I 
118TH CONGRESS 
1ST SESSION 
H. R. 982 
To address the health needs of incarcerated women related to pregnancy 
and childbirth, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 10, 2023 
Ms. KAMLAGER-DOVE (for herself and Mrs. LESKO) introduced the following 
bill; which was referred to the Committee on the Judiciary, and in addi-
tion to the Committee on the Budget, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To address the health needs of incarcerated women related 
to pregnancy and childbirth, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Pregnant Women in 
Custody Act’’. 
SEC. 2. DEFINITIONS. 
In this Act: 
(1) IN CUSTODY.—The term ‘‘in custody’’, with 
respect to an individual, means that the individual is 
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under the supervision of a Federal, State, Tribal, or 
local correctional facility, including a pretrial, juve-
nile, medical, or mental health facility and a facility 
operated under a contract with the Federal Govern-
ment or a State, Tribal, or local government. 
(2) OTHER PREGNANCY OUTCOME.—The term 
‘‘other pregnancy outcome’’ means a pregnancy that 
ends in stillbirth, miscarriage, or ectopic pregnancy. 
(3) 
POSTPARTUM
RECOVERY.—The 
term 
‘‘postpartum recovery’’ has the meaning given that 
term in section 4051(c) of title 18, United States 
Code, as added by this Act. 
(4) 
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. 
(5) RESTRICTIVE
HOUSING.—The term ‘‘re-
strictive housing’’ has the meaning given that term 
in section 4322 of title 18, United States Code, as 
added by this Act. 
SEC. 3. DATA COLLECTION. 
(a) IN GENERAL.—Beginning not later than 1 year 
after the date of enactment of this Act, pursuant to the 
authority under section 302 of title I of the Omnibus 
Crime Control and Safe Streets Act of 1968 (34 U.S.C. 
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10132), the Director of the Bureau of Justice Statistics 
shall include in the National Prisoner Statistics Program 
and Annual Survey of Jails statistics relating to the health 
needs of incarcerated pregnant women in the criminal jus-
tice system at the Federal, State, Tribal, and local levels, 
including— 
(1) demographic and other information about 
incarcerated women who are pregnant, in labor, or 
in postpartum recovery, including the race, ethnicity, 
and age of the woman; 
(2) the provision of pregnancy care and services 
provided for such women, including— 
(A) whether prenatal, delivery, and post- 
delivery check-up visits were scheduled and pro-
vided; 
(B) whether a social worker, psychologist, 
doula or other support person was offered and 
provided during pregnancy and delivery and 
post-delivery; 
(C) whether a pregnancy or parenting pro-
gram was offered and provided during preg-
nancy; 
(D) whether a nursery or residential pro-
gram to keep mothers and infants together 
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post-delivery was offered and whether such a 
nursery or residential program was provided; 
(E) the number of days the mother stayed 
in the hospital post-delivery; 
(F) the number of days the infant re-
mained with the mother post-delivery; and 
(G) the number of days the infant re-
mained in the hospital after the mother was 
discharged; 
(3) the location of the nearest hospital with a 
licensed obstetrician-gynecologist in proximity to 
where the incarcerated pregnant woman is housed 
and the length of travel required to transport the 
woman; 
(4) whether a written policy or protocol is in 
place— 
(A) to respond to unexpected childbirth, 
labor, deliveries, or medical complications re-
lated to the pregnancies of incarcerated preg-
nant women; and 
(B) for incarcerated pregnant women expe-
riencing labor or medical complications related 
to pregnancy outside of a hospital; 
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(5) the number of incarcerated women who are 
determined by a health care professional to have a 
high-risk pregnancy; 
(6) the total number of incarcerated pregnant 
women and the number of incarcerated women who 
became pregnant while incarcerated; 
(7) the number of incidents in which an incar-
cerated woman who is pregnant, in labor, or in 
postpartum recovery is placed in restrictive housing, 
the reason for such restriction or placement, and the 
circumstances under which each incident occurred, 
including the duration of time in restrictive housing, 
during— 
(A) pregnancy; 
(B) labor; 
(C) delivery; 
(D) postpartum recovery; and 
(E) the 6-month period after delivery; and 
(8) the disposition of the custody of the infant 
post-delivery. 
