tion with senior officials in health services, 
makes an individualized determination that the 
prisoner— 
‘‘(i) is an immediate and credible 
flight risk that cannot reasonably be pre-
vented by other means; or 
‘‘(ii) poses an immediate and serious 
threat of harm to herself or others that 
cannot reasonably be prevented by other 
means; or 
‘‘(B) a health care professional responsible 
for the health and safety of the prisoner deter-
mines that the use of medical restraints is ap-
propriate for the medical safety of the prisoner, 
and such professional reviews such determina-
tion not later than every 6 hours after such use 
is initially approved until such use is termi-
nated. 
‘‘(2) LEAST RESTRICTIVE RESTRAINTS.—In the 
case that restraints are used pursuant to an excep-
tion under paragraph (1), only the least restrictive 
restraints necessary to prevent the harm or risk of 
escape described in paragraph (1) may be used. 
‘‘(A) APPLICATION.—The exceptions under 
paragraph (1) may not be applied— 
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‘‘(i) to place restraints around the an-
kles, legs, or waist of a prisoner; 
‘‘(ii) to restrain a prisoner’s hands be-
hind her back; 
‘‘(iii) to restrain a prisoner using 
four-point restraints; or 
‘‘(iv) to attach a prisoner to another 
prisoner. 
‘‘(B) MEDICAL
REQUEST.—Notwithstand-
ing paragraph (1), upon the request of a 
healthcare professional who is responsible for 
the health and safety of a prisoner, a correc-
tions officer or United States marshal, as appli-
cable, shall refrain from using restraints on the 
prisoner or remove restraints used on the pris-
oner. 
‘‘(C) SITUATIONAL USE.—The individual-
ized determination described under paragraph 
(1) shall only apply to a specific situation and 
must be reaffirmed through the same process, 
to use restraints again in any future situation 
involving the same prisoner. 
‘‘(3) ACCESS TO CARE.—Immediately upon the 
cessation of the use of restraints or restrictive hous-
ing as outlined in this subsection, the Bureau of 
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Prisons or United States Marshal Service shall pro-
vide the prisoner with immediate access to physical 
and mental health assessments and all indicated 
treatment. 
‘‘(4) USE OF RESTRICTIVE HOUSING.—The pro-
hibition under subsection (a) related to restrictive 
housing shall not apply if the senior Bureau of Pris-
ons official or United States Marshals Service offi-
cial overseeing women’s health and services, in con-
sultation with senior officials in health services, 
makes an individualized determination that restric-
tive housing is required as a temporary response to 
behavior that poses a serious and immediate risk of 
physical harm and reviews and affirms that deter-
mination at least every 24 hours. 
‘‘(c) REPORTS.— 
‘‘(1) 
REPORT
TO
THE
DIRECTOR
AND 
HEALTHCARE
PROFESSIONAL
AFTER
THE
USE
OF 
RESTRAINTS.—If an official identified in subsection 
(b)(1), correctional officer, or United States Marshal 
uses restraints on a prisoner under subsection 
(b)(2), that official, including a designated correc-
tional officer or marshal shall submit, not later than 
30 days after placing the prisoner in restraints, to 
the Director of the Bureau of Prisons or the Direc-
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tor of the United States Marshals Service, as appli-
cable, and to the healthcare professional responsible 
for the health and safety of the prisoner, a written 
report which describes the facts and circumstances 
surrounding the use of restraints, and includes— 
‘‘(A) the reasoning upon which the deter-
mination to use restraints was made; 
‘‘(B) the details of the use of restraints, 
including the type of restraints used and length 
of time during which restraints were used; 
‘‘(C) any resulting physical effects on the 
inmate, fetus, or the neonate observed by or re-
ported by the qualified health care professional; 
and 
‘‘(D) a description of all attempts to use 
alternative interventions and sanctions before 
the restraints were used. 
