Modern Day Chain Gangs: Shackling Pregnant Mothers in Georgia Prisons and Jails

Tonya Williams

“I cannot imagine a place where one might stand and have a clearer view of concentrated disadvantage based on race, class, and gender inequality in the country then from inside the walls of women’s prisons.”  Beth E. Richie

“I cannot imagine a place where one might stand and have a clearer view of concentrated disadvantage based on race, class, and gender inequality in the country then from inside the walls of women’s prisons.”  – Beth E. Richie

When Gwen got locked up for a minor non-violent drug offense, she didn’t know she was pregnant. Just days into her confinement, she began to experience cramping, severe abdominal pains and bleeding. She immediately tried to alert the guards about her condition.  After what seemed like hours of pleading and begging for medical assistance, an officer finally came to take Gwen to the infirmary.  She was eventually rushed to the hospital. By the end of her brief stint in a Fulton County jail, she would discover she was pregnant, miscarry, and as a final illustration of neglect and callous disregard, she was shackled by the wrists and ankles as the physician removed the remains of her stillborn fetus from her womb.

While Gwen’s story is one of the most egregious stories of state-condoned reproductive oppression that I have documented, incarcerated pregnant women across the state of Georgia have been and continue to be subjected to shackling by the wrists, ankles or around the belly on their way to the hospital, during labor and delivery and in recovery. Dehumanized, shamed by the visible signs of their bondage, and oftentimes unable to receive the holistic and essential pre- and postnatal care and nutrition needed, pregnant women in Georgia must confront a painful reality. They have become a part of the modern day chain gang.

Georgia is one of more than forty states that continue to permit the use of restraints on incarcerated pregnant women during transport, labor, delivery and recovery.  According to a study of state prison policies and laws around the country undertaken by the Rebecca Project for Human Rights, “it seems safe to assume that prisons” in Georgia “are engaging in shackling as a matter of routine.”

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Over the last few years, several states have prohibited the practice concluding that shackling incarcerated pregnant women during the birthing process is not only unnecessary, but unduly subjects women to cruel, degrading and inhumane treatment. More recently, the national anti-shackling movement has witnessed a string of victories condemning the practice as activists on the state level have successfully won bans in West Virginia and Washington state and are on the verge of victory in Pennsylvania. 

The Federal Bureau of Prisons outlawed the practice in federal prisons after considerable lobbying from a broad range of health care professionals, prison advocacy, civil liberties, and women’s rights groups.  A few months ago, the 8th District Court of Appeals, in Nelson v. Norris held that “the U.S. Constitution protects pregnant women in prison from the unnecessary and unsafe practice of shackling during labor and childbirth.” Moreover, the practice of shackling incarcerated women during labor, delivery and recovery violates international standards and norms. Clearly, the time to end this practice in the United States is upon us. While, the shackling of incarcerated pregnant women has sounded a clarion call, mobilizing reproductive justice groups around the country, we understand that the use of restraints on pregnant women is symptomatic of a much larger problem in our prisons around the provision of medical care and reproductive health of female inmates.

For more than two years, SPARK Reproductive Justice NOW has engaged in an extensive participatory research and documentation effort, with community and formerly incarcerated women to bring awareness around the conditions pregnant, incarcerated women are subjected to during the laboring and birthing processes. Most pregnant incarcerated women, imprisoned for non-violent crimes relating to poverty and/or substance abuse, pose no physical threat to health care professionals, themselves, correctional officers or society

In Georgia, two correctional officers accompany the shackled pregnant woman and one is always in close proximity to her except under rare circumstances.  From our understanding, whether restraints are used, under what circumstances and for how long, largely depends on the guard not policy or law. While, prison officials justify the use of restraints as a security precaution, nurses that provide essential care and spend the most time with the women, will tell you, no woman has ever tried to escape nor could she if she wanted to. Labor is called labor for a reason.  Furthermore, they say, it’s just cruel.

