117TH CONGRESS 

2D SESSION H. R. 6878 

AN ACT 

To address the health needs of incarcerated women related 

to pregnancy and childbirth, and for other purposes. 

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

2 This Act may be cited as the ‘‘Pregnant Women in 

3 Custody Act’’. 

4 SEC. 2. DEFINITIONS. 

5 In this Act: 

6 (1) IN CUSTODY.—The term ‘‘in custody’’, with 

7 respect to an individual, means that the individual is 

8 under the supervision of a Federal, State, Tribal, or 

9 local correctional facility, including a pretrial, juve10 nile, medical, or mental health facility and a facility 

11 operated under a contract with the Federal Govern12 ment or a State, Tribal, or local government. 

13 (2) OTHER PREGNANCY OUTCOME.—The term 

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

15 ends in stillbirth, miscarriage, or ectopic pregnancy. 

16 (3) POSTPARTUM RECOVERY.—The term 

17 ‘‘postpartum recovery’’ has the meaning given that 

18 term in section 4051(c) of title 18, United States 

19 Code, as added by this Act. 

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

21 means any physical or mechanical device used to 

22 control the movement of an incarcerated pregnant 

23 woman’s body, limbs, or both. 

24 (5) RESTRICTIVE HOUSING.—The term ‘‘re25 strictive housing’’ has the meaning given that term 
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1 in section 4322 of title 18, United States Code, as 

2 added by this Act. 

3 SEC. 3. DATA COLLECTION. 

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

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

6 authority under section 302 of title I of the Omnibus 

7 Crime Control and Safe Streets Act of 1968 (34 U.S.C. 

8 10132), the Director of the Bureau of Justice Statistics 

9 shall include in the National Prisoner Statistics Program 

10 and Annual Survey of Jails statistics relating to the health 

11 needs of incarcerated pregnant women in the criminal jus12 tice system at the Federal, State, Tribal, and local levels, 

13 including— 

14 (1) demographic and other information about 

15 incarcerated women who are pregnant, in labor, or 

16 in postpartum recovery, including the race, ethnicity, 

17 and age of the woman; 

18 (2) the provision of pregnancy care and services 

19 provided for such women, including— 

20 (A) whether prenatal, delivery, and post21 delivery check-up visits were scheduled and pro22 vided; 

23 (B) whether a social worker, psychologist, 

24 doula or other support person was offered and 
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1 provided during pregnancy and delivery and 

2 post-delivery; 

3 (C) whether a pregnancy or parenting pro4 gram was offered and provided during preg5 nancy; 

6 (D) whether a nursery or residential pro7 gram to keep mothers and infants together 

8 post-delivery was offered and whether such a 

9 nursery or residential program was provided; 

10 (E) the number of days the mother stayed 

11 in the hospital post-delivery; 

12 (F) the number of days the infant re13 mained with the mother post-delivery; and 

14 (G) the number of days the infant re15 mained in the hospital after the mother was 

16 discharged; 

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

18 licensed obstetrician-gynecologist in proximity to 

19 where the incarcerated pregnant woman is housed 

20 and the length of travel required to transport the 

21 woman; 

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

23 place— 

24 (A) to respond to unexpected childbirth, 

25 labor, deliveries, or medical complications re-
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1 lated to the pregnancies of incarcerated preg2 nant women; and 

3 (B) for incarcerated pregnant women expe4 riencing labor or medical complications related 

5 to pregnancy outside of a hospital; 

6 (5) the number of incarcerated women who are 

7 determined by a health care professional to have a 

8 high-risk pregnancy; 

9 (6) the total number of incarcerated pregnant 

10 women and the number of incarcerated women who 

11 became pregnant while incarcerated; 

12 (7) the number of incidents in which an incar13 cerated woman who is pregnant, in labor, or in 

14 postpartum recovery is placed in restrictive housing, 

15 the reason for such restriction or placement, and the 

16 circumstances under which each incident occurred, 

17 including the duration of time in restrictive housing, 

18 during— 

19 (A) pregnancy; 

20 (B) labor; 

21 (C) delivery; 

22 (D) postpartum recovery; and 

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

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

25 post-delivery. 
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1 (b) PERSONALLY IDENTIFIABLE INFORMATION.— 

2 Data collected under this section may not contain any per3 sonally identifiable information of any incarcerated preg4 nant woman or woman in postpartum recovery. 