‘‘(2) 
REPORT
TO
THE
DIRECTOR
AND 
HEALTHCARE PROFESSIONAL AFTER PLACEMENT IN 
RESTRICTIVE HOUSING.—If an official identified in 
subsection (b)(3), correctional officer, or United 
States Marshal places a prisoner in restrictive hous-
ing under subsection (b)(3), that official, correc-
tional officer, or United States Marshal shall submit, 
not later than 30 days after placing the prisoner in 
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restrictive housing, to the Director of the Bureau of 
Prisons or the Director of the United States Mar-
shals Service, as applicable, and to the healthcare 
professional responsible for the health and safety of 
the prisoner, a written report which describes the 
facts and circumstances surrounding the restrictive 
housing placement, and includes— 
‘‘(A) the reasoning upon which the deter-
mination for the placement was made; 
‘‘(B) the details of the placement, includ-
ing length of time of placement and how fre-
quently and how many times the determination 
was made subsequent to the initial determina-
tion to continue the restrictive housing place-
ment; and 
‘‘(C) any resulting physical effects on the 
inmate, fetus, or the neonate observed by or re-
ported by qualified health care professional. 
‘‘(3) SUPPLEMENTAL REPORT TO THE DIREC-
TOR.—Upon receipt of a report under subsection (c), 
the healthcare professional responsible for the health 
and safety of the prisoner shall submit to the Direc-
tor such information as the healthcare professional 
determines is relevant to the use of restrictive hous-
ing or restraints on the prisoner. 
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‘‘(4) REPORT TO JUDICIARY COMMITTEES.— 
‘‘(A) IN GENERAL.—Not later than 1 year 
after the date of enactment of this Act, and an-
nually thereafter, the Director of the Bureau of 
Prisons and the Director of the United States 
Marshals Service shall each submit to the Judi-
ciary Committee of the Senate and of the 
House of Representatives a report that certifies 
compliance with this section and includes the 
information required to be reported under para-
graphs (1) and (2). 
‘‘(B) PERSONALLY IDENTIFIABLE INFOR-
MATION.—The report under this paragraph 
shall not contain any personally identifiable in-
formation of any prisoner. 
‘‘(d) NOTICE.—Not later than 24 hours after the con-
firmation of a prisoner’s pregnancy by a health care pro-
fessional, that prisoner shall be notified, orally and in writ-
ing, by an appropriate health care professional, corrections 
official or officer, or United States Marshal, as applicable, 
of— 
‘‘(1) the restrictions on the use of restraints 
and restrictive housing placements under this sec-
tion; 
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‘‘(2) the prisoner’s right to make a confidential 
report of a violation of restrictions on the use of re-
straints or restrictive housing placement; and 
‘‘(3) that the facility staff have been advised of 
all rights of the prisoner under subsection (a). 
‘‘(e) VIOLATION REPORTING PROCESS.—Not later 
than 180 days after the date of enactment of this Act, 
the Director of the Bureau of Prisons, and the Director 
of the United States Marshals Service shall establish proc-
esses through which a prisoner may report a violation of 
this section. 
‘‘(f) NOTIFICATION OF RIGHTS.—The head of the 
Bureau of Prisons facility where a pregnant woman is in 
custody shall notify all facility staff of the pregnancy and 
of the pregnant prisoner’s rights under subsection (a). 
‘‘(g) RETALIATION.—It shall be unlawful for any Bu-
reau of Prisons or United States Marshal Service em-
ployee to retaliate against a prisoner for reporting under 
the provisions of subsection (d) a violation of subsection 
(a). 
‘‘(h) EDUCATION.— 
‘‘(1) IN GENERAL.—Not later than 180 days 
after the date of enactment of this Act, the Director 
of the Bureau of Prisons and the Director of the 
United States Marshals Service shall each develop 
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education guidelines regarding the physical and 
mental health needs of pregnant prisoners, and the 
use of restrictive housing placements and the use of 
restraints on female prisoners during the period of 
pregnancy, labor, and postpartum recovery, and 
shall incorporate such guidelines into appropriate 
education programs. Such education guidelines shall 
include— 
‘‘(A) how to identify certain symptoms of 
pregnancy that require immediate referral to a 
health care professional; 
‘‘(B) in the case that an exception under 
subsection (b)(1) applies, how to apply re-
straints in a way that does not harm the pris-
oner, the fetus, or the neonate; 
‘‘(C) circumstances under which the excep-
tions under subsection (b)(3) would apply; 
‘‘(D) the information required to be re-
ported under subsection (d); and 
‘‘(E) the right of a health care professional 
to request that restraints not be used, and the 
requirement under subsection (b)(2)(B) to com-
ply with such a request. 