As a reproductive justice organization, our work is rooted in the belief that individuals and communities should have the resources and power to make sustainable and libratory decisions about their fertility, bodies, genders, sexualities, families and lives. Thus, the rapid expansion of the prison system, disappearing tens of thousands of predominately low-income women of color, especially black women, is a reproductive justice issue. Birthing while incarcerated is a reproductive justice issue.  Shackling of incarcerated pregnant women is a reproductive justice issue. Prisons and jails, by far, are some of the most invisible and unaccountable sites of reproductive oppression where justice is hardly won or realized.  As we celebrate Mothers Day, let us not forget those women rendered invisible and silenced by the walls, intersecting systems of oppression, social stigma, shame and physical restraints that define their lives in so many ways. 

For more information about our efforts toward advancing reproductive justice in Georgia, please visit us at: www.legislatethis.org.

Analysis LGBTQ

Reimagining Safety for Queer and Trans Communities in Wake of Orlando

Tina Vasquez

“We need to have a national conversation about racism, homophobia, and transphobia,” said Alan Pelaez Lopez, a member of the organization Familia: Trans Queer Liberation Movement. “If these things do not happen, the nation, by definition, will have done nothing to support our communities.”

The same day of the Orlando Pulse nightclub shooting that would take the lives of 49 mostly Latino and LGBTQ-identified people, thousands of miles away in Santa Monica, California, a man was found with weapons, ammunition, and explosive-making materials in his car with plans to attend the annual Pride festival taking place in West Hollywood later that day.

Conversations around security and safety were raised by law enforcement almost immediately. In the days since, reports have emerged that from San Francisco to New York, there will be more police and “ramped-up security measures” at Pride events nationwide.

But queer and trans people of color (QTPOC) say these responses are missing the mark, because what their communities really need are deeper conversations and more resources that address their specific experiences, including fewer police at Pride events.

House Democrats held a sit-in on gun control this week as a direct response to the Orlando shooting. Though Alan Pelaez Lopez—an Afro-Latinx, gender-nonconforming immigrant, poet, and member of the organization Familia: Trans Queer Liberation Movement—agrees that gun control is important and should be considered by Congress, they said it can also feel like the community affected by the shooting almost always gets erased from those discussions.

“We need to have a national conversation about racism, homophobia, and transphobia,” the poet said. “If these things do not happen, the nation, by definition, will have done nothing to support our communities.”

Rethinking ‘Pride’ for People of Color

In mid-May, Rewire reported on the National Queer Asian Pacific Islander Alliance (NQAPIA)’s week of action to #RedefineSecurity, which encouraged participants to reimagine what safety looked like in Asian and Pacific Islander communities, and called for them to push back against police presences at Pride events.

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Pride events and festivals take place each June to commemorate the Stonewall riots in New York City, a clash between police officers and members of the LGBTQ community—led by trans women of color—that would kickstart the modern LGBTQ movement.

Even after the Orlando shooting at a gay nightclub, NQAPIA organizing director Sasha W. told Rewire their stance on police at Pride events hasn’t changed, but only grown more resolute.

As an organizer working with queer and trans Muslim, South Asian, and Middle Eastern communities, Sasha W. said the populations they work with say that framing the Orlando shooting as a “terrorist attack” makes them feel “increasingly unsafe.”

“I think part of what we need to remember is to examine what ‘terror’ looked like in queer and trans communities over the course of our history in this country,” Sasha W. said. They cited the Stonewall riots and the inaction by the government during the HIV and AIDS epidemic as examples of some of the many ways the state has inflicted violence on queer and trans communities.

Sasha W. added that pointing blame at Daesh is too easy, and that the oppression queer and trans people face in the United States has always been state-sanctioned. “We have not historically faced ‘terror’ at the hands of Muslim people or brown people. That is not where our fear has come from,” they said.

What’s missing, they said, is a conversation about why police officers make certain people feel safe, and “interrogating where that privilege comes from.” In other words, there are communities who do not have to fear the police, who are not criminalized by them, and who are confident that cops will help them in need. These are not privileges experienced by many in queer and trans communities of color.

