IB 

Union Calendar No. 436 

116TH CONGRESS 

2D SESSION H. R. 7718 

[Report No. 116–536] 

To address the health needs of incarcerated women related to pregnancy 

and childbirth, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 22, 2020 

Ms. BASS (for herself, Mr. RESCHENTHALER, Ms. CLARK of Massachusetts, 

and Mrs. LESKO) introduced the following bill; which was referred to the 

Committee on the Judiciary 

SEPTEMBER 24, 2020 

Additional sponsors: Mrs. RODGERS of Washington, Mrs. WATSON COLEMAN, 

Ms. LEE of California, Ms. SPEIER, Mrs. WALORSKI, Mr. CHABOT, Mrs. 

WAGNER, Mrs. LAWRENCE, Mr. CARSON of Indiana, Mr. BLUMENAUER, 

Ms. NORTON, Ms. MENG, Ms. ADAMS, Ms. BONAMICI, Ms. WASSERMAN

SCHULTZ, Ms. SEWELL of Alabama, Mrs. BUSTOS, Ms. KAPTUR, Mrs. 

BEATTY, Mr. VELA, Ms. ROYBAL-ALLARD, Mr. BROWN of Maryland, Mr. 

HASTINGS, Mrs. HAYES, Mr. THOMPSON of Mississippi, Mr. CA ́RDENAS, 

Mr. RYAN, Ms. BLUNT ROCHESTER, Mr. CORREA, Ms. JACKSON LEE, 

Mr. COHEN, and Ms. GARCIA of Texas 

SEPTEMBER 24, 2020 

Reported from the Committee on the Judiciary; committed to the Committee 

of the Whole House on the State of the Union and ordered to be printed 


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A BILL 

To address the health needs of incarcerated women related 

to pregnancy and childbirth, and for other purposes. 


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

3 SECTION 1. SHORT TITLE. 

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

5 and Wellness of Babies and Pregnant Women in Custody 

6 Act’’. 

7 SEC. 2. DATA COLLECTION. 

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

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

10 the authority under section 302 of the Omnibus Crime 

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

12 the Director of the Bureau of Justice Statistics shall in13 clude in the National Prisoner Statistics Program and An14 nual Survey of Jails statistics relating to the health needs 

15 of incarcerated pregnant women in the criminal justice 

16 system at the Federal, State, tribal, and local levels, in17 cluding— 

18 (1) demographic and other information about 

19 incarcerated women who are pregnant, in labor, or 

20 in postpartum recovery, including the race, ethnicity, 

21 and age of the pregnant woman; 

22 (2) the provision of pregnancy care and services 

23 provided for such women, including— 


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1 (A) whether prenatal, delivery, and post2 delivery check-up visits were scheduled and pro3 vided; 

4 (B) whether a social worker, psychologist, 

5 doula or other support person, or pregnancy or 

6 parenting program was offered and provided 

7 during pregnancy and delivery; 

8 (C) whether a nursery or residential pro9 gram to keep mothers and infants together 

10 post-delivery was offered and whether such a 

11 nursery or residential program was provided; 

12 (D) the number of days the mother stayed 

13 in the hospital post-delivery; 

14 (E) the number of days the infant re15 mained with the mother post-delivery; and 

16 (F) the number of days the infant re17 mained in the hospital after the mother was 

18 discharged; 

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

20 licensed obstetrician-gynecologist in proximity to 

21 where the inmate is housed and the length of travel 

22 required to transport the inmate; 

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

24 place to respond to unexpected childbirth, labor, de25 liveries, and medical complications related to the 


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1 pregnancies of incarcerated pregnant women and for 

2 incarcerated pregnant women experiencing labor or 

3 medical complications related to pregnancy outside 

4 of a hospital; 

5 (5) the number of incarcerated women who are 

6 determined by a health care professional to have a 

7 high-risk pregnancy; 

8 (6) the total number of incarcerated pregnant 

9 women and the number of incarcerated women who 

10 became pregnant while incarcerated; 

11 (7) the number of incidents in which an incar12 cerated woman who is pregnant, in labor, or in 

13 postpartum recovery is placed in restrictive housing, 

14 the reason for such restriction or placement, and the 

15 circumstances under which each incident occurred, 

16 including the duration of time in restrictive housing, 

17 during— 

18 (A) pregnancy; 

19 (B) labor; 

20 (C) delivery; 

21 (D) postpartum recovery; and 

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

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

24 post-delivery. 


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1 (b) PERSONALLY IDENTIFIABLE INFORMATION.— 

2 Data collected under this paragraph may not contain any 

3 personally identifiable information of any incarcerated 

4 pregnant woman. 

