116TH CONGRESS 

2D SESSION H. R. 7718 

AN ACT 

To address the health needs of incarcerated women related 

to pregnancy and childbirth, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Protecting the Health 

3 and Wellness of Babies and Pregnant Women in Custody 

4 Act’’. 

5 SEC. 2. DATA COLLECTION. 

6 (a) IN GENERAL.—Beginning not later than 1 year 

7 after the date of the enactment of this Act, pursuant to 

8 the authority under section 302 of the Omnibus Crime 

9 Control and Safe Streets Act of 1968 (34 U.S.C. 10132), 

10 the Director of the Bureau of Justice Statistics shall in11 clude in the National Prisoner Statistics Program and An12 nual Survey of Jails statistics relating to the health needs 

13 of incarcerated pregnant women in the criminal justice 

14 system at the Federal, State, tribal, and local levels, in15 cluding— 

16 (1) demographic and other information about 

17 incarcerated women who are pregnant, in labor, or 

18 in postpartum recovery, including the race, ethnicity, 

19 and age of the pregnant woman; 

20 (2) the provision of pregnancy care and services 

21 provided for such women, including— 

22 (A) whether prenatal, delivery, and post23 delivery check-up visits were scheduled and pro24 vided; 

25 (B) whether a social worker, psychologist, 

26 doula or other support person, or pregnancy or 
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1 parenting program was offered and provided 

2 during pregnancy and delivery; 

3 (C) whether a nursery or residential pro4 gram to keep mothers and infants together 

5 post-delivery was offered and whether such a 

6 nursery or residential program was provided; 

7 (D) the number of days the mother stayed 

8 in the hospital post-delivery; 

9 (E) the number of days the infant re10 mained with the mother post-delivery; and 

11 (F) the number of days the infant re12 mained in the hospital after the mother was 

13 discharged; 

14 (3) the location of the nearest hospital with a 

15 licensed obstetrician-gynecologist in proximity to 

16 where the inmate is housed and the length of travel 

17 required to transport the inmate; 

18 (4) whether a written policy or protocol is in 

19 place to respond to unexpected childbirth, labor, de20 liveries, and medical complications related to the 

21 pregnancies of incarcerated pregnant women and for 

22 incarcerated pregnant women experiencing labor or 

23 medical complications related to pregnancy outside 

24 of a hospital; 
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1 (5) the number of incarcerated women who are 

2 determined by a health care professional to have a 

3 high-risk pregnancy; 

4 (6) the total number of incarcerated pregnant 

5 women and the number of incarcerated women who 

6 became pregnant while incarcerated; 

7 (7) the number of incidents in which an incar8 cerated woman who is pregnant, in labor, or in 

9 postpartum recovery is placed in restrictive housing, 

10 the reason for such restriction or placement, and the 

11 circumstances under which each incident occurred, 

12 including the duration of time in restrictive housing, 

13 during— 

14 (A) pregnancy; 

15 (B) labor; 

16 (C) delivery; 

17 (D) postpartum recovery; and 

18 (E) the 6-month period after delivery; and 

19 (8) the disposition of the custody of the infant 

20 post-delivery. 

21 (b) PERSONALLY IDENTIFIABLE INFORMATION.— 

22 Data collected under this paragraph may not contain any 

23 personally identifiable information of any incarcerated 

24 pregnant woman. 
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1 SEC. 3. CARE FOR FEDERALLY INCARCERATED WOMEN RE2 LATED TO PREGNANCY AND CHILDBIRTH. 

3 (a) IN GENERAL.—The Director of the Bureau of 

4 Prisons shall ensure that appropriate services and pro5 grams are provided to women in custody, to address the 

6 health and safety needs of such women related to preg7 nancy and childbirth. The warden of each Bureau of Pris8 ons facility that houses women shall ensure that these 

9 services and programs are implemented for women in cus10 tody at that facility. 

11 (b) SERVICES AND PROGRAMS PROVIDED.—The Di12 rector of the Bureau of Prisons shall ensure that the fol13 lowing services and programs are available to women in 

14 custody: 

15 (1) ACCESS TO COMPLETE APPROPRIATE

16 HEALTH SERVICES FOR THE LIFE CYCLE OF

17 WOMEN.—The Director of the Bureau of Prisons 

18 shall provide to each woman in custody who is of re19 productive age pregnancy testing, contraception, and 

20 testing for sexually transmitted diseases and provide 

21 each woman with the option to decline such services. 

22 (2) COMPLIANCE WITH PROTOCOLS RELATING

23 TO HEALTH OF A PREGNANT WOMAN.—On confirma24 tion of the pregnancy of a woman in custody by clin25 ical diagnostics and assessment, the chief health 

26 care professional of a Bureau of Prisons facility that 
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1 houses women shall ensure that a summary of all 

2 appropriate protocols directly pertaining to the safe3 ty and well-being of the woman are provided to the 

4 woman and that such protocols are complied with, 

5 including an assessment of undue safety risks and 

6 necessary changes to accommodate the woman where 

7 and when appropriate, as it relates to— 

8 (A) housing or transfer to a lower bunk for 

9 safety reasons; 

10 (B) appropriate bedding or clothing to re11 spond to a woman’s changing physical require12 ments and the temperature in housing units; 

13 (C) regular access to water and bathrooms; 

14 (D) a diet that complies with the nutri15 tional standards established by the Secretary of 

