The San Diego County Sheriff’s Department restrains women inmates who are in labor as a matter of routine, despite a state law that limits the use of restraints except in certain dangerous cases.

When a pregnant woman is booked into a San Diego County jail, she’s told she “will be chained and handcuffed” when she delivers her baby, according to the Sheriff Department’s “Pregnant Patient’s Rights.”

State law prohibits restraints “by the wrists, ankles, or both” during labor, delivery and recovery unless an inmate’s deemed a threat to herself or others.

Yet “all inmates start off minimally restrained (one wrist to the bed or something similar) while they are in the hospital,” said Sheriff’s Department spokeswoman Lt. Karen Stubkjaer said via email. Restraints will be removed at the request of an attending physician, or if law enforcement personnel determine a woman poses no threat, she said. But the latter rarely happens.

“In the majority of cases,” inmates are shackled during labor and delivery, Lt. David Gilmore wrote in a March 26 letter to the Citizens’ Law Enforcement Review Board. The letter was in response to the board’s recommendation that the department change the wording in its Pregnant Patient’s Rights from “You will be chained and handcuffed during labor and delivery” to “A pregnant inmate in labor, during delivery, or in recovery after delivery, shall not be restrained by the wrists, ankles, or both, unless deemed necessary for the safety and security of the inmate, the staff, or the public.”

The Sheriff’s Department rejected the recommendation. “The statement as it currently reads is an accurate advisement,” Gilmore wrote.

Carol Strickman, an attorney with Legal Services for Prisoners with Children, which has published a series of reports on the shackling of pregnant inmates, said restraints are supposed to be the exception, not the norm.

“To start out as routine — a standard that everybody’s going to be shackled until we decide we don’t need to — is wrong,” she said.

Strickman said her organization thought San Diego was complying with state law based on the department’s written policies that say restraints should be used only if “deemed necessary.”

“I’m really disappointed to hear this,” she said. “We know a lot of times the counties’ policies are in compliance, but we can’t really speak to what their practice is.”

It wasn’t until 2013, when legislation written by then-Assemblywoman Toni Atkins, now president pro tem of the state Senate, took effect that sheriff’s departments and the Board of State and Community Corrections were required to draw up policies dictating how and when pregnant inmates could be shackled. Atkins’ bill banned the use of specific restraints — leg irons, waist chains and behind-the-back handcuffs — and prohibited restraint “by the wrists, ankles, or both” during labor, delivery and recovery “unless deemed necessary for the safety and security of the inmate, the staff, or the public.”

The law also requires jail staff to advise pregnant inmates of their right not to be shackled unless they’re considered a safety risk. Strickman said the fact that the department’s “Pregnant Patients Rights” tells a woman she will be “chained and handcuffed” — as opposed to telling a woman she will be restrained only if necessary — is “completely wrong.”

“It needs to be communicated — the actual law,” she said, “not their illegal procedure.”

Atkins said she was troubled to hear the Sheriff’s Department was automatically restraining pregnant inmates.

“Restraints should be used only in cases in which there is a compelling threat to safety or security,” she said via email. She also said she plans to contact Sheriff Bill Gore to discuss the issue.

Stubkjaer said 54 county jail inmates gave birth between Jan. 1, 2015, and March 31, 2018. She said the department doesn’t track the use of restraints because that information is part of an inmate’s medical record, which is confidential.