AN ACT RELATIVE TO SAFE PREGNANCIES AND RELATED HEALTH CARE FOR FEMALE INMATES.

              Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 127 of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by striking out section 118 and inserting in place thereof the following:—

Section 118.  (a) All female inmates, upon admission to a correctional facility when awaiting trial or sentenced, shall be screened and assessed for pregnancy by a nurse and shall be informed of any medical tests administered in connection with such screening. Pregnant inmates shall receive nondirective counseling and written material, in a form understandable by each inmate, on issues including but not limited to pregnancy options and correctional facility policies and practices regarding care and labor for pregnant inmates. The correctional facility shall ensure that at least one member of the medical and nursing staff is trained in pregnancy-related care, which shall at a minimum include knowledge of prenatal nutrition, high-risk pregnancy, addiction and substance abuse during pregnancy, and childbirth education.

Pregnant and postpartum inmates shall be provided regular prenatal and postpartum medical care at the correctional facility in which they are housed, periodic health monitoring and evaluation during pregnancy, and postpartum screening for depression.  Regular prenatal care shall include the opportunity for a minimum of one hour of ambulatory movement each day and a diet containing the nutrients necessary to maintain a healthy pregnancy, including prenatal vitamins and supplements.  The Department of Correction shall, in consultation with the Department of Public Health, develop appropriate standards of care for pregnant and postpartum inmates, which shall reflect, at a minimum, the standards set forth by the National Commission on Correctional Health Care and the American Dietetic Association.  If pregnant inmates require medically necessary, specialized care that is unavailable at the correctional facility, they shall have access to such care at a supporting medical facility with appropriate expertise.  If a postpartum inmate is determined to be suffering from postpartum depression, she shall have regular access to a mental health clinician.  Postpartum inmates shall not be subject to isolation absent an individualized, documented determination that the inmate poses a serious risk of harm to herself or others.

All pregnant inmates shall be offered weekly prenatal classes or, when not practicable, written information, regarding prenatal nutrition, maintaining a healthy pregnancy, and childbirth, and shall have the opportunity to discuss this information with the medical personnel trained in these matters. Pregnant and postpartum inmates shall be provided maternity clothes, athletic support bras, sanitary pads, and breast pads.

Prior to delivery, all pregnant inmates shall be given the opportunity to develop a custody plan, including the opportunity to contact family members and the Department of Children and Families to explore and understand their options.  Every effort shall be made to keep infants of twelve months or less born to incarcerated mothers with their mothers. If it is not possible for the child to remain with the mother, female inmates who are expected to retain custody upon release shall be allowed a minimum of at least one visit per week with their child.

Prior to release, correctional facility medical personnel shall provide pregnant inmates counseling and discharge planning in order to ensure continuity of pregnancy-related care, including uninterrupted substance abuse treatment.

(b) Pregnant inmates shall have access to labor and delivery care in an accredited hospital and shall not be removed to another penal institution for giving birth.  An inmate who has been transferred to a hospital for labor and delivery care shall be permitted to stay in such hospital for a minimum of forty-eight hours after delivery, provided however that in no case shall an inmate be removed to the correctional facility until the hospital physician certifies she may be safely removed.

Pregnant and postpartum inmates shall be transported to and from visits to medical providers and court proceedings in a car with seatbelts.  Except in extraordinary circumstances, no restraints of any kind may be used on any pregnant inmates during transportation to and from visits to medical providers and court proceedings beyond the first trimester of her pregnancy, or during postpartum recovery.  For purposes of this section, “extraordinary circumstances” exist where a corrections officer makes an individualized determination that restraints are necessary to prevent a pregnant inmate from escaping, or from injuring herself, medical or correctional personnel, or others.  In the event the corrections officer determines that extraordinary circumstances exist and restraints are used, the corrections officer must fully document in writing the reasons that he or she determined such extraordinary circumstances existed such that restraints were used.  As part of this documentation, the corrections officer must also include the kind of restraints used and the reasons those restraints were considered the least restrictive available and the most reasonable under the circumstances.

While the pregnant inmate is in labor or in childbirth, no restraints of any kind may be used.  Nothing in this section affects the use of hospital restraints requested for the medical safety of a patient by treating physicians.             

Any time restraints are permitted to be used on a pregnant inmate, the restraints must be the least restrictive available and the most reasonable under the circumstances, but in no case shall leg or waist restraints be used on any pregnant or postpartum inmate.

No correctional personnel shall be present in the room during the pregnant inmate’s physical examinations, labor, or childbirth, unless specifically requested by medical personnel.  If the employee’s presence is requested by medical personnel, the employee should be female.

If the doctor, nurse, or other health professional treating the pregnant inmate requests that restraints not be used, the corrections officer accompanying the pregnant inmate shall immediately remove all restraints.

(c) Not less than three months prior to the date of release for a female inmate of child-bearing age, medical personnel at the correctional facility shall offer the inmate counseling and written information regarding contraception and sexually transmitted diseases, provide a list of FDA-approved contraceptives, and provide her with any contraceptive method she may select.  If the inmate selects a form of contraception that must be taken for a period of time before it becomes effective, said contraception shall be introduced into her regular medical regimen without delay.  Upon her release, medical personnel shall furnish the inmate with a twelve-month prescription to refill any contraceptive medication and a copy of the Directory of Family Planning Agencies issued by the Department of Public Health.