16 Agriculture and the Secretary of Health and 

17 Human Services in the Dietary Guidelines for 

18 Americans report published pursuant to section 

19 301 of the National Nutrition Monitoring and 

20 Related Research Act of 1990 (7 U.S.C. 

21 5341(a)(3)), and that includes— 

22 (i) any appropriate dietary supple23 ment, including prenatal vitamins; 

24 (ii) timely and regular nutritious 

25 meals; 
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1 (iii) additional caloric content in 

2 meals provided; 

3 (iv) a prohibition on withholding food 

4 from an incarcerated pregnant woman or 

5 serving any food that is used as a punish6 ment, including nutraloaf or any food simi7 lar to nutraloaf that is not considered a 

8 nutritious meal; and 

9 (v) such other modifications to the 

10 diet of the woman as the Director of the 

11 Bureau of Prisons determines to be nec12 essary after consultation with the Sec13 retary of Health and Human Services and 

14 consideration of such recommendations as 

15 the Secretary may provide; 

16 (E) modified recreation and transpor17 tation, in accordance with standards within the 

18 obstetrical and gynecological care community, 

19 to prevent overexertion or prolonged periods of 

20 inactivity; and 

21 (F) such other changes to living conditions 

22 as the Director of the Bureau of Prisons may 

23 require after consultation with the Secretary of 

24 Health and Human Services and consideration 
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1 of such recommendations as the Secretary may 

2 provide. 

3 (3) EDUCATION AND SUPPORT SERVICES.— 

4 (A) PREGNANCY IN CUSTODY.—In the case 

5 of a woman who is pregnant at intake or who 

6 becomes pregnant while in custody, that woman 

7 shall, at intake or not later than 48 hours after 

8 pregnancy is confirmed, as appropriate, receive 

9 prenatal education, counseling, and birth sup10 port services provided by a provider trained to 

11 provide such services, including— 

12 (i) information about the parental 

13 rights of the woman, including the right to 

14 place the child in kinship care, and notice 

15 of the rights of the child; 

16 (ii) information about family preserva17 tion support services that are available to 

18 the woman; 

19 (iii) information about the nutritional 

20 standards referred to in paragraph (2)(D); 

21 (iv) information pertaining to the 

22 health and safety risks of pregnancy, child23 birth, and parenting, including postpartum 

24 depression; 
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1 (v) information on breastfeeding, lac2 tation, and breast health; 

3 (vi) appropriate educational materials, 

4 resources, and services related to preg5 nancy, childbirth, and parenting; 

6 (vii) information and notification serv7 ices for incarcerated parents regarding the 

8 risk of debt repayment obligations associ9 ated with their child’s participation in so10 cial welfare programs, including assistance 

11 under any State program funded under 

12 part A of title IV of the Social Security 

13 Act (42 U.S.C. 601 et seq.) or benefits 

14 under the supplemental nutrition assist15 ance program, as defined in section 3 of 

16 the Food and Nutrition Act of 2008 (7 

17 U.S.C. 2012), or any State program car18 ried out under that Act; and 

19 (viii) information from the Office of 

20 Child Support Enforcement of the Depart21 ment of Health and Human Services re22 garding seeking or modifying child support 

23 while incarcerated, including how to par24 ticipate in the Bureau of Prison’s Inmate 

25 Financial Responsibility Program under 
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1 subpart B of title 28, Code of Federal 

2 Regulations (or any successor program). 

3 (B) BIRTH WHILE IN CUSTODY OR PRIOR

4 TO CUSTODY.—In the case of a woman who 

5 gave birth in custody or who experienced any 

6 other pregnancy outcome during the 6-month 

7 period immediately preceding intake, that 

8 woman shall receive counseling provided by a li9 censed or certified provider trained to provide 

10 such services, including— 

11 (i) information about the parental 

12 rights of the woman, including the right to 

13 place the child in kinship care, and notice 

14 of the rights of the child; and 

15 (ii) information about family preserva16 tion support services that are available to 

17 the woman. 

18 (4) TESTING.—Not later than 1 day after an 

19 incarcerated woman notifies an employee of the Bu20 reau of Prisons that the woman may be pregnant, 

21 a Bureau of Prisons healthcare care professional 

22 shall administer a pregnancy test to determine 

23 whether the woman is pregnant. 

24 (5) EVALUATIONS.—Each woman in custody 

25 who is pregnant or whose pregnancy results in a 
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1 birth or any other pregnancy outcome during the 6- 

2 month period immediately preceding intake or any 

3 time in custody thereafter shall be evaluated not 

4 later than 4 days after intake or confirmation of 

5 pregnancy through evidence-based screening and as6 sessment for substance use disorders or mental 

7 health conditions, including postpartum depression 

8 or depression related to a pregnancy outcome or 

9 early child care. Screening shall include identifica10 tion of any of the following risk factors: 

11 (A) An existing mental or physical health 

12 condition or substance use disorder. 

13 (B) Being underweight or overweight. 

14 (C) Multiple births or a previous still birth. 

15 (D) A history of preeclampsia. 

16 (E) A previous Caesarean section. 

17 (F) A previous miscarriage. 

18 (G) Being older than 35 or younger than 

19 15. 

20 (H) Being diagnosed with the human im21 munodeficiency virus, hepatitis, diabetes, or hy22 pertension. 

23 (I) Such other risk factors as the chief 

24 health care professional of a Bureau of Prisons 
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1 facility that houses women may determine to be 

2 appropriate. 

3 (6) UNEXPECTED BIRTHS RULEMAKING.—Not 

4 later than 180 days after the date of enactment of 

5 this Act, the Attorney General shall make rules es6 tablishing procedures for responding to unexpected 

7 childbirth deliveries, labor complications, and med8 ical complications related to pregnancy if a woman 

9 in custody is unable to access a hospital in a timely 

10 manner. 

