Laws and Standards for Pregnancy-Related Health Care and Abortion Access for Incarcerated Women

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  • Alaska

  • Alabama

    • Alabama

      Click to learn more about your state

      DOC Website:
      http://www.doc.state.al.us

      DOC Policies and/or State Laws:

      DOC Administrative Regulations
      AR 703 Inmate Co-Payment for Health Services     

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Alabama DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      The Alabama memorandum includes several attachments that describe the DOC’s policies for pregnancy related care. These policies are not posted elsewhere.

      Memorandum Attachments:
      * DOC Standard Operating Procedure, No. 9-14: Pregnant Inmates/Placement of Infants/Death of Infants and/or Inmate Mothers
      * DOC Health Services Policy & Procedures Manual, No. P-G-07.00: Care of the Pregnant Inmate
      * Baptist Health Security Department Policy & Security Manual, No. 5.100: Handling Patients and Visitors in Custody

      DOC Contact Information:

      General Contact Information

      Alabama Department of Corrections
      301 S. Ripley Street
      P.O. Box 301501
      Montgomery, AL 36130-1501
      Phone: (334) 353-3883
      Email: Constituent.Services@doc.alabama.gov

      Health Services Department:
      Phone (334) 353-3887

  • Arkansas

    • Arkansas

      Click to learn more about your state

      DOC Website:
      http://www.adc.arkansas.gov/

      DOC Policies and/or State Laws:

      DOC Administrative Directive
      # 00-01 Use of Restraints

      Arkansas Administrative Code
      159.00.1-7.1 Prenatal Care/Pregnant Inmates/Residents
      004.00.2-829 Prenatal Care/Pregnant Inmates

      DOC Contact Information:

      General Contact Information

      Arkansas Department of Correction
      P.O. Box 8707
      Pine Bluff, AR 71611-8707
      Phone: (870) 267-6999
      Email: adc.inmate.info@arkansas.gov

      Medical Services
      Phone: (870) 267-6365

  • Arizona

    • Arizona

      Click to learn more about your state

      DOC Website:
      www.azcorrections.gov

      DOC Policies and/or State Laws:

      Arizona Revised Statutes
      Tit. 31, § 31-601 Pregnant prisoners; restraints; written findings; rules; definitions

      DOC Policies
      Department Order 705 Inmate Transportation
      Department Order 1101 Inmate Access to Health Care

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Arizona DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information
      ADC Central Office
      1601 W. Jefferson St
      Phoenix AZ 85007
      Phone: (602) 542-5497

      Health Services Administrator
      Phone: (602) 364-2900

  • California

  • Colorado

    • Colorado

      Click to learn more about your state

      DOC Website:
      www.doc.state.co.us

      DOC Policies and/or State Laws:

      Colorado Revised Statutes
      § 17-1-113.7 Prohibition against the use of restraints on pregnant inmates in the custody of correctional facilities and private contract prisons
      § 19-2-924.7 Juveniles committed to the department of human services - prohibition against the use of restraints on pregnant juveniles

      * While direct links are not available, the above statutes can be found by entering the section numbers in the Colorado Revised Statue search tool linked to above.

      DOC Administrative Regulation
      Regulation Number 700-12 Birth Control, Pregnancy, Child Placement and Abortion

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Colorado DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.

      DOC Contact Information:
      General Contact Information

  • Connecticut

  • District of Columbia

    • Washington DC

      Click to learn more about your state

      DOC Website:
      http://doc.dc.gov/

      DOC Policies and/or State Laws:

      DOC Policy
      6000.1H Medical Management

      DOC Contact Information:

      General Contact Information
      DC Department of Corrections
      2000 14th Street, NW, Seventh Floor
      Washington, DC 20009
      Phone: (202) 673-7316
      Email: doc@dc.gov

  • Delaware

  • Florida

    • Florida

      Click to learn more about your state

      DOC Website:
      http://www.dc.state.fl.us/

      DOC Policies and/or State Laws:

      Florida Statutes
      944.24 Administration of correctional institutions for women
      § 944.241 Shackling of incarcerated pregnant women
      § 951.175 Provision of programs for women

      Florida Administrative Code
      R. 33-103.011 Time Frames for Inmate Grievances
      R. 33-601.603 Furloughs
      R. 33-602.101 Care of Inmates
      R. 33-602.211 Restraint of Pregnant Inmates

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Florida DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.

      DOC Contact Information:

      General Contact Information
      Florida Department of Corrections
      501 South Calhoun Street
      Tallahassee, FL 32399-2500
      Phone: (850) 488-5021

      DOC Health Services
      Assistant Secretary for Health Services
      Phone: (850) 717-3277

  • Georgia

    • Georgia

      Click to learn more about your state

      DOC Website:
      http://www.dcor.state.ga.us/

      DOC Policies and/or State Laws:
      None posted.