Asking the mainstream LGBTQ community to rethink their stance on police and institutions that have historically targeted and criminalized communities of color has been challenging for queer and trans people of color.

What’s become clear, according to Familia: Trans Queer Liberation Movement founder Jorge Gutierrez, is that after a tragedy like Orlando, white LGBTQ members want to feel united, but many don’t want to discuss how things like race and citizenship status affect feelings of safety. Instead, some will push for a greater police presence at events. 

There have already been instances of white members of the LGBTQ community publicly shutting down conversations around racial justice. Advocates say the public needs to understand the broader context of this moment.

“The white LGBTQ community doesn’t face the criminalization and policing that our community faces every day. Not just at Pride, but every day, everywhere we go. That’s our life,” Gutierrez said. “If you don’t listen to us when it comes to these issues of safety, you’re not just erasing us from a tragedy that impacted us, but you’re really hurting us.”

As Gutierrez explained, in the hours after the shooting, some media coverage failed to mention Pulse was a gay club, failed to mention it was people of color who were killed on Latino night, and failed to mention that trans women were performing just before the shooting broke out. Gutierrez told Rewire he felt like his community and their pain was being erased, so his organization put together a video featuring queer and trans immigrants of color, including Lopez, to discuss their immediate feelings after the Pulse shootingand many shared sentiments similar to Sasha W.’s and Lopez’s. One trans Latina said the shooting was “years in the making.”

“The video was important for us to release because the shooting was being framed as an isolated event that randomly happened, but we know that’s not true. We know that the United States has a history of hurting queer and trans people of color and we needed to produce our own media, with our own messaging, from our own people to tell people what really happened, the history that lead to it happening, and who it really impacted. We didn’t want our voices and our realities as immigrants, as undocumented people, as queer and trans people of color, erased,” Gutierrez said.

Without even factoring in an increase in law enforcement, Lopez told Rewire Pride already felt unsafe for people like them.

“I have experienced a lot of racism [at Pride events], the pulling of my hair from people walking behind me, and I have also been sexually harassed by white people who claim to want to experiment with being with a Black person,” Lopez said.

Though Lopez didn’t attend any Pride events in Los Angeles this year, they told Rewire that in previous years, there was already a large police presence at Pride events and as a “traumatized person” who has had many negative interactions with police officers, including being racially profiled and stopped and frisked, encountering law enforcement was scary.

“Seeing [cops] at Pride makes me remember that I am always a target because at no time has the police made me feel protected,” the poet said. “Signs of heavy police presence are really triggering to people who have developed post-traumatic stress disorder from violent interactions with the police, for undocumented communities, for transgender communities, for young people of color, and for formerly incarcerated individuals. When I think of security, I do not think of police.”

Lopez isn’t alone. Whether it’s law enforcement violence against women and trans people of color, law enforcement working with Immigration and Customs Enforcement (ICE) for the detainment and deportation of undocumented people, or the way law enforcement has reportedly discriminated against and harassed gender-nonconforming people, QTPOC have very real reasons for feeling vulnerable around police officers, advocates say.

Another reason Lopez chose not to attend Pride this year: It was being sponsored by Wells Fargo. The banking corporation sponsors over 50 yearly Pride events and has been called a “longtime advocate of LGBT equality” by organizations like the Human Rights Campaign, which also lists Wells Fargo as a top-rated company on its Corporate Equality Index. But Wells Fargo has a history of investing in private prisons, including detention centers. Calls to drop Wells Fargo from Pride events have been unsuccessful. For queer immigrants like Lopez, attending Pride would mean “financially contributing” to the same corporation and system that they said killed their friends, the same corporation that they said has incarcerated their family, and that they said has tried—but failed—to incarcerate them.

Sasha W. told Rewire that for QTPOC, it’s easy to forget that the event is supposed to be about celebration.

“For many of us, we can’t really bring our whole selves into these places that are meant to make us feel free or we have to turn off parts of who we are in order to enjoy ourselves” the organizer said. “And as far as the policing of these events go, I think it’s worth noting that policing has always been about protecting property. It’s always been about property over people since the days of the slave trade. When we see police at Pride events the assumption [by our communities] is that those police will protect money and business over our queer brown and Black bodies.”

