AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 203
(A-10)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35

Introduced by:

American Congress of Obstetricians and Gynecologists
Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and
Vermont Delegations

Subject:

Shackling of Pregnant Women in Labor

Referred to:

Reference Committee B
(Julie A. Komarow, MD, Chair)

Whereas, A New York Times editorial recently highlighted the need for an end to the barbaric
and medically hazardous practice of shackling female patients in labor 1 ; and
Whereas, In 2007, ACOG sent a letter to the Rebecca Project for Human Rights advocating for
federal legislation to prohibit the practice of shackling incarcerated pregnant women in labor 2 ;
and
Whereas, The 8th Circuit US Court of Appeals recently ruled favorably in the case of Shannon
Nelson (a shackled nonviolent inmate who sustained injuries in labor) vs. Correctional Medical
Services; and
Whereas, Thirty-four organizations submitted amicus briefs in support of Shannon Nelson’s
advocacy to prevent future inmates from being shackled during labor; and
Whereas, The aforementioned NY Times editorial noted the Federal Bureau of Prisons position
to end the “routine use of restraints for women in labor and limited shackling to cases in which a
woman presents a danger to herself, the baby or the staff”; and
Whereas, AMA Policy H-430.997 states the detention facilities should “provide medical care that
meets prevailing community standards”; and
Whereas, The American Civil Liberties Union has developed a draft medical bill and six states
(CA, IL, NM, NY, TX and VT) have enacted laws discouraging this practice; therefore be it
RESOLVED, That our American Medical Association support language recently adopted by the
New Mexico legislature that at “an adult or juvenile correctional facility, detention center or local
jail shall use the least restrictive restraints necessary when the facility has actual or constructive
knowledge that an inmate is in the 2nd or 3rd trimester of pregnancy. No restraints of any kind
shall be used on an inmate who is in labor, delivering her baby or recuperating from the delivery
unless there are compelling grounds to believe that the inmate presents:
•
An immediate and serious threat of harm to herself, staff or others; or
•
A substantial flight risk and cannot be reasonably contained by other means.
If an inmate who is in labor or who is delivering her baby is restrained, only the least
restrictive restraints necessary to ensure safety and security shall be used.” (New HOD
Policy); and be it further
1

New York Times Editorial: Childbirth in Chains. July 21,2009
http://www.acog.org/departments/dept_notice.cfm?recno=18&bulletin=4631, accessed 17 December
2009

2

Resolution: 203 (A-10)
Page 2

1
2

RESOLVED, That our AMA develop model state legislation prohibiting the use of shackles on
pregnant women unless flight or safety concerns exist. (Directive to Take Action)
Fiscal Note: Staff cost estimated at less than $500 to implement.
Received: 04/16/10
RELEVANT AMA POLICY
H-430.997 Standards of Care for Inmates of Correctional Facilities - Our AMA believes that
correctional and detention facilities should provide medical care that meets prevailing
community standards. (Res. 60, A-84; Reaffirmed by CLRPD Rep. 3 - I-94; Amended: Res. 416,
I-99; Reaffirmed: CEJA Rep. 8, A-09; Reaffirmation I-09)