Commentary Maternity and Birthing

Hyperemesis is Serious Business, Whether You’re a Princess or a Pauper

Jodi Jacobson

Hyperemesis is no stroll in the palace park. Kate may be a princess, but she is also human. Women of every race, class, and income level face risks in pregnancy and put their bodies on the line every time they get pregnant. The only differences between the princess and the pauper are that one has proper food, nutrition, and care and the other has none.

As you might imagine, virtually every news outlet still located on planet Earth has covered the fact that Princess Catherine, Duchess of Cambridge, is officially pregnant. A feeding frenzy of press coverage on the royal pregnancy has been virtually guaranteed since the day she and Prince William got engaged.

But unlike those princesses in the fairy tales, Princess Kate’s pregnancy is so far neither easy nor uneventful. An announcement from the Royal Family stated that she was hospitalized with hyperemesis gravidarum, which the American Pregnancy Association explains as “a condition characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance. Mild cases are treated with dietary changes, rest and antacids. More severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line (IV).”

Major news organizations are not widely known for their effective treatment of women’s health issues, and so it’s not been surprising to me that many have reported Kate is suffering with a “bad case of morning sickness.” Others have been downright rude and ignorant. Gawker’s Caity Weaver, for example, wrote that “hyperemesis gravidarum [is] what they call regular old morning sickness when you are a princess.”

I beg to differ.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Unless I am missing something, I am no princess; otherwise, my butler has been missing in action for quite a while and my diamond tiaras are nowhere to be found. I suffered from hyperemesis in both of my pregnancies. I assure you it has no relationship to the quaint notion of saltine-crackers-and-ginger ale morning sickness we all think about if and when we think about morning sickness at all. Really, it doesn’t.

From the very day of the six-week mark in my first pregnancy, I began to throw up. I never stopped. I vomited until there was nothing left to throw up, and then I would keep vomiting, resulting in sustained convulsing dry heaves. And this was day two. If I took a sip of water, it came right back up. If I tried to drink plain broth, same thing. Pregnancy vitamins? No way. If you have ever had a really, really bad case of food poisoning and gotten to the point where you were begging God just to let you die, you have a sense of what I am talking about here. But food poisoning lasts at most a few days. Try nine months like that.

In my case, within a couple of days of my “hyperemetic episode,” I was unable to walk around; when the dry-heave convulsing became literally painful, I was taken to the hospital for intravenous (IV) fluids. In that first pregnancy, I spent a cumulative total of five months in the hospital or at home in bed on IVs, with home health aides, catheters, nausea medicine, and the rest, unable to eat enough to sustain myself and tethered to IVs. I lost more than 30 pounds. (That made for great jokes *after* the baby was born, about how I never realized that all I needed to do to lose weight was to get pregnant.)

I was virtually unable to work for the better part of five months of my pregnancy, because I became so weak that walking up and down stairs—and some days lifting my head off the pillow at all—was difficult and made me excruciatingly tired and dizzy. When I did go places, we brought my IV bag. And the IVs only worked to keep me hydrated as long as I had them in; take out that IV, and I would go back into convulsive vomiting and lapse back into serious dehydration. I was six months pregnant and still on IVs before I could sip chicken broth or drink what oddly enough I most craved, Diet Pepsi, and hope to keep some down. When I expressed (constantly) to my doctor my concern for the baby, she reassured me: “Don’t worry. You came into this healthy and well-nourished. Its not the baby that is in danger right now, it is you, because the baby is feeding off all your reserves and you have nothing with which to replenish yourself.”

My daughter arrived as a healthy, alert 8-plus-pound baby. And, much to my obstetrician’s shock, I went through it all over again with my son.

Like Kate, I was lucky. I had a job I could keep; disability insurance; health insurance; and help from my then-husband, who had to take off work to change the intravenous fluids and take care of me. I had contraception to plan my pregnancies, great medical care, a wonderful Ob-Gyn, and the reassurance, even when I did not believe it, that my babies would be okay. Kate may have it worse or better than I did medically, but either way she is suffering from a potentially serious complication of pregnancy. And, what is more, she is going to be expected to “perform” for the cameras some time very soon, putting more pressure on her as a woman dealing with a serious condition in early pregnancy. The very thought of mixing cameras with hyperemesis makes me sick all over again.

The treatment of Kate’s condition by at least some media outlets as just another bout of morning sickness is at least in part a failure to really understand and report on pregnancy as anything other than a fantastic event, a tug of war between “choice” and anti-choice movements, a struggle to *get* pregnant, or a major social drama (think teen pregnancy).

