Mothers in shackles

Carolyn Moynihan
16 July 2014
Reproduced with Permission

One of the most distressing details to emerge from the persecution of Sudanese Christian Meriam Ibrahim is that she was forced to give birth in prison with her feet shackled . Together. "I gave birth chained, " said in a telephone interview with CNN on July 1. "Not cuffs - but chains on my legs. I couldn't open my legs so the women had to lift me off the table. I wasn't lying on the table."

The gratuitous cruelty of this treatment of a mother and baby fills one with revulsion for the sharia legal system under which it took place. Meriam was already in prison - on account of her crime of "apostasy". She could not run away. She was not accused of making trouble in the prison - everything points to her quiet dignity, even after being sentenced to flogging and death.

What possible reason could justify chaining her legs together so that she could not labour and deliver the baby in a natural way? None at all. This appears as arbitrary punishment, intended to frighten and humiliate Meriam and possibly even to harm her and her baby. It was an attempt to demonstrate her worthlessness in the eyes of the law and God.

(And it did frighten her. A doctor herself, she was convinced following the traumatic birth that baby Maya might never walk. However, a doctor who visited her in the US Embassy in Khartoum has reassured her, according to a report in the Daily Mail.)

Such a thing, surely, could only happen in those benighted regions of the world where extreme Islamism or some other fanatical ideology holds sway - one that respects mothers and their babies only when they serve political or religious ends.

Alas, that is not the case. The shackling of pregnant women for security reasons was a standard practice in Britain until 1996. An Australian Ombudsman found it necessary in 2012 to recommend that a pregnant woman should never be restrained during labour. And a recent Briefing Paper of the American Civil Liberties Union (ACLU) states: "Although widely regarded as an assault on human dignity as well as unsafe medical practice, women prisoners are still routinely shackled during pregnancy and childbirth," in the US.

Handcuffs, leg shackles and waist restraints may be used during transport to prenatal and postnatal appointments, and even during labour, delivery and immediately following childbirth. The ACLU cites the notorious case of Shawanna Nelson, a 29-year-old non-violent offender who was six months pregnant with her second child when she was incarcerated by the Arkansas Department of Corrections (ADOC) in June 2003.

Three months later, after going into labor, she was taken to a local hospital where correctional officers shackled her legs to opposite sides of the bed. Nelson remained shackled to the bed for several hours of labor until she was finally taken to the delivery room.

The shackles caused Nelson cramps and intense pain, as she could not adjust her position during contractions. She was unshackled during delivery, but was immediately re-shackled after the birth of her son. After childbirth, the use of shackles caused her to soil the sheets of her bed because she could not be unshackled quickly enough to get to a bathroom.

A federal appeals court in 2009 condemned the shocking treatment of Shawanna Nelson, saying that it violated constitutional protections of prisoners' health. Subsequently the American College of Obstetricians & Gynaecologists and the American Medical Association issued statements opposing shackling. Various other professional associations and public agencies have at different times recommended limiting use of restraint, especially during childbirth. But to date, only 10 states have laws prohibiting shackling (with exceptions for serious security risks) and another eight have legislated to limit the practice.

In 2010, Pennsylvania passed a law, the Healthy Birth for Incarcerated Women Act, stating that, starting from the beginning of the second trimester, pregnant women prisoners can only be shackled during prenatal and postnatal doctor's visits, transport, and labour under "extraordinary medical or security circumstances." Furthermore, each time shackles are used, the reason for the decision must be documented in reports filed with the Pennsylvania Department of Corrections. Leg and waist restraints during labour are prohibited (meaning that a hand could be shackled). In all cases, only the lightest restraint deemed necessary must be used, and medical staff can request removal.

However, in a letter to the state Attorney-General in May the ACLU says the law is not being consistently observed. It says that a survey of staff at 26 hospitals between 2011 and 2013 (the Duvall Project) showed restraints were "routinely being used" on women in their second and third trimester during transport, despite low numbers reported to the DOC. Staff at one large women's hospital said that "a significant number of women are still being handcuffed to their beds during deliveries and prenatal testing" and that leg restraints were also occasionally being used. In one case a woman imprisoned near Pittsburgh who was seven months pregnant tripped and fell face down during a hospital visit because of her leg and waist restraints.

Another survey in the state showed that "the vast majority of clinicians were unfamiliar with the law, and most did not know that they could ask a correctional officer to remove restraints from any pregnant patient."

California recently (2012) tightened its 2005 law on restraining pregnant prisoners, but a report by Legal Services for Prisoners With Children in February claims that only 21 of 55 counties in the state had policies fully compliant with the new law, and that another three counties had failed to respond to the advocacy group's request for a copy of their policy.

It does seem that the US is trying to bring an end to the demeaning and dangerous practice of putting shackles on heavily pregnant and birthing women. If it has been slower than some countries that may be because of the sheer volume of people passing through its prisons. The female population has surged over the past two decades, largely because of a crackdown on drugs - a quarter of the women (if not more) in prison currently are there for drug-related but non-violent crimes. Although pregnant women with addiction problems may pose a security risk, most female prisoners are low-security and in prison for short terms, according to ACLU.

Hard cases are one thing, but the continuation of a practice condemned over and over again by United Nations treaties as "inhuman and degrading treatment" simply because it's "standard" and prison authorities have not got around to reviewing it, or because doctors and nurses "don't know" they can ask for a prisoner in the labour ward to have her shackles taken off, is just wrong.

Handcuffs and sometimes leg chains may be a necessary part of the general humiliation that comes with arrest and imprisonment, something the prisoner has brought on himself, but the idea of a heavily pregnant woman in shackles is deeply disturbing. A mother about to give birth, and her baby, are among the most vulnerable of human beings and they deserve special care and respect, even if the mother is some kind of criminal.

It appears that other Western countries have woken up to this. The alternative for that part of America which has not is to be seen in the same league as Sudan. It might not throw women into prison for being Christians, but its attitude to those who are pregnant would still be appalling.