(b) PERSONALLY IDENTIFIABLE INFORMATION.— 
Data collected under this section may not contain any per-
sonally identifiable information of any incarcerated preg-
nant woman or woman in postpartum recovery. 
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SEC. 4. CARE FOR FEDERALLY INCARCERATED WOMEN RE-
LATED TO PREGNANCY AND CHILDBIRTH. 
(a) IN GENERAL.—The Director of the Bureau of 
Prisons shall ensure that appropriate services and pro-
grams, as described in subsection (b), are provided to 
women in custody, to address the health and safety needs 
of such women related to pregnancy and childbirth. The 
warden of each Bureau of Prisons facility that houses 
women shall ensure that these services and programs are 
implemented for women in custody at that facility. 
(b) SERVICES AND PROGRAMS PROVIDED.—The serv-
ices and programs described in this subsection are the fol-
lowing: 
(1) 
ACCESS
TO
COMPLETE
APPROPRIATE 
HEALTH
SERVICES
FOR
THE
LIFE
CYCLE
OF 
WOMEN.—The Director of the Bureau of Prisons 
shall ensure that each woman of reproductive age in 
custody at a Bureau of Prisons facility— 
(A) has access to contraception and testing 
for pregnancy and sexually transmitted dis-
eases, upon request of any such woman; and 
(B) is administered a pregnancy test on 
the date on which the woman enters the facility, 
which the woman may decline. 
(2) COMPLIANCE WITH PROTOCOLS RELATING 
TO HEALTH OF A PREGNANT WOMAN.—On confirma-
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tion of the pregnancy of a woman in custody by clin-
ical diagnostics and assessment, the chief health 
care professional of the Bureau of Prisons facility in 
which the woman is housed shall ensure that— 
(A) a summary of all appropriate protocols 
directly pertaining to the safety and well-being 
of the woman are provided to the woman; 
(B) such protocols are complied with; and 
(C) such protocols include an assessment 
of undue safety risks and necessary changes to 
accommodate the woman where and when ap-
propriate, as it relates to— 
(i) housing or transfer to a lower 
bunk for safety reasons; 
(ii) appropriate bedding or clothing to 
respond to the woman’s changing physical 
requirements and the temperature in hous-
ing units; 
(iii) regular access to water and bath-
rooms; 
(iv) a diet that— 
(I) complies with the nutritional 
standards established by the Secretary 
of Agriculture and the Secretary of 
Health and Human Services in the 
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retary of Health and Human 
Services and consideration of 
such recommendations as the 
Secretary may provide; 
(v) modified recreation and transpor-
tation, in accordance with standards within 
the obstetrical and gynecological care com-
munity, to prevent overexertion or pro-
longed periods of inactivity; and 
(vi) such other changes to living con-
ditions as the Director of the Bureau of 
Prisons may require after consultation 
with the Secretary of Health and Human 
Services and consideration of such rec-
ommendations as the Secretary may pro-
vide. 
(3) EDUCATION AND SUPPORT SERVICES.— 
(A) PREGNANCY IN CUSTODY.—A woman 
who is pregnant at intake or who becomes preg-
nant while in custody shall, not later than 14 
days after the pregnant woman notifies a Bu-
reau of Prisons official of the pregnancy, re-
ceive prenatal education, counseling, and birth 
support services provided by a provider trained 
to provide such services, including— 
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(i) information about the parental 
rights of the woman, including the right to 
place the child in kinship care, and notice 
of the rights of the child; 
(ii) information about family preserva-
tion support services that are available to 
the woman; 
(iii) information about the nutritional 
standards 
referred 
to 
in 
paragraph 
(2)(C)(iv); 
(iv) information pertaining to the 
health and safety risks of pregnancy, child-
birth, and parenting, including postpartum 
depression; 
(v) information on breast-feeding, lac-
tation, and breast health; 
(vi) appropriate educational materials, 
resources, and services related to preg-
nancy, childbirth, and parenting; 
(vii) information and notification serv-
ices for incarcerated parents regarding the 
risk of debt repayment obligations associ-
ated with their child’s participation in so-
cial welfare programs, including assistance 
under any State program funded under 
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part A of title IV of the Social Security 
Act (42 U.S.C. 601 et seq.) or benefits 
under the supplemental nutrition assist-
ance program, as defined in section 3 of 
the Food and Nutrition Act of 2008 (7 
U.S.C. 2012), or any State program car-
ried out under that Act; and 
(viii) information from the Office of 
Child Support Enforcement of the Depart-
ment of Health and Human Services re-
garding seeking or modifying child support 
while incarcerated, including how to par-
ticipate in the Bureau of Prison’s Inmate 
Financial Responsibility Program under 
subpart B of part 545 of title 28, Code of 
Federal Regulations (or any successor pro-
gram). 