Missing is an examination of just how dangerous pregnancy can be, and how dependent the lives of pregnant women are on access to good nutrition, good medical care, and good support systems. This same reality was illustrated in a different but tragic way in the case of Savita Halappanavar, who died last month in an Irish hospital because doctors refused to terminate her pregnancy at 17 weeks even though it was clear she was miscarrying and even after it became clear she could not survive unless in fact they terminated the pregnancy, quickly. They let her die.

But it is a reality played out every day in places throughout the world in which papparazzi have no interest. More than 350,000 women die each year from complications of pregnancy and unsafe abortion. The malnutrition, anemia, and other health conditions rampant among pregnant women worldwide are contributing factors. Cultural, economic, and social discrimination mean that both women and girls are exceptionally vulnerable to poverty and are less likely than men and boys to have  adequate food intake. Iron deficiency anemia, for example, contributes to 20 percent of all maternal deaths worldwide. One study conducted by UNICEF in Samburu, Kenya revealed that 60 percent of the pregnant women were malnourished, and even so, they still gave up shares of their food to make sure they could give more to their children.

Data show that HIV-positive pregnant women are more likely to be malnourished than their HIV-negative counterparts, a serious problem in regions like Africa where women make up the majority of those infected with HIV. Lack of emergency obstetric care is one of the leading factors in high rates of maternal death and illness throughout Africa, Asia, and Latin America. And in regions where under-nourishment in pregnant women is widespread, infants are far more likely to be born at low birth weight, a risk factor for neonatal deaths, learning disabilities, mental, retardation, poor health, blindness and premature death in infants.

So if I were a woman with hyperemesis in, say, rural Kenya, Nigeria, or Uganda, the outlook for me and my baby would have been dramatically different than it was in fact for the middle class United States me, or than it is for Kate (barring, of course, any other complications with her pregnancy). There would have been no IV fluids, little rest, and likely no extra resources to assist me. I might have died, along with my baby, and even if I had survived, my daughter would have a higher risk of dying and far poorer prospects in life.

Kate may be a princess, but she is also human. And as human beings, women of every race, class, and income level face many risks in pregnancy. What Kate—and Savita before her—have reminded us is that women put their bodies on the line every time they get pregnant. I wish Kate all the best. But the only differences between the princess and the pauper in this case are that one has proper food, nutrition, and care and the other has none.

Commentary Abortion

Language Matters: Why I Don’t Fear Being Called ‘Pro-Abortion’

Maureen Shaw

Words can and do hurt, especially when they cast people who seek or provide abortion care as immoral or murderers. But pro-choice activists can embrace unapologetic language that represents hope, self-determination, and bodily autonomy.

Recently, an anti-choice website profiled me, repeatedly describing me as “pro-abortion.” I understood immediately that this was meant to be an insult and a negative character judgment. But instead of taking offense or feeling bullied, I smiled—even as the vitriol poured into my Twitter mentions.

I haven’t always been able to smile at anti-choice trolls. They attack your ideology, personality, and even your family. It’s threatening and can feel very unsafe, and with good reason; just ask any clinic escort, pro-choice journalist, or abortion provider who has been targeted by anti-choice zealots or organizations. Online harassment and bullying is deliberate and meant to incite fear; it’s also a stepping stone to physical violence and intimidation.

The first time I was on the receiving end of such hatred, it made me sick to my stomach and I was tempted to abandon social media altogether. But removing my pro-choice voice from the conversation felt like handing trolls a victory. So with a few tweaks to my public profiles (like erasing my location and no longer posting photos of my children), I’ve decidedly moved beyond that fear and refuse to shrink in the face of online harassment (Twitter’s mute function certainly helps too).

These experiences taught me two very important lessons: first, about cowardice (it’s so easy to spew hatred from the anonymity of the internet) and second, about the importance of language. Most of us here in the United States have heard the saying, “Sticks and stones may break my bones, but words will never hurt me.” While this is certainly true in the most literal of interpretations, we know words can hurt when they come in the form of threats against abortion providers or calling women who have abortions “murderers.”

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Indeed, the way we talk about abortion is critical, from how we describe our adversaries to legislative bill titles and abortion procedures themselves. When anti-choice lawmakers and activists wield language that is inflammatory, misleading, or demonizing, the public’s perceptions of abortion are compromised. The ensuing negativity, in turn, helps transform commonplace medical procedures into “morally repugnant offenses”—to use the language of ethics, which the anti-choice movement so often co-opts—that abortion opponents want to heavily restrict (at best) or outlaw (at worst).

