I 

116TH CONGRESS 

2D SESSION H. R. 7718 

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 

A BILL 

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, 

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 


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

2 the Director of the Bureau of Justice Statistics shall in3 clude in the National Prisoner Statistics Program and An4 nual Survey of Jails statistics relating to the health needs 

5 of incarcerated pregnant women in the criminal justice 

6 system at the Federal, State, tribal, and local levels, in7 cluding— 

8 (1) demographic and other information about 

9 incarcerated women who are pregnant, in labor, or 

10 in postpartum recovery, including the race, ethnicity, 

11 and age of the pregnant woman; 

12 (2) the provision of pregnancy care and services 

13 provided for such women, including— 

14 (A) whether prenatal, delivery, and post15 delivery check-up visits were scheduled and pro16 vided; 

17 (B) whether a social worker, psychologist, 

18 doula or other support person, or pregnancy or 

19 parenting program was offered and provided 

20 during pregnancy and delivery; 

21 (C) whether a nursery or residential pro22 gram to keep mothers and infants together 

23 post-delivery was offered and whether such a 

24 nursery or residential program was provided; 


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1 (D) the number of days the mother stayed 

2 in the hospital post-delivery; 

3 (E) the number of days the infant re4 mained with the mother post-delivery; and 

5 (F) the number of days the infant re6 mained in the hospital after the mother was 

7 discharged; 

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

9 licensed obstetrician-gynecologist in proximity to 

10 where the inmate is housed and the length of travel 

11 required to transport the inmate; 

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

13 place to respond to unexpected childbirth, labor, de14 liveries, and medical complications related to the 

15 pregnancies of incarcerated pregnant women and for 

16 incarcerated pregnant women experiencing labor or 

17 medical complications related to pregnancy outside 

18 of a hospital; 

19 (5) the number of incarcerated women who are 

20 determined by a health care professional to have a 

21 high-risk pregnancy; 

22 (6) the total number of incarcerated pregnant 

23 women and the number of incarcerated women who 

24 became pregnant while incarcerated; 


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1 (7) the number of incidents in which an incar2 cerated woman who is pregnant, in labor, or in 

3 postpartum recovery is placed in restrictive housing, 

4 the reason for such restriction or placement, and the 

5 circumstances under which each incident occurred, 

6 including the duration of time in restrictive housing, 

7 during— 

8 (A) pregnancy; 

9 (B) labor; 

10 (C) delivery; 

11 (D) postpartum recovery; and 

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

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

14 post-delivery. 

15 (b) PERSONALLY IDENTIFIABLE INFORMATION.— 

16 Data collected under this paragraph may not contain any 

17 personally identifiable information of any incarcerated 

18 pregnant woman. 

19 SEC. 3. CARE FOR FEDERALLY INCARCERATED WOMEN RE20 LATED TO PREGNANCY AND CHILDBIRTH. 

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

22 Prisons shall ensure that appropriate services and pro23 grams are provided to women in custody, to address the 

24 health and safety needs of such women related to preg25 nancy and childbirth. The warden of each Bureau of PrisVerDate Sep 11 2014 04:21 Aug 09, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7718.IH H7718

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1 ons facility that houses women shall ensure that these 

2 services and programs are implemented for women in cus3 tody at that facility. 

4 (b) SERVICES AND PROGRAMS PROVIDED.—The Di5 rector of the Bureau of Prisons shall ensure that the fol6 lowing services and programs are available to women in 

7 custody: 

8 (1) ACCESS TO COMPLETE APPROPRIATE

9 HEALTH SERVICES FOR THE LIFE CYCLE OF

10 WOMEN.—The Director of the Bureau of Prisons 

11 shall provide to each woman in custody who is of re12 productive age pregnancy testing, contraception, and 

13 testing for sexually transmitted diseases and provide 

14 each woman with the option to decline such services. 

