Today, the Pennsylvania Legislature gave final approval to a bill that restricts the shackling of pregnant women in jail or prison; it now goes to the governor for his signature. The bill prohibits using restraints on pregnant women when they are being taken to a medical facility, in labor, and after giving birth, absent “extraordinary” circumstances.
As these developments demonstrate, recognition is growing that restraining women in labor and childbirth is both cruel and unnecessary, given that corrections officers or jail deputies are always with women during their hospital stay. The American Medical Association and American Bar Association recently made clear their opposition to the practice of restraining women who are in labor, following the American Public Health Association, the American College of Obstetricians and Gynecologists, and a host of women’s rights, human rights, and health organizations.
When it comes time to go on record and cast a vote, almost every legislator has voted in support of these measures. Yet, as is so often the case with social policy in the U.S., shackling women in labor is a problem that has primarily been tackled state by state, which means there is still a long way to go to ensure that all women in custody can give birth safely and with dignity.
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.
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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“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.”
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.”
Ignorance is caused by fear, reporter Joanna Connors writes, and it is with this attitude that, 21 years after she was raped, she begins the process of trying to understand the man who raped her, the man she thought “would be the last human being [she] would see on this earth.”
She was fine. That’s what she told everyone, including herself. After filing a report with the Cleveland police and getting her rapist locked up, she was fine. Fine, fine, fine. Except she wasn’t.
In I Will Find You: A Reporter Investigates the Life of the Man Who Raped Her, reporter Joanna Connors realizes that she is most assuredly not fine during a college campus visit with her daughter.
Ignorance is caused by fear, Connors writes. And it is with this attitude that, 21 years after she was raped—she immediately reported her rape to the police, and her rapist was caught the next day—she begins the process of breaking through the fear to understand the man who raped her, the man she thought “would be the last human being [she] would see on this earth.” She had thought she was over it, but it wasn’t until breaking down during that college tour that she realized she was still afraid of her rapist and still terrified he would find her.
When Connors was 30, she went to a Case Western Reserve University theater where a rehearsal of a play that she was covering for her newspaper, Cleveland’s Plain Dealer, was taking place.
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A man inside the empty theater—the actors had left by the time Connors arrived—beckoned her inside, saying that he was working on the lights. Then, brandishing a sharpened pair of scissors, he threatened to kill her if she didn’t do what he said and spent more than an hour raping her.
The chapter detailing her rape is chilling, as she describes the various acts performed, the way she went along with what her rapist told her to do, coaxing him on, hoping to make the ordeal end more quickly. By describing specifics of her rape, Connors is confronting and stripping away the shame she experienced by showing the reader the cold, hard facts of what a rape can be like.
Her words demonstrate how a person who was raped becomes a survivor. Even in her dissociative state, she didn’t want to die there at the hands of a man she didn’t know. She managed to convince him to stop and leave, and he kissed her goodbye outside, as if what had just happened was completely, utterly normal. Maybe, for him, a man whom she says was smoking menthols and who had a tattoo on his arm with his own name on it—”DAVE”—it was.
Connors found an eerie irony in that she was raped on a college campus before such rapes were more widely discussed. In recent years, there has been a rise in awareness regarding the frequency of rapes at institutions of higher learning. There are now websites dedicated to explaining the statistics as well as documentaries like The Hunting Ground, which explores the sexual violence that happens on U.S. collegecampuses and how students are pushing back against institutional cover-ups and injustices. Since Connors’ experience, society has begun to more broadly understand the terms “rape” and “sexual assault,” and there has been more discussion about the rapes and sexual assaults that happen within existing relationships; eight out of ten rapes occur between people who know one another.
It’s perhaps less common these days to find discussions of the other kind of rape: the kind that we’re warned about when we’re young and told not to take candy from strangers, the kind that makes us automatically cross the street when a group of men we find threatening happens to be walking toward us, the kind that happens when a complete stranger attacks us. This was Connors’ experience.
I Will Find You takes the reader through two distinct processes. The first is Connors’ discovery that her rapist may have been a sexual-violence survivor in his own right. The second, which carries the narrative, is how Connors came to terms with how being raped by David Francis, the “DAVE”-tattooed man, separated her life into a “before” and an “after.”
Before the rape, she was a reporter who lived largely without fear. Connors explains that she went into the theater, where her rapist, a young Black man, was beckoning her, for one reason: “I could not allow myself to be the white woman who fears black men.”
