Shackled: The Devastating Reality of Childbirth Behind Bars
Pamela Winn was once inmate number 54458-019. Today she is the founder of RestoreHER, a reentry advocacy organization led by and for women of color based in Georgia. That’s because when she was incarcerated, Winn experienced a trauma no living being should ever have to.
In 2008, Winn was facing charges for a white collar crime. She was in the Robert A. Deyton Detention Facility in Georgia, a federal holding center. Winn, 39, along with other prisoners, was shackled by her hands and feet, with handcuffs, leg irons, and waist chains, while she was transported back and forth to court. That same year, she found out she was pregnant.
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“One of the days that we were going to court, the ankle cuffs were really tight on my legs and like biting into my ankles,” says Winn. “The pain was excruciating, causing me to fall when I tried to step up into the van.”
Winn says guards quickly scooped her up but paid her no further mind.
When she returned to the detention facility, she says, she started bleeding. First it was just spotting, but then got heavier. Winn says she wrote medical request after medical request, for weeks. Before her incarceration, Winn was a registered nurse specializing in women’s health. She knew the bleeding was a sign that something happened to her baby when she fell.
Finally, Winn was admitted to the facility’s medical unit. She recalls the director and contracting physician, both black women like Winn, were there. They knew that Winn was an RN and she felt like they sympathized with her.
“And so because of that, they wanted to give me the professional courtesy of speaking to me themselves and letting me know that there was nothing that they could do for me, that the facility was built for men,” she says. “They didn’t expect to have women, definitely didn’t expect to have a pregnant woman.”
It took nearly three months before she was able to get cleared to see an obstetrician, but the obstetrician didn’t have the ultrasound equipment Winn needed. So she put in another request for another doctor. Four weeks later, while she was waiting for a reply, her worst fear happened.
It was around 10 p.m., during lockdown. “It was brown water coming out of the fountain this particular day. I hadn’t drank anything at all,” says Winn. “The only other beverages we had were some orange, purple, or red drink that came with our food, which I didn’t wanna drink because I knew it wasn’t good for my pregnancy.”
That’s when she started cramping. She thought it was from dehydration, so she began to drink the brown water out of the sink.
“The cramps got worse. I laid down, tried to go to sleep, thinking when I woke up, you know, it would be over,” she says. “But the cramping woke me up out of my sleep and at this point I was having full-blown contractions.”
Then she felt a warm goo between her legs.
“They didn’t have a call button or any way to notify anybody,” she says. It was pitch black in the cells.”
She woke up her cellmate, who started screaming and banging on the door for help. Something was wrong with the baby.
“So just based on my own medical experience and what I knew, just common sense, I just laid down, squeezed my legs tightly, hoping that somebody would come around soon and make rounds,” she says.
But it was over four hours before anyone came. When the guards arrived, they found that the warm goo between her legs was blood. It was everywhere.
“I was losing so much blood and they were debating between the officers and the nurses about what to do with me.” Winn says she was begging the correctional staff to call 911. Finally, she says, after her blood pressure dropped significantly, they decided to take her to the hospital.
They put her on a stretcher and shackled her wrists and ankles to it. This is standard correctional facility transport procedures to prevent escape and for security concerns — to protect hospital personnel from potential violence. Historically and appallingly, this shackling has been maintained during actual labor and delivery.
Once she got to the hospital, she was placed in a room, still bound to the bed, with male guards watching her. Eventually, she was informed by a nurse that she had miscarried.
“That’s how I endured the remainder of my miscarriage — with two male officers between my legs refusing to give me any privacy. I asked would they at least just step to a different side of the room? They refused to even do that,” she says. “I felt like an animal. It was very dehumanizing and very embarrassing.” She was in the hospital where she had trained in labor and delivery. She knew many of the nurses. She says for them to see her like that was humiliating.
Holding back tears, Winn said after the hospital, she was placed in solitary confinement for 8 months for “medical observation.” PBS documented Winn’s story in a short video.
As harrowing it is, however, Winn’s story is not unique.
The U.S. prison system is fundamentally designed to incarcerate men, and nowhere is that more clear than looking at facilities for childbirth. In most cases, pregnant women are transferred to medical facilities for labor and delivery. Yet the number of pregnant women who enter jails and prisons each year is estimated to be over 58,000, and actual numbers are not collected by government officials so the real number is likely much higher. Thousands of these women give birth while incarcerated in facilities that are often not equipped to deal with them.