11 (7) TREATMENT.—In the case of any woman in 

12 custody who, after an evaluation under paragraph 

13 (4), is diagnosed as having a substance use disorder 

14 or a mental health disorder, that woman shall be en15 titled to treatment in accordance with the following: 

16 (A) Treatment shall include participation 

17 in a support group, including a 12-step pro18 gram, such as Alcoholics Anonymous, Narcotics 

19 Anonymous, and Cocaine Anonymous or a com20 parable nonreligious program. 

21 (B) Treatment may include psychosocial 

22 interventions and medication. 

23 (C) In the case that adequate treatment 

24 cannot be provided to a woman in custody in a 

25 Bureau of Prisons facility, the Director of the 
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1 Bureau of Prisons shall transfer the woman to 

2 a residential reentry program that offers such 

3 treatment pursuant to section 508 of the Public 

4 Health Service Act (42 U.S.C. 290bb–1). 

5 (D) To the extent practicable, treatment 

6 for substance use disorders provided pursuant 

7 to this section shall be conducted in a licensed 

8 hospital. 

9 SEC. 4. USE OF RESTRICTIVE HOUSING AND RESTRAINTS 

10 ON INCARCERATED PREGNANT WOMEN DUR11 ING PREGNANCY, LABOR, AND POSTPARTUM 

12 RECOVERY PROHIBITED. 

13 (a) IN GENERAL.—Section 4322 of title 18, United 

14 States Code, is amended to read as follows: 

15 ‘‘§ 4322. Use of restraints and restrictive housing on 

16 incarcerated women during the period of 

17 pregnancy, labor, and postpartum recov18 ery prohibited and to improve pregnancy 

19 care for women in Federal prisons 

20 ‘‘(a) PROHIBITION.—Except as provided in sub21 section (b), beginning on the date on which pregnancy is 

22 confirmed by a health care professional and ending not 

23 earlier than 12 weeks after delivery, an incarcerated 

24 woman in the custody of the Bureau of Prisons, or in the 

25 custody of the United States Marshals Service pursuant 
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1 to section 4086, shall not be placed in restraints or held 

2 in restrictive housing. 

3 ‘‘(b) EXCEPTIONS.— 

4 ‘‘(1) USE OF RESTRAINTS.—The prohibition 

5 under subsection (a) shall not apply if the senior 

6 Bureau of Prisons official or United States Marshals 

7 Service official overseeing women’s health and serv8 ices and a health care professional responsible for 

9 the health and safety of the incarcerated woman de10 termines that the use of restraints is appropriate for 

11 the medical safety of the woman, and the health care 

12 professional reviews such determination not later 

13 than every 6 hours after such use is initially ap14 proved until such use is terminated. 

15 ‘‘(2) SITUATIONAL USE.—The individualized de16 termination described under paragraph (1) shall only 

17 apply to a specific situation and must be reaffirmed 

18 through the same process to use restraints again in 

19 any future situation involving the same woman. 

20 ‘‘(3) ACCESS TO CARE.—Immediately upon the 

21 cessation of the use of restraints or restrictive hous22 ing as outlined in this subsection, the Director of the 

23 Bureau of Prisons or the United States Marshal 

24 Service shall provide the incarcerated woman with 
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1 immediate access to physical and mental health as2 sessments and all recommended treatment. 

3 ‘‘(4) RESPONSE TO BEHAVIORAL RISKS IN THE

4 BUREAU OF PRISONS.— 

5 ‘‘(A) RESTRICTIVE HOUSING.—The prohi6 bition under subsection (a) relating to restric7 tive housing shall not apply if the Director of 

8 the Bureau of Prisons or a senior Bureau of 

9 Prisons official overseeing women’s health and 

10 services, in consultation with senior officials in 

11 health services, makes an individualized deter12 mination that restrictive housing is required as 

13 a temporary response to behavior that poses a 

14 serious and immediate risk of physical harm. 

15 ‘‘(B) REVIEW.—The official who makes a 

16 determination under subparagraph (A) shall re17 view such determination every 4 hours for the 

18 purpose of removing an incarcerated woman as 

19 quickly as feasible from restrictive housing. 

20 ‘‘(C) RESTRICTIVE HOUSING PLAN.—The 

21 official who makes a determination under sub22 paragraph (A) shall develop an individualized 

23 plan to move an incarcerated woman to less re24 strictive housing within a reasonable amount of 

25 time, not to exceed 2 days. 
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1 ‘‘(D) MONITORING.—An incarcerated 

2 woman who is placed in restrictive housing pur3 suant to this paragraph shall be— 

4 ‘‘(i) monitored every hour; 

5 ‘‘(ii) placed in a location visible to cor6 rectional officers; and 

7 ‘‘(iii) prohibited from being placed in 

8 solitary confinement if the incarcerated 

9 woman is in her third trimester. 

10 ‘‘(c) REPORTS.— 

11 ‘‘(1) REPORT TO THE DIRECTOR AND HEALTH

12 CARE PROFESSIONAL AFTER THE USE OF RE13 STRAINTS.—If an official identified in subsection 

14 (b)(1) or a correctional officer uses restraints on an 

15 incarcerated woman under subsection (b), that offi16 cial (or an officer or marshal designated by that offi17 cial) or correctional officer shall submit, not later 

18 than 30 days after placing the woman in restraints, 

19 to the Director of the Bureau of Prisons or the Di20 rector of the U.S. Marshal Service, as applicable, a 

21 written report which describes the facts and cir22 cumstances surrounding the use of restraints, and 

23 includes each of the following: 
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1 ‘‘(A) A description of all attempts to use 

2 alternative interventions and sanctions before 

3 the restraints were used. 

