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From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

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And I'm Robert Siegel.

When prison inmates go to a hospital for treatment, they're usually wearing handcuffs and other shackles, and that apparently includes some pregnant women in labor. There's evidence around the country that that still happens: women giving birth with an arm or a leg shackled to the bed.

There's a growing movement opposing this. Ten states have outlawed it. Pennsylvania did so just two weeks ago. And there are lawsuits. Just yesterday, a jury in Arkansas found that a guard had violated the constitutional rights of a woman by shackling her in labor. The jurors awarded her one dollar.

NPR's Andrea Hsu went to Chicago to report on a class-action lawsuit there.

(Soundbite of baby crying)

ANDREA HSU: Twenty-five-year-old Jennifer Farrar is home with her third child, a mischievous little girl, Brianna(ph).

Ms. JENNIFER FARRAR: My mom has called her my partner in crime because she was in my belly. She was with me the whole time.

HSU: In November, 2008, Farrar got caught cashing fake payroll checks. She was charged with forgery. Officers booked into the Cook County Jail, a sprawling complex on the southwest side of Chicago. She was almost seven months pregnant.

Then one day the following January, Farrar went to court for a hearing. It was there that the pains began. An ambulance was called. Farrar says officers cuffed her hands and chained her legs together. Another chain around her belly connected her hands to her feet. She says when she got to the hospital, the belly chain was removed but her legs were left shackled and one hand was cuffed to the bed.

Ms. FARRAR: And the doctor and the nurse, they were, like, you know, telling the officer, like, is this necessary, you know? Like, where is she going to go? She's in labor, you know.

HSU: She says she remained that way for eight or nine hours.

Ms. FARRAR: Up until I was ready to push. The doctor is like, she's got to push now, so her legs have to be open. So you have to take the shackles off.

HSU: The correctional officer unlocked the leg restraints but left her handcuffed to the bed. An hour later, Jennifer Farrar delivered her baby girl.

Ms. FARRAR: Here I am, a mother giving birth. It should be a happy time in my life, you know. I know that I did something wrong, and you have to take the responsibility for what you do. But it wasn't like I was a murderer, you know.

Ms. GAIL SMITH (Executive Director, Chicago Legal Advocacy for Incarcerated Mothers): I think that there is a general attitude on the part of some people that they don't deserve to be treated with full human rights, and I find that appalling.

HSU: Gail Smith is with the group Chicago Legal Advocacy for Incarcerated Mothers. She thinks what Farrar went through is essentially torture. The American College of Obstetricians and Gynecologists also condemns shackling, saying that physical restraints have put the health and lives of women and unborn children at risk. And an Illinois statute passed in 1999 clearly forbids the shackling of women in labor.

Mr. STEVE PATTERSON (Spokesman, Cook County Sheriff Tom Dart): The issue is: When is a person in labor?

HSU: Steve Patterson is the spokesman for Cook County Sheriff Tom Dart. The sheriff and the county have been sued by Jennifer Farrar and 21 others.

Mr. PATTERSON: A correctional officer working on a tier on the midnight shift is not trained - or any other shift, is not trained to know when a woman is in labor or not.

HSU: Therefore, Patterson says, they rely on medical personnel to make that call, and only then do the restraints come off. He says that policy is consistent with state law and is necessary in a public hospital.

Mr. PATTERSON: We have to bring inmates to the same area that the general public comes to. So, if you're laying in a hospital bed and in the next hospital bed is a woman who is in on a double murder charge, because she's pregnant, she shouldn't be handcuffed to the side of the bed? I think if you're the person lying in the bed next to her, you might disagree.

HSU: No one is sure of just how many incarcerated women give birth every year. It's thought to be more than 1,000. And no one knows how many women are shackled. Over the past few weeks, I heard stories from around the country but had a hard time finding real numbers.

And then I heard about Ginette Ferszt, a professor of nursing at the University of Rhode Island. She, too, wanted a better understanding of how correctional facilities deal with pregnant inmates. So last year, she and the Rhode Island state prison doctor sent out questionnaires to wardens in all 50 states. Nineteen replied.

One question she posed was about shackling during transport to hospitals for prenatal visits.

Ms. GINETTE FERSZT (Professor of Nursing, University of Rhode Island): I think what I was quite, quite surprised at is that two continued to use leg irons and belly chains and handcuffs.

HSU: Ferszt also found that among the 19 prisons that responded, six of them cuff either a woman's hands or her ankle at the beginning of labor. Then during delivery of the baby, one prison said handcuffs stay on, while four reported that they keep an ankle shackled.

As for the 31 prisons that didn't respond to the survey, Ferszt says she's quite certain that at least some of them still shackle. When she spoke with two wardens about the practice, she found it wasn't something they'd really thought about.

Ms. FERSZT: It sort of was not on their radar screen. You know, they hadn't really considered looking at these policies. It hadn't really occurred to these two wardens that this could potentially be a health problem, a health issue.

HSU: Both have since told her they'll sit down and make changes.

In Cook County, Illinois, Jennifer Farrar's attorneys believe there could be many more women joining their class action suit. Cora Fletcher has already signed on. In 2006, when she was 17, Fletcher was charged with retail theft. A year later, she missed a court date, a warrant was issued for her arrest. A year after that, officers showed up at her house and took her in eight months pregnant.

Ms. CORA FLETCHER: When I got to the police station, there was a sergeant there, and he saw that I was pregnant. He asked the police officers: You all didn't have nothing else to do?

HSU: A couple weeks later, in a prenatal checkup at the jail, it was discovered that Cora Fletcher's baby had no heartbeat. They took her to the county hospital, and there:

Ms. FLETCHER: One arm was cuffed on one side of the bed rail. The other arm was cuffed on the other side of the bed rail. One feet was cuffed on one side of the bed rail, and the other feet was cuffed on the other side of the bed rail.

HSU: Doctors tried to induce her, but it wasn't until three days later that she went into labor. Even then, she says, she was left with one hand and one leg shackled to the bed.

Ms. FLETCHER: It was difficult to try to have a baby like that, especially that is being my first baby, and it was so painful, and it hurted so bad, and you know, you can't even move around and stuff like how you want to.

HSU: After it was over, Cora Fletcher held her stillborn child for 20 minutes. I asked Steve Patterson, the sheriff's spokesman, if Fletcher's case represents a violation of prison policy.

Mr. PATTERSON: I don't know. That goes back to the original question posed of what is labor, what is delivery? And I personally don't know the answer to that. I don't know at what point the doctors deemed her to be in labor. Again, that's not our call.

SHU: Two years on, Cora Fletcher has a healthy baby boy and another baby on the way. Jennifer Farrar says Brianna will be her last her child. It stunk that it was a bad experience, she says, but I'm done.

Andrea Hsu, NPR News.

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