(B) BIRTH WHILE IN CUSTODY OR PRIOR 
TO CUSTODY.—A woman who, while in custody 
or during the 6-month period immediately pre-
ceding intake, gave birth or experienced any 
other pregnancy outcome shall receive coun-
seling provided by a licensed or certified pro-
vider trained to provide such services, includ-
ing— 
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(i) information about the parental 
rights of the woman, including the right to 
place the child in kinship care, and notice 
of the rights of the child; 
(ii) information about family preserva-
tion support services that are available to 
the woman; and 
(iii) postpartum health conditions. 
(4) EVALUATIONS.— 
(A) IN GENERAL.—Each woman in custody 
who is pregnant or whose pregnancy results in 
a birth or any other pregnancy outcome during 
the 6-month period immediately preceding in-
take or any time in custody thereafter shall be 
evaluated as soon as practicable after intake or 
confirmation of pregnancy through evidence- 
based screening and assessment for substance 
use disorders or mental health conditions, in-
cluding postpartum depression or depression re-
lated to pregnancy, birth, or any other preg-
nancy outcome or early child care. 
(B) RISK FACTORS.—Screening under sub-
paragraph (A) shall include identification of 
any of the following risk factors: 
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(i) An existing mental or physical 
health condition or substance use disorder. 
(ii) Being underweight or overweight. 
(iii) Multiple births or a previous still 
birth. 
(iv) A history of preeclampsia. 
(v) A previous Caesarean section. 
(vi) A previous miscarriage. 
(vii) Being older than 35 or younger 
than 15. 
(viii) Being diagnosed with the human 
immunodeficiency virus, hepatitis, diabetes, 
or hypertension. 
(ix) Such other risk factors as the 
chief health care professional of the Bu-
reau of Prisons facility that house the 
woman may determine to be appropriate. 
(5) UNEXPECTED BIRTHS RULEMAKING.—The 
Director of the Bureau of Prisons shall provide serv-
ices to respond to unexpected childbirth deliveries, 
labor complications, and medical complications re-
lated to pregnancy if a woman in custody is unable 
to access a hospital in a timely manner in accord-
ance with rules promulgated by the Attorney Gen-
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eral, which shall be promulgated not later than 180 
days after the date of enactment of this Act. 
(6) TREATMENT.—The Director of the Bureau 
of Prisons shall use best efforts to provide a woman 
in custody who is pregnant and diagnosed with hav-
ing a substance use disorder or a mental health dis-
order with appropriate evidence-based treatment. 
SEC. 5. USE OF RESTRICTIVE HOUSING ON INCARCERATED 
PREGNANT 
WOMEN 
DURING 
PREGNANCY, 
LABOR, AND POSTPARTUM RECOVERY PRO-
HIBITED. 
(a) IN GENERAL.—Section 4322 of title 18, United 
States Code, is amended to read as follows: 
‘‘§ 4322. Use of restrictive housing on incarcerated 
women during the period of pregnancy, 
labor, and postpartum recovery prohib-
ited 
‘‘(a) PROHIBITION.—Except as provided in sub-
section (b), during the period beginning on the date on 
which pregnancy is confirmed by a health care professional 
and ending not earlier than 12 weeks after delivery, an 
incarcerated woman in the custody of the Bureau of Pris-
ons, or in the custody of the United States Marshals Serv-
ice pursuant to section 4086, shall not be held in restric-
tive housing. 
