North Carolina Has a Policy Against Shackling Prisoners Giving Birth—So Why Is It Still Happening?

Advocates have formed a coalition to help stop shackling—and to address other prenatal and reproductive issues facing people in prison, beyond policy and legislative change.

[Photo: A prisoner's hands reach around the bars of their cell, connected by handcuffs.]
In most cases, shackling involves not only handcuffs, but also leg irons and a heavy chain looped around the belly. Chains attach the handcuffs, the belly chain, and the leg iron, leaving little ability for movement. Thawornnurak / Shutterstock

UPDATE, March 27, 11 a.m.: As reported by WRAL, the North Carolina Director of Prisons expanded its anti-shackling policy on Monday to ban the use of restraints “at the onset of contractions, during delivery, post-partum recuperation, during inductions, transportation for C-section and initial bonding with newborn.”

What should have been joyous occasions for two expecting parents in North Carolina instead turned into an ordeal involving handcuffs, restraints, and a refusal to recognize birthing as a medically significant process that also carries unexpected risks and dangers.

Why? Because these two people giving birth were under the custody of North Carolina’s Department of Public Safety, which operates the state’s prison system. The Department has had a policy prohibiting the use of restraints during childbirth since 2015.

And yet, the two still had to undergo labor in January while restrained.

On two separate days, the individuals incarcerated at the North Carolina Correctional Institution for Women (NCCIW) were brought to the local hospital to give birth. They were restrained throughout their labor.

Medical staff asked the accompanying officers to remove the restraints. The officers refused. When medical staff referred to the Department’s policy prohibiting restraints during labor, officers told them that the department defined labor as actual pushing.

North Carolina does not have legislation restricting shackling during pregnancy. What it does have is a 2015 policy, one that is vague enough that officers can—and, in at least these two instances, did—define as they see fit. The lack of clear policy means that countless people face the possibility of giving birth in some form of restraints. In 2017, 81 people in North Carolina gave birth while incarcerated. According to Pamela Walker, spokesperson for North Carolina’s Department of Public Safety, 50 pregnant people are currently incarcerated in North Carolina’s state prisons.

The North Carolina Department of Public Safety has not yet answered Rewire.News‘ questions about this policy or about the January incidents.

Across the nation, jail and prison staff routinely shackle people whenever they are taken out of the facility, a practice commonly known as shackling. In most cases, shackling involves not only handcuffs, but also leg irons and a heavy chain looped around the belly. Chains attach the handcuffs, the belly chain, and the leg iron, leaving little ability for movement.

Restraining a person during pregnancy has many medical risks. It can increase the person’s risk of falling, causing injury to the fetus. It also heightens the risk of blood clots, which is a major cause of maternal death. Restraints can also delay access to medical treatment during an emergency. Medical professionals and organizations such as the American College of Obstetricians and Gynecologists, the American Medical Association and the American College of Nurse-Midwives, have publicly condemned shackling pregnant people during labor and delivery as unsafe and dangerous.

Twenty-two states currently have laws that prohibit the shackling of pregnant prisoners during labor, delivery, or postpartum recovery. (Lawmakers in Kentucky and Connecticut are now considering anti-shackling bills.) Several state laws extend the prohibition to the second or third trimester of pregnancy. However, as people who have given birth behind bars in New York and Massachusetts can attest, laws on paper are not always put into practice. But in states that lack legislation, there is little recourse to either learning more about the pervasiveness of the problem or pressuring correctional staff to keep handcuffs and chains off people in labor.

In North Carolina, health-care workers later alerted SisterSong and Forward Justice, advocacy organizations that work around reproductive, racial, and economic justice. Alarmed, advocates wrote to both Erik A. Hooks, the head of the Department of Public Safety, and the department’s medical director, Dr. Armayne Dunston, outlining their concerns, the medical implications of shackling during childbirth, and how shackling could not only violate a person’s constitutional protection against cruel and unusual punishment, but also their human rights under the United Nations. They received a response from the department’s assistant counsel acknowledging their letters and stating that department officials would be making revisions to the policy.

