Transportation and Security of Pregnant Inmates

In order to maintain appropriate treatment of pregnant and post-partum inmates at the county correctional facility, written policy and procedure shall require and, absent such written policy and procedure, 103 CMR 924.17 requires: (1) Transportation To/From Medical and/or Court Visits. When transporting pregnant inmates to and from visits to medical providers and court proceedings, a vehicle with seatbelts shall be utilized, and restraints, if any, shall be used as follows: (a) During the second or third trimester, only handcuffs in the front shall be applied. (b) An inmate who is in any stage of labor, as determined by a medical professional, shall not be placed in restraints. (c) During post-delivery recuperation, as determined by the attending physician, only handcuffs in the front shall be applied, except where a correction officer makes a determination, approved by a superintendent, that extraordinary circumstances necessitate greater restraint. The least restrictive restraint necessary to address those extraordinary circumstances shall be used. The type of restraint used and approval process shall be documented. (2) In-hospital Security for Pregnant Inmates. (a) During the second or third trimester, only handcuffs in the front shall be applied. (b) An inmate who is in any stage of labor, as determined by a medical professional, shall not be placed in restraints. One correction officer may remain in the hospital room during delivery or physical examination; however, the correction officer shall, if possible, be female and be situated in a locale respective of the inmate's privacy. (c) During post-delivery recuperation, as determined by the attending physician, no restraint shall occur unless a correction officer makes a determination, approved by a superintendent, that extraordinarycircumstances necessitate restraint, and a medical professional determines that such restraints are not medically contraindicated. The least restrictive restraint necessary to address those extraordinary circumstances shall be used. The type of restraint used and approval process shall be documented. (d) If the attending physician or nurse treating the pregnant inmate requests that the restraints be removed for a medical reason, the correction officer shall immediately remove all restraints, followed by an immediate verbal notification to a superintendent that is additionally documented in writing. (e) Nothing in 103 CMR 924.17(2) shall prohibit use of hospital restraints requested by a treating physician for the medical safety of a patient. (3) Use of Leg Irons and Waist Chains. Neither leg irons nor waist chains shall be used on an inmate who is pregnant or in post-partum recuperation, as determined by the treating physician. Extraordinary Circumstances. For the purposes of 103 CMR 924.17, extraordinary circumstances exist where a correction officer makes an individualized determination, with prior approval by a superintendent if practicable, that the inmate presents an immediate, serious threat of hurting herself or others, or that the inmate presents an immediate and credible risk of escape that cannot be reasonably contained through other methods. Absent prior approval, immediate verbal notification of the application of restraints shall be made to a superintendent. If an inmate is restrained, the restraints shall be the least restrictive available and the most reasonable under the circumstances, but in no case shall include leg or waist restraints. Any determination of extraordinary circumstances must be documented in writing in advance of the application of any restraint or, if not practicable, by the conclusion of the correction officer's shift. This written documentation shall include the reasons the officer determined extraordinary circumstances existed; the kind of restraints used; and the reasons those restraints were considered the least restrictive available and the most reasonable under the circumstances.