4 ‘‘(B) A description of the circumstances 

5 that led to the use of restraints. 

6 ‘‘(C) Strategies the facility is putting in 

7 place to identify more appropriate alternative 

8 interventions should a similar situation arise 

9 again. 

10 ‘‘(2) REPORT TO CONGRESS.—Beginning on the 

11 date that is 6 months after the date of enactment 

12 of the Protecting the Health and Wellness of Babies 

13 and Pregnant Women in Custody Act, and every 6 

14 months thereafter for a period of 10 years, the At15 torney General shall submit to the Committees on 

16 the Judiciary of the House of Representatives and 

17 the Senate a report on— 

18 ‘‘(A) the reasoning upon which the deter19 mination to use restraints was made; 

20 ‘‘(B) the details of the use of restraints, 

21 including the type of restraints used and length 

22 of time during which restraints were used; and 

23 ‘‘(C) any resulting physical effects on the 

24 prisoner observed by or known to the correc-
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1 tions official or United States Marshal, as ap2 plicable. 

3 ‘‘(3) REPORT TO THE DIRECTOR AND HEALTH

4 CARE PROFESSIONAL AFTER PLACEMENT IN RE5 STRICTIVE HOUSING.—If an official identified in 

6 subsection (b)(3), correctional officer, or United 

7 States Marshal places or causes an incarcerated 

8 woman to be placed in restrictive housing under 

9 such subsection, that official, correctional officer, or 

10 United States Marshal shall submit, not later than 

11 30 days after placing or causing the placement of 

12 the incarcerated woman in restrictive housing, to the 

13 Director of the Bureau of Prisons or the Director of 

14 the United States Marshals Service, as applicable, 

15 and to the health care professional responsible for 

16 the health and safety of the woman, a written report 

17 which describes the facts and circumstances sur18 rounding the restrictive housing placement, and in19 cludes the following: 

20 ‘‘(A) The reasoning upon which the deter21 mination for the placement was made. 

22 ‘‘(B) The details of the placement, includ23 ing length of time of placement and how fre24 quently and how many times the determination 

25 was made subsequent to the initial determina-
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1 tion to continue the restrictive housing place2 ment. 

3 ‘‘(C) A description of all attempts to use 

4 alternative interventions and sanctions before 

5 the restrictive housing was used. 

6 ‘‘(D) Any resulting physical effects on the 

7 woman observed by or reported by the health 

8 care professional responsible for the health and 

9 safety of the woman. 

10 ‘‘(E) Strategies the facility is putting in 

11 place to identify more appropriate alternative 

12 interventions should a similar situation arise 

13 again. 

14 ‘‘(4) REPORT TO CONGRESS.—Beginning on the 

15 date that is 6 months after the date of enactment 

16 of the Protecting the Health and Wellness of Babies 

17 and Pregnant Women in Custody Act, and every 6 

18 months thereafter for a period of 10 years, the At19 torney General shall submit to the Committees on 

20 the Judiciary of the House of Representatives and 

21 the Senate a report on the information described in 

22 paragraph (3). 

23 ‘‘(d) NOTICE.—Not later than 24 hours after the con24 firmation of an incarcerated woman’s pregnancy by a 

25 health care professional, that woman shall be notified, 
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1 orally and in writing, by an appropriate health care profes2 sional, correctional officer, or United States Marshal, as 

3 applicable— 

4 ‘‘(1) of the restrictions on the use of restraints 

5 and restrictive housing placements under this sec6 tion; 

7 ‘‘(2) of the incarcerated woman’s right to make 

8 a confidential report of a violation of restrictions on 

9 the use of restraints or restrictive housing place10 ment; and 

11 ‘‘(3) that the facility staff have been advised of 

12 all rights of the incarcerated woman under sub13 section (a). 

14 ‘‘(e) VIOLATION REPORTING PROCESS.—Not later 

15 than 180 days after the date of enactment of this Act, 

16 the Director of the Bureau of Prisons and the Director 

17 of the United States Marshals Service shall establish proc18 esses through which an incarcerated person may report 

19 a violation of this section. 

20 ‘‘(f) NOTIFICATION OF RIGHTS.—The warden of the 

21 Bureau of Prisons facility where a pregnant woman is in 

22 custody shall notify necessary facility staff of the preg23 nancy and of the incarcerated pregnant woman’s rights 

24 under subsection (a). 
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1 ‘‘(g) RETALIATION.—It shall be unlawful for any Bu2 reau of Prisons or United States Marshal Service em3 ployee to retaliate against an incarcerated person for re4 porting under the provisions of subsection (e) a violation 

5 of subsection (a). 

6 ‘‘(h) EDUCATION.—Not later than 90 days after the 

7 date of enactment of the Protecting the Health and 

8 Wellness of Babies and Pregnant Women in Custody Act, 

9 the Director of the Bureau of Prisons and the Director 

10 of the United States Marshals Service shall each develop 

11 education guidelines regarding the physical and mental 

12 health needs of incarcerated pregnant women, and the use 

13 of restraints and restrictive housing placements on incar14 cerated women during the period of pregnancy, labor, and 

15 postpartum recovery, and shall incorporate such guidelines 

16 into appropriate education programs. 

