Bodies in a Zone of Indistinction: a history of the Biomedicalization of Pregnancy in Prison



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Unshackling Movement

In recent years, the unshackling movement has gained momentum in many states as they reevaluate their policies on restraining pregnant women during their labor and delivery. Aided by media groups disseminating information about past travesties of prisons that neglected pregnant inmates calls for medical help and that the use of restraints caused complications during their labor, the publicity received from these new stories has led to a number of states passing anti-shackling laws in their states.72 Buffered by the support of advocates in healthcare professions, the logos of medical recommendations have helped to shape the argument for passing such laws across states.

New York’s Anti-Shackling Bill, passed in 2009, develops a similar medical rhetoric used in recommendations for improving prenatal care and labor preparation. By mandating that prison personnel following medical advice in the treatment of inmates during labor, this law seemingly places medical authority and the health of women as higher imperatives than the prison’s correctional purposes:

NO RESTRAINTS OF ANY KIND SHALL BE USED WHEN SUCH

WOMAN IS IN LABOR, ADMITTED TO A HOSPITAL, INSTITUTION

OR CLINIC FOR DELIVERY, OR RECOVERING AFTER GIVING BIRTH.

ANY SUCH PERSONNEL AS MAY BE NECESSARY TO SUPERVISE

THE WOMAN DURING TRANSPORT TO AND FROM AND DURING

HER STAY AT THE HOSPITAL, INSTITUTION OR CLINIC SHALL

BE PROVIDED TO ENSURE ADEQUATE CARE, CUSTODY AND

CONTROL OF THE WOMAN. THE SUPERINTENDENT OR SHERIFF

OR HIS OR HER DESIGNEE SHALL CAUSE SUCH WOMAN TO BE

subject to [her] return to such institution OR LOCAL CORRECTIONAL

FACILITY as soon after the birth of her child as the state of her health will

permit AS DETERMINED BY THE MEDICAL PROFESSIONAL

RESPONSIBLE FOR THE CARE OF SUCH WOMAN.73


Despite her being under the supervision of medical professionals, this law’s call for penal supervision to ensure the “care, custody and control” of the inmate still evokes the prison’s language of discipline, and the very administration of medical care remains deeply engaged within the political spheres of prison through act of possessing the custody and control “OF THE WOMAN.” In this manner, the woman’s body is still objectified as a risk, a site in need of control of both medical and penal supervision.

Texas state law Section 501.066 also bans the use of restraints during labor and delivery, but provides the following stipulations for prisoners deemed likely to harm others or to escapes from the hospital:

Sec. 501.066. RESTRAINT OF PREGNANT INMATE OR DEFENDANT.


  1. The department may not use restraints to control the movement of a

pregnant woman in the custody of the department at any time during

which the woman is in labor or delivery or recovering from delivery,

unless the director or director’s designee determines that the use of

restraints is necessary to:



  1. ensure the safety and security of the woman or her infant,

department or medical personnel, or any member of the public; or

  1. prevent a substantial risk that the woman will attempt to escape.

  1. If a determination to use restraints is made under Subsection (a), the

type of restraint is used must be the least restrictive available under the circumstances to ensure safety and security or to prevent escape.74
This section of the law indicates that the state still has greater authority than medical professions if the pregnant inmate is deemed to be a threat for those in the hospital or a risk for escaping into the free world. Under the auspices of “safety and security,” the state’s imperative to maintain possession of its pregnant inmates under perpetuates the idea that attention must be paid at all times, and that even while in labor these women present potential threats to herself, “her infant, department or medical personnel, or any member of the public.” Thus, at least in Texas, the will to secure the pregnant inmate labeled hazardous trumps medical advice to provide her an experience of labor and deliver without restraints.

In Florida, a proposed bill relies heavily on medical advice to advocate for outlawing shackling practices in state prisons:

WHEREAS, restraining a pregnant prisoner can pose undue health

risks and increase the potential for physical harm to the woman and her

pregnancy, and

WHEREAS, the vast majority of female prisoners in this state are

nonviolent offenders, and

WHEREAS, freedom from physical restraints is especially critical

during labor, delivery, and postpartum recovery after delivery as women

often need to move around during labor and recovery, including moving

their legs as part of the birthing process, and

WHEREAS, restraints on a pregnant woman can interfere with the

medical staff’s ability to appropriately assist in childbirth or to conduct

sudden emergency procedures, and

WHEREAS, the Federal Bureau of Prisons, the United States Marshals

Service, the American Correctional Association, the American College of

Obstetricians and Gynecologists, and the American Public Health Association

all oppose restraining women during labor, delivery, and postpartum recovery

because it is unnecessary and dangerous to a woman’s health and well-being,

NOW, THEREFORE,

Be It Enacted by the Legislature of the State of Florida:

Section 1. Shackling of incarcerated pregnant prisoners.—

(1) SHORT TITLE.—This section may be cited as the “Healthy

Pregnancies for Incarcerated Women Act.”75


In this bill (unlike Texas’s law), shackling is considered a threat for “physical harm” to the inmate and “dangerous to a woman’s health and well-being.” Recognizing the nonviolent nature of most female prisoners, the “critical” importance for freedom from constraints during labor, and the threat restraints pose in the advent of “sudden emergency procedures,” the bill claims the language of “health” to advocate for altering the Florida prison system. Moreover, in evoking the policy recommendations of the American College of Obstetricians and Gynecologists (ACOG) and the American Public Health Association (APHA), this bill gives credence to the power of medical authorities to help inform the manner in which healthcare is administered for prisoners.

As healthcare professionals make inroads into changing policies in prison to better serve the goals of medicine, they must often negotiate the imperatives of prisons as well. While some states like New York give more credence to physician’s advice, states like Texas have TDCJ supervisor determine whether or not pregnant women pose enough threat to receive shackles during labor, and the treatment of the prisoner ultimately remains the State’s power. Likewise, in states like Florida, the recommendations given by the ACOG, the APHA, and other professional health organizations clearly hold greater sway than in other states for passing laws against shackling. Through reading the bills and amendments, the co-constitutive nature of medicine and law becomes quite evident here as well.






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