“Really Troubling Policies”

As organizations and corporations work to meet the short-term needs of victims of the Orlando shooting, advocates are thinking ahead to the policies that will adversely affect their communities, and strategizing to redefine safety and security for QTPOC.

Gutierrez told Rewire that what has made him feel safe in the days since the Orlando shooting is being around his QTPOC community, listening to them, mourning with them, sharing space with them, and honoring the lives of the brothers and sisters that were lost. His community, the organizer said, is now more committed than ever to exist boldly and to make the world a safer place for people like themand that means pushing back against what he believes to be a troubling narrative about what safety should look like.

However, Gutierrez said that politicians are using his community’s pain in the wake of the Orlando shooting to push an anti-Muslim agenda and pit the LGBTQ community against Muslims, conveniently forgetting that there are people who live at the intersection of being queer and Muslim. Perhaps more troubling are the policies that may arise as a result of the shooting, policies that will add to the surveilling and profiling Muslims already experience and that will further stigmatize and criminalize vulnerable communities.

“The government, the police, politicians, they’re trying to equate safety with having more police on the street, at gay clubs—that are like home to many of us, and at Pride. We know that doesn’t make us safe; we know police are part of the problem,” he said.

“Of course we need to make it more difficult for people to get guns, but we also need more resources for our communities so our communities can truly be safe on the streets, in the workplace, at school, at the clubs, and at Pride,” he said. “That means having healthy communities that have resources so people can thrive and live authentically. The answer to our problems is not more police.”

Sasha W. echoed Gutierrez, saying that their community is already fearful of what’s to come because moments of national crisis often create the space for “really troubling policies.”

“That’s how we got the Patriot Act,” the organizer said. “There is a fear that we are in another one of those moments where there are calls for protection and it’s being tied to the false idea of a foreign threat that requires an increase of surveillance of Muslims. Think of how calls for protection have also hurt queer communities, communities of color, trans communities, like the idea that bathrooms aren’t safe because of trans people. Who is really unsafe in this country, and why do policies hurt us instead of protect us?”

Lopez added: “The Orlando shooting was powered by the fact that the United States has a history of violence against LGBTQIA communities, a history of violence against immigrants, a history of violence against women, and a history of colonization of the island of Puerto Rico … The U.S. needs to address institutional problems of race, ethnicity, class, gender, sex, and sexuality if it wants to put an end to future massacres.”

The question remains: How can vulnerable communities be made to feel safer not just at Pride events, but in a political moment when transphobia is state-sanctioned, Islamophobia is applauded, and communities of color still have to fight for their humanity?

Sasha W. urges QTPOC to “expand their political imagination” and re-envision what security looks like. In the long term, the organizer said, they hope more people recognize who their communities’ “actual enemies” are, instead of turning on each other.

“Let’s recognize that the state has always been something we’ve had to fight to survive and that institutions that hurt us are growing increasingly strong in this moment of crisis, as they often do, so we have to work to disarm and dismantle the institutions that terrorize our communities” they said.

“On another note, we have always been our own best defense, especially in communities of color,” they said. “Supporting each other to protect ourselves better doesn’t happen overnight, I know, but so much of this starts with building community with each other so that we know each other, love each other, and throw down for one another.”

Analysis Maternity and Birthing

Pregnant Women Are Being Shackled in Massachusetts—Even Though It’s Been Illegal for Years

Victoria Law

According to a new report, not a single jail or prison facility in the state has written policies that are fully compliant with the law against restraining pregnant women behind bars.

Korianne Gamble was six months pregnant in November 2014 when she arrived at the Bristol County Sheriff’s Office Women’s Center, a jail in North Dartmouth, Massachusetts. Six months prior, the state had passed “An Act to Prevent Shackling and Promote Safe Pregnancies for Female Inmates.”

