her baby and keeps her from being able to breast feed. [ * ]
State legislatures and departments of corrections in several states and jurisdictions have addressed this issue. Legislation in Illinois and California, and a pending bill in New York prohibit the use of restraints during the transportation of pregnant inmates to the hospital or during labor and delivery there. Five state departments of corrections [ *] and the District of Columbia have written policies stipulating that no restraints are to be used on inmates during labor and birth. The New York City Department of Corrections' policy prohibits the use of restraints on pregnant inmates admitted to hospital for delivery "unless the inmate attempts to e scape at the hospital or the inmate engages in violent behavior at the hospital which presents a danger of injury." Furthermore, 14 other states told AI that their practice is not to restrain women during labor and birth. [ *]
Amnesty International recommends that jails and prisons adopt policies prohibiting the use of restraints on pregnant women, except in very limited circumstances as detailed in the policy guidelines below. The prohibition on restraints should include transport, pre-natal treatment, labor, and delivery. Policies should also prohibit the use of restraints on women who have just given birth, for the duration of their hospital stay, and during transportation back to the prison.
It is common practice to have an officer, or even two officers, escort women to the hospital from the correctional center. Amnesty International believes that unless there are exceptionally compelling security concerns, the officer, who should be female, should be placed outside the door of the delivery room in order to respect the privacy and dignity of the woman giving birth. Such a measure would seem adequate in terms of security for all women during active labor.
AI notes that for all persons in custody, international standards stipulate that jails and prisons should use restraints only when restraints are required as a precaution against escape or to prevent an inmate from injuring herself or other people or damaging property. In every case, due regard must be given to an inmate's i ndividual history.
There is an urgent need for all authorities to take action to ensure that the rights and health of pregnant women and their children are protected.
Thank you for reviewing your Department's policies and bringing them into line with these standards. I, or a member of AIUSA's Research Department, will be available for further discussions or questions. I would be grateful if you could communicate to me any changes you make to your policies.
Sincerely,
Sheila Dauer Director,
Women's Human Rights Program
Amnesty International USA
Footnotes:
[*] Rule 33, United Nations Standard Minimum Rules for the Treatment of Prisoners.
[*] 10th General Report on the CPT's activities covering the period 1 January to 31 December 1999: http://www.cpt.coe.int/en/annual/rep-10.htm#_Toc490017789.
[*] Dr Garcia is an obstetrician and gynecologist at Northwestern University's Prentice Women's Hospital
[*] Connecticut, Florida, Rhode Island, Washington and Wyoming.
[*] Hawaii, Iowa and Kansas, California, Georgia, Michigan, Missouri, Montana, Nebraska, New Mexico, New York, Oregon, South Dakota and Texas.