5 SEC. 4. 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, as described in subsection (b), are provided to 

10 women in custody, to address the health and safety needs 

11 of such women related to pregnancy and childbirth. The 

12 warden of each Bureau of Prisons facility that houses 

13 women shall ensure that these services and programs are 

14 implemented for women in custody at that facility. 

15 (b) SERVICES AND PROGRAMS PROVIDED.—The serv16 ices and programs described in this subsection are the fol17 lowing: 

18 (1) ACCESS TO COMPLETE APPROPRIATE

19 HEALTH SERVICES FOR THE LIFE CYCLE OF

20 WOMEN.—The Director of the Bureau of Prisons 

21 shall ensure that each woman of reproductive age in 

22 custody at a Bureau of Prisons facility— 

23 (A) has access to contraception and testing 

24 for pregnancy and sexually transmitted dis25 eases, upon request of any such woman; and 
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1 (B) is administered a pregnancy test on 

2 the date on which the woman enters the facility, 

3 which the woman may decline. 

4 (2) COMPLIANCE WITH PROTOCOLS RELATING

5 TO HEALTH OF A PREGNANT WOMAN.—On confirma6 tion of the pregnancy of a woman in custody by clin7 ical diagnostics and assessment, the chief health 

8 care professional of the Bureau of Prisons facility in 

9 which the woman is housed shall ensure that— 

10 (A) a summary of all appropriate protocols 

11 directly pertaining to the safety and well-being 

12 of the woman are provided to the woman; 

13 (B) such protocols are complied with; and 

14 (C) such protocols include an assessment 

15 of undue safety risks and necessary changes to 

16 accommodate the woman where and when ap17 propriate, as it relates to— 

18 (i) housing or transfer to a lower 

19 bunk for safety reasons; 

20 (ii) appropriate bedding or clothing to 

21 respond to the woman’s changing physical 

22 requirements and the temperature in hous23 ing units; 

24 (iii) regular access to water and bath25 rooms; 
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1 (iv) a diet that— 

2 (I) complies with the nutritional 

3 standards established by the Secretary 

4 of Agriculture and the Secretary of 

5 Health and Human Services in the 

6 Dietary Guidelines for Americans re7 port published pursuant to section 

8 301(a)(3) of the National Nutrition 

9 Monitoring and Related Research Act 

10 of 1990 (7 U.S.C. 5341(a)(3)); and 

11 (II) includes— 

12 (aa) any appropriate dietary 

13 supplement, including prenatal 

14 vitamins; 

15 (bb) timely and regular nu16 tritious meals; 

17 (cc) additional caloric con18 tent in meals provided; 

19 (dd) a prohibition on with20 holding food from the woman or 

21 serving any food that is used as 

22 a punishment, including 

23 nutraloaf or any food similar to 

24 nutraloaf that is not considered a 

25 nutritious meal; and 
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1 (ee) such other modifications 

2 to the diet of the woman as the 

3 Director of the Bureau of Pris4 ons determines to be necessary 

5 after consultation with the Sec6 retary of Health and Human 

7 Services and consideration of 

8 such recommendations as the 

9 Secretary may provide; 

10 (v) modified recreation and transpor11 tation, in accordance with standards within 

12 the obstetrical and gynecological care com13 munity, to prevent overexertion or pro14 longed periods of inactivity; and 

15 (vi) such other changes to living con16 ditions as the Director of the Bureau of 

17 Prisons may require after consultation 

18 with the Secretary of Health and Human 

19 Services and consideration of such rec20 ommendations as the Secretary may pro21 vide. 

22 (3) EDUCATION AND SUPPORT SERVICES.— 

23 (A) PREGNANCY IN CUSTODY.—A woman 

24 who is pregnant at intake or who becomes preg25 nant while in custody shall, not later than 14 
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1 days after the pregnant woman notifies a Bu2 reau of Prisons official of the pregnancy, re3 ceive prenatal education, counseling, and birth 