17 ‘‘(i) DEFINITION.—In this section: 

18 ‘‘(1) RESTRAINTS.—The term ‘restraints’ 

19 means any physical or mechanical device used to 

20 control the movement of an incarcerated pregnant 

21 woman’s body, limbs, or both. 

22 ‘‘(2) RESTRICTIVE HOUSING.—The term ‘re23 strictive housing’ means any type of detention that 

24 involves— 
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1 ‘‘(A) removal from the general inmate pop2 ulation, whether voluntary or involuntary; 

3 ‘‘(B) placement in a locked room or cell, 

4 whether alone or with another inmate; and 

5 ‘‘(C) inability to leave the room or cell for 

6 the vast majority of the day.’’. 

7 (b) CLERICAL AMENDMENT.—The table of sections 

8 at the beginning of chapter 317 of title 18, United States 

9 Code, is amended by amending the item relating to section 

10 4322 to read as follows: 

‘‘4322. Use of restraints and restrictive housing on incarcerated women during 

the period of pregnancy, labor, and postpartum recovery prohibited and to improve pregnancy care for women in Federal 

prisons.’’. 

11 SEC. 5. TREATMENT OF WOMEN WITH HIGH-RISK PREG12 NANCIES. 

13 (a) IN GENERAL.—Chapter 303 of title 18, United 

14 States Code, is amended by adding at the end the fol15 lowing: 

16 ‘‘§ 4051. Treatment of incarcerated pregnant women 

17 ‘‘(a) HIGH-RISK PREGNANCY HEALTH CARE.—The 

18 Director of the Bureau of Prisons shall ensure that each 

19 incarcerated pregnant woman receives health care appro20 priate for a high-risk pregnancy, including obstetrical and 

21 gynecological care, during pregnancy and post-partum re22 covery. 

23 ‘‘(b) HIGH-RISK PREGNANCIES.— 
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1 ‘‘(1) IN GENERAL.—The Director of the Bureau 

2 of Prisons shall transfer any incarcerated woman, 

3 who is determined by a health care professional to 

4 have a high-risk pregnancy and who agrees to be 

5 transferred, to a Residential Reentry Center with 

6 adequate health care during her pregnancy and post7 partum recovery. 

8 ‘‘(2) PRIORITY.—The Residential Reentry Cen9 ter to which an incarcerated pregnant woman is 

10 transferred pursuant to paragraph (1) shall be in a 

11 geographical location that is close to the family 

12 members of the incarcerated pregnant woman. In 

13 the case that a Residential Reentry Center is un14 available, the incarcerated pregnant woman shall be 

15 transferred to alternative housing, including housing 

16 with a family member. 

17 ‘‘(3) TRANSPORTATION.—To transport an in18 carcerated pregnant woman to a Residential Reentry 

19 Center, the Director of the Bureau of Prisons shall 

20 provide to the woman a mode of transportation that 

21 has been approved by the woman’s health care pro22 fessional, at no expense to the woman. 

23 ‘‘(4) MONITORING.—In the case that an incar24 cerated pregnant woman transferred to alternative 

25 housing pursuant to this section is monitored elec-
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1 tronically, an ankle monitor may not be used on the 

2 woman, unless there is no feasible alternative for 

3 monitoring the woman. 

4 ‘‘(5) SERVICE OF SENTENCE.—Any time ac5 crued at a Residential Reentry Center or alternative 

6 housing as a result of a transfer made pursuant to 

7 this section shall be credited toward service of the 

8 incarcerated pregnant woman’s sentence. 

9 ‘‘(6) CREDIT FOR PRETRIAL CUSTODY.—In the 

10 case of an incarcerated pregnant woman, any time 

11 accrued in pretrial custody shall be credited toward 

12 service of the woman’s sentence. 

13 ‘‘(c) DEFINITIONS.—In this section: 

14 ‘‘(1) FAMILY MEMBER.—The term ‘family 

15 member’ means any individual related by blood or 

16 affinity whose close association with the incarcerated 

17 pregnant woman is the equivalent of a family rela18 tionship, including a parent, sibling, child, or indi19 vidual standing in loco parentis. 

20 ‘‘(2) RESIDENTIAL REENTRY CENTER.—The 

21 term ‘Residential Reentry Center’ means a Bureau 

22 of Prisons contracted residential reentry center. 

23 ‘‘(3) HEALTH CARE PROFESSIONAL.— 

24 ‘‘(A) IN GENERAL.—The term ‘health care 

25 professional’ means— 
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1 ‘‘(i) a doctor of medicine or osteop2 athy who is authorized to practice medicine 

3 or surgery by the State in which the doctor 

4 practices; 

5 ‘‘(ii) any physician’s assistant or 

6 nurse practitioner who is supervised by a 

7 doctor of medicine or osteopathy described 

8 in clause (i); or 

9 ‘‘(iii) any other person determined by 

10 the Secretary to be capable of providing 

11 health care services. 

12 ‘‘(B) OTHER HEALTH CARE SERVICES.—A 

13 person is capable of providing health care serv14 ices if the person is— 

15 ‘‘(i) a podiatrist, dentist, clinical psy16 chologist, optometrist, or chiropractor (lim17 ited to treatment consisting of manual ma18 nipulation of the spine to correct a sub19 luxation as demonstrated by X-ray to 

20 exist) authorized to practice in the State 

21 and performing within the scope of their 

22 practice as defined under State law; 

23 ‘‘(ii) a nurse practitioner, nurse-mid24 wife, clinical social worker, or physician’s 

25 assistant who is authorized to practice 
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1 under State law and who is performing 

2 within the scope of their practice as de3 fined under State law; and 

4 ‘‘(iii) any health care professional 

5 from whom an employer or the employer’s 

6 group health plan’s benefits manager will 

7 accept certification of the existence of a se8 rious health condition to substantiate a 

9 claim for benefits. 