      DOC Contact Information:

      General Contact Information
      Georgia Department of Corrections
      300 Patrol Road
      Forsyth, GA 31029

      Office of the Ombudsman and Family Advocacy
      Phone: (404) 992-5358

  • Hawaii

  • Iowa

  • Idaho

    • Idaho

      Click to learn more about your state

      DOC Website:
      www.idoc.idaho.gov

      DOC Policies and/or State Laws:

      Idaho Code
      Tit. 20, § 20-901 Definitions
      Tit. 20, § 20-902 Restraint of Pregnant Prisoners
      Tit. 20, § 20-903 Notice to Prisoners

      DOC Policies
      307.02.01.001 Use of Force
      322.02.01.001 Transports: Medical, Court, Family Emergency, State
      401.06.03.055 Care of the Pregnant Offender
      401.06.03.058 Pregnancy Counseling
      401.06.03.073 Abortion

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights published Mothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Idaho DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information
      Idaho Department of Corrections
      1299 N. Orchard St. Suite 110
      Boise, ID 83706
      Phone: (208) 658-2000
      Email: inquire@idoc.idaho.gov

  • Illinois

  • Indiana

    • Indiana

      Click to learn more about your state

      DOC Website:
      http://www.in.gov/idoc/

      DOC Policies and/or State Laws:

      Indiana Code
      § 11-10-3-3 Prenatal and Postnatal care, Treatment

      DOC Contact Information:

      General Contact Information

      Mailing Address:
      302 W. Washington Street, Room E-334
      Indianapolis, IN 46204
      Phone: (317) 233-5541

  • Kansas

  • Kentucky

    • Kentucky

      Click to learn more about your state

      DOC Website:
      http://www.corrections.ky.gov/

      DOC Policies and/or State Laws:

      Kentucky Administrative Regulations
      Tit. 501, 3:090 Medical Services
      Tit. 501, 7:090 Medical Services

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Kentucky DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information

      Administrative Services Division
      Phone: (502) 564-4726

      Health Services Division
      Phone: (502) 222-7808 ext: 221

      Kentucky Correctional Institution for Women
      3000 Ash Ave.
      Pewee Valley, Kentucky 40056
      Phone: (502) 241-8454

  • Louisiana

  • Massachusetts

    • Massachusetts

      Click to learn more about your state

      DOC Website:
      http://mass.gov/doc

      DOC Policies and/or State Laws:

      DOC Policies
      Policy # 521.05 Transportation [See page 3 of memorandum]
      Policy # 521.07 In-Hospital Security Procedures [See page 3 of memorandum]
      Policy # 620.04 Programs for Female Inmates

      * A list of all DOC policies can be found here

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Massachusetts DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      General Laws of Massachusetts
      Ch. 127, § 118 Pregnant females

      Code of Massachusetts Regulations
      Tit. 120, § 200.11 Early Parole for Pregnant Females

      DOC Contact Information:

      General Contact Information
      DOC Central Headquarters
      50 Maple Street, Suite 3
      Milford, MA 01757 -3698
      Phone: (508) 422-3300

  • Maryland

  • Maine

  • Michigan

    • Michigan

      Click to learn more about your state

      DOC Website:
      http://www.michigan.gov/corrections

      DOC Policies and/or State Laws:

      Michigan Administrative Code
      R 791.731  Health Screening

      DOC Policy Directive
      No. 03.04.100 Health Services
      No. 03.04.105 Informed Consent to Medical Care

      Women's Huron Valley Correctional Facility Operating Procedure
      No. 03.04.100B Pregnant and Postpartum Prisoners

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Michigan DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information

      Michigan Department of Corrections
      206 E. Michigan Avenue
      Grandview Plaza
      P.O. Box 30003
      Lansing MI 48909
      Phone: (517) 335-1426

      Women's Huron Valley Correctional Facility
      3201 Bemis Road
      Ypsilanti, MI 48197-0911
      Phone: (734) 572-9900

  • Minnesota

  • Missouri

    • Missouri

      Click to learn more about your state

      DOC Website:
      http://doc.mo.gov/

      DOC Policies and/or State Laws:

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Missouri DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information

      Missouri Department of Corrections
      Division of Adult Institutions
      2729 Plaza Drive
      P.O. Box 236
      Jefferson City, MO 65102
      Phone: (573) 751-2389

      Missouri Department of Corrections Medical Services Section
      Division of Offender Rehabilitative Services
      P.O. Box 236
      Jefferson City, MO 65102
      Email: healthservices@doc.mo.gov

  • Mississippi

  • Montana

  • North Carolina

    • North Carolina

      Click to learn more about your state

      DOC Website:
      http://www.doc.state.nc.us/

      DOC Policies and/or State Laws:

      DOC Publication
      Handbook for Family and Friends of Inmates (2010)  PDF

      DOC Health Care Policy and Procedure Manual
      POLICY # CC-4 Pregnant Inmates

      North Carolina Correctional Institution for Women (NCCIW) Policy 
      Managing the Pregnant Inmate PDF

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the North Carolina DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.

      DOC Contact Information:

      General Contact Information
      North Carolina Department of Public Safety
      4201 Mail Service Center
      Raleigh, NC 27699-4201
      Phone: (919) 838-4000

      North Carolina Division of Prisons Health Service
      831 West Morgan Street
      4278 Mail Service Center
      Raleigh, NC  27699-4278
      Phone: 919-838-3850

  • North Dakota

    • North Dakota

      Click to learn more about your state

      DOC Website:
      www.nd.gov/docr

      DOC Policies and/or State Laws:

      Southwest Multi-County Correction Center Policies and Procedures Manual, Dakota Women’s Correctional Rehab Center
      ACA Related Standard 4-4189 Transportation of Inmates Outside the Institution [See Page two of the linked PDF]

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the North Dakota DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information
      Department of Corrections and Rehabilitation
      Street Address: 3100 Railroad Avenue
      Mailing Address: P.O. Box 1898
      Bismarck, ND 58502-1898
      Phone: (701) 328-6362

      Dakota Women's Correctional and Rehabilitation Facility
      Warden: Rachelle Juntunen 
      Dakota Women’s Correction and Rehabilitation Facility
      440 McKenzie Street
      New England, ND 58647
      Phone: (701) 579-5100

  • Nebraska

    • Nebraska

      Click to learn more about your state

      DOC Website:
      http://www.corrections.nebraska.gov/

      DOC Policies and /or State Laws:
      None listed.