4 support services provided by a provider trained 

5 to 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 

15 (2)(C)(iv); 

16 (iv) information pertaining to the 

17 health and safety risks of pregnancy, child18 birth, and parenting, including postpartum 

19 depression; 

20 (v) information on breast-feeding, lac21 tation, and breast health; 

22 (vi) appropriate educational materials, 

23 resources, and services related to preg24 nancy, childbirth, and parenting; 
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1 (vii) information and notification serv2 ices for incarcerated parents regarding the 

3 risk of debt repayment obligations associ4 ated with their child’s participation in so5 cial welfare programs, including assistance 

6 under any State program funded under 

7 part A of title IV of the Social Security 

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

9 under the supplemental nutrition assist10 ance program, as defined in section 3 of 

11 the Food and Nutrition Act of 2008 (7 

12 U.S.C. 2012), or any State program car13 ried out under that Act; and 

14 (viii) information from the Office of 

15 Child Support Enforcement of the Depart16 ment of Health and Human Services re17 garding seeking or modifying child support 

18 while incarcerated, including how to par19 ticipate in the Bureau of Prison’s Inmate 

20 Financial Responsibility Program under 

21 subpart B of part 545 of title 28, Code of 

22 Federal Regulations (or any successor pro23 gram). 

24 (B) BIRTH WHILE IN CUSTODY OR PRIOR

25 TO CUSTODY.—A woman who, while in custody 
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1 or during the 6-month period immediately pre2 ceding intake, gave birth or experienced any 

3 other pregnancy outcome shall receive coun4 seling provided by a licensed or certified pro5 vider trained to provide such services, includ6 ing— 

7 (i) information about the parental 

8 rights of the woman, including the right to 

9 place the child in kinship care, and notice 

10 of the rights of the child; 

11 (ii) information about family preserva12 tion support services that are available to 

13 the woman; and 

14 (iii) postpartum health conditions. 

15 (4) EVALUATIONS.— 

16 (A) IN GENERAL.—Each woman in custody 

17 who is pregnant or whose pregnancy results in 

18 a birth or any other pregnancy outcome during 

19 the 6-month period immediately preceding in20 take or any time in custody thereafter shall be 

21 evaluated as soon as practicable after intake or 

22 confirmation of pregnancy through evidence23 based screening and assessment for substance 

24 use disorders or mental health conditions, in25 cluding postpartum depression or depression re-
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1 lated to pregnancy, birth, or any other preg2 nancy outcome or early child care. 

3 (B) RISK FACTORS.—Screening under sub4 paragraph (A) shall include identification of 

5 any of the following risk factors: 

6 (i) An existing mental or physical 

7 health condition or substance use disorder. 

8 (ii) Being underweight or overweight. 

9 (iii) Multiple births or a previous still 

10 birth. 

11 (iv) A history of preeclampsia. 

12 (v) A previous Caesarean section. 

13 (vi) A previous miscarriage. 

14 (vii) Being older than 35 or younger 

15 than 15. 

16 (viii) Being diagnosed with the human 

17 immunodeficiency virus, hepatitis, diabetes, 

18 or hypertension. 

19 (ix) Such other risk factors as the 

20 chief health care professional of the Bu21 reau of Prisons facility that house the 

22 woman may determine to be appropriate. 

23 (5) UNEXPECTED BIRTHS RULEMAKING.—The 

24 Director of the Bureau of Prisons shall provide serv25 ices to respond to unexpected childbirth deliveries, 
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1 labor complications, and medical complications re2 lated to pregnancy if a woman in custody is unable 

3 to access a hospital in a timely manner in accord4 ance with rules promulgated by the Attorney Gen5 eral, which shall be promulgated not later than 180 

6 days after the date of enactment of this Act. 

7 (6) TREATMENT.—The Director of the Bureau 

8 of Prisons shall use best efforts to provide a woman 

9 in custody who is pregnant and diagnosed with hav10 ing a substance use disorder or a mental health dis11 order with appropriate evidence-based treatment. 

