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‘‘(A) A description of all attempts to use 
alternative interventions and sanctions before 
the restraints were used. 
‘‘(B) A description of the circumstances 
that led to the use of restraints. 
‘‘(C) Strategies the facility is putting in 
place to identify more appropriate alternative 
interventions should a similar situation arise 
again. 
‘‘(2) REPORT TO CONGRESS.—Beginning on the 
date that is 6 months after the date of enactment 
of the Protecting the Health and Wellness of Babies 
and Pregnant Women in Custody Act, and every 6 
months thereafter for a period of 10 years, the At-
torney General shall submit to the Committees on 
the Judiciary of the House of Representatives and 
the Senate a report on— 
‘‘(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; and 
‘‘(C) any resulting physical effects on the 
prisoner observed by or known to the correc-
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tions official or United States Marshal, as ap-
plicable. 
‘‘(3) REPORT TO THE DIRECTOR AND HEALTH 
CARE
PROFESSIONAL
AFTER
PLACEMENT
IN
RE-
STRICTIVE
HOUSING.—If an official identified in 
subsection (b)(3), correctional officer, or United 
States Marshal places or causes an incarcerated 
woman to be placed in restrictive housing under 
such subsection, that official, correctional officer, or 
United States Marshal shall submit, not later than 
30 days after placing or causing the placement of 
the incarcerated woman in restrictive housing, to the 
Director of the Bureau of Prisons or the Director of 
the United States Marshals Service, as applicable, 
and to the health care professional responsible for 
the health and safety of the woman, a written report 
which describes the facts and circumstances sur-
rounding the restrictive housing placement, and in-
cludes the following: 
‘‘(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-
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tion to continue the restrictive housing place-
ment. 
‘‘(C) A description of all attempts to use 
alternative interventions and sanctions before 
the restrictive housing was used. 
‘‘(D) Any resulting physical effects on the 
woman observed by or reported by the health 
care professional responsible for the health and 
safety of the woman. 
‘‘(E) Strategies the facility is putting in 
place to identify more appropriate alternative 
interventions should a similar situation arise 
again. 
‘‘(4) REPORT TO CONGRESS.—Beginning on the 
date that is 6 months after the date of enactment 
of the Protecting the Health and Wellness of Babies 
and Pregnant Women in Custody Act, and every 6 
months thereafter for a period of 10 years, the At-
torney General shall submit to the Committees on 
the Judiciary of the House of Representatives and 
the Senate a report on the information described in 
paragraph (3). 
‘‘(d) NOTICE.—Not later than 24 hours after the con-
firmation of an incarcerated woman’s pregnancy by a 
health care professional, that woman shall be notified, 
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orally and in writing, by an appropriate health care profes-
sional, correctional officer, or United States Marshal, as 
applicable— 
‘‘(1) of the restrictions on the use of restraints 
and restrictive housing placements under this sec-
tion; 
‘‘(2) of the incarcerated woman’s right to make 
a confidential report of a violation of restrictions on 
the use of restraints or restrictive housing place-
ment; and 
‘‘(3) that the facility staff have been advised of 
all rights of the incarcerated woman under sub-
section (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 an incarcerated person may report 
a violation of this section. 
‘‘(f) NOTIFICATION OF RIGHTS.—The warden of the 
Bureau of Prisons facility where a pregnant woman is in 
custody shall notify necessary facility staff of the preg-
nancy and of the incarcerated pregnant woman’s rights 
under subsection (a). 
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‘‘(g) RETALIATION.—It shall be unlawful for any Bu-
reau of Prisons or United States Marshal Service em-
ployee to retaliate against an incarcerated person for re-
porting under the provisions of subsection (e) a violation 
of subsection (a). 
‘‘(h) EDUCATION.—Not later than 90 days after the 
date of enactment of the Protecting the Health and 
Wellness of Babies and Pregnant Women in Custody Act, 
the Director of the Bureau of Prisons and the Director 
of the United States Marshals Service shall each develop 
education guidelines regarding the physical and mental 
health needs of incarcerated pregnant women, and the use 
of restraints and restrictive housing placements on incar-
cerated women during the period of pregnancy, labor, and 
postpartum recovery, and shall incorporate such guidelines 
into appropriate education programs. 
‘‘(i) DEFINITION.—In this section: 
‘‘(1) 
RESTRAINTS.—The 
term 
‘restraints’ 
means any physical or mechanical device used to 
control the movement of an incarcerated pregnant 
woman’s body, limbs, or both. 
‘‘(2) RESTRICTIVE
HOUSING.—The term ‘re-
strictive housing’ means any type of detention that 
involves— 
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‘‘(A) removal from the general inmate pop-
ulation, whether voluntary or involuntary; 
‘‘(B) placement in a locked room or cell, 
whether alone or with another inmate; and 
‘‘(C) inability to leave the room or cell for 
the vast majority of the day.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 317 of title 18, United States 
Code, is amended by amending the item relating to section 
4322 to read as follows: 
‘‘4322. Use of restraints and restrictive housing on incarcerated women during 
the period of pregnancy, labor, and postpartum recovery pro-
hibited and to improve pregnancy care for women in Federal 
prisons.’’. 
SEC. 5. TREATMENT OF WOMEN WITH HIGH-RISK PREG-
NANCIES. 
(a) IN GENERAL.—Chapter 303 of title 18, United 
States Code, is amended by adding at the end the fol-
lowing: 
‘‘§ 4051. Treatment of incarcerated pregnant women 
‘‘(a) HIGH-RISK PREGNANCY HEALTH CARE.—The 
Director of the Bureau of Prisons shall ensure that each 
incarcerated pregnant woman receives health care appro-
priate for a high-risk pregnancy, including obstetrical and 
gynecological care, during pregnancy and post-partum re-
covery. 