      DOC Contact Information:
      Nebraska Department of Correctional Services
      P.O. Box 94661
      Lincoln NE 68509-4661
      (402) 471-2654

  • New Hampshire

  • New Jersey

    • New Jersey

      Click to learn more about your state

      DOC Website:
      http://www.state.nj.us/corrections/

      DOC Policies and/or State Laws:

      New Jersey Administrative Code
      10A:16–2.11 Medical examinations
      10A:16–6.1 Care of pregnant inmates
      10A:16–6.2 Obstetrical services
      10A:16–6.3 Maternity clothes, housing assignments, exercise and work schedules
      10A:16–6.4 Termination of pregnancy
      10A:16–6.5 Father of the child
      10A:16–6.6 Placement of infants
      10A:31–13.9 Medical screening
      10A:31–13.10 Care of pregnant inmates

      * While direct links are not available, these rules can be found by using the Lexus Nexus search tool

      DOC Contact Information:

      General Contact Information
      New Jersey Department of Corrections
      Whittlesey Road
      PO Box 863
      Trenton, NJ 08625
      Phone: (609) 292-4036
      Email

      Health Services Unit
      Phone: 609-826-5618

  • New Mexico

    • New Mexico

      Click to learn more about your state

      DOC Website:
      www.corrections.state.nm.us

      DOC Policies and/or State Laws:

      New Mexico Statute
      § 33-1-4.2 Restraints on pregnant prisoners

      * While direct link is not available, the above statute can be found by entering the section number in the New Mexico Statue search tool linked to above.

      DOC Policy
      Policy Number 170100 Medical Clinical Services [See page 8 for pregnancy related care]

      DOC Contact Information:

      General Contact Information
      4337 NM 14, Santa Fe NM 87508
      P.O. Box 27116, Santa Fe NM 87502-0116
      Phone: (505) 827-8645

      Health Services Administrator
      Elke Jackson
      Phone: (505) 827-8628

  • Nevada

    • Nevada

      Click to learn more about your state

      DOC Website:
      www.doc.nv.gov

      DOC Policies and/or State Laws:

      Nevada Revised Statutes
      209. 376 Limitations on use of restraints on offender who is in labor, delivering her baby or recuperating from delivery

      DOC Administrative Regulations
      AR 455 Use of Handcuffs and Restraints on Pregnant Inmates
      AR 623 Health Care for Women
      AR 624 Placement of Infants

      DOC Contact Information:

      General Contact Information
      Nevada Department of Corrections
      5500 Snyder Avenue
      P.O. Box 7011
      Carson City, Nevada 89701
      Phone: (775) 887-3285

  • New York

    • New York

      Click to learn more about your state

      DOC Website:
      http://www.doccs.ny.gov/

      DOC Policies and/or State Laws:

      DOC Directive
      No. 4916 Transporting Pregnant Inmates and Inmates with Babies

      Compilation of Codes, Rules and Regulations of the State of New York
      Tit. 9, § 7651.17 Prenatal and infant care services

      Consolidated Laws of New York
      N.Y. Correct. Law § 611 Births to inmates of correctional institutions and care of children of inmates of correctional institutions

      DOC Contact Information:

      General Contact Information
      NYS Department of Corrections and Community Supervision
      Building 2
      1220 Washington Ave
      Albany, New York 12226-2050
      Phone: (518) 457-8126

      Additional Resources:
      NYCLU Report
      Access to Reproductive Health Care in New York State Jails PDF

  • Ohio

  • Oklahoma

    • Oklahoma

      Click to learn more about your state

      DOC Website:
      http://www.doc.state.ok.us/

      DOC Policies and/or State Laws:

      DOC Office of Medical Services Resource Manual
      MSRM-140118-01 Management of Alleged Non-consensual Sexual Contact
      MSRM 140137-03 Management of Human Immunodeficiency Virus Infection/Acquired Immunodeficiency Syndrome
      MSRM-140145-01 Management of Pregnancy

      DOC  Policy & Operations Memoranda
      OP-140114 Screening New Arrivals
      OP-140115 Health Assessment
      OP-140145 Female Offender Health Services  

      DOC Contact Information:

      General Contact Information

      Physical Address:
      Oklahoma Department of Corrections
      3400 Martin Luther King Avenue
      Oklahoma City, Oklahoma 73111-4298

      Mailing Address:
      Oklahoma Department of Corrections
      P.O. Box 11400
      Oklahoma City, Oklahoma 73136-0400
      Phone: (405) 425-2500
      Email: webmaster@doc.state.ok.us

      Medical Services
      Don Sutmiller, DO/MBA, Chief Medical Officer
      Oklahoma City Office:
      Cameron Building
      2901 N. Classen Blvd., Suite 200
      Oklahoma City, OK 73106-5493
      Phone: (405) 962-6155
      E-mail: cheri.atkinson@doc.state.ok.us