12 SEC. 5. USE OF RESTRICTIVE HOUSING ON INCARCERATED 

13 PREGNANT WOMEN DURING PREGNANCY, 

14 LABOR, AND POSTPARTUM RECOVERY PRO15 HIBITED. 

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

17 States Code, is amended to read as follows: 

18 ‘‘§ 4322. Use of restrictive housing on incarcerated 

19 women during the period of pregnancy, 

20 labor, and postpartum recovery prohib21 ited 

22 ‘‘(a) PROHIBITION.—Except as provided in sub23 section (b), during the period beginning on the date on 

24 which pregnancy is confirmed by a health care professional 

25 and ending not earlier than 12 weeks after delivery, an 
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1 incarcerated woman in the custody of the Bureau of Pris2 ons, or in the custody of the United States Marshals Serv3 ice pursuant to section 4086, shall not be held in restric4 tive housing. 

5 ‘‘(b) EXCEPTIONS.— 

6 ‘‘(1) RESTRICTIVE HOUSING.—Subject to para7 graph (4), the prohibition under subsection (a) relat8 ing to restrictive housing shall not apply if the Di9 rector of the Bureau of Prisons or a senior Bureau 

10 of Prisons official overseeing women’s health and 

11 services, in consultation with senior officials in 

12 health services, makes an individualized determina13 tion that restrictive housing is required as a tem14 porary response to behavior that poses a serious and 

15 immediate risk of physical harm. 

16 ‘‘(2) REVIEW.—The official who makes a deter17 mination under subparagraph (A) shall review such 

18 determination daily for the purpose of removing an 

19 incarcerated woman as quickly as feasible from re20 strictive housing. 

21 ‘‘(3) RESTRICTIVE HOUSING PLAN.—The offi22 cial who makes a determination under subparagraph 

23 (A) shall develop an individualized plan to move an 

24 incarcerated woman to less restrictive housing within 

25 a reasonable amount of time. 
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1 ‘‘(4) PROHIBITION ON SOLITARY CONFINE2 MENT.—An incarcerated woman who is placed in re3 strictive housing under this subsection may not be 

4 placed in solitary confinement if the incarcerated 

5 woman is in her third trimester. 

6 ‘‘(c) REPORTS.— 

7 ‘‘(1) REPORT TO DIRECTORS AND HEALTH

8 CARE PROFESSIONAL AFTER PLACEMENT IN RE9 STRICTIVE HOUSING.—Not later than 30 days after 

10 the date on which an incarcerated woman is placed 

11 in restrictive housing under subsection (b), the ap12 plicable official identified in subsection (b)(1), cor13 rectional officer, or United States Marshal shall sub14 mit to the Director of the Bureau of Prisons or the 

15 Director of the United States Marshals Service, as 

16 applicable, and to the health care professional re17 sponsible for the health and safety of the woman, a 

18 written report which describes the facts and cir19 cumstances surrounding the restrictive housing 

20 placement, and includes the following: 

21 ‘‘(A) The reasoning upon which the deter22 mination for the placement was made. 

23 ‘‘(B) The details of the placement, includ24 ing length of time of placement and how fre25 quently and how many times the determination 
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1 was made subsequent to the initial determina2 tion to continue the restrictive housing place3 ment. 

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

5 alternative interventions and sanctions before 

6 the restrictive housing was used. 

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

8 woman observed by or reported by the health 

9 care professional responsible for the health and 

10 safety of the woman. 

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

12 place to identify more appropriate alternative 

13 interventions should a similar situation arise 

14 again. 