10 ‘‘(C) AUTHORIZED TO PRACTICE IN THE

11 STATE.—The term ‘authorized to practice in 

12 the State’ means that a professional must be 

13 authorized to diagnose and treat physical or 

14 mental health conditions under the laws of the 

15 State in which the professional practices and 

16 where the facility is located. 

17 ‘‘(4) HIGH-RISK PREGNANCY.—The term ‘high18 risk pregnancy’ means, with respect to an incarcer19 ated woman, that the pregnancy threatens the 

20 health or life of the woman or pregnancy, as deter21 mined by a health care professional. 

22 ‘‘(5) POST-PARTUM RECOVERY.—The term 

23 ‘post-partum recovery’ means the 3-month period be24 ginning on the date on which an incarcerated preg25 nant woman gives birth.’’. 
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1 (b) CONFORMING AMENDMENT.—The table of sec2 tions for chapter 303 of title 18, United States Code, is 

3 amended by adding at the end the following: 

‘‘4051. Treatment of incarcerated pregnant women.’’. 

4 SEC. 6. EXEMPTION OF INCARCERATED PREGNANT WOMEN 

5 FROM THE REQUIREMENTS FOR SUITS BY 

6 PRISONERS. 

7 Section 7 of the Civil Rights of Institutionalized Per8 sons Act (42 U.S.C. 1997e) is amended— 

9 (1) in subsection (a), by inserting after the pe10 riod at the end the following: ‘‘This subsection shall 

11 not apply with respect to an incarcerated pregnant 

12 woman who brings an action relating to or affecting 

13 the woman’s pregnancy.’’; and 

14 (2) in subsection (d)(1), insert ‘‘, except an in15 carcerated pregnant woman,’’ before ‘‘who is con16 fined’’. 

17 SEC. 7. DEFINITIONS. 

18 In this Act: 

19 (1) IN CUSTODY.—The term ‘‘in custody’’ 

20 means, with respect to an individual, that the indi21 vidual is under the supervision of a Federal, State, 

22 tribal or local correctional facility, including pretrial 

23 and contract facilities, and juvenile or medical or 

24 mental health facilities. 
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1 (2) OTHER PREGNANCY OUTCOME.—The term 

2 ‘‘other pregnancy outcome’’ means a pregnancy that 

3 ends in stillbirth, miscarriage, or ectopic pregnancy. 

4 (3) POSTPARTUM RECOVERY.—The term ‘‘post5 partum recovery’’ means the 12-week period, or 

6 longer as determined by the health care professional 

7 responsible for the health and safety of the incarcer8 ated pregnant woman, following delivery, and shall 

9 include the entire period that the incarcerated preg10 nant woman is in the hospital or infirmary. 

11 (4) RESTRAINTS.—The term ‘‘restraints’’ 

12 means any physical or mechanical device used to 

13 control the movement of an incarcerated pregnant 

14 woman’s body, limbs, or both. 

15 (5) RESTRICTIVE HOUSING.—The term ‘‘re16 strictive housing’’ means any type of detention that 

17 involves— 

18 (A) removal from the general inmate popu19 lation, whether voluntary or involuntary; 

20 (B) placement in a locked room or cell, 

21 whether alone or with another inmate; and 

22 (C) inability to leave the room or cell for 

23 the vast majority of the day. 
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1 SEC. 8. EDUCATION AND TECHNICAL ASSISTANCE. 

2 The Director of the National Institute of Corrections 

3 shall provide education and technical assistance, in con4 junction with the appropriate public agencies, at State and 

5 local correctional facilities that house women and facilities 

6 in which incarcerated women go into labor and give birth, 

7 in order to educate the employees of such facilities, includ8 ing health personnel, on the dangers and potential mental 

9 health consequences associated with the use of restrictive 

10 housing and restraints on incarcerated women during 

11 pregnancy, labor, and postpartum recovery, and on alter12 natives to the use of restraints and restrictive housing 

13 placement. 

14 SEC. 9. BUREAU OF PRISONS STAFF AND U.S. MARSHALS 

15 TRAINING. 

16 (a) BUREAU OF PRISONS TRAINING.—Beginning not 

17 later than 180 days after the date of enactment of this 

18 Act, and biannually thereafter, the Director of the Bureau 

19 of Prisons shall train each correctional officer at any Bu20 reau of Prisons women’s facility to carry out the require21 ments of this Act. 

22 (b) NEW HIRES.—Beginning not later than 180 days 

23 after the date of enactment of this Act, the Director of 

24 the Bureau of Prisons shall train any newly hired correc25 tional officer at a Bureau of Prisons facility that houses 
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1 women to carry out the requirements of this Act not later 

2 than 30 days after the date on which the officer is hired. 

3 (c) U.S. MARSHAL TRAINING.—Beginning not later 

4 than 180 days after the date of enactment of this Act, 

5 and biannually thereafter, the Director of the U.S. Mar6 shals Service shall ensure that each Deputy U.S. Marshal 

7 is trained pursuant to the guidelines described in sub8 section (d). Newly hired deputies shall receive such train9 ing not later than 30 days after the date on which such 

10 deputy starts employment. 