  • Oregon

    • Oregon

      Click to learn more about your state

      DOC Website:
      www.oregon.gov/doc

      DOC Policies and/or State Laws:

      Oregon Administrative Rules
      291-013-0104 Security Equipment

      DOC Policy
      40.1.1 Escorting of Inmates

      DOC Health Services Policies and Procedures
      P-E-06 Dental Services for Pregnant Inmates
      P-G-07 Care of the Pregnant Inmate (Essential)
      P-G-09 Pregnancy Counseling (Important)

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Oregon DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information
      Oregon Department of Corrections
      2575 Center St. NE
      Salem, OR 97301-4667
      Email: DOC.Info@doc.state.or.us
      Phone: (530) 945-9090

  • Pennsylvania

    • Pennsylvania

      Click to learn more about your state

      DOC Website:
      http://www.cor.state.pa.us/

      DOC Policies and/or State Laws:

      DOC Policies
      6.3.1 Use of Restraints during Labor and Delivery
      13.02.01 Access to Health Care
      13.01.01 Management & Administration of Health Care

      * PDFs of the above policies can be downloaded here.

      DC-ADMs/Inmate Handbook Policy
      008 Prison Rape Elimination Act (PREA)

      * A PDF of the policy can be downloaded here.

      Pennsylvania Administrative Code
      Tit. 37, § 93.12 Prison Medical Services Program

      Pennsylvania Statutes and Consolidated Statutes
      Tit, 61, § 1104 State recording system for application of restraints to pregnant prisoners or detainees
      Tit. 61, § 1758 County recording system for application of restraints to pregnant prisoners or detainees
      Tit. 61, § 5905 Healthy birth for incarcerated women

      DOC Contact Information:

      General Contact Information
      Pennsylvania Department of Corrections
      1920 Technology Parkway
      Mechanicsburg, PA 17050
      Phone: (717) 728-2573
      Email: ra-contactdoc@pa.gov

      Bureau of Health Care Services
      Phone (717) 728-5309

      Additional Resources:
      ACLU of Pennsylvania Report
      Reproductive Health Locked Up: An Examination of Pennsylvania Jail Policies (2012) PDF

  • Rhode Island

  • South Carolina

  • South Dakota

    • South Dakota

      Click to learn more about your state

      DOC Website:
      http://doc.sd.gov/

      DOC Policies and/or State Laws:

      South Dakota Women’s Prison Operational Memorandum
      Policy 4.3.D.6 Special Needs Inmates, Restraints for Pregnant Inmates

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the South Dakota DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information
      Department of Corrections
      3200 East Highway 34
      c/o 500 East Capitol Avenue
      Pierre SD 57501
      Phone: (605) 773-3478

      South Dakota Women's Prison
      Phone: (605) 773-6636

  • Tennessee

    • Tennessee

      Click to learn more about your state

      DOC Website:
      http://www.state.tn.us/correction/

      DOC Policies and/or State Laws:

      Tennessee Code Annotated
      § 41-21-227 Grant of Furloughs to Inmates

      DOC Policies and Procedures
      113.15 Inmate Co-Payment for Health Services
      113.30 Access to Health Care
      113.45 AIDS: Education, Prevention and Case Management

      DOC Contact Information:

      General Contact Information

      Tennessee Department of Corrections
      Rachel Jackson Building, Sixth Floor
      320 Sixth Avenue North
      Nashville, Tennessee 37243-0465
      Phone: (615) 741-1000
      Email: TDOC.Webmaster@tn.gov

      Director of Clinical Services  
      Phone: (615) 253-8157

      Medical Director
      Phone: (615) 253-8163

  • Texas

  • Utah

  • Virginia

  • Vermont

    • Vermont

      Click to learn more about your state

      DOC Website:
      http://www.doc.state.vt.us/

      DOC Policies and/or State Laws:

      DOC Policies
      Policy # 351 Health Care Services
      DOC Health Services handbook for Families & Friends of Inmates (2007) PDF

      Vermont Statutes
      Tit. 28, § 801a Pregnant inmates

      Vermont Administrative Code
      12-5-102:2 Opiate Treatment Approval Rules

      * While a direct link is not available, the rule can be accessed by following these steps: 1) Enter: “ Opiate Treatment Approval Rules” into the search box 2) Check the “Natural Language Box” 3) Check the “  Full-text of source documents” box. 3) Click “search”

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Vermont DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.

      DOC Contact Information:

      General Contact Information
      Vermont Department of Corrections

      Mailing Address:
      103 South Main Street
      Waterbury, VT 05671-1001

      Physical Address:
      426 Industrial Ave.
      Williston, VT 05495

      Phone:
      General: (802) 951-5003
      Health Services Director: (802) 951-5013

  • Washington

    • Washington

      Click to learn more about your state

      DOC Website:
      http://www.doc.wa.gov/

      DOC Policies and/or State Laws:

      Revised Code of Washington
      § 72.09.015 Definitions.
      § 72.09.651 Use of restraints on pregnant women or youth in custody — Allowed in extraordinary circumstances.
      § 72.09.652 Use of restraints on pregnant women or youth in custody — Provision of information to staff and pregnant women and youth in custody.
      § 70.48.500 Use of restraints on pregnant women or youth in custody — Allowed in extraordinary circumstances.

