Being pregnant in a Texas lock up can be hell. So it shouldn’t be surprising that the practice of shackling women during childbirth and recovery is still done in some Texas jails even though the United States Bureau of Prisons has banned the practice. Texas jails are able to use restraints on women as a matter of course regardless of whether a woman has a history of violence (which only a minority have), regardless of whether she has ever attempted escape (which few women have), and regardless of her state of consciousness. Hopefully, that will change with HB 3653 which, if signed by Governor Rick Perry when it hits his desk this month, will prohibit the Texas Department of Criminal Justice, Texas Youth Commission, and municipal and county jails from using restraints to control the movement of pregnant inmates in custody while the inmate is in labor or delivery, or recovery from delivery. The bill could take effect as early as September l. A sister bill, HB 3654, requires county jails to have a plan for medical care of pregnant inmates in county jails as well as requiring administrators to include the number of pregnant women in their population reports. Presently there are NO numbers on pregnant inmates or the number of infants born in jail. Also, under current law, there is no mandate for medical care or nutritional supplements for pregnant inmates. Diana Claitor, executive director of the Texas Jail Project who worked with Texas ACLU staffer Matt Simpson to create the initial drafts for both bills, said many people believe all of the above will occur automatically. But in her experience, unless there is a law on the books, it won’t be considered a priority or even considered at all. Texas county jails hold up to 80,000 inmates a night and approximately 14 percent of those are women. Claitor said, “The public has no idea how many young mothers and their babies come out of jail injured or traumatized.” Most jail health-care systems function independently, have no checks and balances, and are isolated from the outside medical community, except for inspections by the Texas Commission on Jail Standards which typically look for problems with male inmate overcrowding and fire exits. It doesn’t help that jail administrators and staff are prone to lump complaining inmates into one big group: whiners- liars- and troublemakers. That’s why an inmate with a serious illness and injury can suffer without treatment, often until they are dying or dead. Claitor said, “I can say with utter conviction that just because you ask for medical care or even beg for medical care in Texas jails, there are plenty of times when you’re not going to get it. Period. If it doesn’t happen when a person is convulsing in seizures or going into a diabetic coma [see a federal report on Dallas County Jail: http://www.usdoj.gov/crt/split/documents/dallas_county_findlet_12-8-06.pdf], it is certainly not likely to happen when a pregnant woman says she is not getting enough food or that she’s in pain and bleeding.” The Texas Jail Project, a volunteer jail advocacy group that is based in Austin, became increasingly aware of cases on pregnant women through a ‘listening project’ publicized through their website (www.texasjailproject.org). Families and friends were encouraged to email and phone about problems pregnant women faced in county jails, including shackling during childbirth. Shacking during labor and delivery can cause intense pain, cramping, swelling, reduced circulation and increased risk of thrombosis or blood clots. It can interfere with appropriate medical care, be harmful to the health of the mother and infant, and violate the dignity of the pregnant inmate. It is not uncommon for a shackled inmate to soil herself or her bed sheets because she could not get unshackled quickly enough to get to the bathroom. One such victim of this practice was Shanna (not her real name) at the Lew Sterret jail in Dallas, Texas, in 2009. She wrote an eloquent letter about what it was like to spend a month in Parkland Hospital eight months pregnant and with a staph infection. She was transported to the hospital with chains around her legs, hands, and lower waist, although she was charged with a non-violent crime. When she reached the hospital she was escorted down a long hallway with people looking at her like she had just killed someone. For one whole month, Shanna was without TV, phone, or books and chained to her hospital bed twenty-four hours a day, seven days a week. Even though Shanna’s ankles and feet were badly swollen and she had developed bedsores, the guards refused to allow her to walk around. A doctor had to intercede on her behalf in order for Shanna to be allowed to walk in the hallway, her hands and feet still chained to a long monitoring pole. An inmate we will call Roberta was a trustee for three months at Harris County’s Baker Unit last year. She described her wait for medical attention sitting on the floor next to a woman who was