11 (d) GUIDELINES.—The Director of the Bureau of 

12 Prisons and the United States Marshals Service shall each 

13 develop guidelines on the treatment of incarcerated women 

14 during pregnancy, labor, and postpartum recovery and in15 corporate such guidelines in the training required under 

16 this section. Such guidelines shall include guidance on— 

17 (1) the transportation of incarcerated pregnant 

18 women; 

19 (2) housing of incarcerated pregnant women; 

20 (3) nutritional requirements for incarcerated 

21 pregnant women; and 

22 (4) the right of a health care professional to re23 quest that restraints not be used. 
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1 SEC. 10. GAO STUDY ON STATE AND LOCAL CORRECTIONAL 

2 FACILITIES. 

3 The Comptroller General of the United States shall 

4 conduct a study of services and protections provided for 

5 pregnant incarcerated women in local and State correc6 tional settings, including policies on obstetrical and gyne7 cological care, education on nutrition, health and safety 

8 risks associated with pregnancy, mental health and sub9 stance use treatment, access to prenatal and post-delivery 

10 support services and programs, the use of restraints and 

11 restrictive housing placement, and the extent to which the 

12 intent of such policies are fulfilled. 

13 SEC. 11. GAO STUDY ON FEDERAL PRETRIAL DETENTION 

14 FACILITIES. 

15 (a) STUDY.—The Comptroller General of the United 

16 States shall conduct a study of services and protections 

17 provided for pregnant women who are incarcerated in Fed18 eral pretrial detention facilities. Specifically, the study 

19 shall examine— 

20 (1) what available data indicate about pregnant 

21 women detained or held in Federal pretrial detention 

22 facilities; 

23 (2) existing U.S. Marshals Service policies and 

24 standards that address the care of pregnant women 

25 in Federal pretrial detention facilities; and 
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1 (3) what is known about the care provided to 

2 pregnant women in Federal pretrial detention facili3 ties. 

4 (b) REPORT AND BEST PRACTICES.—Not later than 

5 2 years after the date of enactment of this Act, the Comp6 troller General shall submit a report of the results of the 

7 study conducted under subsection (a) to the Committee 

8 on the Judiciary of the Senate and the Committee on the 

9 Judiciary of the House of Representatives. The report 

10 shall identify best practices for ensuring that Federal pre11 trial detention facilities implement services and protec12 tions for pregnant women consistent with this Act and 

13 shall provide recommendations on how to implement these 

14 best practices among all Federal pretrial detention facili15 ties. 

16 (c) DEFINITION.—For purposes of this section, the 

17 term ‘‘Federal pretrial detention facilities’’ includes State, 

18 local, private, or other facilities under contract with the 

19 U.S. Marshals Service for the purpose of housing Federal 

20 pretrial detainees. 

21 SEC. 12. PWIC GRANT PROGRAM. 

22 Section 508 of the Omnibus Crime Control and Safe 

23 Streets Act of 1968 (34 U.S.C. 10151 et seq.) is amended 

24 to read as follows: 
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1 ‘‘SEC. 508. PREGNANT WOMEN IN CUSTODY GRANT PRO2 GRAM. 

3 ‘‘(a) SHORT TITLE.—This section may be cited as the 

4 ‘Pregnant Women in Custody Grant Program of 2020’ or 

5 the ‘PWIC Act of 2020’. 

6 ‘‘(b) ESTABLISHMENT.—The Attorney General may 

7 make grants to eligible entities that have established a 

8 program to promote the health needs of incarcerated preg9 nant women in the criminal justice system at the State, 

10 tribal, and local levels or have declared their intent to es11 tablish such a program. Eligible entities shall— 

12 ‘‘(1) promote the safety and wellness of preg13 nant women in custody; 

14 ‘‘(2) provide services for obstetrical and gyneco15 logical care, for women in custody; 

16 ‘‘(3) facilitate resources and support services 

17 for nutrition and physical and mental health, for 

18 women in custody; 

19 ‘‘(4) establish and maintain policies that are 

20 substantially similar to the limitations imposed 

21 under section 4322 of title 18, United States Code, 

22 limiting the use of restraints on pregnant women in 

23 custody; and 

24 ‘‘(5) maintain, establish, or build post-delivery 

25 lactation and nursery care or residential programs to 

26 keep the infant with the mother and to promote and 
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1 facilitate bonding skills for incarcerated pregnant 

2 women and women with dependent children. 

3 ‘‘(c) GRANT PERIOD.—A grant awarded under this 

4 section shall be for a period of not more than 5 years. 

5 ‘‘(d) ELIGIBLE ENTITY.—An entity is eligible for a 

6 grant under this section if the entity is— 

7 ‘‘(1) a State or territory department of correc8 tions; 

9 ‘‘(2) a tribal entity that operates a correctional 

10 facility; or 

11 ‘‘(3) a unit of local government that operates a 

12 prison or jail that houses women; or 

13 ‘‘(4) a locally-based nonprofit organization, that 

14 has partnered with a State or unit of local govern15 ment that operates a correctional facility, with ex16 pertise in providing health services to incarcerated 

17 pregnant women. 

18 ‘‘(e) APPLICATION.—To receive a grant under this 

19 section, an eligible entity shall submit an application to 

20 the Attorney General at such time, in such manner, and 

21 containing such information as the Attorney General may 

22 require, including a detailed description of the need for 

23 the grant and an account of the number of individuals the 

24 grantee expects to benefit from the grant. 
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1 ‘‘(f) ADMINISTRATIVE COSTS.—Not more than 5 per2 cent of a grant awarded under this section may be used 

3 for costs incurred to administer such grant. 