5 SEC. 3. CARE FOR FEDERALLY INCARCERATED WOMEN RE6 LATED TO PREGNANCY AND CHILDBIRTH. 

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

8 Prisons shall ensure that appropriate services and pro9 grams are provided to women in custody, to address the 

10 health and safety needs of such women related to preg11 nancy and childbirth. The warden of each Bureau of Pris12 ons facility that houses women shall ensure that these 

13 services and programs are implemented for women in cus14 tody at that facility. 

15 (b) SERVICES AND PROGRAMS PROVIDED.—The Di16 rector of the Bureau of Prisons shall ensure that the fol17 lowing services and programs are available to women in 

18 custody: 

19 (1) ACCESS TO COMPLETE APPROPRIATE

20 HEALTH SERVICES FOR THE LIFE CYCLE OF

21 WOMEN.—The Director of the Bureau of Prisons 

22 shall provide to each woman in custody who is of re23 productive age pregnancy testing, contraception, and 

24 testing for sexually transmitted diseases and provide 

25 each woman with the option to decline such services. 


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1 (2) COMPLIANCE WITH PROTOCOLS RELATING

2 TO HEALTH OF A PREGNANT WOMAN.—On confirma3 tion of the pregnancy of a woman in custody by clin4 ical diagnostics and assessment, the chief health 

5 care professional of a Bureau of Prisons facility that 

6 houses women shall ensure that a summary of all 

7 appropriate protocols directly pertaining to the safe8 ty and well-being of the woman are provided to the 

9 woman and that such protocols are complied with, 

10 including an assessment of undue safety risks and 

11 necessary changes to accommodate the woman where 

12 and when appropriate, as it relates to— 

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

14 safety reasons; 

15 (B) appropriate bedding or clothing to re16 spond to a woman’s changing physical require17 ments and the temperature in housing units; 

18 (C) regular access to water and bathrooms; 

19 (D) a diet that complies with the nutri20 tional standards established by the Secretary of 

21 Agriculture and the Secretary of Health and 

22 Human Services in the Dietary Guidelines for 

23 Americans report published pursuant to section 

24 301 of the National Nutrition Monitoring and 


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

2 5341(a)(3)), and that includes— 

3 (i) any appropriate dietary supple4 ment, including prenatal vitamins; 

5 (ii) timely and regular nutritious 

6 meals; 

7 (iii) additional caloric content in 

8 meals provided; 

9 (iv) a prohibition on withholding food 

10 from an incarcerated pregnant woman or 

11 serving any food that is used as a punish12 ment, including nutraloaf or any food simi13 lar to nutraloaf that is not considered a 

14 nutritious meal; and 

15 (v) such other modifications to the 

16 diet of the woman as the Director of the 

17 Bureau of Prisons determines to be nec18 essary after consultation with the Sec19 retary of Health and Human Services and 

20 consideration of such recommendations as 

21 the Secretary may provide; 

22 (E) modified recreation and transpor23 tation, in accordance with standards within the 

24 obstetrical and gynecological care community, 


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1 to prevent overexertion or prolonged periods of 

2 inactivity; and 

3 (F) such other changes to living conditions 

4 as the Director of the Bureau of Prisons may 

5 require after consultation with the Secretary of 

6 Health and Human Services and consideration 

7 of such recommendations as the Secretary may 

8 provide. 

9 (3) EDUCATION AND SUPPORT SERVICES.— 

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

11 of a woman who is pregnant at intake or who 

12 becomes pregnant while in custody, that woman 

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

14 pregnancy is confirmed, as appropriate, receive 

15 prenatal education, counseling, and birth sup16 port services provided by a provider trained to 

17 provide such services, including— 

18 (i) information about the parental 

19 rights of the woman, including the right to 

20 place the child in kinship care, and notice 

21 of the rights of the child; 

22 (ii) information about family preserva23 tion support services that are available to 

24 the woman; 


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1 (iii) information about the nutritional 

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

3 (iv) information pertaining to the 

4 health and safety risks of pregnancy, child5 birth, and parenting, including postpartum 

6 depression; 

7 (v) information on breastfeeding, lac8 tation, and breast health; 

9 (vi) appropriate educational materials, 

10 resources, and services related to preg11 nancy, childbirth, and parenting; 

12 (vii) information and notification serv13 ices for incarcerated parents regarding the 

14 risk of debt repayment obligations associ15 ated with their child’s participation in so16 cial welfare programs, including assistance 

17 under any State program funded under 

18 part A of title IV of the Social Security 

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

20 under the supplemental nutrition assist21 ance program, as defined in section 3 of 

22 the Food and Nutrition Act of 2008 (7 

23 U.S.C. 2012), or any State program car24 ried out under that Act; and 


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1 (viii) information from the Office of 