15 (2) COMPLIANCE WITH PROTOCOLS RELATING

16 TO HEALTH OF A PREGNANT WOMAN.—On confirma17 tion of the pregnancy of a woman in custody by clin18 ical diagnostics and assessment, the chief health 

19 care professional of a Bureau of Prisons facility that 

20 houses women shall ensure that a summary of all 

21 appropriate protocols directly pertaining to the safe22 ty and well-being of the woman are provided to the 

23 woman and that such protocols are complied with, 

24 including an assessment of undue safety risks and 


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1 necessary changes to accommodate the woman where 

2 and when appropriate, as it relates to— 

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

4 safety reasons; 

5 (B) appropriate bedding or clothing to re6 spond to a woman’s changing physical require7 ments and the temperature in housing units; 

8 (C) regular access to water and bathrooms; 

9 (D) a diet that complies with the nutri10 tional standards established by the Secretary of 

11 Agriculture and the Secretary of Health and 

12 Human Services in the Dietary Guidelines for 

13 Americans report published pursuant to section 

14 301 of the National Nutrition Monitoring and 

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

16 5341(a)(3)), and that includes— 

17 (i) any appropriate dietary supple18 ment, including prenatal vitamins; 

19 (ii) timely and regular nutritious 

20 meals; 

21 (iii) additional caloric content in 

22 meals provided; 

23 (iv) a prohibition on withholding food 

24 from an incarcerated pregnant woman or 

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1 ment, including nutraloaf or any food simi2 lar to nutraloaf that is not considered a 

3 nutritious meal; and 

4 (v) such other modifications to the 

5 diet of the woman as the Director of the 

6 Bureau of Prisons determines to be nec7 essary after consultation with the Sec8 retary of Health and Human Services and 

9 consideration of such recommendations as 

10 the Secretary may provide; 

11 (E) modified recreation and transpor12 tation, in accordance with standards within the 

13 obstetrical and gynecological care community, 

14 to prevent overexertion or prolonged periods of 

15 inactivity; and 

16 (F) such other changes to living conditions 

17 as the Director of the Bureau of Prisons may 

18 require after consultation with the Secretary of 

19 Health and Human Services and consideration 

20 of such recommendations as the Secretary may 

21 provide. 

22 (3) EDUCATION AND SUPPORT SERVICES.— 

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

24 of a woman who is pregnant at intake or who 

25 becomes pregnant while in custody, that woman 


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

2 pregnancy is confirmed, as appropriate, receive 

3 prenatal education, counseling, and birth sup4 port services provided by a provider trained to 

5 provide such services, including— 

6 (i) information about the parental 

7 rights of the woman, including the right to 

8 place the child in kinship care, and notice 

9 of the rights of the child; 

10 (ii) information about family preserva11 tion support services that are available to 

12 the woman; 

13 (iii) information about the nutritional 

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

15 (iv) information pertaining to the 

16 health and safety risks of pregnancy, child17 birth, and parenting, including postpartum 

18 depression; 

19 (v) information on breastfeeding, lac20 tation, and breast health; 

21 (vi) appropriate educational materials, 

22 resources, and services related to preg23 nancy, childbirth, and parenting; 

24 (vii) information and notification serv25 ices for incarcerated parents regarding the 


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1 risk of debt repayment obligations associ2 ated with their child’s participation in so3 cial welfare programs, including assistance 

4 under any State program funded under 

5 part A of title IV of the Social Security 

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

7 under the supplemental nutrition assist8 ance program, as defined in section 3 of 

9 the Food and Nutrition Act of 2008 (7 

10 U.S.C. 2012), or any State program car11 ried out under that Act; and 

12 (viii) information from the Office of 

13 Child Support Enforcement of the Depart14 ment of Health and Human Services re15 garding seeking or modifying child support 

16 while incarcerated, including how to par17 ticipate in the Bureau of Prison’s Inmate 

18 Financial Responsibility Program under 

19 subpart B of title 28, Code of Federal 

20 Regulations (or any successor program). 

21 (B) BIRTH WHILE IN CUSTODY OR PRIOR

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

23 gave birth in custody or who experienced any 

24 other pregnancy outcome during the 6-month 

25 period immediately preceding intake, that 


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1 woman shall receive counseling provided by a li2 censed or certified provider trained to provide 

3 such services, including— 

4 (i) information about the parental 

5 rights of the woman, including the right to 

6 place the child in kinship care, and notice 

7 of the rights of the child; and 

8 (ii) information about family preserva9 tion support services that are available to 

10 the woman. 

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

12 incarcerated woman notifies an employee of the Bu13 reau of Prisons that the woman may be pregnant, 

14 a Bureau of Prisons healthcare care professional 

15 shall administer a pregnancy test to determine 

16 whether the woman is pregnant. 