According to the new law, the jail should have been prohibited from using any type of restraint on Gamble during labor, and using of leg and waist restraints on her during and immediately after her pregnancy. It also guaranteed her minimum standards of pregnancy care and required—as with everyone incarcerated while in their second or third trimesters—that she be transported in the jail’s vehicles with seat belts whenever she was taken to court, medical appointments, or anywhere outside the jail.

But that wasn’t the case for Gamble. Instead, she says, when it came time for her to give birth, she was left to labor in a cell for eight hours before finally being handcuffed, placed in the back of a police cruiser without a seatbelt, and driven to a hospital, where she was shackled to the bed with a leg iron after delivering.

According to a new report, Gamble isn’t alone. Advocates have been monitoring pregnancy-related care since the law’s passage. After obtaining and analyzing the policies of the state’s prison and jail system, they found that no facility has policies that are fully compliant with the 2014 law. They issued their findings in a new report, Breaking Promises: Violations of the Massachusetts Pregnancy Standards and Anti-Shackling Lawco-authored by Marianne Bullock of the Prison Birth Project, Lauren Petit of Prisoners’ Legal Services of Massachusetts, and Rachel Roth, a reproductive-justice expert.

In addition to analyzing policies, they spoke with women who were pregnant while in custody and learned that women continue to be handcuffed during labor, restrained to the bed postpartum, and placed in full restraints—including leg irons and waist chains—after giving birth.

“The promise to respect the human rights of pregnant women in prison and jail has been broken,” the report’s authors concluded.

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Medical experts, including the American Congress of Obstetricians and Gynecologists, the American Medical Association and the American College of Nurse-Midwives, have all agreed that shackling during pregnancy is unnecessary, inhumane, and dangerous. Shackling increases the risk of falling and injury to both mother and fetus while also preventing medical staff from assessing and assisting during labor and delivery. In 2014, both the Massachusetts legislature and then-Gov. Deval Patrick (D) agreed, passing the law against it.

“The Massachusetts law is part of a national trend and is one of the most comprehensive in protecting pregnant and postpartum women from the risks of restraints,” said Roth in an interview with Rewire. “However, like most other states, the Massachusetts law doesn’t have any oversight built in. This report clearly shows the need for staff training and enforcement so that women who are incarcerated will be treated the way the legislature intended.”

Gamble learned all of this firsthand. In the month before her arrest, Gamble had undergone a cervical cerclage, in which a doctor temporarily stitches up the cervix to prevent premature labor. She had weekly visits to a gynecologist to monitor the development of her fetus. The cerclage was scheduled to be removed at 37 weeks. But then she was arrested and sent to jail.

Gamble told jail medical staff that hers was a high-risk pregnancy, that she had had a cerclage, and that her first child had been born six weeks prematurely. Still, she says she waited two months before seeing an obstetrician.

As her due date drew closer, the doctor, concerned about the lack of amniotic fluid, scheduled Gamble for an induction on Feb. 19, 2015. But, she says, jail staff cancelled her induction without telling her why.

That same evening, around 5 p.m., Gamble went into labor. Jail staff took her to the medical unit. There, according to Gamble, the jail’s nurses took her blood pressure and did a quick exam, but did not send her to the hospital. “They [the nurses] thought I was ‘acting up’ because my induction was canceled,” she told Rewire.

She was placed in a see-through cell where, as the hours progressed, her labor pains grew worse. “I kept calling to get the [correctional officers] to get the nurse,” Gamble recalled. By the time a nurse came, Gamble was bleeding. “The nurse made me pull down my pants to show her the blood—in front of a male [correctional officer]!” Gamble stated. Still, she says, no one called for an ambulance or made arrangements to drive her to the hospital.

At 1:45 in the morning, over eight hours after she first went into labor, the jail’s captain learned that Gamble was in labor. “[He] must have heard all the commotion, and he called to find out what was going on,” she said. He ordered his staff to call an ambulance and bring her to the hospital.

But instead of calling an ambulance, Gamble says jail staff handcuffed her, placed her in the back of a police cruiser without a seatbelt—in violation of the law—and drove her to Charlton Memorial Hospital. “My body was already starting to push the baby out,” she said. She recalled that the officers driving the car worried that they would have to pull over and she would give birth by the side of the road.