Women’s incarceration rates are growing at more than twice the rate of men’s, according to the Prison Policy Initiative. Since 1978, women’s state prison populations grew at 834 percent, with poor women of color disproportionately incarcerated. On Season 2 of my Lava for Good podcast, Wrongful Conviction with Maggie Freleng, I highlight many of these women’s stories and the circumstances surrounding their incarcerations — from being subject to inadequate medical treatment during their pregnancies and experiencing horrific conditions while giving birth to having their newborn babies taken away with no chance of reunion.
A 2018 study found that among hospital nurses who said they cared for incarcerated pregnant women, 82.9 percent said that their incarcerated patients were shackled, sometimes all of the time.
The inhumanity and degradation here is self-evident. Women shouldn’t be shackled during childbirth, and babies shouldn’t be born into immediate trauma. A shackled labor and delivery also presents serious health risks for the mother and the baby, and it has detrimental child-development ramifications for the newborn. Shackling limits the ability of a woman to move during labor, leaving her unable to shift positions to avoid pain and ease the baby out. The American Congress of Obstetricians and Gynecologists (ACOG) has stated that shackling interferes with the ability of physicians to safely practice medicine and is “demeaning and unnecessary.”
Fortunately, there have been some initiatives and advocacy that have eliminated the barbaric practice of shackling. The First Step Act, a wide-ranging federal criminal-justice reform bill passed in 2018, prohibits restraints during pregnancy, labor, and postpartum recovery. Ms. Winn was key in helping it to pass. However, according to the Equal Justice Initiative, only about 15 percent of the over 225,000 women incarcerated today are in federal prisons where they are protected by this law.
So Winn also made it her mission to pass state laws, particularly in the South. Today, at least 37 states have laws limiting the shackling of pregnant prisoners.
Besides the cruelty of shackling — and the very serious health risks of giving birth in this manner — the practice defies common sense. How much of a violence risk or an escape threat is a birthing woman with an armed guard standing watch?
In addition to shackling, the prison system is often negligent with other necessary aspects of childbirth, like bonding.
In 2011 Veronica Taft entered the Broom County Jail in Binghamton, New York three months pregnant. Taft tells a heartbreaking story of being induced over a month early to make sure she had her baby at the hospital while she was there. She was shackled during the birth and after:
But she says, the worst part was after the birth; she only got to see her son two times for 10 minutes. “They shackled me, my ankles and my wrist, to the wheel chair for me to go to the NICU to see my son,” she says. After that, he was taken from her custody and placed in foster care, despite Taft having people she trusted willing to care for her son.
Taft had her conviction overturned in 2016 but is still fighting to get her son back.
Typically, the bond between a newborn and a mother can take several days to a few weeks to form. This is a sacred time for child development, connecting a baby with its primary person. These moments can have lasting psychological effects on the newborn that can carry into adulthood. Often in a correctional setting, mothers are allowed only one to three days with their newborn. After that, the mother is returned to incarceration, and the infant is handed over to relatives or placed in foster care.
One study found that children separated from their incarcerated mothers in the early years were more anxious and depressed than children who were raised in prison nurseries where they experienced early maternal interaction. Fewer than a dozen states have operational prison nursery programs allowing mothers and their children to spend this essential time together.
In July 2021, the state of Minnesota made history with the Healthy Start Act, which ends the traumatizing practice of separating incarcerated parents from their newborns during crucial bonding time. In addition, the law also provides mothers pre- and postnatal care in community-based prison alternative settings.
Although some steps have been taken to enact change, there are still too many women dehumanized pre-, during and post-birth. To help make a difference, there are many options. Supporting and partnering with advocacy groups such as Ms. Winn’s RestoreHER, The Rebecca Project For Justice, American Civil Liberties Union, and Advocacy and Research on Reproductive Wellness of Incarcerated People who are actively lobbying for change is one route. You can also join the cause by reaching out to your state’s elected officials directly to demand that their states pass protective laws for incarcerated pregnant women and their newborns.
Every mother is entitled to a safe and healthy child birthing experience. Every newborn deserves to be treated humanely. As a society, we can’t ignore these basic human needs. The U.S. prison system must reform its policies concerning incarcerated pregnant women.
Maggie Freleng is a Pulitzer Prize Award-winning producer and podcast host and one of the foremost journalists in criminal justice reform today. She hosts the Lava for Good podcast Wrongful Conviction with Maggie Freleng, a series that features intimate conversations with people who have spent years in prison for crimes they did not commit.
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