      DOC Offender Health Care Policies (* PDFs of each of the policies listed below can be downloaded here)
      610.025 Medical Management of Offenders in Cases of Alleged Sexual Abuse or Assault
      610.040 Health Screenings, Appraisals, and Status
      610.240 Therapeutic Diets
      610.600 Infirmary/Special Needs Unit Care
      610.650 Outpatient Services
      670.020 HIV Infection and AIDS

      DOC Memorandum
      In 2010, the National Women’s Law Center and the Rebecca Project for Human Rights publishedMothers Behind Bars, a state-by-state report card and analysis of federal policies on conditions of confinement for pregnant and parenting women. A memorandum with the Washington DOC’s official statement in response to the report is posted on the Association of State Correctional Administrators website.  

      DOC Contact Information:

      General Contact Information

      Mailing Address:
      Washington Department of Corrections
      PO Box 41100, Mail Stop 41100
      Olympia, WA 98504-1100

      Physical Address:
      7345 Linderson Way SW
      Tumwater, WA 98501-6504

      Phone: (360) 725-8700
      Email: doccorrespondence@doc1.wa.gov

  • Wisconsin

    • Wisconsin

      Click to learn more about your state

      DOC Website:
      http://doc.wi.gov/Home

      DOC Policies and/or State Laws:

      DOC Policy
      # 306.00.02 Movement and Transportation of Pregnant Inmates

      DOC Contact Information:

      General Contact Information

      Wisconsin Department of Corrections

      Physical Address
      3099 E. Washington Ave.
      Madison, WI 53707-7925

      Mailing Address:
      P.O. Box 7925
      Madison, WI 53707-7925

      Phone: (608) 240-5000
      Email: docweb@wi.gov

      Bureau of Health Services
      Phone: 608-240-5120

      Women’s Facilities

      Milwaukee Women's Correctional Center
      Phone: (414) 267-6101
      Robert E. Ellsworth Correctional Center
      Phone: (262) 878-6000

      Milwaukee Women's Correctional Center
      Phone: (414) 267-6101

  • West Virginia

    • West Virginia

      Click to learn more about your state

      DOC Website:
      http://www.wvdoc.com/wvdoc/

      DOC Policies and/or State Laws:

      DOC Policy Directive
      # 307.00 Use of Restraints

      West Virginia Code
      §31-20-30a Mechanical restraints during pregnancy

      DOC Contact Information:

      General Contact Information

      WVDOC Central Office
      1409 Greenbrier Street
      Charleston, WV 25311
      Phone: (304) 558-2036

  • Wyoming

    • Wyoming

      Click to learn more about your state

      DOC Website
      http://doc.state.wy.us/

      DOC Policies and/or State Laws:

      DOC Policy
      #3.001 Use of Restraints

      DOC Contact Information:

      General Contact Information
      Wyoming DOC
      1934 Wyott Drive Suite 100
      Cheyenne WY 82002
      P: (307) 777-7208

      Wyoming Women's Center
      1000 West Griffith/P.O. Box 300
      Lusk, WY 82225

      Warden: Phil Myer
      Phone: (307) 334.3693
      E-mail: chris.thayer@wyo.gov

State Standards for Pregnancy-Related Health Care and Abortion Access in Correctional Settings (Click on states for more details)

  1. Introduction
  2. National Standards for Pregnancy-Related Health Care in Correctional Settings
  3. National Standards for the Use of Restraints on Pregnant Inmates
  4. Federal Laws & Policies
  5. State Laws & Policies

I. Introduction

On any given day, more than 200,000 women are living behind prison or jail walls. Thousands of these women are pregnant and depend on correctional authorities for their health care. Correctional authorities are legally obligated to meet their needs. Whether an incarcerated woman decides to continue her pregnancy to term or to seek abortion care, the Eighth and Fourteenth Amendments of the United States Constitution protect her right to obtain appropriate medical care while incarcerated.

While most correctional facilities provide some level of health care to inmates, some may inappropriately limit inmates’ access to pregnancy-related health care, including abortion. Moreover, too many correctional facilities routinely restrain inmates during pregnancy and childbirth, notwithstanding the medical dangers of doing so, and the assault on human dignity.

Presented here are summaries of, and links to, standards, laws, and policies that address pregnancy-related health care, access to abortion, and the use of restraints on pregnant women in correctional settings.

This resource guide includes four sections. First, it provides a summary of national standards for pregnancy-related health care and abortion access in correctional settings. Second, it provides a summary of national standards for the use of restraints on pregnant inmates. Third, it provides a brief overview of federal correctional laws and policies that address pregnancy-related health care, access to abortion, and the use of restraints on pregnant inmates. Finally, it provides a state-by-state directory with links to state correctional laws and department of corrections (DOC) policies addressing the same topics.

II. National Standards for Pregnancy-Related Health Care in Correctional Settings

Three organizations have developed well-known standards for correctional health care: the National Commission on Correctional Health Care (NCCHC), the American Congress of Obstetricians and Gynecologists (ACOG), and the American Public Health Association (APHA). These standards specifically address pregnancy-related care, including abortion.

Along with other sources, these standards provide guidance on minimum policies and practices that correctional facilities should implement in order to meet the needs of pregnant inmates, and to respect their constitutional right to health care while incarcerated.