2 Child Support Enforcement of the Depart3 ment of Health and Human Services re4 garding seeking or modifying child support 

5 while incarcerated, including how to par6 ticipate in the Bureau of Prison’s Inmate 

7 Financial Responsibility Program under 

8 subpart B of title 28, Code of Federal 

9 Regulations (or any successor program). 

10 (B) BIRTH WHILE IN CUSTODY OR PRIOR

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

12 gave birth in custody or who experienced any 

13 other pregnancy outcome during the 6-month 

14 period immediately preceding intake, that 

15 woman shall receive counseling provided by a li16 censed or certified provider trained to provide 

17 such services, including— 

18 (i) information about the parental 

19 rights of the woman, including the right to 

20 place the child in kinship care, and notice 

21 of the rights of the child; and 

22 (ii) information about family preserva23 tion support services that are available to 

24 the woman. 


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

2 incarcerated woman notifies an employee of the Bu3 reau of Prisons that the woman may be pregnant, 

4 a Bureau of Prisons healthcare care professional 

5 shall administer a pregnancy test to determine 

6 whether the woman is pregnant. 

7 (5) EVALUATIONS.—Each woman in custody 

8 who is pregnant or whose pregnancy results in a 

9 birth or any other pregnancy outcome during the 6- 

10 month period immediately preceding intake or any 

11 time in custody thereafter shall be evaluated not 

12 later than 4 days after intake or confirmation of 

13 pregnancy through evidence-based screening and as14 sessment for substance use disorders or mental 

15 health conditions, including postpartum depression 

16 or depression related to a pregnancy outcome or 

17 early child care. Screening shall include identifica18 tion of any of the following risk factors: 

19 (A) An existing mental or physical health 

20 condition or substance use disorder. 

21 (B) Being underweight or overweight. 

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

23 (D) A history of preeclampsia. 

24 (E) A previous Caesarean section. 

25 (F) A previous miscarriage. 


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1 (G) Being older than 35 or younger than 

2 15. 

3 (H) Being diagnosed with the human im4 munodeficiency virus, hepatitis, diabetes, or hy5 pertension. 

6 (I) Such other risk factors as the chief 

7 health care professional of a Bureau of Prisons 

8 facility that houses women may determine to be 

9 appropriate. 

10 (6) UNEXPECTED BIRTHS RULEMAKING.—Not 

11 later than 180 days after the date of enactment of 

12 this Act, the Attorney General shall make rules es13 tablishing procedures for responding to unexpected 

14 childbirth deliveries, labor complications, and med15 ical complications related to pregnancy if a woman 

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

17 manner. 

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

19 custody who, after an evaluation under paragraph 

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

21 or a mental health disorder, that woman shall be en22 titled to treatment in accordance with the following: 

23 (A) Treatment shall include participation 

24 in a support group, including a 12-step pro25 gram, such as Alcoholics Anonymous, Narcotics 


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1 Anonymous, and Cocaine Anonymous or a com2 parable nonreligious program. 

3 (B) Treatment may include psychosocial 

4 interventions and medication. 

5 (C) In the case that adequate treatment 

6 cannot be provided to a woman in custody in a 

7 Bureau of Prisons facility, the Director of the 

8 Bureau of Prisons shall transfer the woman to 

9 a residential reentry program that offers such 

10 treatment pursuant to section 508 of the Public 

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

12 (D) To the extent practicable, treatment 

13 for substance use disorders provided pursuant 

14 to this section shall be conducted in a licensed 

15 hospital. 

16 SEC. 4. USE OF RESTRICTIVE HOUSING AND RESTRAINTS 

17 ON INCARCERATED PREGNANT WOMEN DUR18 ING PREGNANCY, LABOR, AND POSTPARTUM 

19 RECOVERY PROHIBITED. 

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

21 States Code, is amended to read as follows: 


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1 ‘‘§ 4322. Use of restraints and restrictive housing on 

2 incarcerated women during the period of 

3 pregnancy, labor, and postpartum recov4 ery prohibited and to improve pregnancy 

5 care for women in Federal prisons 

6 ‘‘(a) PROHIBITION.—Except as provided in sub7 section (b), beginning on the date on which pregnancy is 

8 confirmed by a health care professional and ending not 

9 earlier than 12 weeks after delivery, an incarcerated 

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

11 custody of the United States Marshals Service pursuant 

12 to section 4086, shall not be placed in restraints or held 

13 in restrictive housing. 

14 ‘‘(b) EXCEPTIONS.— 

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

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

17 Bureau of Prisons official or United States Marshals 

18 Service official overseeing women’s health and serv19 ices and a health care professional responsible for 

20 the health and safety of the incarcerated woman de21 termines that the use of restraints is appropriate for 

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

23 professional reviews such determination not later 

24 than every 6 hours after such use is initially ap25 proved until such use is terminated. 