Gamble made it to the hospital, but just barely. Nine minutes after arriving, she gave birth: “I didn’t even make it to Labor and Delivery,” she remembered.

But her ordeal wasn’t over. Gamble’s mother, who had contacted Prisoners’ Legal Services and Prison Birth Project weeks earlier, knew that the law prohibited postpartum restraints. So did Gamble, who had received a packet in jail outlining the law and her rights from Prisoners’ Legal Services. When an officer approached her bed with a leg iron and chain, she told him that, by law, she should not be restrained and asked him to call the jail to confirm. He called, then told her that she was indeed supposed to be shackled. Gamble says she spent the night with her left leg shackled to the bed.

When the female officer working the morning shift arrived, she was outraged. “Why is she shackled to the bed?” Gamble recalled the officer demanding. “Every day in roll call they go over the fact that a pregnant woman is not to be shackled to anything after having a baby.” The officer removed the restraint, allowing Gamble to move around.

According to advocates, it’s not unusual for staff at the same jail to have different understandings of the law. For Gamble, that meant that when the shift changed, so did her ability to move. When the morning shift was over, she says, the next officer once again shackled Gamble’s leg to the bed. “I was so tired, I just went along with it,” Gamble recounted.

Two days after she had given birth, it was time for Gamble to return to the jail. Despite Massachusetts’ prohibition on leg and waist restraints for women postpartum, Gamble says she was fully shackled. That meant handcuffs around her wrists, leg irons around her ankles, a chain around her waist,g and a black box that pulled her handcuffs tightly to the waist chain. That was how she endured the 20-minute drive back to the jail.

Gamble’s jail records do not discuss restraints. According to Petit, who reviewed the records, that’s not unusual. “Because correctional officers don’t see it as out of the ordinary to [shackle], they do not record it,” she explained. “It’s not so much a misapplication of the extraordinary circumstances requirement as failure to apply it at all, whether because they don’t know or they intentionally ignore it.”

While Bristol County Sheriff’s Office Women’s Center’s policies ban shackling during labor, they currently do not prohibit restraints during postpartum recovery in the hospital or on the drive back to the jail. They also do not ban leg and waist restraints during pregnancy. Jonathan Darling, the public information officer for the Bristol County Sheriff’s Office, told Rewire that the jail is currently reviewing and updating policies to reflect the 2014 law. Meanwhile, administrators provide updates and new information about policy and law changes at its daily roll call. For staff not present during roll call, the jail makes these updates, including hospital details, available on its east post. (Roll call announcements are not available to the public.)

“Part of the problem is the difference in interpretation between us and the jurisdictions, particularly in postpartum coverage,” explained Petit to Rewire. Massachusetts has 14 county jails, but only four (and the state prison at Framingham) hold women awaiting trial. As Breaking Promises noted: “Whether or not counties incarcerate women in their jails, every county sheriff is, at minimum, responsible for driving women who were arrested in their county to court and medical appointments. Because of this responsibility, they are all required to have a written policy that spells out how employees should comply with the 2014 law’s restrictions on the use of restraints.”

Four jurisdictions, including the state Department of Correction, have policies that expressly prohibit leg and waist restraints during the postpartum period, but limit that postpartum period to the time before a woman is taken from the hospital back to the jail or prison, rather than the medical standard of six weeks following birth. Jails in 11 other counties, however, have written policies that violate the prohibition on leg and waist shackles during pregnancy, and the postpartum prohibition on restraints when being driven back to the jail or prison.

Even institutions with policies that correctly reflected the law in this regard sometimes failed to follow them: Advocates found that in some counties, women reported being restrained to the bed after giving birth in conflict with the jail’s own policies.

“When the nurse left, the officer stood up and said that since I was not confirmed to be in ‘active labor,’ she would need to restrain me and that she was sorry, but those were the rules,” one woman reported, even though the law prohibits restraining women in any stage of labor.