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‘‘(b) EXCEPTIONS.— 
‘‘(1) RESTRICTIVE HOUSING.—Subject to para-
graph (4), the prohibition under subsection (a) relat-
ing to restrictive housing shall not apply if the Di-
rector of the Bureau of Prisons or a senior Bureau 
of Prisons official overseeing women’s health and 
services, in consultation with senior officials in 
health services, makes an individualized determina-
tion that restrictive housing is required as a tem-
porary response to behavior that poses a serious and 
immediate risk of physical harm. 
‘‘(2) REVIEW.—The official who makes a deter-
mination under subparagraph (A) shall review such 
determination daily for the purpose of removing an 
incarcerated woman as quickly as feasible from re-
strictive housing. 
‘‘(3) RESTRICTIVE HOUSING PLAN.—The offi-
cial who makes a determination under subparagraph 
(A) shall develop an individualized plan to move an 
incarcerated woman to less restrictive housing within 
a reasonable amount of time. 
‘‘(4) PROHIBITION
ON
SOLITARY
CONFINE-
MENT.—An incarcerated woman who is placed in re-
strictive housing under this subsection may not be 
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placed in solitary confinement if the incarcerated 
woman is in her third trimester. 
‘‘(c) REPORTS.— 
‘‘(1) REPORT
TO
DIRECTORS
AND
HEALTH 
CARE
PROFESSIONAL
AFTER
PLACEMENT
IN
RE-
STRICTIVE HOUSING.—Not later than 30 days after 
the date on which an incarcerated woman is placed 
in restrictive housing under subsection (b), the ap-
plicable official identified in subsection (b)(1), cor-
rectional officer, or United States Marshal shall sub-
mit 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 re-
sponsible for the health and safety of the woman, a 
written report which describes the facts and cir-
cumstances surrounding the restrictive housing 
placement, and includes 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-
tion to continue the restrictive housing place-
ment. 
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‘‘(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. 
‘‘(2) REPORT TO CONGRESS.—Not later than 
180 days after the date of enactment of the Preg-
nant Women in Custody Act, and every 180 days 
thereafter for a period of 10 years, the Attorney 
General shall submit to the Committee on the Judi-
ciary of the Senate and the Committee on the Judi-
ciary of the House of Representatives a report on 
the placement of incarcerated women in restrictive 
housing under subsection (b), which shall include the 
information described in paragraph (1). 
‘‘(d) NOTICE.—Not later than 24 hours after the con-
firmation of the pregnancy of an incarcerated woman by 
a health care professional, that woman shall be notified, 
orally and in writing, by an appropriate health care profes-
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sional, correctional officer, or United States Marshal, as 
applicable— 
‘‘(1) of the restrictions on the use of restrictive 
housing placements under this section; 
‘‘(2) of the right of the incarcerated woman to 
make a confidential report of a violation of restric-
tions on the use of restrictive housing placement; 
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 the Pregnant 
Women in Custody Act, the Director of the Bureau of 
Prisons and the Director of the United States Marshals 
Service shall establish processes through which an incar-
cerated 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 rights of the incarcerated pregnant 
woman under subsection (a). 
‘‘(g) RETALIATION.—It shall be unlawful for any Bu-
reau of Prisons or United States Marshals Service em-
ployee to retaliate against an incarcerated person for re-
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porting under the processes established under subsection 
(e) a violation of subsection (a). 
‘‘(h) EDUCATION.—Not later than 90 days after the 
date of enactment of the Pregnant Women in Custody Act, 
the Director of the Bureau of Prisons and the Director 
of the United States Marshals Service shall each— 
‘‘(1) develop education guidelines regarding the 
physical and mental health needs of incarcerated 
pregnant women, and the use of restrictive housing 
placements on incarcerated women during the period 
of pregnancy, labor, and postpartum recovery; and 
‘‘(2) incorporate such guidelines into appro-
priate education programs. 
‘‘(i) DEFINITION.—In this section, the term ‘restric-
tive housing’ means any type of detention that involves— 
‘‘(1) removal from the general inmate popu-
lation, whether voluntary or involuntary; 
‘‘(2) placement in a locked room or cell, wheth-
er alone or with another inmate; and 
‘‘(3) inability to leave the room or cell for the 
vast majority of the day.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
for chapter 317 of title 18, United States Code, is amend-
ed by striking the item relating to section 4322 and insert-
ing the following: 
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