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1 ‘‘(2) SITUATIONAL USE.—The individualized de2 termination described under paragraph (1) shall only 

3 apply to a specific situation and must be reaffirmed 

4 through the same process to use restraints again in 

5 any future situation involving the same woman. 

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

7 cessation of the use of restraints or restrictive hous8 ing as outlined in this subsection, the Director of the 

9 Bureau of Prisons or the United States Marshal 

10 Service shall provide the incarcerated woman with 

11 immediate access to physical and mental health as12 sessments and all recommended treatment. 

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

14 BUREAU OF PRISONS.— 

15 ‘‘(A) RESTRICTIVE HOUSING.—The prohi16 bition under subsection (a) relating to restric17 tive housing shall not apply if the Director of 

18 the Bureau of Prisons or a senior Bureau of 

19 Prisons official overseeing women’s health and 

20 services, in consultation with senior officials in 

21 health services, makes an individualized deter22 mination that restrictive housing is required as 

23 a temporary response to behavior that poses a 

24 serious and immediate risk of physical harm. 


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

2 determination under subparagraph (A) shall re3 view such determination every 4 hours for the 

4 purpose of removing an incarcerated woman as 

5 quickly as feasible from restrictive housing. 

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

7 official who makes a determination under sub8 paragraph (A) shall develop an individualized 

9 plan to move an incarcerated woman to less re10 strictive housing within a reasonable amount of 

11 time, not to exceed 2 days. 

12 ‘‘(D) MONITORING.—An incarcerated 

13 woman who is placed in restrictive housing pur14 suant to this paragraph shall be— 

15 ‘‘(i) monitored every hour; 

16 ‘‘(ii) placed in a location visible to cor17 rectional officers; and 

18 ‘‘(iii) prohibited from being placed in 

19 solitary confinement if the incarcerated 

20 woman is in her third trimester. 

21 ‘‘(c) REPORTS.— 

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

23 CARE PROFESSIONAL AFTER THE USE OF RE24 STRAINTS.—If an official identified in subsection 

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


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1 incarcerated woman under subsection (b), that offi2 cial (or an officer or marshal designated by that offi3 cial) or correctional officer shall submit, not later 

4 than 30 days after placing the woman in restraints, 

5 to the Director of the Bureau of Prisons or the Di6 rector of the U.S. Marshal Service, as applicable, a 

7 written report which describes the facts and cir8 cumstances surrounding the use of restraints, and 

9 includes each of the following: 

10 ‘‘(A) A description of all attempts to use 

11 alternative interventions and sanctions before 

12 the restraints were used. 

13 ‘‘(B) A description of the circumstances 

14 that led to the use of restraints. 

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

16 place to identify more appropriate alternative 

17 interventions should a similar situation arise 

18 again. 

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

20 date that is 6 months after the date of enactment 

21 of the Protecting the Health and Wellness of Babies 

22 and Pregnant Women in Custody Act, and every 6 

23 months thereafter for a period of 10 years, the At24 torney General shall submit to the Committees on 


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1 the Judiciary of the House of Representatives and 

2 the Senate a report on— 

3 ‘‘(A) the reasoning upon which the deter4 mination to use restraints was made; 

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

6 including the type of restraints used and length 

7 of time during which restraints were used; and 

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

9 prisoner observed by or known to the correc10 tions official or United States Marshal, as ap11 plicable. 

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

13 CARE PROFESSIONAL AFTER PLACEMENT IN RE14 STRICTIVE HOUSING.—If an official identified in 

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

16 States Marshal places or causes an incarcerated 

17 woman to be placed in restrictive housing under 

18 such subsection, that official, correctional officer, or 

19 United States Marshal shall submit, not later than 

20 30 days after placing or causing the placement of 

21 the incarcerated woman in restrictive housing, to the 

22 Director of the Bureau of Prisons or the Director of 

23 the United States Marshals Service, as applicable, 

24 and to the health care professional responsible for 

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


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1 which describes the facts and circumstances sur2 rounding the restrictive housing placement, and in3 cludes the following: 

4 ‘‘(A) The reasoning upon which the deter5 mination for the placement was made. 

6 ‘‘(B) The details of the placement, includ7 ing length of time of placement and how fre8 quently and how many times the determination 

9 was made subsequent to the initial determina10 tion to continue the restrictive housing place11 ment. 

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

13 alternative interventions and sanctions before 

14 the restrictive housing was used. 

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

16 woman observed by or reported by the health 

17 care professional responsible for the health and 

18 safety of the woman. 

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

20 place to identify more appropriate alternative 

21 interventions should a similar situation arise 

22 again. 