II-A. National Commission on Correctional Health Care (NCCHC)

The National Commission on Correctional Health Care (NCCHC) is a nonprofit organization dedicated to improving the standard of health care in correctional settings. NCCHC publishes Standards for Health Services in Jails and Standards for Health Services in Prisons as a set of best practices, and to govern its accreditation program. These publications are available for purchase on their website.

NCCHC standards, P-G-09 & J-G-09: Counseling and Care of the Pregnant Inmate, advise making arrangements for delivery in a community facility, and offering pregnant inmates “timely and appropriate prenatal care, specialized obstetrical services when indicated, and postpartum care.” The standards also discuss the need for facilities to be prepared to handle the prevalence of high-risk pregnancies among incarcerated women, set forth specific compliance indicators for pregnancy-related care, and provide guidance on avoiding or limiting the use of restraints.

Compliance Indicators for Pregnancy-Related Care:

  • The facility provides counseling and assistance in accordance with the pregnant inmate’s expressed desires regarding her pregnancy, whether she elects to give birth and keep the child, to give birth and use adoptive services, or to have an abortion.
  • Prenatal care includes:
    • Medical examinations by a clinician qualified to provide medical care
    • Appropriate prenatal laboratory and diagnostic tests
    • Advice on the appropriate levels of activity, safety precautions, and alcohol and drug avoidance
    • Nutritional guidance and counseling
  • No restraints during active labor and delivery
  • Documentation of appropriate postpartum care
  • Maintaining a list of all pregnancies and their outcomes
  • Written policy and defined procedures to address all aspects of the standard

Guidelines on the Use of Restraints

Acknowledging the serious health risks involved in using restraints on pregnant inmates, NCCHC standards recommend avoiding restraints if possible. If that is not possible because of a serious risk of harm to the patient or others, the standards recommend using the least restrictive means possible, and avoiding certain types of restraints. They also stipulate that postpartum restraints should allow for mother-infant bonding.

II-B. American Congress of Obstetricians and Gynecologists (ACOG)

The American Congress of Obstetricians and Gynecologists (ACOG) is a professional organization of medical doctors who specialize in Obstetrics and Gynecology, with a membership that includes over 90% of U.S. board-certified obstetrician-gynecologists.

In November 2011, ACOG published its Committee Opinion on Health Care for Underserved Women, Health Care for Pregnant and Postpartum Incarcerated Women. In addition to providing recommended standards for pregnancy-related care in correctional settings, the Opinion provides a comprehensive overview of the medical concerns and risks associated with the use of restraints on pregnant inmates.

Standards for Pregnancy-Related Care

  • Assessments for pregnancy risk at intake
  • Pregnancy counseling and abortion services
  • Perinatal care that follows ACOG and American Academy of Pediatrics guidelines
  • Assessments and treatment for substance abuse
  • Testing and treatment for HIV, including provisions to prevent perinatal transmission
  • Mental health screenings
  • Dietary supplements for pregnant and breastfeeding inmates
  • Delivery services in a licensed hospital with facilities for high risk pregnancies when available
  • Provision of postpartum contraceptive methods during incarceration
  • Breastfeeding support, including provisions to accommodate storage and transportation of expressed breast milk.
  • Limited use of restraints— Facilities should avoid restraints because they “interfere with the ability of health care providers to safely practice medicine,” and put the woman and fetus at risk. Restraints are appropriate only in exceptional circumstances where there is an “imminent risk of escape or harm,” and the clinician providing care has thoroughly considered the health risks.
  • Oversight on the use of restraints—“If a restraint is used, a report should be filed by the DOC and reviewed by an independent body. There should be consequences for individuals and institutions when the use of restraints was unjustified.”

II-C. American Public Health Association (APHA)

The American Public Health Association (APHA), the oldest and largest national association of public health professionals, publishes its own comprehensive Standards for Health Services in Correctional Institutions, available for purchase on their website.

The standards for the care of pregnant women overlap in some respects with those set forth by NCCHC and ACOG, but also address important issues not mentioned in those standards.

Standards for Pregnancy-Related Care

  • A “sensitive and dignified” reproductive system examination as part of initial health screening
  • Access to abortion counseling and services upon request
  • Prenatal care that is provided by professionals with training and experience in obstetrical care, is consistent with contemporary community standards, and is initiated as soon as the pregnancy is identified
  • Identification and proper referral of high-risk pregnancies
  • Treatment to prevent perinatal transmission of HIV for HIV-positive women
  • Appropriate prenatal screening tests
  • Prenatal health education
  • Special housing and diets when necessary to sustain a healthy pregnancy
  • Standing arrangements for deliveries that include time for the mother and infant to be together after birth
  • Training of health care staff in jails and prisons for labor and delivery in case of emergency
  • Ongoing visitation with newborns after delivery
  • Prohibition of restraints during labor and delivery
  • Access to contraception, including emergency contraception
  • Recommendation that sterilization should only be provided with voluntary written consent after counseling by an outside agency; and that it should not be provided immediately after birth.

III. National Standards for the Use of Restraints on Pregnant Inmates

Too many correctional facilities routinely restrain inmates during pregnancy and childbirth, notwithstanding the medical dangers of doing so, and the assault on human dignity.

Restraining pregnant inmates at any time increases their potential for physical harm from an accidental trip or fall, and can seriously harm the fetus or induce a miscarriage. During labor, delivery, and postpartum recovery, restraints can interfere with appropriate medical care and can be detrimental to the health of the woman and her child. This practice demonstrates unconstitutional, deliberate indifference to a prisoner’s serious medical needs.