But shackling pregnant women during and after labor is only one part of the law that falls short. The law requires that pregnant women be provided with regular prenatal and postpartum medical care, including periodic monitoring and evaluation; a diet with the nutrients necessary to maintain a healthy pregnancy; written information about prenatal nutrition; appropriate clothing; and a postpartum screening for depression. Long waits before transporting women in labor to the hospital are another recurring complaint. So are routinely being given meals without fruits and vegetables, not receiving a postpartum obstetrician visit, and waiting long stretches for postpartum care.

That was also the case with Gamble. It was the middle of the night one week after her son’s birth when Gamble felt as if a rock was coming through her brain. That was all she remembered. One hour later, she woke to find herself back at the hospital, this time in the Critical Care Unit, where staff told her she had suffered a seizure. She later learned that her cellmate, a certified nursing assistant, immediately got help when Gamble’s seizure began. (The cell doors at the jail are not locked.)

Hospital staff told her that she had preeclampsia, a pregnancy complication characterized by high blood pressure. Postpartum preeclampsia is rare, but can occur when a woman has high blood pressure and excess protein in her urine soon after childbirth. She was prescribed medications for preeclampsia; she never had another seizure, but continued to suffer multiple headaches each day.

Dr. Carolyn Sufrin is an assistant professor of gynecology and obstetrics at Johns Hopkins Medicine. She has also provided pregnancy-related care for women at the San Francisco County Jail. “Preeclampsia is a leading cause of maternal mortality,” she told Rewire. Delayed preeclampsia, or postpartum preeclampsia, which develops within one to two weeks after labor and delivery, is a very rare condition. The patient suffering seizures as a result of the postpartum preeclampsia is even more rare.

Postpartum preeclampsia not only needs to be treated immediately, Sufrin said, but follow-up care within a week at most is urgent. If no follow-up is provided, the patient risks having uncontrolled high blood pressure, stroke, and heart failure. Another risk, though much rarer, is the development of abnormal kidney functions.

While Sufrin has never had to treat postpartum preeclampsia in a jail setting, she stated that “the protocol if someone needs obstetrical follow-up, is to give them that follow-up. Follow through. Have continuity with the hospital. Follow their instructions.”

But that didn’t happen for Gamble, who was scheduled for a two-week follow-up visit. She says she was not brought to that appointment. It was only two months later that she finally saw a doctor, shortly before she was paroled.

As they gathered stories like Gamble’s and information for their report, advocates with the Prison Birth Project and Prisoners’ Legal Services of Massachusetts met with Rep. Kay Khan (D-Newton), to bring her attention to the lack of compliance by both county jails and the state prison system. In June 2015, Khan introduced An Act to Ensure Compliance With the Anti-Shackling Law for Pregnant Incarcerated Women (Bill H 3679) to address the concerns raised by both organizations.

The act defines the postpartum period in which a woman cannot be restrained as six weeks. It also requires annual staff trainings about the law and that, if restraints are used, that the jail or prison administration report it to the Secretary of Public Safety and Security within 48 hours. To monitor compliance, the act also includes the requirement that an annual report about all use of restraints be made to the legislature; the report will be public record. Like other statutes and bills across the country, the act does not have specific penalties for noncompliance.

In December 2015, Gamble’s son was 9 months old and Gamble had been out of jail for several months. Nonetheless, both Gamble and her mother drove to Boston to testify at a Public Safety Committee hearing, urging them to pass the bill. “I am angered, appalled, and saddened that they shackled her,” Gamble’s mother told legislators. “What my daughter faced is cruel and unusual punishment. It endangered my daughter’s life, as well as her baby.”

Since then, both the Public Safety Committee and Health Care Financing Committee approved the bill. It is now before the House Committee for Bills in the Third Reading, which means it is now at the stage where it can be taken up by the House for a vote.

Though she has left the jail behind, Gamble wants to ensure that the law is followed. “Because of the pain I went through, I don’t ever want anyone to go through what I did,” she explained to Rewire. “Even though you’re in jail and you’re being punished, you still have rights. You’re a human being.”