‘‘(b) HIGH-RISK PREGNANCIES.— 
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‘‘(1) IN GENERAL.—The Director of the Bureau 
of Prisons shall transfer any incarcerated woman, 
who is determined by a health care professional to 
have a high-risk pregnancy and who agrees to be 
transferred, to a Residential Reentry Center with 
adequate health care during her pregnancy and post- 
partum recovery. 
‘‘(2) PRIORITY.—The Residential Reentry Cen-
ter to which an incarcerated pregnant woman is 
transferred pursuant to paragraph (1) shall be in a 
geographical location that is close to the family 
members of the incarcerated pregnant woman. In 
the case that a Residential Reentry Center is un-
available, the incarcerated pregnant woman shall be 
transferred to alternative housing, including housing 
with a family member. 
‘‘(3) TRANSPORTATION.—To transport an in-
carcerated pregnant woman to a Residential Reentry 
Center, the Director of the Bureau of Prisons shall 
provide to the woman a mode of transportation that 
has been approved by the woman’s health care pro-
fessional, at no expense to the woman. 
‘‘(4) MONITORING.—In the case that an incar-
cerated pregnant woman transferred to alternative 
housing pursuant to this section is monitored elec-
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tronically, an ankle monitor may not be used on the 
woman, unless there is no feasible alternative for 
monitoring the woman. 
‘‘(5) SERVICE
OF
SENTENCE.—Any time ac-
crued at a Residential Reentry Center or alternative 
housing as a result of a transfer made pursuant to 
this section shall be credited toward service of the 
incarcerated pregnant woman’s sentence. 
‘‘(6) CREDIT FOR PRETRIAL CUSTODY.—In the 
case of an incarcerated pregnant woman, any time 
accrued in pretrial custody shall be credited toward 
service of the woman’s sentence. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) FAMILY
MEMBER.—The term ‘family 
member’ means any individual related by blood or 
affinity whose close association with the incarcerated 
pregnant woman is the equivalent of a family rela-
tionship, including a parent, sibling, child, or indi-
vidual standing in loco parentis. 
‘‘(2) RESIDENTIAL
REENTRY
CENTER.—The 
term ‘Residential Reentry Center’ means a Bureau 
of Prisons contracted residential reentry center. 
‘‘(3) HEALTH CARE PROFESSIONAL.— 
‘‘(A) IN GENERAL.—The term ‘health care 
professional’ means— 
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‘‘(i) a doctor of medicine or osteop-
athy who is authorized to practice medicine 
or surgery by the State in which the doctor 
practices; 
‘‘(ii) any physician’s assistant or 
nurse practitioner who is supervised by a 
doctor of medicine or osteopathy described 
in clause (i); or 
‘‘(iii) any other person determined by 
the Secretary to be capable of providing 
health care services. 
‘‘(B) OTHER HEALTH CARE SERVICES.—A 
person is capable of providing health care serv-
ices if the person is— 
‘‘(i) a podiatrist, dentist, clinical psy-
chologist, optometrist, or chiropractor (lim-
ited to treatment consisting of manual ma-
nipulation of the spine to correct a sub-
luxation as demonstrated by X-ray to 
exist) authorized to practice in the State 
and performing within the scope of their 
practice as defined under State law; 
‘‘(ii) a nurse practitioner, nurse-mid-
wife, clinical social worker, or physician’s 
assistant who is authorized to practice 
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under State law and who is performing 
within the scope of their practice as de-
fined under State law; and 
‘‘(iii) any health care professional 
from whom an employer or the employer’s 
group health plan’s benefits manager will 
accept certification of the existence of a se-
rious health condition to substantiate a 
claim for benefits. 
‘‘(C) AUTHORIZED TO PRACTICE IN THE 
STATE.—The term ‘authorized to practice in 
the State’ means that a professional must be 
authorized to diagnose and treat physical or 
mental health conditions under the laws of the 
State in which the professional practices and 
where the facility is located. 
‘‘(4) HIGH-RISK PREGNANCY.—The term ‘high- 
risk pregnancy’ means, with respect to an incarcer-
ated woman, that the pregnancy threatens the 
health or life of the woman or pregnancy, as deter-
mined by a health care professional. 
‘‘(5) 
POST-PARTUM
RECOVERY.—The 
term 
‘post-partum recovery’ means the 3-month period be-
ginning on the date on which an incarcerated preg-
nant woman gives birth.’’. 
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is making good faith efforts to collect the informa-
tion required under paragraph (1). 
‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
to remain available until expended— 
‘‘(1) for fiscal year 2021, $5,000,000; 
‘‘(2) for fiscal year 2022, $5,000,000; 
‘‘(3) for fiscal year 2023, $5,000,000; 
‘‘(4) for fiscal year 2024, $6,000,000; and 
‘‘(5) for fiscal year 2025, $6,000,000. 
‘‘(m) FUNDS TO BE SUPPLEMENTAL.—To receive a 
grant under this section, the eligible entity shall certify 
to the Attorney General that the amounts received under 
the grant shall be used to supplement, not supplant, non- 
Federal funds that would otherwise be available for pro-
grams or services in the prison where funds will be used. 
‘‘(n) UNOBLIGATED AND UNSPENT FUNDS.—Funds 
made available pursuant to this section that remain unob-
ligated for a period of 6 months after the end of the fiscal 
year for which the funds have been appropriated shall be 
awarded to other recipients of this grant. 
‘‘(o) CIVIL RIGHTS OBLIGATION.—A recipient of a 
grant under this section shall be subject to the non-
discrimination requirement under section 40002(b)(13) of 
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