17 (5) EVALUATIONS.—Each woman in custody 

18 who is pregnant or whose pregnancy results in a 

19 birth or any other pregnancy outcome during the 6- 

20 month period immediately preceding intake or any 

21 time in custody thereafter shall be evaluated not 

22 later than 4 days after intake or confirmation of 

23 pregnancy through evidence-based screening and as24 sessment for substance use disorders or mental 

25 health conditions, including postpartum depression 


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1 or depression related to a pregnancy outcome or 

2 early child care. Screening shall include identifica3 tion of any of the following risk factors: 

4 (A) An existing mental or physical health 

5 condition or substance use disorder. 

6 (B) Being underweight or overweight. 

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

8 (D) A history of preeclampsia. 

9 (E) A previous Caesarean section. 

10 (F) A previous miscarriage. 

11 (G) Being older than 35 or younger than 

12 15. 

13 (H) Being diagnosed with the human im14 munodeficiency virus, hepatitis, diabetes, or hy15 pertension. 

16 (I) Such other risk factors as the chief 

17 health care professional of a Bureau of Prisons 

18 facility that houses women may determine to be 

19 appropriate. 

20 (6) UNEXPECTED BIRTHS RULEMAKING.—Not 

21 later than 180 days after the date of enactment of 

22 this Act, the Attorney General shall make rules es23 tablishing procedures for responding to unexpected 

24 childbirth deliveries, labor complications, and med25 ical complications related to pregnancy if a woman 


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

2 manner. 

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

4 custody who, after an evaluation under paragraph 

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

6 or a mental health disorder, that woman shall be en7 titled to treatment in accordance with the following: 

8 (A) Treatment shall include participation 

9 in a support group, including a 12-step pro10 gram, such as Alcoholics Anonymous, Narcotics 

11 Anonymous, and Cocaine Anonymous or a com12 parable nonreligious program. 

13 (B) Treatment may include psychosocial 

14 interventions and medication. 

15 (C) In the case that adequate treatment 

16 cannot be provided to a woman in custody in a 

17 Bureau of Prisons facility, the Director of the 

18 Bureau of Prisons shall transfer the woman to 

19 a residential reentry program that offers such 

20 treatment pursuant to section 508 of the Public 

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

22 (D) To the extent practicable, treatment 

23 for substance use disorders provided pursuant 

24 to this section shall be conducted in a licensed 

25 hospital. 


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1 SEC. 4. USE OF RESTRICTIVE HOUSING AND RESTRAINTS 

2 ON INCARCERATED PREGNANT WOMEN DUR3 ING PREGNANCY, LABOR, AND POSTPARTUM 

4 RECOVERY PROHIBITED. 

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

6 States Code, is amended to read as follows: 

7 ‘‘§ 4322. Use of restraints and restrictive housing on 

8 incarcerated women during the period of 

9 pregnancy, labor, and postpartum recov10 ery prohibited and to improve pregnancy 

11 care for women in Federal prisons 

12 ‘‘(a) PROHIBITION.—Except as provided in sub13 section (b), beginning on the date on which pregnancy is 

14 confirmed by a health care professional and ending not 

15 earlier than 12 weeks after delivery, an incarcerated 

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

17 custody of the United States Marshals Service pursuant 

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

19 in restrictive housing. 

20 ‘‘(b) EXCEPTIONS.— 

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

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

23 Bureau of Prisons official or United States Marshals 

24 Service official overseeing women’s health and serv25 ices and a health care professional responsible for 

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1 termines that the use of restraints is appropriate for 

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

3 professional reviews such determination not later 

4 than every 6 hours after such use is initially ap5 proved until such use is terminated. 

6 ‘‘(2) SITUATIONAL USE.—The individualized de7 termination described under paragraph (1) shall only 

8 apply to a specific situation and must be reaffirmed 

9 through the same process to use restraints again in 

10 any future situation involving the same woman. 

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

12 cessation of the use of restraints or restrictive hous13 ing as outlined in this subsection, the Director of the 

14 Bureau of Prisons or the United States Marshal 

15 Service shall provide the incarcerated woman with 

16 immediate access to physical and mental health as17 sessments and all recommended treatment. 

