While you are pregnant your health needs extra attention to ensure that you and your baby are healthy and that you have as few complications as possible during your pregnancy.  You should be able to ensure that your health and that of the baby are protected even while you are in jail or prison.  On May 15, 2014, Massachusetts passed a law, G.L. c. 127, § 118, making it illegal to shackle pregnant persons in most circumstances and requiring correctional facilities that hold women to provide basic prenatal education and care.  This law is very important in establishing the rights of pregnant persons incarcerated in Massachusetts.  Its requirements apply to all correctional facilities in the state. 

If you are a pregnant person incarcerated in Massachusetts, you can contact PLS for assistance in obtaining the rights provided by this law.  We are especially interested in tracking and addressing any improper use of restraints on pregnant and post-partum persons.  If you are expecting to give birth while incarcerated, please contact PLS in advance of your due date and discuss your situation with us.  If you would like us to advocate for removing restraints, if any restraints are used during your labor or post-partum period, it would be best for us to have releases of information on file.  Even if you don’t want us to contact the facility regarding your situation, we would appreciate you contacting us to let us know what your experience was so that we can assess whether each facility is following the statute as required.

If you feel the facility or medical staff are not following the requirements of the law, you should file a grievance (a medical grievance if it is the medical staff who are not following the law, a facility grievance if it is the correctional staff not following the law) and be sure to appeal any denial of that grievance.  You need to file the grievance even if you also contact PLS for assistance.

The full language of G.L. c. 127, § 118 is available here.  Some of the important rights provided by the law are:

Health care

• All pregnant persons must be provided counseling and written material, in a form they can understand, on pregnancy options and correctional facility policies and practices regarding care and labor for pregnant persons. This means the material must be in, or translated into, a language the individual understands.
• All pregnant and postpartum persons must be provided regular prenatal and postpartum medical care.
• All pregnant and postpartum persons must be provided the opportunity for at least 1 hour of recreation each day.
• All pregnant and postpartum persons must be provided a diet containing the nutrients necessary to maintain a healthy pregnancy, including prenatal vitamins and supplements, and written information regarding prenatal nutrition, maintaining a healthy pregnancy and childbirth.
• All pregnant and postpartum persons must be provided the opportunity for postpartum screening for depression.  An individual suffering from postpartum depression must have regular access to a mental health clinician and must not be subject to isolation unless they pose a serious risk of harm to themselves or others.
• All pregnant and postpartum persons must be provided appropriate clothing, undergarments and sanitary materials.
• Prior to their release, facility medical staff must provide a pregnant person with counseling and discharge planning in order to ensure continuity of pregnancy-related care in the community, including uninterrupted substance abuse treatment.

Restraints and transportation

• All pregnant persons in their second and third trimesters of pregnancy or during recuperation after childbirth must be transported to and from visits to medical providers and court in a vehicle with seat belts and may only be restrained using handcuffs in front.
• Leg or waist restraints shall not be used on a pregnant or postpartum person under any circumstances.
• An individual in any stage of labor or delivery, as determined by a health care professional, must not be placed in restraints at any time, including during transportation. There is no exception to this requirement.
• If a correction officer is present in the room during a person’s physical examinations, labor or childbirth, the officer should be female and should be positioned to maximize the person’s privacy.
• During post-partum recuperation, the new parent will remain in the hospital until the attending physician certifies that they may be safely discharged. A person in post-partum recuperation must not be placed in restraints, except under extraordinary circumstances.  “Extraordinary circumstances” requires a correction officer determining that the specific person presents an immediate and serious threat to themselves or others or an immediate and credible risk of escape that cannot be curtailed by other reasonable means.   An officer finding extraordinary circumstances requiring restraint of a post-childbirth person must document, in writing, the reasons for that finding, the kind of restraints used and the reasons those restraints were considered the least restrictive available and the most reasonable under the circumstances. The superintendent must approve the use of any restraints on a post-partum person due to extraordinary circumstances.
• If the attending physician or nurse treating the pregnant or post-partum person requests that restraints be removed for medical reasons, the correction officer must immediately remove all restraints.

If you are restrained while you are in labor, this office will advocate for you to be removed from restraints.  You can contact us from any DOC facility at the speed dial number 9004, or from any county facility by calling collect at 617-482-4124.  If you are unable to call, you can also ask your medical provider or your family to contact our office to report this problem.  We will need releases of information to get any information when we advocate, so it is best to get releases of information on file with this office in advance if you anticipate being incarcerated at the time you give birth.

In 1992, this office worked out a formal agreement with the DOC in a case called McDonald v. Fair, No. 80352 (Mass. Super. Ct. Apr. 7 1992) about the care pregnant persons are entitled to at MCI-Framingham.  The most important parts of that case, beyond what G.L. c. 127, § 118 requires, are listed below.  If you are pregnant and incarcerated somewhere other than MCI-Framingham, this Agreement does not apply to you, but you are covered by the law described above. 

Diet and Vitamins

• Once your pregnancy has been confirmed, the HSU must notify the Food Services Unit, who must place you on the pregnancy diet which should ensure that you get proper nutrients for the baby’s development.  Within 2 working days of the confirmation of pregnancy, the HSU must also request that you be seen by a dietician.
• The dietician’s consult form will become part of your medical record.
• If you have additional medically based dietary needs or restrictions (for example a diabetic diet), those requirements must also be provided by the dietician to the Food Services Unit in writing, and written into your medical file.
• Whenever you believe that a meal does not conform to the required diet, you should report this to the Institutional Grievance Coordinator on the institutional grievance form.  You may also approach food service personnel, shift commanders, and others to voice dietary concerns or problems immediately.
• The DOC must keep the name of each pregnant person on the “Diet Roster” maintained in the Food Services Unit.

Prenatal and Postpartum Counseling

• The DOC must offer pregnant persons access to weekly prenatal classes providing counseling and education.
• The DOC must maintain weekly prenatal clinics at MCI-Framingham.  Each pregnant individual shall be given access monthly at such clinics, or more frequently if medically necessary.
• The DOC must provide access to mental health counseling and HIV counseling.
• The DOC must offer you contact, including telephone access, with the Department of Social Services if your child is to be placed in the Department of Social Services custody.

Prenatal Clothing

• The DOC must provide pregnant individuals with tops, slacks or jeans appropriate for pregnant individuals and larger sizes of underwear.

Medical Screening

• After intake medical screening, within 48 hours of entrance into MCI Framingham, a pregnant person must be seen by a physician, or nurse practitioner, or perinatal nurse coordinator, who must ask about the following areas:
  • Unusual bleeding or vaginal discharge
  • Presence of an I.U.D.
  • Breast masses or nipple discharge
• After you have been medically screened, if you are pregnant but have no other medical or mental health issues, you should not be placed with unscreened individuals. 
• After medical screening, pregnant individuals admitted to MCI Framingham who have health or mental health issues aside from pregnancy, must be placed in the HSU, with only medically screened individuals.  You should not come into physical contact with others who are quarantined.

Transportation

• The DOC must ensure that pregnant persons being transported to outside medical care, or courts or hospitals, receive the total dietary intake specified above.

Prenatal and Postpartum Medical Examinations

• Pregnant individuals shall be provided with regular prenatal (before birth) and postpartum (after birth) medical examinations and treatment as medically indicated.
• If you are designated “high risk” status by an obstetrician, the DOC must follow all medical recommendations that are confirmed by the on-site medical personnel of MCI Framingham.