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

24 date that is 6 months after the date of enactment 

25 of the Protecting the Health and Wellness of Babies 


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1 and Pregnant Women in Custody Act, and every 6 

2 months thereafter for a period of 10 years, the At3 torney General shall submit to the Committees on 

4 the Judiciary of the House of Representatives and 

5 the Senate a report on the information described in 

6 paragraph (3). 

7 ‘‘(d) NOTICE.—Not later than 24 hours after the con8 firmation of an incarcerated woman’s pregnancy by a 

9 health care professional, that woman shall be notified, 

10 orally and in writing, by an appropriate health care profes11 sional, correctional officer, or United States Marshal, as 

12 applicable— 

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

14 and restrictive housing placements under this sec15 tion; 

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

17 a confidential report of a violation of restrictions on 

18 the use of restraints or restrictive housing place19 ment; and 

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

21 all rights of the incarcerated woman under sub22 section (a). 

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

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

25 the Director of the Bureau of Prisons and the Director 


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1 of the United States Marshals Service shall establish proc2 esses through which an incarcerated person may report 

3 a violation of this section. 

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

5 Bureau of Prisons facility where a pregnant woman is in 

6 custody shall notify necessary facility staff of the preg7 nancy and of the incarcerated pregnant woman’s rights 

8 under subsection (a). 

9 ‘‘(g) RETALIATION.—It shall be unlawful for any Bu10 reau of Prisons or United States Marshal Service em11 ployee to retaliate against an incarcerated person for re12 porting under the provisions of subsection (e) a violation 

13 of subsection (a). 

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

15 date of enactment of the Protecting the Health and 

16 Wellness of Babies and Pregnant Women in Custody Act, 

17 the Director of the Bureau of Prisons and the Director 

18 of the United States Marshals Service shall each develop 

19 education guidelines regarding the physical and mental 

20 health needs of incarcerated pregnant women, and the use 

21 of restraints and restrictive housing placements on incar22 cerated women during the period of pregnancy, labor, and 

23 postpartum recovery, and shall incorporate such guidelines 

24 into appropriate education programs. 

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


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

2 means any physical or mechanical device used to 

3 control the movement of an incarcerated pregnant 

4 woman’s body, limbs, or both. 

5 ‘‘(2) RESTRICTIVE HOUSING.—The term ‘re6 strictive housing’ means any type of detention that 

7 involves— 

8 ‘‘(A) removal from the general inmate pop9 ulation, whether voluntary or involuntary; 

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

11 whether alone or with another inmate; and 

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

13 the vast majority of the day.’’. 

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

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

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

17 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.’’. 

18 SEC. 5. TREATMENT OF WOMEN WITH HIGH-RISK PREG19 NANCIES. 

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

21 States Code, is amended by adding at the end the fol22 lowing: 


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1 ‘‘§ 4051. Treatment of incarcerated pregnant women 

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

3 Director of the Bureau of Prisons shall ensure that each 

4 incarcerated pregnant woman receives health care appro5 priate for a high-risk pregnancy, including obstetrical and 

6 gynecological care, during pregnancy and post-partum re7 covery. 

8 ‘‘(b) HIGH-RISK PREGNANCIES.— 

9 ‘‘(1) IN GENERAL.—The Director of the Bureau 

10 of Prisons shall transfer any incarcerated woman, 

11 who is determined by a health care professional to 

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

13 transferred, to a Residential Reentry Center with 

14 adequate health care during her pregnancy and post15 partum recovery. 

16 ‘‘(2) PRIORITY.—The Residential Reentry Cen17 ter to which an incarcerated pregnant woman is 

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

19 geographical location that is close to the family 

20 members of the incarcerated pregnant woman. In 

21 the case that a Residential Reentry Center is un22 available, the incarcerated pregnant woman shall be 

23 transferred to alternative housing, including housing 

24 with a family member. 

25 ‘‘(3) TRANSPORTATION.—To transport an in26 carcerated pregnant woman to a Residential Reentry 


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1 Center, the Director of the Bureau of Prisons shall 

2 provide to the woman a mode of transportation that 

3 has been approved by the woman’s health care pro4 fessional, at no expense to the woman. 

5 ‘‘(4) MONITORING.—In the case that an incar6 cerated pregnant woman transferred to alternative 

7 housing pursuant to this section is monitored elec8 tronically, an ankle monitor may not be used on the 

9 woman, unless there is no feasible alternative for 

10 monitoring the woman. 

11 ‘‘(5) SERVICE OF SENTENCE.—Any time ac12 crued at a Residential Reentry Center or alternative 

13 housing as a result of a transfer made pursuant to 

14 this section shall be credited toward service of the 

15 incarcerated pregnant woman’s sentence. 