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

19 BUREAU OF PRISONS.— 

20 ‘‘(A) RESTRICTIVE HOUSING.—The prohi21 bition under subsection (a) relating to restric22 tive housing shall not apply if the Director of 

23 the Bureau of Prisons or a senior Bureau of 

24 Prisons official overseeing women’s health and 

25 services, in consultation with senior officials in 


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1 health services, makes an individualized deter2 mination that restrictive housing is required as 

3 a temporary response to behavior that poses a 

4 serious and immediate risk of physical harm. 

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

6 determination under subparagraph (A) shall re7 view such determination every 4 hours for the 

8 purpose of removing an incarcerated woman as 

9 quickly as feasible from restrictive housing. 

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

11 official who makes a determination under sub12 paragraph (A) shall develop an individualized 

13 plan to move an incarcerated woman to less re14 strictive housing within a reasonable amount of 

15 time, not to exceed 2 days. 

16 ‘‘(D) MONITORING.—An incarcerated 

17 woman who is placed in restrictive housing pur18 suant to this paragraph shall be— 

19 ‘‘(i) monitored every hour; 

20 ‘‘(ii) placed in a location visible to cor21 rectional officers; and 

22 ‘‘(iii) prohibited from being placed in 

23 solitary confinement if the incarcerated 

24 woman is in her third trimester. 

25 ‘‘(c) REPORTS.— 


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

2 CARE PROFESSIONAL AFTER THE USE OF RE3 STRAINTS.—If an official identified in subsection 

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

5 incarcerated woman under subsection (b), that offi6 cial (or an officer or marshal designated by that offi7 cial) or correctional officer shall submit, not later 

8 than 30 days after placing the woman in restraints, 

9 to the Director of the Bureau of Prisons or the Di10 rector of the U.S. Marshal Service, as applicable, a 

11 written report which describes the facts and cir12 cumstances surrounding the use of restraints, and 

13 includes each of the following: 

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

15 alternative interventions and sanctions before 

16 the restraints were used. 

17 ‘‘(B) A description of the circumstances 

18 that led to the use of restraints. 

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

20 place to identify more appropriate alternative 

21 interventions should a similar situation arise 

22 again. 

23 ‘‘(2) 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— 

6 ‘‘(A) the reasoning upon which the deter7 mination to use restraints was made; 

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

9 including the type of restraints used and length 

10 of time during which restraints were used; and 

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

12 prisoner observed by or known to the correc13 tions official or United States Marshal, as ap14 plicable. 

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

16 CARE PROFESSIONAL AFTER PLACEMENT IN RE17 STRICTIVE HOUSING.—If an official identified in 

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

19 States Marshal places or causes an incarcerated 

20 woman to be placed in restrictive housing under 

21 such subsection, that official, correctional officer, or 

22 United States Marshal shall submit, not later than 

23 30 days after placing or causing the placement of 

24 the incarcerated woman in restrictive housing, to the 

25 Director of the Bureau of Prisons or the Director of 


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1 the United States Marshals Service, as applicable, 

2 and to the health care professional responsible for 

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

4 which describes the facts and circumstances sur5 rounding the restrictive housing placement, and in6 cludes the following: 

7 ‘‘(A) The reasoning upon which the deter8 mination for the placement was made. 

9 ‘‘(B) The details of the placement, includ10 ing length of time of placement and how fre11 quently and how many times the determination 

12 was made subsequent to the initial determina13 tion to continue the restrictive housing place14 ment. 

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

16 alternative interventions and sanctions before 

17 the restrictive housing was used. 

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

19 woman observed by or reported by the health 

20 care professional responsible for the health and 

21 safety of the woman. 

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

23 place to identify more appropriate alternative 

24 interventions should a similar situation arise 

25 again. 


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

2 date that is 6 months after the date of enactment 

3 of the Protecting the Health and Wellness of Babies 

4 and Pregnant Women in Custody Act, and every 6 

5 months thereafter for a period of 10 years, the At6 torney General shall submit to the Committees on 

7 the Judiciary of the House of Representatives and 

8 the Senate a report on the information described in 

9 paragraph (3). 