Recommended best practices for the use of restraints on pregnant inmates are provided by the National Task Force on the Use of Restraints with Pregnant Women under Correctional Custody. In addition, leading national correctional and medical organizations and associations recommend eliminating or limiting the use of restraints on pregnant inmates.

III-A. Standards and Best Practices

The U.S. Department of Justice convened the National Task Force on the Use of Restraints with Pregnant Women under Correctional Custody in 2011. Membership includes representatives from national, state, and local correctional, medical, and advocacy organizations. In 2014, the task force published Best Practices in the Use of Restraints with Pregnant Women and Girls Under Correctional Custody.

Task Force Recommendations on the Use of Restraints on Pregnant Inmates

  • Abdominal, leg and ankle, behind-the-back wrist, and four-point restraints are expressly prohibited under any circumstances due to risk of injury to the pregnant woman or girl and fetus/newborn.
  • Wrist restraints may be used only in a manner that allows the pregnant woman or girl to protect herself and her fetus in the event of a forward fall.
  • Restraints should never be used during labor and delivery.
  • The use of restraints should be avoided during the postpartum period; if restraints are deemed absolutely necessary, they should not interfere with the pregnant woman’s or girl’s ability to safely handle and promptly respond to the needs of her newborn.
  • When transporting a pregnant woman or girl, restraints should not be used except where absolutely necessary.
  • Standard operating procedures should outline a clear process and frequency for reassessing the use of restraints when they have been deemed absolutely necessary.
  • Standard operating procedures should be in place to address emergency and non-emergency decisions around the use of restraints.
  • All uses of restraints should be documented thoroughly.
  • A debrief should occur following any use of restraints to review documentation and determine whether proper procedures were followed.
  • Correctional staff should universally receive training on restraint policy, procedures, and specific variations for use with pregnant women and girls in custody.
  • Quality control and assurance methods should be in place to track adherence to policy and procedure, the impact/effectiveness of the restraint policy, and the need for adjustment in policy or practice over time.

A PDF of the Best Practices in the Use of Restraints with Pregnant Women and Girls under Correctional Custody report is available here.

III-B. Organizational Statements on the Use of Restraints

National correctional and medical organizations and associations recommend eliminating or limiting the use of restraints on pregnant inmates.

Medical Organizations & Associations

  • The American Congress of Obstetricians and Gynecologists (ACOG), the nation’s leading experts in maternal and fetal health care, have clearly stated their opposition. According to ACOG, the use of restraints on pregnant inmates interferes with the ability of physicians to safely practice medicine and is “demeaning and unnecessary.”
  • The American Medical Association (AMA), the largest association of medical doctors and medical students in the United States, has published a policy statement limiting its support for the use of restraints on pregnant inmates. In the 2nd or 3rd trimester of pregnancy, the AMA recommends that correctional officers use the least restrictive restraints necessary. During labor or postpartum recovery, the AMA recommends that restraints should not be used unless there are compelling safety or flight concerns.
  • The American Public Health Association (APHA), a national association of public health professionals, recommends that “[w]omen must never be shackled during labor and delivery.”
  • The Association of Women’s Health, Obstetrics and Neonatal Nurses (AWHONN), an organization of American nurses that focuses on the health of women and newborns, “opposes the practice of shackling incarcerated pregnant women.” According to AWHONN, restraints should only be used “if prison officials reasonably believe, after an impartial and thorough evaluation, that a particular individual may attempt to harm herself or others or presents a legitimate flight risk.”
  • The National Commission on Correctional Health Care (NCCHC) is a nonprofit organization dedicated to improving the standard of health care in correctional settings. NCCHC maintains that restraints should not be used during labor and delivery. During all other pre- and postpartum periods, NCCHC recommends that restraints should be “restricted as much as possible and, when used, done so with consultation from medical staff.”

Correctional Organizations & Associations

  • The American Correctional Association (ACA) is the oldest association developed specifically for practitioners in the correctional profession. ACA approves the use of restraints in the least restrictive manner possible throughout pregnancy, based on an assessment of the risk posed and the medical needs of the inmate. It recommends that waist and electronic restraints should never be used during pregnancy, and that leg restraints should be reserved for extreme circumstances during transport.
  • The Association of State Correctional Administrators (ASCA) is a professional association open to individuals who are appointed to be directly responsible for the administration of the correctional facilities or correctional system of a jurisdiction. ASCA endorses the use of physical restraints of pregnant inmates “only when absolutely necessary to protect the pregnant inmate from harming herself or others, and only in such a manner acceptable to and authorized by medical staff attending the pregnant inmate.”
  • The American Correctional Health Services Administration (ASHSA) is a national association of correctional health professionals. ASHSA supports banning the use of restraints on pregnant women during labor, delivery, and immediately after they have given birth. During the 2nd add 3rd trimesters of pregnancy, they support the use of restraints only when there is a safety or flight concern, and only in the form of handcuffs in the front.
  • The American Jail Association (AJA) is a national association that supports professionals who operate jails. It is the only national association that focuses exclusively on issues specific to the operation of local correctional facilities. AJA supports utilizing the least restrictive methods and restraints on pregnant inmates possible, and recommends that restraints should not be used during labor, childbirth, or postpartum recovery. They do, however, support exceptions for “extraordinary circumstances, which are defined as preventing the pregnant offender from escape or injuring herself or others....”