‘‘(2) DEVELOPMENT OF GUIDELINES.—In de-
veloping the guidelines required by paragraph (1), 
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the Directors shall each consult with health care 
professionals, professional associations, and United 
States Department of Health and Human Services 
entities with expertise in caring for women during 
the period of pregnancy and postpartum recovery.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 317 of title 18, United States 
Code, is amended by adding after the item relating to sec-
tion 4321 the following: 
‘‘4322. Use of restraints and restrictive housing on prisoners during the period 
of pregnancy, labor, and postpartum recovery prohibited and to 
improve pregnancy care for women in Federal prisons.’’. 
SEC. 6. DEFINITIONS. 
(a) IN CUSTODY.—The term ‘‘in custody’’ means, 
with regard to an individual, that the individual is under 
the supervision of a Federal, State, tribal or local correc-
tional facility, including pretrial and contract facilities, 
and juvenile or medical or mental health facilities. 
(b) OTHER
PREGNANCY
OUTCOME.—The term 
‘‘other pregnancy outcome’’ means a pregnancy that ends 
in stillbirth, miscarriage, ectopic pregnancy, or other non- 
live birth outcome. 
(c) POSTPARTUM RECOVERY.—The term ‘‘postpar-
tum recovery’’ means the eight-week period, or longer as 
determined by the healthcare professional responsible for 
the health and safety of the prisoner, following delivery, 
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and shall include the entire period that the prisoner is in 
the hospital or infirmary. 
(d) PRISONER OR INMATE.—The term ‘‘prisoner’’ or 
‘‘inmate’’ means a person who has been sentenced to a 
term of imprisonment pursuant to a conviction for a Fed-
eral criminal offense, or a person in the custody of the 
Bureau of Prisons, including a person in a Bureau of Pris-
ons pre-trial or contracted facility, or a person in the cus-
tody of the United States Marshal Service, including a 
person in the United States Marshal contracted facility. 
(e) RESTRAINTS.—The term ‘‘restraints’’ means any 
physical or mechanical device used to control the move-
ment of a prisoner’s body, limbs, or both. 
(f) RESTRICTIVE HOUSING.—The term ‘‘restrictive 
housing’’ means any type of detention that involves— 
(1) removal from the general inmate population, 
whether voluntary or involuntary; 
(2) placement in a locked room or cell, whether 
alone or with another inmate; and 
(3) inability to leave the room or cell for the 
vast majority of the day. 
SEC. 7. SENSE OF CONGRESS. 
It is the sense of Congress that States should enact 
comprehensive laws to ensure that the health needs of in-
carcerated women, including women during the period of 
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pregnancy and postpartum recovery, are met, and that 
such laws should include a prohibition of the use of restric-
tive housing and restraints on inmates during the period 
of pregnancy and postpartum recovery that is substan-
tially similar to the restriction under section 4322 of title 
18, United States Code. 
SEC. 8. EDUCATION AND TECHNICAL ASSISTANCE. 
The Director of the Bureau of Justice Assistance, in 
consultation with the Secretary of Health and Human 
Services, shall provide education and technical assistance, 
in conjunction with the appropriate public agencies, at 
State and local correctional facilities that house women 
and facilities in which incarcerated women labor and give 
birth, in order to— 
(1) educate the employees of such facilities, in-
cluding health personnel, on the dangers and poten-
tial mental health consequences associated with the 
use of restrictive housing and restraints on incarcer-
ated women during pregnancy, labor, and postpar-
tum recovery, and on alternatives to the use of re-
straints and restrictive housing placement; 
(2) foster a culture of safe, high-quality care in 
these facilities that voids the use of restrictive hous-
ing and restraints on incarcerated women during 
pregnancy, labor, and postpartum recovery; 
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