AILSA CHANG, HOST:
There's not much time left before Congress leaves town for the holidays, and one piece of legislation waiting for a vote is a criminal justice reform bill known as the First Step Act. It is now up to Senate Majority Leader Mitch McConnell to bring the bill up for a vote. We've been reporting on how this bill would reduce lengthy prison sentences, and that remains a sticking point for some lawmakers.
But today, we're going to focus on a less controversial provision in this bill - a ban on shackling pregnant women. About two dozen states already ban it in their own correctional facilities, but the practice persists in many parts of the U.S. And for more on why, we're joined by Dr. Carolyn Sufrin. She's a medical anthropologist and an obstetrician gynecologist at Johns Hopkins School of Medicine. Welcome.
CAROLYN SUFRIN: Thank you so much.
CHANG: I understand you've worked a lot with incarcerated women. Why are pregnant women being shackled in the first place?
SUFRIN: Well, part of the reason has to do with the fact that our correctional system was really designed with men in mind, maybe not intentionally, but they are presumed to be the default prisoner. And when taken off-site, all incarcerated persons are presumed to be dangerous and a potential flight risk. And a pregnant person needs to be taken off-site for medical attention at times and when it's time for child birth. And so when she's in a public space, the presumption is that she must be a flight risk, and she must be a public safety risk. That is the default assumption.
CHANG: And what do we mean when we say shackled? Are we talking about just, like, one handcuff on one wrist?
SUFRIN: So the more general term that the laws refer to is restraints, the use of restraints in pregnancy. And that includes many different ways of applying restraints. It can include handcuffs in front or behind the back. It can include chains around the ankles, belly chains, chaining a person to another person. When the term shackles is used, it often refers very specifically to a configuration that can sometimes look like four-point restraints. But when people use it...
CHANG: You mean four limbs being restrained.
SUFRIN: Four limbs, but it's often colloquially used to describe more generally the use of restraints in pregnant women in a variety of ways.
CHANG: You're an OB-GYN. Can you just explain, why is it dangerous for a pregnant woman to be shackled?
SUFRIN: There are so many risks involved with shackling a pregnant woman. In labor, there are emergencies that arise unexpectedly where we might need to do an emergency C-section if there are signs of distress or the baby's shoulder could get stuck in the birth canal. As a health care professional, we need to focus on our patient, not on asking a guard to unshackle her. If a pregnant woman falls, she could have a dangerous condition where the placenta separates, and she could hemorrhage, and shackles can increase her risk of falling and also prevent her from breaking a fall if she does fall. But on top of all of that, you know, the chances that a woman in the middle of labor or even not in labor but a pregnant woman could outrun someone and be a flight risk are just ludicrous to me.
CHANG: And what's the criminal background generally of most of these women who have been pregnant while incarcerated?
SUFRIN: Most of the pregnant women who are incarcerated in our country, and this is true of women in general who are in custody, have been arrested or convicted of nonviolent charges. The majority have other conditions in their lives that have determined their pathways to the criminal justice system that I as an OB-GYN also think of as social determinants of health, such as poverty. They struggle often with addiction, with histories of untreated mental illness, especially sexual and physical trauma histories. These women are not hardened, violent criminals.
CHANG: Have you ever been present during the delivery of a woman who was giving birth while being shackled?
SUFRIN: I have. When I was a first-year OB-GYN resident in training in Pennsylvania, I delivered the baby of a woman who was shackled to the bed. I had no idea that this was even possible, and I didn't know if I was authorized to ask the guard to unshackle her. And I just kept worrying about what I would do if there was an emergency. Luckily, the birth itself went fine, but this was a deeply troubling moment for me - of course much more so for the woman herself. But it's a pretty harrowing experience to have to practice medicine with someone who is in chains.
CHANG: Dr. Carolyn Sufrin of Johns Hopkins School of Medicine, thank you very much for coming in today.
SUFRIN: Thank you so much for having me, Ailsa.
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