According to a spokesperson for the Department of Public Safety, prison officials are currently consulting with the Federal Bureau of Prisons (which banned shackling during labor and delivery in 2008 and has control over federal prisons but no control over state ones), the National Commission on Correctional Health Care, and the American Correctional Association to help develop a revised policy. However, advocates’ repeated requests to be part of the policy revision process or to meet with Department officials have been denied.

Alongside this effort, advocates have formed a coalition to help stop shackling—and to address other prenatal and reproductive issues facing people in prison, beyond policy and legislative change.

“The policy win is only one step,” reflected Omisade Burney-Scott of SisterSong, which is taking the lead on the anti-shackling campaign, in a phone interview with Rewire.News. “You have to have implementation and monitoring and accountability. You can never rest on policy change as the end of the process. We’ve learned that with voting rights and with reproductive rights.”

“Experience teaches us that policy change on paper isn’t going to mean anything,” added Nia Wilson. Wilson is the co-director of SpiritHouse, a grassroots organization led by Black women, which has long worked around issues of mass incarceration, policing, and abolition in North Carolina. “The interpretation of the policy that exists is left up to them,” she reminded Rewire.News.

At the same time, Burney-Scott and Wilson know that shackling is only one of many concerns facing pregnant people in state prisons. “What do they have access to eat? What is their medical care? Do they have access to prenatal vitamins?” asked Burney-Scott. “We don’t know these things.”

Miea Walker spent four years at NCCIW (followed by another five years at the minimum-security Raleigh Correctional Center for Women, which has since merged with NCCIW). Though she was never pregnant while behind bars, she spent her first weeks in the prison’s reception area with pregnant people. Her bunkmate was pregnant and gave birth while Walker was her roommate.

In the prison’s reception unit, everyone was required to wake at 4:30 for breakfast, Walker said. After breakfast, women returned to their housing units where they were required to clean the living areas, bathrooms and bunk areas. “You could not lay down until 2 or 3 o’clock that day,” she told Rewire.News. “Remember, we’d have been up since 4:30.”

Pregnant women, including her bunkmate, were exempt from the prohibition against resting until mid-afternoon. They were also given extra food and extra milk. But, Walker added, as soon as they gave birth, they were immediately subject to the same taxing manual labor and lack of rest as everyone else. In addition, they had to contend with the abrupt separation from their newborn, a separation for which she never saw the prison offer counseling or support services.

Walker remembers being surprised when her roommate returned to the prison less than 72 hours after she was taken to the hospital to give birth. “It was very painful for her,” she recalled. “You’re incarcerated and have to deal with not being with your child day to day.” Shortly after giving birth, that roommate was transferred to another part of the prison. Walker recalled that some of the pregnant women in that dorm had been sentenced to prison terms as short as 90 days to one year.

Furthermore, both Walker and Burney-Scott note that, like everything pertaining to mass incarceration, these policies have a greater impact on people of color. “We know that people of color are disproportionately incarcerated,” pointed out Burney-Scott. In 2016, Black people made up 22 percent of North Carolina’s population but, inside its prisons, they were nearly half the population.

“Of the people who are pregnant [in prison], how many are people of color?” asked Burney-Scott.

In addition, throughout her interview with Rewire.News, Burney-Scott pointed out several times that not every person in a women’s prison identifies as a woman. But, she continued, how does the prison treat trans and/or gender non-conforming pregnant people? “We don’t know what that looks like in a prison.”

Walker now works as an advocate with Forward Justice. Reflecting on her years inside—and the invisibility of pregnancy behind bars during those nine years—she remembers, “It was never spoken about. I can’t give you one sister who spoke about what happened—giving birth, being shackled, having less than 72 hours before having to give her baby up.” In addition, the women inside often felt powerless and invisible, not only around pregnancy and birth, but about all of the other issues they encountered while incarcerated. “No one cares once you are fingerprinted, once you have a number. That’s what you’re labeled as.”

That’s what organizers want to change. As part of SisterSong’s anti-shackling campaign, they’re embarking on a storytelling project to identify and collect stories from people who have been either formerly incarcerated or employed at NCCIW.  Their goal is to increase public awareness and education around the Department’s practice and policy around shackling during pregnancy. “Our ultimate goal is a policy shift and a revision to the policy that is reflective of what we consider a human rights and reproductive justice framework and, of course, a high standard of medical care,” said Burney-Scott.