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

17 case of an incarcerated pregnant woman, any time 

18 accrued in pretrial custody shall be credited toward 

19 service of the woman’s sentence. 

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

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

22 member’ means any individual related by blood or 

23 affinity whose close association with the incarcerated 

24 pregnant woman is the equivalent of a family relaVerDate Sep 11 2014 22:31 Sep 24, 2020 Jkt 099200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\H7718.RH H7718

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1 tionship, including a parent, sibling, child, or indi2 vidual standing in loco parentis. 

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

4 term ‘Residential Reentry Center’ means a Bureau 

5 of Prisons contracted residential reentry center. 

6 ‘‘(3) HEALTH CARE PROFESSIONAL.— 

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

8 professional’ means— 

9 ‘‘(i) a doctor of medicine or osteop10 athy who is authorized to practice medicine 

11 or surgery by the State in which the doctor 

12 practices; 

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

14 nurse practitioner who is supervised by a 

15 doctor of medicine or osteopathy described 

16 in clause (i); or 

17 ‘‘(iii) any other person determined by 

18 the Secretary to be capable of providing 

19 health care services. 

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

21 person is capable of providing health care serv22 ices if the person is— 

23 ‘‘(i) a podiatrist, dentist, clinical psy24 chologist, optometrist, or chiropractor (lim25 ited to treatment consisting of manual maVerDate Sep 11 2014 22:31 Sep 24, 2020 Jkt 099200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\H7718.RH H7718

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1 nipulation of the spine to correct a sub2 luxation as demonstrated by X-ray to 

3 exist) authorized to practice in the State 

4 and performing within the scope of their 

5 practice as defined under State law; 

6 ‘‘(ii) a nurse practitioner, nurse-mid7 wife, clinical social worker, or physician’s 

8 assistant who is authorized to practice 

9 under State law and who is performing 

10 within the scope of their practice as de11 fined under State law; and 

12 ‘‘(iii) any health care professional 

13 from whom an employer or the employer’s 

14 group health plan’s benefits manager will 

15 accept certification of the existence of a se16 rious health condition to substantiate a 

17 claim for benefits. 

18 ‘‘(C) AUTHORIZED TO PRACTICE IN THE

19 STATE.—The term ‘authorized to practice in 

20 the State’ means that a professional must be 

21 authorized to diagnose and treat physical or 

22 mental health conditions under the laws of the 

23 State in which the professional practices and 

24 where the facility is located. 


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1 ‘‘(4) HIGH-RISK PREGNANCY.—The term ‘high2 risk pregnancy’ means, with respect to an incarcer3 ated woman, that the pregnancy threatens the 

4 health or life of the woman or pregnancy, as deter5 mined by a health care professional. 

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

7 ‘post-partum recovery’ means the 3-month period be8 ginning on the date on which an incarcerated preg9 nant woman gives birth.’’. 

10 (b) CONFORMING AMENDMENT.—The table of sec11 tions for chapter 303 of title 18, United States Code, is 

12 amended by adding at the end the following: 

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

13 SEC. 6. EXEMPTION OF INCARCERATED PREGNANT WOMEN 

14 FROM THE REQUIREMENTS FOR SUITS BY 

15 PRISONERS. 

16 Section 7 of the Civil Rights of Institutionalized Per17 sons Act (42 U.S.C. 1997e) is amended— 

18 (1) in subsection (a), by inserting after the pe19 riod at the end the following: ‘‘This subsection shall 

20 not apply with respect to an incarcerated pregnant 

21 woman who brings an action relating to or affecting 

22 the woman’s pregnancy.’’; and 

23 (2) in subsection (d)(1), insert ‘‘, except an in24 carcerated pregnant woman,’’ before ‘‘who is con25 fined’’. 


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1 SEC. 7. DEFINITIONS. 

2 In this Act: 

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

4 means, with respect to an individual, that the indi5 vidual is under the supervision of a Federal, State, 

6 tribal or local correctional facility, including pretrial 

7 and contract facilities, and juvenile or medical or 

8 mental health facilities. 

9 (2) OTHER PREGNANCY OUTCOME.—The term 

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

11 ends in stillbirth, miscarriage, or ectopic pregnancy. 

12 (3) POSTPARTUM RECOVERY.—The term ‘‘post13 partum recovery’’ means the 12-week period, or 

14 longer as determined by the health care professional 

15 responsible for the health and safety of the incarcer16 ated pregnant woman, following delivery, and shall 

17 include the entire period that the incarcerated preg18 nant woman is in the hospital or infirmary. 

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

20 means any physical or mechanical device used to 

21 control the movement of an incarcerated pregnant 

22 woman’s body, limbs, or both. 