pregnant with twins. The pregnant woman had waited 5 or 6 hours to see a nurse. She was cramping, in pain, bleeding through her pants onto the floor, and extremely upset. Roberta said she remembered the woman repeating how scared she was that she might lose her babies. Roberta and the other waiting inmates kept telling the guard to take the pregnant woman first, but the guard only replied with something along the lines of, “Shut the f… up!” Claitor was contacted in March of this year by a woman in Henderson County Jail who said her pregnant daughter had requested to see a doctor four times but had yet to see one. She was having a fever, discharge, swollen glands, and she was six months pregnant. Her daughter ended up in the emergency room where the nurses told her she was dehydrated and undernourished. Luckily, she had only a few days before her release and her mother had her in the doctor’s office the next day. But what if she had another two months to serve? Women in jails differ from their male counterparts in more ways than that they can get pregnant and give birth. Women’s crimes are less likely to be violent and more likely to be motivated by poverty and addiction where drugs are often used to medicate the pain of abusive relationships. Women are seldom drug dealers or traffickers. When they do commit a violent offense, it is often against a man who abused them. They rarely pose a violent threat to the general public. Jailed women also have more challenges to overcome in dealing with their pregnancies and their birth experiences. Their pregnancies are often high-risk and complicated. Frankie was 24 years old and six months pregnant with her first child when she was picked up on a warrant in Victoria, Texas and thrown into jail. Frankie had a rare uterine condition and so, immediately, she began bleeding. When she notified the guard, the guard demanded that Frankie show her the bloody underwear. Frankie’s condition worsened further: her water broke. But the guard said Frankie was hallucinating and that she wouldn’t have the baby for a month. Then the guards decided that Frankie was faking and a troublemaker so she was put into isolation and threatened with a taser gun if she didn’t go. Frankie proceeded to go into labor in an isolated cell and, with a breech birth, the baby died. Frankie was not even allowed to attend the baby’s funeral. Last year, 19-year-old Amber was in the Ellis County Jail when she was 10 weeks pregnant. Recently, however, Amber brought the story of her experience to the Texas capitol, where she helped HB 3654 pass the scrutiny of the House County Affairs Committee. Her voice trembling at times, Amber described her stay at the jail. She said no one seemed to care that she needed prenatal vitamins, the right food to eat, or milk to drink for her baby to grow normally. She never saw an obstetrician or had any prenatal checkups. For several weeks she bled and spotted and she reported that to the guards. The guards in turn would call the nurse who gave her Tylenol. She finally saw a doctor who told her that he did not think she was pregnant or even had a uterus. A nurse listened to the baby’s heartbeat and told her she could not hear the baby’s heartbeat. She thought the baby might have died. Amber called her mother and begged her to do something. She became so upset that the jail put her on suicide watch in an isolation cell where she bled even more. After her release, Amber’s baby, Zannah, was born, weighing 6 lbs and 6 ounces. To this day, Amber said, she still worries that something might not be right with Zannah as she grows older because of the neglect and unhealthy conditions that she suffered in the Ellis County Jail. Amber summed up her unsettling testimony before the Texas legislature in April by saying, “Babies deserve to be taken care of no matter what the mother has done. The baby is not responsible.” These stories are only too common because many jail administrators, without rules and guidelines, fail to do the right thing for the women in their care and the babies they carry. However, even in the midst of the chaos of a Texas legislative system that was overburdened with bills and dominated by controversy, an unlikely coalition– the Catholic Conference of Texas, Texas ACLU, Texas Right to Life, and Texas Jail Project– worked on passing two small bills that may start Texas on a path to more healthy moms and healthy babies. During the long tedium of one House committee hearing, Representative Valinda Bolten asked a pointed question of Adan Munoz, the director of the Texas Commission on Jail Standards. He was providing background information when Bolton abruptly asked, “How long have county jails in Texas been housing incarcerated women?” Munoz replied, “As long as jails have been open.” Bolton said, “So…we don’t really have the answer to why it’s taken ‘til 2009 to address this issue of the medical needs of pregnant women.” It is a question and answer that is long overdue.