10 ‘‘(d) NOTICE.—Not later than 24 hours after the con11 firmation of an incarcerated woman’s pregnancy by a 

12 health care professional, that woman shall be notified, 

13 orally and in writing, by an appropriate health care profes14 sional, correctional officer, or United States Marshal, as 

15 applicable— 

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

17 and restrictive housing placements under this sec18 tion; 

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

20 a confidential report of a violation of restrictions on 

21 the use of restraints or restrictive housing place22 ment; and 

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

24 all rights of the incarcerated woman under sub25 section (a). 


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

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

3 the Director of the Bureau of Prisons and the Director 

4 of the United States Marshals Service shall establish proc5 esses through which an incarcerated person may report 

6 a violation of this section. 

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

8 Bureau of Prisons facility where a pregnant woman is in 

9 custody shall notify necessary facility staff of the preg10 nancy and of the incarcerated pregnant woman’s rights 

11 under subsection (a). 

12 ‘‘(g) RETALIATION.—It shall be unlawful for any Bu13 reau of Prisons or United States Marshal Service em14 ployee to retaliate against an incarcerated person for re15 porting under the provisions of subsection (e) a violation 

16 of subsection (a). 

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

18 date of enactment of the Protecting the Health and 

19 Wellness of Babies and Pregnant Women in Custody Act, 

20 the Director of the Bureau of Prisons and the Director 

21 of the United States Marshals Service shall each develop 

22 education guidelines regarding the physical and mental 

23 health needs of incarcerated pregnant women, and the use 

24 of restraints and restrictive housing placements on incar25 cerated women during the period of pregnancy, labor, and 


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1 postpartum recovery, and shall incorporate such guidelines 

2 into appropriate education programs. 

3 ‘‘(i) DEFINITION.—In this section: 

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

5 means any physical or mechanical device used to 

6 control the movement of an incarcerated pregnant 

7 woman’s body, limbs, or both. 

8 ‘‘(2) RESTRICTIVE HOUSING.—The term ‘re9 strictive housing’ means any type of detention that 

10 involves— 

11 ‘‘(A) removal from the general inmate pop12 ulation, whether voluntary or involuntary; 

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

14 whether alone or with another inmate; and 

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

16 the vast majority of the day.’’. 

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

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

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

20 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.’’. 


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1 SEC. 5. TREATMENT OF WOMEN WITH HIGH-RISK PREG2 NANCIES. 

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

4 States Code, is amended by adding at the end the fol5 lowing: 

6 ‘‘§ 4051. Treatment of incarcerated pregnant women 

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

8 Director of the Bureau of Prisons shall ensure that each 

9 incarcerated pregnant woman receives health care appro10 priate for a high-risk pregnancy, including obstetrical and 

11 gynecological care, during pregnancy and post-partum re12 covery. 

13 ‘‘(b) HIGH-RISK PREGNANCIES.— 

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

15 of Prisons shall transfer any incarcerated woman, 

16 who is determined by a health care professional to 

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

18 transferred, to a Residential Reentry Center with 

19 adequate health care during her pregnancy and post20 partum recovery. 

21 ‘‘(2) PRIORITY.—The Residential Reentry Cen22 ter to which an incarcerated pregnant woman is 

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

24 geographical location that is close to the family 

25 members of the incarcerated pregnant woman. In 

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1 available, the incarcerated pregnant woman shall be 

2 transferred to alternative housing, including housing 

3 with a family member. 

4 ‘‘(3) TRANSPORTATION.—To transport an in5 carcerated pregnant woman to a Residential Reentry 

6 Center, the Director of the Bureau of Prisons shall 

7 provide to the woman a mode of transportation that 

8 has been approved by the woman’s health care pro9 fessional, at no expense to the woman. 

10 ‘‘(4) MONITORING.—In the case that an incar11 cerated pregnant woman transferred to alternative 

12 housing pursuant to this section is monitored elec13 tronically, an ankle monitor may not be used on the 

14 woman, unless there is no feasible alternative for 

15 monitoring the woman. 

16 ‘‘(5) SERVICE OF SENTENCE.—Any time ac17 crued at a Residential Reentry Center or alternative 

18 housing as a result of a transfer made pursuant to 

19 this section shall be credited toward service of the 

20 incarcerated pregnant woman’s sentence. 

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

22 case of an incarcerated pregnant woman, any time 

23 accrued in pretrial custody shall be credited toward 

24 service of the woman’s sentence. 