23 (5) RESTRICTIVE HOUSING.—The term ‘‘re24 strictive housing’’ means any type of detention that 

25 involves— 


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1 (A) removal from the general inmate popu2 lation, 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 SEC. 8. EDUCATION AND TECHNICAL ASSISTANCE. 

8 The Director of the National Institute of Corrections 

9 shall provide education and technical assistance, in con10 junction with the appropriate public agencies, at State and 

11 local correctional facilities that house women and facilities 

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

13 in order to educate the employees of such facilities, includ14 ing health personnel, on the dangers and potential mental 

15 health consequences associated with the use of restrictive 

16 housing and restraints on incarcerated women during 

17 pregnancy, labor, and postpartum recovery, and on alter18 natives to the use of restraints and restrictive housing 

19 placement. 

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

21 TRAINING. 

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

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

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

25 of Prisons shall train each correctional officer at any BuVerDate Sep 11 2014 22:31 Sep 24, 2020 Jkt 099200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6201 E:\BILLS\H7718.RH H7718

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1 reau of Prisons women’s facility to carry out the require2 ments of this Act. 

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

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

5 the Bureau of Prisons shall train any newly hired correc6 tional officer at a Bureau of Prisons facility that houses 

7 women to carry out the requirements of this Act not later 

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

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

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

11 and biannually thereafter, the Director of the U.S. Mar12 shals Service shall ensure that each Deputy U.S. Marshal 

13 is trained pursuant to the guidelines described in sub14 section (d). Newly hired deputies shall receive such train15 ing not later than 30 days after the date on which such 

16 deputy starts employment. 

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

18 Prisons and the United States Marshals Service shall each 

19 develop guidelines on the treatment of incarcerated women 

20 during pregnancy, labor, and postpartum recovery and in21 corporate such guidelines in the training required under 

22 this section. Such guidelines shall include guidance on— 

23 (1) the transportation of incarcerated pregnant 

24 women; 

25 (2) housing of incarcerated pregnant women; 


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1 (3) nutritional requirements for incarcerated 

2 pregnant women; and 

3 (4) the right of a health care professional to re4 quest that restraints not be used. 

5 SEC. 10. GAO STUDY ON STATE AND LOCAL CORRECTIONAL 

6 FACILITIES. 

7 The Comptroller General of the United States shall 

8 conduct a study of services and protections provided for 

9 pregnant incarcerated women in local and State correc10 tional settings, including policies on obstetrical and gyne11 cological care, education on nutrition, health and safety 

12 risks associated with pregnancy, mental health and sub13 stance use treatment, access to prenatal and post-delivery 

14 support services and programs, the use of restraints and 

15 restrictive housing placement, and the extent to which the 

16 intent of such policies are fulfilled. 

17 SEC. 11. GAO STUDY ON FEDERAL PRETRIAL DETENTION 

18 FACILITIES. 

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

20 States shall conduct a study of services and protections 

21 provided for pregnant women who are incarcerated in Fed22 eral pretrial detention facilities. Specifically, the study 

23 shall examine— 


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1 (1) what available data indicate about pregnant 

2 women detained or held in Federal pretrial detention 

3 facilities; 

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

5 standards that address the care of pregnant women 

6 in Federal pretrial detention facilities; and 

7 (3) what is known about the care provided to 

8 pregnant women in Federal pretrial detention facili9 ties. 

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

11 2 years after the date of enactment of this Act, the Comp12 troller General shall submit a report of the results of the 

13 study conducted under subsection (a) to the Committee 

14 on the Judiciary of the Senate and the Committee on the 

15 Judiciary of the House of Representatives. The report 

16 shall identify best practices for ensuring that Federal pre17 trial detention facilities implement services and protec18 tions for pregnant women consistent with this Act and 

19 shall provide recommendations on how to implement these 

20 best practices among all Federal pretrial detention facili21 ties. 

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

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

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


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

2 pretrial detainees. 

3 SEC. 12. PWIC GRANT PROGRAM. 

4 Section 508 of the Omnibus Crime Control and Safe 

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

6 to read as follows: 

7 ‘‘SEC. 508. PREGNANT WOMEN IN CUSTODY GRANT PRO8 GRAM. 

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

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

11 the ‘PWIC Act of 2020’. 

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

13 make grants to eligible entities that have established a 

14 program to promote the health needs of incarcerated preg15 nant women in the criminal justice system at the State, 

16 tribal, and local levels or have declared their intent to es17 tablish such a program. Eligible entities shall— 

18 ‘‘(1) promote the safety and wellness of preg19 nant women in custody; 

20 ‘‘(2) provide services for obstetrical and gyneco21 logical care, for women in custody; 

22 ‘‘(3) facilitate resources and support services 

23 for nutrition and physical and mental health, for 

24 women in custody; 


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

2 substantially similar to the limitations imposed 

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

4 limiting the use of restraints on pregnant women in 

5 custody; and 

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

7 lactation and nursery care or residential programs to 

8 keep the infant with the mother and to promote and 

9 facilitate bonding skills for incarcerated pregnant 

10 women and women with dependent children. 