But after, she writes, “this new fear of black men shamed me more than the rape.” Connors explains she didn’t want to be the stereotypical white woman of privilege, who clutches her purse and crosses the street when she sees a Black man walking her way. As a woman aware of her socioeconomic and racial privilege, she didn’t want to participate in oppression.
But it wasn’t just Black men that she feared—it was everything:
I turned my life into performance art. I acted normal, or as normal as I could manage, all the while living on my secret island of fear. As time went on, the list of my fears continued to grow. I was afraid of flying. Afraid of driving. Afraid of riding in a car while someone else drove. Afraid of driving over bridges. Afraid of elevators. Afraid of enclosed spaces. Afraid of the dark. Afraid of going into crowds. Afraid of being alone. Afraid, most of all, to let my children out of my sight.
From the outside, my performance worked. I looked and acted like most other mothers. Only I knew that my entire body vibrated with dread, poised to flee when necessary.
Years after her rape, Connors tells her children about it—both were born after the living nightmare in the theater and are college-aged by then—and begins to confront the fact that she has never “gotten over” it, even though she’s told countless therapists that she has. It is then, despite her husband’s protests and her own fears, that she decides that she must also confront her ignorance regarding her rapist and find him, just as he once threatened that he would find her.
Connors’ investigation is difficult, as she finds out almost at once that her rapist died in a prison hospital some years before. This, however, doesn’t stop her: She begins to investigate his family, trying to find anyone who may have known him and could explain, perhaps, why he did what he did.
Connors regards what she finds out about her rapist with empathy. Connors doesn’t forgive and forget—rather, she forgives, in a sense, by remembering, by finding others who remember, by dredging up a past that is as unpleasant for her interviewees as it is for her.
She eventually gets support from her newspaper to research and write her own story. At every one of the interviews, she expresses discomfort with what she’s doing and almost backs off. Pushed on by her photographer co-worker—and her own need to know—she continues on what has become a journalistic mission. Connors knows she is intruding into people’s lives and realizes she’s coming from a place of privilege, but ends up relating to so much of their stories that she finds her rage toward her rapist fizzling.
It’s with great care, too, that Connors treats the racial tensions that arise during her investigation. Connors talks to women of color who, in 2007 when she conducted her interviews, had never reported their rapes: “I know about rape,” one of Francis’ relatives says. “I was raped myself. Three times. But I asked for it because I was on drugs and I was prostituting.” Connors tells the woman that she didn’t ask for it or deserve it, but the woman tells her the story of how one of her rapes happened and concludes with: “And besides that […] he was a white guy.” This woman felt that nothing would be done about it, even if she did report it.
Connors also writes that in her case, she served as the “perfect witness”; she explains that her rape “isn’t [hers] at all. It’s the state’s, as in The State of Ohio v. David Francis.” The prosecutor tells her: “You’re the ideal witness,” because she is “a journalist, trained to observe details and remember them.” She adds:
I know what he really means. To him, I’m the perfect victim because I happen to fulfill just about all the requirements of a woman accusing a man of rape, going back before the Civil War. I am white, educated, and middle-class. I resisted, and I have a cut on my neck, bruises still healing on my spine, and a torn and blood-stained blouse to prove it. I immediately ran to report the rape.
Needless to say, David Francis is the perfect defendant: black, poor, and uneducated, with a criminal record.
In fact, as she finds out during her investigation, her assailant was both Black and Native American, and spent his youth in and out of juvenile detention, starting at age 12. Connors looks at the racial disparity in prisons, at the rate of poverty in the areas of Cleveland that she visits, at the way socioeconomic status and race are interwoven, how violence and drug abuse feed into those factors as well, and how sexual assault and abusive environments are so often passed down through generations. Connors discovered fellow survivors in her rapist’s family—his sister Laura, with whom Connors is still in touch, described her mother’s boyfriend raping her in a church. His entire family, she discovers, have been survivors of one kind or another.
Connors believes that her rapist was likely raped himself. During her assault, she had a clear feeling that Francis was re-enacting something done to him. And after learning that rape was common at the juvenile detention center where Francis did many stints, she assumes that he had been abused there and during his time spent locked up as an adult.
What is most striking about Connors’ book is not its bravery—though it is brave—or its shock value, which exists. The book is valuable because Connors recognizes and conveys to readers the cyclical nature of abuse, its pathological nature, and one of its sources: in David Francis’ case, perhaps learning by example.