15 ‘‘(2) REPORT TO CONGRESS.—Not later than 

16 180 days after the date of enactment of the Preg17 nant Women in Custody Act, and every 180 days 

18 thereafter for a period of 10 years, the Attorney 

19 General shall submit to the Committee on the Judi20 ciary of the Senate and the Committee on the Judi21 ciary of the House of Representatives a report on 

22 the placement of incarcerated women in restrictive 

23 housing under subsection (b), which shall include the 

24 information described in paragraph (1). 
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1 ‘‘(d) NOTICE.—Not later than 24 hours after the con2 firmation of the pregnancy of an incarcerated woman by 

3 a health care professional, that woman shall be notified, 

4 orally and in writing, by an appropriate health care profes5 sional, correctional officer, or United States Marshal, as 

6 applicable— 

7 ‘‘(1) of the restrictions on the use of restrictive 

8 housing placements under this section; 

9 ‘‘(2) of the right of the incarcerated woman to 

10 make a confidential report of a violation of restric11 tions on the use of restrictive housing placement; 

12 and 

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

14 all rights of the incarcerated woman under sub15 section (a). 

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

17 than 180 days after the date of enactment of the Pregnant 

18 Women in Custody Act, the Director of the Bureau of 

19 Prisons and the Director of the United States Marshals 

20 Service shall establish processes through which an incar21 cerated person may report a violation of this section. 

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

23 Bureau of Prisons facility where a pregnant woman is in 

24 custody shall notify necessary facility staff of the preg-
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1 nancy and of the rights of the incarcerated pregnant 

2 woman under subsection (a). 

3 ‘‘(g) RETALIATION.—It shall be unlawful for any Bu4 reau of Prisons or United States Marshals Service em5 ployee to retaliate against an incarcerated person for re6 porting under the processes established under subsection 

7 (e) a violation of subsection (a). 

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

9 date of enactment of the Pregnant Women in Custody Act, 

10 the Director of the Bureau of Prisons and the Director 

11 of the United States Marshals Service shall each— 

12 ‘‘(1) develop education guidelines regarding the 

13 physical and mental health needs of incarcerated 

14 pregnant women, and the use of restrictive housing 

15 placements on incarcerated women during the period 

16 of pregnancy, labor, and postpartum recovery; and 

17 ‘‘(2) incorporate such guidelines into appro18 priate education programs. 

19 ‘‘(i) DEFINITION.—In this section, the term ‘restric20 tive housing’ means any type of detention that involves— 

21 ‘‘(1) removal from the general inmate popu22 lation, whether voluntary or involuntary; 

23 ‘‘(2) placement in a locked room or cell, wheth24 er alone or with another inmate; and 
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1 ‘‘(3) inability to leave the room or cell for the 

2 vast majority of the day.’’. 

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

4 for chapter 317 of title 18, United States Code, is amend5 ed by striking the item relating to section 4322 and insert6 ing the following: 

‘‘4322. Use of restrictive housing on incarcerated women during the period of 

pregnancy, labor, and postpartum recovery prohibited.’’. 

7 SEC. 6. TREATMENT OF WOMEN WITH HIGH-RISK PREG8 NANCIES. 

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

10 States Code, is amended by adding at the end the fol11 lowing: 

12 ‘‘§ 4052. Treatment of incarcerated pregnant women 

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

14 Director of the Bureau of Prisons shall ensure that each 

15 incarcerated pregnant woman receives an evaluation to de16 termine if the pregnancy is high-risk and, if so, receives 

17 healthcare appropriate for a high-risk pregnancy, includ18 ing obstetrical and gynecological care, during pregnancy 

19 and postpartum recovery. 

20 ‘‘(b) HIGH-RISK PREGNANCIES.— 

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

22 of Prisons shall transfer to a Residential Reentry 

23 Center with adequate health care during her preg-
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1 nancy and postpartum recovery any incarcerated 

2 woman who— 

3 ‘‘(A) is determined by a health care profes4 sional to have a high-risk pregnancy; and 

5 ‘‘(B) agrees to be transferred. 

6 ‘‘(2) PRIORITY.—The Residential Reentry Cen7 ter to which an incarcerated pregnant woman is 

8 transferred under paragraph (1) shall, to the extent 

9 practicable, be in a geographical location that is 

10 close to the family members of the incarcerated 

11 pregnant woman. 