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


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

2 member’ means any individual related by blood or 

3 affinity whose close association with the incarcerated 

4 pregnant woman is the equivalent of a family rela5 tionship, including a parent, sibling, child, or indi6 vidual standing in loco parentis. 

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

8 term ‘Residential Reentry Center’ means a Bureau 

9 of Prisons contracted residential reentry center. 

10 ‘‘(3) HEALTH CARE PROFESSIONAL.— 

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

12 professional’ means— 

13 ‘‘(i) a doctor of medicine or osteop14 athy who is authorized to practice medicine 

15 or surgery by the State in which the doctor 

16 practices; 

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

18 nurse practitioner who is supervised by a 

19 doctor of medicine or osteopathy described 

20 in clause (i); or 

21 ‘‘(iii) any other person determined by 

22 the Secretary to be capable of providing 

23 health care services. 


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

2 person is capable of providing health care serv3 ices if the person is— 

4 ‘‘(i) a podiatrist, dentist, clinical psy5 chologist, optometrist, or chiropractor (lim6 ited to treatment consisting of manual ma7 nipulation of the spine to correct a sub8 luxation as demonstrated by X-ray to 

9 exist) authorized to practice in the State 

10 and performing within the scope of their 

11 practice as defined under State law; 

12 ‘‘(ii) a nurse practitioner, nurse-mid13 wife, clinical social worker, or physician’s 

14 assistant who is authorized to practice 

15 under State law and who is performing 

16 within the scope of their practice as de17 fined under State law; and 

18 ‘‘(iii) any health care professional 

19 from whom an employer or the employer’s 

20 group health plan’s benefits manager will 

21 accept certification of the existence of a se22 rious health condition to substantiate a 

23 claim for benefits. 

24 ‘‘(C) AUTHORIZED TO PRACTICE IN THE

25 STATE.—The term ‘authorized to practice in 


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1 the State’ means that a professional must be 

2 authorized to diagnose and treat physical or 

3 mental health conditions under the laws of the 

4 State in which the professional practices and 

5 where the facility is located. 

6 ‘‘(4) HIGH-RISK PREGNANCY.—The term ‘high7 risk pregnancy’ means, with respect to an incarcer8 ated woman, that the pregnancy threatens the 

9 health or life of the woman or pregnancy, as deter10 mined by a health care professional. 

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

12 ‘post-partum recovery’ means the 3-month period be13 ginning on the date on which an incarcerated preg14 nant woman gives birth.’’. 

15 (b) CONFORMING AMENDMENT.—The table of sec16 tions for chapter 303 of title 18, United States Code, is 

17 amended by adding at the end the following: 

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

18 SEC. 6. EXEMPTION OF INCARCERATED PREGNANT WOMEN 

19 FROM THE REQUIREMENTS FOR SUITS BY 

20 PRISONERS. 

21 Section 7 of the Civil Rights of Institutionalized Per22 sons Act (42 U.S.C. 1997e) is amended— 

23 (1) in subsection (a), by inserting after the pe24 riod at the end the following: ‘‘This subsection shall 

25 not apply with respect to an incarcerated pregnant 


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1 woman who brings an action relating to or affecting 

2 the woman’s pregnancy.’’; and 

3 (2) in subsection (d)(1), insert ‘‘, except an in4 carcerated pregnant woman,’’ before ‘‘who is con5 fined’’. 

6 SEC. 7. DEFINITIONS. 

7 In this Act: 

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

9 means, with respect to an individual, that the indi10 vidual is under the supervision of a Federal, State, 

11 tribal or local correctional facility, including pretrial 

12 and contract facilities, and juvenile or medical or 

13 mental health facilities. 

14 (2) OTHER PREGNANCY OUTCOME.—The term 

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

16 ends in stillbirth, miscarriage, or ectopic pregnancy. 

17 (3) POSTPARTUM RECOVERY.—The term ‘‘post18 partum recovery’’ means the 12-week period, or 

19 longer as determined by the health care professional 

20 responsible for the health and safety of the incarcer21 ated pregnant woman, following delivery, and shall 

22 include the entire period that the incarcerated preg23 nant woman is in the hospital or infirmary. 

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

25 means any physical or mechanical device used to 


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1 control the movement of an incarcerated pregnant 

2 woman’s body, limbs, or both. 

