August 1, 2005 - San Jose Mercury News (CA) Legislation Calls For An End To Cuffing Women During Labor Bill Aims To Limit Inmate Shackling By Karen de Sá, Mercury News

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Desiree Callahan raced in an ambulance to deliver her first-born at a Madera hospital, racked with contractions every three minutes, her ankle chained to a gurney.

Even after she had general anesthesia and an emergency C-section, the state of California still considered the 21-year-old serving time in a San Joaquin Valley prison a flight risk. As Callahan regained consciousness and learned that her baby girl had died shortly after birth, the shackles were there, securing her to the bed rail. She remained in cuffs for most of her four-day hospital recovery last spring, under the constant watch of an armed guard.

In California and across the country, female prisoners are routinely shackled for most of labor and immediately after childbirth -- a longstanding practice opposed by a growing number of legislators and even a spokesman for the conservative guards union. A bill introduced by Assemblywoman Sally Lieber that would ban the practice has moved from the Assembly into the Senate.

"They've got to do what they've got to do, but at the same time it's humiliating,'' Callahan said this week, days after her release from 20 months in the Valley State Prison for Women. "And it's just ridiculous. If I really wanted to -- even if I had a ride and everything -- I couldn't make it out the front door.''

The practice of shackling laboring inmates is defended by the state Department of Corrections and Rehabilitation, although there is no known record of an escape or assault by a prisoner giving birth. All inmates, male and female, who leave state institutions for community hospitals are shackled and guarded by at least one armed correctional officer. That includes the 185 female prisoners on average who give birth each year in California.

"Basically, we don't want them to escape -- that's the bottom line,'' said department spokeswoman Terry Thornton. "It's part of our mission of public safety. When any inmate is away from the institution, they need to be appropriately supervised and restrained to prevent escape.''

But Lieber, a San Jose Democrat, calls applying such a rule to pregnant inmates "an inhumane practice'' that violates United Nations prison standards.

"When we have individuals who are incarcerated, we have a duty to provide minimum standards of health care, particularly when there is a newborn involved,'' she said.

The treatment of pregnant inmates is yet another example of the deteriorated state of the state's $1.1 billion prison health care system, where custody trumps treatment. Even comatose and brain-dead inmates are shackled and guarded on overtime at tremendous cost to taxpayers.

As many as 64 California prisoners die unnecessarily each year from medical negligence or malpractice, according to the U.S. District Court, which seized control of the system July 1. The receiver has yet to be named, and it is unlikely the treatment of prisoners giving birth will be an immediate priority.

But Justice Now and other Bay Area prisoner rights groups are taking up the cause, documenting cases of mothers at the Valley State Prison for Women in Chowchilla -- where more than 100 pregnant prisoners are housed on any given day. They deliver at the nearby Madera Community Hospital.

Shackling Practice

In general, the women ride to and from the hospital in handcuffs. Inside, they can be shackled to a bed during early labor, a critical period when walking and changing positions assists the progress and comfort of delivery. Per department policy, after giving birth, they have one leg shackled to the bed for the duration of their stay.

Callahan, a first-time offender from Merced, said the shackles were more than emotionally traumatic -- they made her physical recovery more difficult. "You have to be stuck to a bed even though the doctors say you need to get up and walk because your stomach was cut open,'' she said. "They uncuffed me because a doctor and a nurse had given direct orders for me to walk around.''

Between 1998 and 2004, California prisoners gave birth to 1,300 babies, the majority conceived before their mothers' sentencing. Most of those babies went home with relatives or into foster care.

Pregnant inmates get extra milk with meals and the services of a "doula'' -- a trained labor coach who runs weekly childbirth preparation classes and provides bedside support during delivery.

According to prison officials, hospital doctors decide when a patient is in "active labor,'' and that is when restraints are removed. But that stage is ill-defined.

"Active labor means contractions that are regular, forceful and coordinated, and that can go on for 36 hours,'' said Corey Weinstein, a correctional medical consultant who serves on the board of the San Francisco-based California Prison Focus. Women interviewed by advocacy groups report being restrained until the pushing stage, the last part of active labor, a practice Weinstein described as "barbaric.''

Practice Not Uncommon

Although the American Public Health Association opposes shackling prisoners during childbirth, it is not uncommon nationwide. According to a 2001 Amnesty International report, 21 state departments of correction allow women to be restrained during labor and delivery.

Yet even the California Correctional Peace Officers' Association, the guards' union typically opposed to loosening restrictions on inmates, called the practice inhumane.

"Obviously there's a security risk any time a prisoner is not restrained,'' said union spokesman Lance Corcoran. "But labor is such an intense experience that I think the risk is very minimal.''

Speaking as a father and a correctional officer, Corcoran said he favors a policy change, with exceptions for high-risk inmates. "The personal presence of an officer would be sufficient in most cases,'' he said. "Certainly, shackling someone to a bed when they're in labor and transition is horrible. It just doesn't make any sense.''

Department officials said pregnant inmate issues may be addressed by a new Gender-Responsive Strategies Commission, which includes staff members and outside experts. So far, the commission has developed soon-to-be-implemented regulations eliminating body searches of female inmates by male staff members. More than 57 percent of the 11,000 incarcerated women in California are victims of sexual or physical abuse, and the searches are believed to exacerbate their trauma.

Department spokeswoman Thornton said the state will investigate or rethink any other questionable policies. But in the end, she said, "security is paramount.''

Contact Karen de Sá at kdesa@mercurynews.com or (650) 688-7587.

© 2005 MercuryNews.com

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