12 ‘‘(3) TRANSPORTATION.—To transport an in13 carcerated pregnant woman to a Residential Reentry 

14 Center, the Director of the Bureau of Prisons shall 

15 provide to the woman a mode of transportation that 

16 a healthcare professional has determined to be safe 

17 for transporting the pregnant woman. 

18 ‘‘(4) SERVICE OF SENTENCE.—Any time ac19 crued at a Residential Reentry Center or alternative 

20 housing as a result of a transfer made under this 

21 section shall be credited toward service of the incar22 cerated pregnant woman’s sentence. 

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

24 ‘‘(1) HEALTH CARE PROFESSIONAL.—The term 

25 ‘health care professional’ means— 
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1 ‘‘(A) a doctor of medicine or osteopathy 

2 who is authorized to diagnose and treat phys3 ical or mental health conditions under the laws 

4 of the State in which the doctor practices and 

5 where the facility is located; 

6 ‘‘(B) any physician’s assistant or nurse 

7 practitioner who is supervised by a doctor of 

8 medicine or osteopathy described in subpara9 graph (A); or 

10 ‘‘(C) any other person determined by the 

11 Director of the Bureau of Prisons to be capable 

12 of providing health care services. 

13 ‘‘(2) HIGH-RISK PREGNANCY.—The term ‘high14 risk pregnancy’ means, with respect to an incarcer15 ated woman, that the pregnancy threatens the 

16 health or life of the woman or pregnancy, as deter17 mined by a health care professional. 

18 ‘‘(3) POSTPARTUM RECOVERY.—The term 

19 ‘postpartum recovery’ means the 3-month period be20 ginning on the date on which an incarcerated preg21 nant woman gives birth, or longer as determined by 

22 a health care professional following delivery, and 

23 shall include the entire period that the incarcerated 

24 pregnant woman is in the hospital or infirmary. 
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1 ‘‘(4) RESIDENTIAL REENTRY CENTER.—The 

2 term ‘Residential Reentry Center’ means a Bureau 

3 of Prisons contracted residential reentry center.’’. 

4 (b) CONFORMING AMENDMENT.—The table of sec5 tions for chapter 303 of title 18, United States Code, is 

6 amended by adding at the end the following: 

‘‘4052. Treatment of incarcerated pregnant women.’’. 

7 SEC. 7. REPORTING REQUIREMENT REGARDING CLAIMS 

8 FILED BY PREGNANT INMATES. 

9 The Director of the Federal Bureau of Prisons shall 

10 make publicly available on the website of the Federal Bu11 reau of Prisons on an annual basis the following informa12 tion: 

13 (1) The total number of Administrative Remedy 

14 appeals related to pregnant inmates that were filed 

15 during the previous year. 

16 (2) The total number of institution-level Re17 quests for Administrative Remedy related to preg18 nant inmates that were filed during the previous 

19 year. 

20 (3) The total number of informal requests for 

21 administrative remedy related to pregnant inmates 

22 that were filed during the previous year. 

23 (4) The total number of requests or appeals re24 lated to pregnant inmates during the previous year 

25 that were not resolved before the inmate gave birth 
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1 or that were mooted because the inmate’s pregnancy 

2 ended. 

3 (5) The average amount of time that each cat4 egory of request or appeal took to resolve during the 

5 previous year. 

6 (6) The shortest and longest amounts of time 

7 that a request or appeal in each category that was 

8 resolved in the last year took to resolve. 

9 SEC. 8. EDUCATION AND TECHNICAL ASSISTANCE. 

10 The Director of the National Institute of Corrections 

11 shall provide education and technical assistance, in con12 junction with the appropriate public agencies, at State and 

13 local correctional facilities that house women and facilities 

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

15 in order to educate the employees of such facilities, includ16 ing health personnel, on the dangers and potential mental 

17 health consequences associated with the use of restrictive 

18 housing and restraints on incarcerated women during 

19 pregnancy, labor, and postpartum recovery, and on alter20 natives to the use of restraints and restrictive housing 

21 placement. 