3 (5) RESTRICTIVE HOUSING.—The term ‘‘re4 strictive housing’’ means any type of detention that 

5 involves— 

6 (A) removal from the general inmate popu7 lation, whether voluntary or involuntary; 

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

9 whether alone or with another inmate; and 

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

11 the vast majority of the day. 

12 SEC. 8. EDUCATION AND TECHNICAL ASSISTANCE. 

13 The Director of the National Institute of Corrections 

14 shall provide education and technical assistance, in con15 junction with the appropriate public agencies, at State and 

16 local correctional facilities that house women and facilities 

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

18 in order to educate the employees of such facilities, includ19 ing health personnel, on the dangers and potential mental 

20 health consequences associated with the use of restrictive 

21 housing and restraints on incarcerated women during 

22 pregnancy, labor, and postpartum recovery, and on alter23 natives to the use of restraints and restrictive housing 

24 placement. 


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

2 TRAINING. 

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

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

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

6 of Prisons shall train each correctional officer at any Bu7 reau of Prisons women’s facility to carry out the require8 ments of this Act. 

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

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

11 the Bureau of Prisons shall train any newly hired correc12 tional officer at a Bureau of Prisons facility that houses 

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

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

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

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

17 and biannually thereafter, the Director of the U.S. Mar18 shals Service shall ensure that each Deputy U.S. Marshal 

19 is trained pursuant to the guidelines described in sub20 section (d). Newly hired deputies shall receive such train21 ing not later than 30 days after the date on which such 

22 deputy starts employment. 

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

24 Prisons and the United States Marshals Service shall each 

25 develop guidelines on the treatment of incarcerated women 

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1 corporate such guidelines in the training required under 

2 this section. Such guidelines shall include guidance on— 

3 (1) the transportation of incarcerated pregnant 

4 women; 

5 (2) housing of incarcerated pregnant women; 

6 (3) nutritional requirements for incarcerated 

7 pregnant women; and 

8 (4) the right of a health care professional to re9 quest that restraints not be used. 

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

11 FACILITIES. 

12 The Comptroller General of the United States shall 

13 conduct a study of services and protections provided for 

14 pregnant incarcerated women in local and State correc15 tional settings, including policies on obstetrical and gyne16 cological care, education on nutrition, health and safety 

17 risks associated with pregnancy, mental health and sub18 stance use treatment, access to prenatal and post-delivery 

19 support services and programs, the use of restraints and 

20 restrictive housing placement, and the extent to which the 

21 intent of such policies are fulfilled. 

22 SEC. 11. GAO STUDY ON FEDERAL PRETRIAL DETENTION 

23 FACILITIES. 

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

25 States shall conduct a study of services and protections 


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1 provided for pregnant women who are incarcerated in Fed2 eral pretrial detention facilities. Specifically, the study 

3 shall examine— 

4 (1) what available data indicate about pregnant 

5 women detained or held in Federal pretrial detention 

6 facilities; 

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

8 standards that address the care of pregnant women 

9 in Federal pretrial detention facilities; and 

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

11 pregnant women in Federal pretrial detention facili12 ties. 

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

14 2 years after the date of enactment of this Act, the Comp15 troller General shall submit a report of the results of the 

16 study conducted under subsection (a) to the Committee 

17 on the Judiciary of the Senate and the Committee on the 

18 Judiciary of the House of Representatives. The report 

19 shall identify best practices for ensuring that Federal pre20 trial detention facilities implement services and protec21 tions for pregnant women consistent with this Act and 

22 shall provide recommendations on how to implement these 

23 best practices among all Federal pretrial detention facili24 ties. 


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

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

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

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

5 pretrial detainees. 

6 SEC. 12. PWIC GRANT PROGRAM. 

7 Section 508 of the Omnibus Crime Control and Safe 

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

9 to read as follows: 

10 ‘‘SEC. 508. PREGNANT WOMEN IN CUSTODY GRANT PRO11 GRAM. 

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

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

14 the ‘PWIC Act of 2020’. 