IV. Federal Laws & Policies

The extent to which federal correctional laws and policies include provisions for pregnancy-related health care, access to abortion, and restrictions on the use of restraints is one important indicator of how federal correctional facilities treat pregnant women in their custody, and ensure their constitutionally protected right to health care while incarcerated.

The federal Prison Rape Elimination Act includes standards for the provision of pregnancy- related health care to women who become pregnant as a result of sexual abuse while incarcerated. In addition, several federal agencies have policies in place that regulate the provision of pregnancy-related health care, access to abortion, and the use of restraints on pregnant women in federal prisons and immigration detention facilities.

IV-A. Federal Laws

Code of Federal Regulations

Tit. 28, § 115.81 Medical and mental health screenings; history of sexual abuse

Tit. 28 § 115.82 Access to emergency medical and mental health services

Tit. 28, § 115.83 Ongoing medical and mental health care for sexual abuse victims and abusers

* PDF, see pages 30-31

Summary

The Prison Rape Elimination Act (PREA) is a federal law that sets national standards to prevent, detect, and respond to sexual abuse in correctional facilities. The PREA standards are binding on the Federal Bureau of Prisons (BOP). While the standards are not binding on states, states that do not comply are subject to a five percent reduction in federal prison funding.

PREA standards stipulate that correctional facilities must provide victims of sexual abuse with access to timely and appropriate medical care at no cost, including access to pregnancy-related health care for women and abortion for women who become pregnant as a result of sexual abuse while incarcerated.

IV-B. Federal Agency Policies

Several federal agencies have policies in place that regulate the provision of pregnancy-related health care, access to abortion, and the use of restraints on pregnant women in federal prisons and immigration detention facilities. These standards vary.

Immigration and Customs Enforcement (ICE)

Immigration and Customs Enforcement (ICE) is a federal law enforcement agency under the Department of Homeland Security. ICE operates detention centers throughout the United States and detains individuals who are in violation of civil immigration laws and are facing removal proceedings.

Policies

ICE Performance-Based National Detention Standard: 2.15 Use of Restraints (PDF, see pages 213-214)

ICE Performance-Based National Detention Standard 4.4: Medical Care (PDF, see pages 304-308)

Summary

ICE regulations on health care for female inmates contain comprehensive requirements regarding the provision of pregnancy-related health care. Provisions are included for pregnancy options counseling, abortion, prenatal and postpartum care, lactation services, mental health services, appropriate nutrition, and parenting skills education.

In addition, ICE prohibits the use of restraints during labor and delivery, and limits use during pregnancy and postpartum to “truly extraordinary circumstances that render restraints absolutely necessary as documented by a supervisor and directed by the on-site medical authority.”

U.S. Marshals Service (USMS)

The United States Marshals Service (USMS) is an agency within the U.S. Department of Justice. The USMS is responsible for the custody and transport of federal prisoners, beginning at the time of arrest and ending when prisoners are acquitted, arrive at a designated Federal BOP facility to serve a sentence, or are otherwise ordered released from USMS custody.

Policies

USMS Policy Directive 9.5: Health Care for Pregnant Prisoners (PDF)

USMS Directive 9.18: Restraining Devices (PDF)

Summary

USMS policy directives state that all female USMS prisoners will receive medically necessary reproductive health care while in custody. Provisions are included for pregnancy testing, an initial sonogram to date the pregnancy, prenatal examinations according to ACOG standards, parental vitamin supplements, hospitalization for labor and delivery, and access to abortion. There is no provision for pregnancy options counseling.

With regard to the use of restraints, USMS requires correctional officers to use the least restrictive means possible to restrain women during pregnancy, and does not permit restraints during labor, delivery, and postpartum recovery.

The Federal Bureau of Prisons (BOP)

The Federal Bureau of Prisons (BOP) is the agency within the U.S. Department of Justice that is responsible for the administration of the federal prison system.

Policies

BOP Program Statement No. 6070.05: Birth Control, Pregnancy, Child Placement and Abortion (PDF)

BOP Program Statement No. 5538.05: Escorted Trips (PDF)

Summary

BOP facilities must offer a pregnant inmate medical, religious, and social counseling to aid her in making a decision whether to continue or to end her pregnancy. They must also provide her with medical, case management, and social services related to pregnancy, abortion, and child placement.

BOP policies prohibit the use of custody control belts when escorting pregnant women for medical trips, but permit the use of other restraints at the escorting officers’ discretion.

V. State Laws & Policies

The extent to which a state’s correctional laws and policies include provisions for pregnancy-related health care, access to abortion, and restrictions on the use of restraints is one important indicator of how that state treats pregnant women in its custody, and ensures their constitutionally-protected right to adequate health care while incarcerated.

Using the interactive map tool at the top of this page, click on a specific state to access links to the laws, standards, and DOC policies of that state.

The information provided in this state-by state directory is the result of the ACLU’s research to identify pregnancy-specific correctional policies that are publicly posted on state DOC websites or contained in databases of state laws and regulations. Please note that we have only included laws, standards, and polices that include pregnancy-specific provisions. Accordingly, this resource is not intended to provide an exhaustive survey of all laws, standards, and polices that may relate to, or inform, the treatment of pregnant inmates.

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