22 SEC. 9. BUREAU OF PRISONS STAFF AND UNITED STATES 

23 MARSHALS TRAINING. 

24 (a) BUREAU OF PRISONS TRAINING.— 

25 (1) IN GENERAL.— 
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1 (A) INITIAL TRAINING.—Not later than 

2 180 days after the date of enactment of this 

3 Act, the Director of the Bureau of Prisons shall 

4 provide training to carry out the requirements 

5 of this Act and the amendments made by this 

6 Act to each correctional officer at any Bureau 

7 of Prisons facility that houses women who is 

8 employed on the date of enactment of this Act. 

9 (B) SUBSEQUENT TRAINING.—After the 

10 initial training provided under subparagraph 

11 (A), the Director of the Bureau of Prisons shall 

12 provide training to carry out the requirements 

13 of this Act and the amendments made by this 

14 Act twice each year to each correctional officer 

15 at any Bureau of Prisons facility that houses 

16 women. 

17 (2) NEW HIRES.— 

18 (A) DEFINITION.—In this paragraph, the 

19 term ‘‘covered new correctional officer’’ means 

20 an individual appointed to a position as a cor21 rectional officer at a Bureau of Prisons facility 

22 that houses women on or after the date that is 

23 180 days after the date of enactment of this 

24 Act. 
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1 (B) TRAINING.—The Director of the Bu2 reau of Prisons shall train each covered new 

3 correctional officer to carry out the require4 ments of this Act and the amendments made by 

5 this Act not later than 30 days after the date 

6 on which the covered new correctional officer is 

7 appointed. 

8 (b) UNITED STATES MARSHALS TRAINING.— 

9 (1) IN GENERAL.—On and after the date that 

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

11 the Director of the United States Marshals Service 

12 shall ensure that each Deputy United States Mar13 shal has received trained pursuant to the guidelines 

14 described in subsection (c). 

15 (2) NEW HIRES.— 

16 (A) DEFINITION.—In this paragraph, the 

17 term ‘‘new Deputy United States Marshal’’ 

18 means an individual appointed to a position as 

19 a Deputy United States Marshal after the date 

20 of enactment of this Act. 

21 (B) TRAINING.—Not later than 30 days 

22 after the date on which a new Deputy United 

23 States Marshal is appointed, the new Deputy 

24 United States Marshal shall receive training 
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1 pursuant to the guidelines described in sub2 section (c). 

3 (c) GUIDELINES.— 

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

5 of Prisons and the United States Marshals Service 

6 shall each develop guidelines on the treatment of in7 carcerated women during pregnancy, labor, and 

8 postpartum recovery and incorporate such guidelines 

9 in the training required under this section. 

10 (2) CONTENTS.—The guidelines developed 

11 under paragraph (1) shall include guidance on— 

12 (A) the transportation of incarcerated 

13 pregnant women; 

14 (B) housing of incarcerated pregnant 

15 women; 

16 (C) nutritional requirements for incarcer17 ated pregnant women; and 

18 (D) the right of a health care professional 

19 to request that restraints not be used. 

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

21 FACILITIES. 

22 The Comptroller General of the United States shall 

23 conduct a study of services and protections provided for 

24 pregnant incarcerated women in local and State correc25 tional settings, including— 
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1 (1) policies on— 

2 (A) obstetrical and gynecological care; 

3 (B) education on nutritional issues and 

4 health and safety risks associated with preg5 nancy; 

6 (C) mental health and substance use treat7 ment; 

8 (D) access to prenatal and post-delivery 

9 support services and programs; and 

10 (E) the use of restraints and restrictive 

11 housing placement; and 

12 (2) the extent to which the intent of such poli13 cies is fulfilled. 

14 SEC. 11. DETERMINATION OF BUDGETARY EFFECTS. 

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

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

17 shall be determined by reference to the latest statement 

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

19 Act, submitted for printing in the Congressional Record 

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

2 vote on passage. 

Passed the House of Representatives December 1, 

2022. 

Attest: 

Clerk. 
117TH CONGRESS 

2D SESSION H. R. 6878 

AN ACT 

To address the health needs of incarcerated women 

other purposes. related to pregnancy and childbirth, and for