A new policy will remove wrist restraints once an inmate is in labor and the use of leg or waist restraints will now also be prevented

Pregnant inmates will no longer give birth in shackles in North Carolina after a change in the state’s prison rules.

Prisons director Kenneth Lassiter has announced a new policy that will remove wrist restraints once an inmate is in labor unless she poses an immediate risk of escape or is a clear threat to herself or others. The use of leg or waist restraints will now also be stopped.

North Carolina joins 18 other states where legislation prohibits or restricts such shackling, although many of those laws are not properly implemented according to the American Civil Liberties Union. Of the 200,000 women in US prisons or jails each year, 6%, or 12,000, are pregnant when they are incarcerated, the ACLU reported.

Eight states have no laws or policies on the subject at all, essentially giving prisons the option to handcuff an inmate while she’s having her baby and also use other restraints earlier in the labor. Other states have some restrictive policies but no laws protecting the mother from being shackled in childbirth.

Map showing states with no laws or policies restricting use of shackles on inmates giving birth Source: University of Chicago Law School report shackling of incarcerated pregnant women: a human rights violation committed regularly in the United States.



Dr Carolyn Sufrin, an OB-GYN at Johns Hopkins school of medicine, welcomed North Carolina’s decision but said: “Passing laws and changing policy is only one steps– there needs to be training and accountability and oversight to make sure that it doesn’t actually happen.”

Sufrin has delivered the babies of several imprisoned women, but only one who was in chains. She described it as a “deeply troubling experience”. She said: “I felt like I was not providing good care to that patient. I worried about what I would do if the baby’s shoulder got stuck in the birth canal or if the mother needed an emergency C-section. I wondered how she would be able to hold the baby after it was born.”

The continued use of shackles has repeatedly been criticized by human rights organizations and health professionals. The American Medical Association has described it as “a barbaric practice that needlessly inflicts excruciating pain and humiliation”. The practice contravenes the United Nations convention against torture.

There are health risks too, according to the American College of Obstetricians and Gynecologists, including:

Increased duration and painfulness of labor. Women who are shackled to a hospital bed cannot walk or change position (which can shorten and ease labor).

Possible delays if emergency operations are needed.

Increased risk of postpartum hemorrhaging.

Many of these pregnancies are already high risk. Incarcerated women often lack adequate pre-natal care and are at greater exposure to poor nutrition, domestic violence, mental illness, and drug or alcohol abuse.

Amy Fettig, the deputy director of the ACLU national prison project, told the Guardian: “I am unaware of any cases of women or girls in labor attempting to escape. If I did, I would suggest that they are superhuman. Corrections officials often use this crazy scenario as a justification for chaining women prisoners during childbirth – but it simply doesn’t hold water.”

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Shawanna Nelson’s experience in Arkansas has helped to shift the debate in recent years. When she arrived to the hospital in 2003 with her legs shackled together, she had already been in labor for 12 hours. After childbirth, shackles caused her to soil the bed sheets as she was unable to reach a bathroom in time.

North Carolina’s change in policy came after repeated criticism from advocacy groups such as SisterSong, which campaigns for reproductive rights for women of color.

SisterSong lobbied the department after it received reports that two prisoners had been shackled during childbirth in the state in recent months, despite medical staff asking that the shackles be removed.

Omisade Burney Scott, director of strategic partnerships and advocacy for SisterSong, said: “I don’t know many pregnant women who try to escape the hospital when they’re in the throes of labor.”

The Associated Press contributed to this report.

For more information on this subject, full state-by-state report cards were published here in 2010 by the National Women’s Law Center and the Rebecca Project for Human Rights