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

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

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

14 grant under this section if the entity is— 

15 ‘‘(1) a State or territory department of correc16 tions; 

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

18 facility; or 

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

20 prison or jail that houses women; or 

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

22 has partnered with a State or unit of local govern23 ment that operates a correctional facility, with ex24 pertise in providing health services to incarcerated 

25 pregnant women. 


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

2 section, an eligible entity shall submit an application to 

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

4 containing such information as the Attorney General may 

5 require, including a detailed description of the need for 

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

7 grantee expects to benefit from the grant. 

8 ‘‘(f) ADMINISTRATIVE COSTS.—Not more than 5 per9 cent of a grant awarded under this section may be used 

10 for costs incurred to administer such grant. 

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

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

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

14 projects, other than new construction or upgrade to a fa15 cility used to provide lactation, nursery, obstetrical, or 

16 gynecological services. 

17 ‘‘(h) PRIORITY FUNDING FOR STATES THAT PRO18 VIDE PROGRAMS AND SERVICES FOR INCARCERATED

19 WOMEN RELATED TO PREGNANCY AND CHILDBIRTH.— 

20 In determining the amount provided to a State or unit 

21 of local government under this section, the Attorney Gen22 eral shall give priority to States or units of local govern23 ment that have enacted laws or policies and implemented 

24 services or pilot programs for incarcerated pregnant 

25 women aimed at enhancing the safety and wellness of 


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1 pregnant women in custody, including providing services 

2 for obstetrical and gynecological care, resources and sup3 port services for nutrition and physical and mental health, 

4 and post-delivery lactation and nursery care or residential 

5 programs to keep the infant with the mother and to pro6 mote and facilitate bonding skills for incarcerated preg7 nant women and women with dependent children. 

8 ‘‘(i) SUBGRANT PRIORITY.—A State that receives a 

9 grant under this section shall prioritize subgrants to a unit 

10 of local government within the State that has established 

11 a pilot program that enhances safety and wellness of preg12 nant women in custody. 

13 ‘‘(j) FEDERAL SHARE.— 

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

15 grant under this section may not exceed 75 percent 

16 of the total costs of the projects described in the 

17 grant application. 

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

19 (1) may be waived by the Assistant Attorney Gen20 eral upon a determination that the financial cir21 cumstances affecting the applicant warrant a finding 

22 that such a waiver is equitable. 

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

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

25 an eligible entity receives a grant under this section, 


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1 such entity shall implement a policy that is substan2 tially similar to the policy under section 3 of Pro3 tecting the Health and Wellness of Babies and Preg4 nant Women in Custody Act. 

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

6 provide a 120-day extension to an eligible entity that 

7 is making good faith efforts to collect the informa8 tion required under paragraph (1). 

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

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

11 to remain available until expended— 

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

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

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

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

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

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

18 grant under this section, the eligible entity shall certify 

19 to the Attorney General that the amounts received under 

20 the grant shall be used to supplement, not supplant, non21 Federal funds that would otherwise be available for pro22 grams or services in the prison where funds will be used. 

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

24 made available pursuant to this section that remain unob25 ligated for a period of 6 months after the end of the fiscal 


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1 year for which the funds have been appropriated shall be 

2 awarded to other recipients of this grant. 

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

4 grant under this section shall be subject to the non5 discrimination requirement under section 40002(b)(13) of 

6 the Violence Against Women Act of 1994 (34 U.S.C. 

7 12291(b)(13)). 

8 ‘‘(p) DEFINITIONS.—In this section, the term ‘in cus9 tody’ means, with respect to an individual, that the indi10 vidual is under the supervision of a Federal, State, tribal, 

11 or local correctional facility, including pretrial and con12 tract facilities, and juvenile or medical or mental health 

13 facilities.’’. 

14 SEC. 13. PLACEMENT IN PRERELEASE CUSTODY. 

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

16 is amended by adding at the end the following: ‘‘Notwith17 standing any other provision of this paragraph, in the case 

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

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

20 woman may be placed into prerelease custody beginning 

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

22 woman’s due date.’’. 


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Union Calendar No. 436 

116TH CONGRESS 

2D SESSION H. R. 7718 

[Report No. 116–536] 

A BILL 

To address the health needs of incarcerated women 

other purposes. related to pregnancy and childbirth, and for 

SEPTEMBER 24, 2020 

Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 


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