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

16 make grants to eligible entities that have established a 

17 program to promote the health needs of incarcerated preg18 nant women in the criminal justice system at the State, 

19 tribal, and local levels or have declared their intent to es20 tablish such a program. Eligible entities shall— 

21 ‘‘(1) promote the safety and wellness of preg22 nant women in custody; 

23 ‘‘(2) provide services for obstetrical and gyneco24 logical care, for women in custody; 


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1 ‘‘(3) facilitate resources and support services 

2 for nutrition and physical and mental health, for 

3 women in custody; 

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

5 substantially similar to the limitations imposed 

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

7 limiting the use of restraints on pregnant women in 

8 custody; and 

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

10 lactation and nursery care or residential programs to 

11 keep the infant with the mother and to promote and 

12 facilitate bonding skills for incarcerated pregnant 

13 women and women with dependent children. 

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

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

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

17 grant under this section if the entity is— 

18 ‘‘(1) a State or territory department of correc19 tions; 

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

21 facility; or 

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

23 prison or jail that houses women; or 

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

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1 ment that operates a correctional facility, with ex2 pertise in providing health services to incarcerated 

3 pregnant women. 

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

5 section, an eligible entity shall submit an application to 

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

7 containing such information as the Attorney General may 

8 require, including a detailed description of the need for 

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

10 grantee expects to benefit from the grant. 

11 ‘‘(f) ADMINISTRATIVE COSTS.—Not more than 5 per12 cent of a grant awarded under this section may be used 

13 for costs incurred to administer such grant. 

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

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

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

17 projects, other than new construction or upgrade to a fa18 cility used to provide lactation, nursery, obstetrical, or 

19 gynecological services. 

20 ‘‘(h) PRIORITY FUNDING FOR STATES THAT PRO21 VIDE PROGRAMS AND SERVICES FOR INCARCERATED

22 WOMEN RELATED TO PREGNANCY AND CHILDBIRTH.— 

23 In determining the amount provided to a State or unit 

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1 ment that have enacted laws or policies and implemented 

2 services or pilot programs for incarcerated pregnant 

3 women aimed at enhancing the safety and wellness of 

4 pregnant women in custody, including providing services 

5 for obstetrical and gynecological care, resources and sup6 port services for nutrition and physical and mental health, 

7 and post-delivery lactation and nursery care or residential 

8 programs to keep the infant with the mother and to pro9 mote and facilitate bonding skills for incarcerated preg10 nant women and women with dependent children. 

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

12 grant under this section shall prioritize subgrants to a unit 

13 of local government within the State that has established 

14 a pilot program that enhances safety and wellness of preg15 nant women in custody. 

16 ‘‘(j) FEDERAL SHARE.— 

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

18 grant under this section may not exceed 75 percent 

19 of the total costs of the projects described in the 

20 grant application. 

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

22 (1) may be waived by the Assistant Attorney Gen23 eral upon a determination that the financial cir24 cumstances affecting the applicant warrant a finding 

25 that such a waiver is equitable. 


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

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

3 an eligible entity receives a grant under this section, 

4 such entity shall implement a policy that is substan5 tially similar to the policy under section 3 of Pro6 tecting the Health and Wellness of Babies and Preg7 nant Women in Custody Act. 

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

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

10 is making good faith efforts to collect the informa11 tion required under paragraph (1). 

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

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

14 to remain available until expended— 

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

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

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

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

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

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

21 grant under this section, the eligible entity shall certify 

22 to the Attorney General that the amounts received under 

23 the grant shall be used to supplement, not supplant, non24 Federal funds that would otherwise be available for pro25 grams or services in the prison where funds will be used. 


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

2 made available pursuant to this section that remain unob3 ligated for a period of 6 months after the end of the fiscal 

4 year for which the funds have been appropriated shall be 

5 awarded to other recipients of this grant. 

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

7 grant under this section shall be subject to the non8 discrimination requirement under section 40002(b)(13) of 

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

10 12291(b)(13)). 

11 ‘‘(p) DEFINITIONS.—In this section, the term ‘in cus12 tody’ means, with respect to an individual, that the indi13 vidual is under the supervision of a Federal, State, tribal, 

14 or local correctional facility, including pretrial and con15 tract facilities, and juvenile or medical or mental health 

16 facilities.’’. 

17 SEC. 13. PLACEMENT IN PRERELEASE CUSTODY. 

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

19 is amended by adding at the end the following: ‘‘Notwith20 standing any other provision of this paragraph, in the case 

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

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

23 woman may be placed into prerelease custody beginning 


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

2 woman’s due date.’’. 

Æ 


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