4 ‘‘(g) CONSTRUCTION COSTS.—Notwithstanding any 

5 other provision of this Act, no funds provided under this 

6 section may be used, directly or indirectly, for construction 

7 projects, other than new construction or upgrade to a fa8 cility used to provide lactation, nursery, obstetrical, or 

9 gynecological services. 

10 ‘‘(h) PRIORITY FUNDING FOR STATES THAT PRO11 VIDE PROGRAMS AND SERVICES FOR INCARCERATED

12 WOMEN RELATED TO PREGNANCY AND CHILDBIRTH.— 

13 In determining the amount provided to a State or unit 

14 of local government under this section, the Attorney Gen15 eral shall give priority to States or units of local govern16 ment that have enacted laws or policies and implemented 

17 services or pilot programs for incarcerated pregnant 

18 women aimed at enhancing the safety and wellness of 

19 pregnant women in custody, including providing services 

20 for obstetrical and gynecological care, resources and sup21 port services for nutrition and physical and mental health, 

22 and post-delivery lactation and nursery care or residential 

23 programs to keep the infant with the mother and to pro24 mote and facilitate bonding skills for incarcerated preg25 nant women and women with dependent children. 
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1 ‘‘(i) SUBGRANT PRIORITY.—A State that receives a 

2 grant under this section shall prioritize subgrants to a unit 

3 of local government within the State that has established 

4 a pilot program that enhances safety and wellness of preg5 nant women in custody. 

6 ‘‘(j) FEDERAL SHARE.— 

7 ‘‘(1) IN GENERAL.—The Federal share of a 

8 grant under this section may not exceed 75 percent 

9 of the total costs of the projects described in the 

10 grant application. 

11 ‘‘(2) WAIVER.—The requirement of paragraph 

12 (1) may be waived by the Assistant Attorney Gen13 eral upon a determination that the financial cir14 cumstances affecting the applicant warrant a finding 

15 that such a waiver is equitable. 

16 ‘‘(k) COMPLIANCE AND REDIRECTION OF FUNDS.— 

17 ‘‘(1) IN GENERAL.—Not later than 1 year after 

18 an eligible entity receives a grant under this section, 

19 such entity shall implement a policy that is substan20 tially similar to the policy under section 3 of Pro21 tecting the Health and Wellness of Babies and Preg22 nant Women in Custody Act. 

23 ‘‘(2) EXTENSION.—The Attorney General may 

24 provide a 120-day extension to an eligible entity that 
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1 is making good faith efforts to collect the informa2 tion required under paragraph (1). 

3 ‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out this section, 

5 to remain available until expended— 

6 ‘‘(1) for fiscal year 2021, $5,000,000; 

7 ‘‘(2) for fiscal year 2022, $5,000,000; 

8 ‘‘(3) for fiscal year 2023, $5,000,000; 

9 ‘‘(4) for fiscal year 2024, $6,000,000; and 

10 ‘‘(5) for fiscal year 2025, $6,000,000. 

11 ‘‘(m) FUNDS TO BE SUPPLEMENTAL.—To receive a 

12 grant under this section, the eligible entity shall certify 

13 to the Attorney General that the amounts received under 

14 the grant shall be used to supplement, not supplant, non15 Federal funds that would otherwise be available for pro16 grams or services in the prison where funds will be used. 

17 ‘‘(n) UNOBLIGATED AND UNSPENT FUNDS.—Funds 

18 made available pursuant to this section that remain unob19 ligated for a period of 6 months after the end of the fiscal 

20 year for which the funds have been appropriated shall be 

21 awarded to other recipients of this grant. 

22 ‘‘(o) CIVIL RIGHTS OBLIGATION.—A recipient of a 

23 grant under this section shall be subject to the non24 discrimination requirement under section 40002(b)(13) of 
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1 the Violence Against Women Act of 1994 (34 U.S.C. 

2 12291(b)(13)). 

3 ‘‘(p) DEFINITIONS.—In this section, the term ‘in cus4 tody’ means, with respect to an individual, that the indi5 vidual is under the supervision of a Federal, State, tribal, 

6 or local correctional facility, including pretrial and con7 tract facilities, and juvenile or medical or mental health 

8 facilities.’’. 

9 SEC. 13. PLACEMENT IN PRERELEASE CUSTODY. 

10 Section 3624(c)(1) of title 18, United States Code, 

11 is amended by adding at the end the following: ‘‘Notwith12 standing any other provision of this paragraph, in the case 

13 of a pregnant woman in custody, if that woman’s due date 

14 is within the final year of her term of imprisonment, that 

15 woman may be placed into prerelease custody beginning 

16 not earlier than the date that is 2 months prior to that 

17 woman’s due date.’’. 

18 SEC. 14. DETERMINATION OF BUDGETARY EFFECTS. 

19 The budgetary effects of this Act, for the purpose of 

20 complying with the Statutory Pay-As-You-Go Act of 2010, 

21 shall be determined by reference to the latest statement 

22 titled ‘‘Budgetary Effects of PAYGO Legislation’’ for this 

23 Act, submitted for printing in the Congressional Record 

24 by the Chairman of the House Budget Committee, pro-
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1 vided that such statement has been submitted prior to the 

2 vote on passage. 

Passed the House of Representatives October 1, 

2020. 

Attest: 

Clerk. 
116TH CONGRESS 

2D SESSION H. R. 7718 

AN ACT 

To address the health needs of incarcerated women 

other purposes. related to pregnancy and childbirth, and for