The so-called pro-life constituency understands this all too well and has done a brilliant job of manipulating language to guide the national discourse on abortion. Even the “pro-life” moniker is a calculated—not to mention hypocritical—move. After all, if a person is not “pro-life,” they’re implicitly anti-family and anti-child. This automatically puts pro-choice activists and allies in a needlessly defensive position and posits anti-choice ideology as favorable.

This perceived favorability runs deep and has very real implications for pregnant people. For example, politicians and activists alike jumped at the chance to essentially redefine dilation and extraction (a surgical procedure used in later abortions) as “partial birth abortion” (and sometimes, “dismemberment abortion”). It’s an obvious misnomer and a dangerous conflation, as one cannot be born and aborted; that would be murder, not abortion. As a result, the procedure was banned without a health exception, courtesy of the 2003 federal Partial Birth Abortion Act. And there’s no ignoring the current onslaught of anti-choice legislation with catchy names like the “Women’s Public Health and Safety Act,” the “Born-Alive Abortion Survivors Protection Act,” and the “Pain-Capable Unborn Child Protection Act.”

Let’s be honest: These bills are not about protecting women’s health or safety. Their sole purpose is to demean women by prioritizing unviable fetuses over women’s very real health-care needs. And they’re successful in part due to their phrasing: The words “child,” “survivor,” and “protection” all evoke positive imagery, while simultaneously (and not so subtly) vilifying the person who no longer wishes to be pregnant.

To be fair, anti-choicers aren’t the only ones with a working knowledge of the power of language. The pro-choice community has made serious efforts in recent years to reclaim the word “abortion” and paint it as a positive (or at the very least, common) experience. Just look at 1 in 3 Campaign’s Abortion Speakout, the #ShoutYourAbortion social media campaign, and websites that curate positive abortion stories, and you’ll see a plethora of women embracing this shared reality. And it’s not just grassroots activists who have thrown down the proverbial gauntlet: Developers recently created a Google extension to change all “pro-life” mentions to “anti-choice.” Take that, anti-choice interwebs!

There have been efforts to move away from the terms “pro-choice” and “pro-life” altogether, because those simple labels don’t reflect a truly intersectional approach that goes beyond the traditional narrative around reproductive rights. I continue to identify as pro-choice because the term works for me. I believe it accurately expresses my support of the full spectrum of choice—parenting, pregnancy, adoption, and abortion—though I also understand and support activists’ rejection of the label.

As a pro-choice activist, I am heartened by these efforts and the ground gained. For so long, we’ve been on the defensive, from fighting stereotypes that pro-choicers can’t be parents to furiously trying to keep clinics open nationwide (and it doesn’t help that the mainstream media often fails to responsibly or fairly report on abortion). It’s been like trying to climb a steep hill covered in oil slicks.

But no longer. Thanks to the campaigns I’ve mentioned and others like them, pro-choicers everywhere—myself included—can more easily reclaim the power of language to shatter stigma surrounding abortion.

While I don’t pretend to have a new dictionary for those of us who work to support abortion rights, there are simple ways to leverage the words already in our lexicon to achieve success on this front. For starters, we can refuse to use the term “pro-life” in exchange for a more accurate description of the movement fighting to end access to a basic health service: “anti-choice.” We can also explicitly describe abortion as mainstream health care more consistently; doing so helps dispel the myth that abortion is rare, immoral, and a marginalized component of women’s health. And finally, we shouldn’t be afraid to embrace being called “pro-abortion.”

Why? Because “abortion” is by no means a dirty word—or thing, for that matter. I will happily embrace being called “pro-abortion.” Admittedly, the term is problematic when it’s used to suggest that all pregnancies should end in abortion or used to simplify reproductive justice and human rights issues. For me, pro-abortion means hope, self-determination, and bodily autonomy. And I’m most definitely in favor of all of those things.

I’d like to think the tables will turn in the very near future: that our courts nationwide will follow the Supreme Court’s lead and affirm the right to abortion without political interference, and that people will no longer be shamed for seeking abortion care. Until then, it’s paramount that each and every individual of the pro-choice community continues to demand progress. And what better way than with powerfully pro-choice and pro-abortion words? They’re the building blocks of our movement, after all.

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.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

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.”