Crystal Muñoz was four months pregnant when federal agents knocked on her door. They assured the Texas mother that she wasn’t in any trouble; they just wanted to know about a map she had drawn for some people two years earlier. Little did she know that talking with them would lead to a 20-year prison sentence — and delivering her baby with her wrist and ankle cuffed to a hospital bed.
Federal agents arrested Muñoz for conspiracy to distribute marijuana. During her trial, Munoz was allowed to remain at home with her husband as well as her daughter of months. In October 2007, a jury found her guilty and she was sent to Ector County Detention Center in anticipation of her sentencing. She was now in her final trimester.
“It was horrible to be in there at all,” Muñoz told Truthout, “but to be pregnant [in that jail] was super-awful.”
She recalled being handcuffed and shackled — with cuffs around her wrists and ankles — when she was brought to an outside hospital for prenatal visits. The officer might also have put a metal chain around her waist.
Each day brought the same meal — beans, cornbread and bologna, even though lunch meats can cause listeria in pregnant people and result in serious illness for fetuses. Muñoz requested extra fruits and vegetables to no avail. Prenatal vitamins weren’t available at the prison. Although her husband tried to get her prenatal vitamins through the jail bureaucracy, he was unsuccessful.
The American College of Obstetricians and Gynecologists states that pregnant people should drink eight to twelve cups of water each day, but Muñoz recalled that meals were the only times that the jail provided drinking water. Women would otherwise have to use the bathroom sink to wash their hands, brush their teeth and wash their skin. “And it’s right by the toilet,” Muñoz added.
Not wanting to risk bacteria, Muñoz hid empty potato chip and snack bags, filled them with ice, then drank the contents.
The day after Christmas, Muñoz went into labor. Officers secured Munoz’s left wrist and ankle to the posts at the hospital. Although the attending doctor ordered the officers to remove the restraints, they did so slowly — first freeing Munoz’s ankle and, when she began birthing her baby, her wrist.
“I was super-healthy, so she came out super-healthy,” Muñoz said, recalling that her baby was the same size as her first daughter. Her pregnancy and birth could have been worse if she had experienced a more difficult pregnancy or had pre-existing conditions.
Federal lawmakers now seek to improve the care of pregnant women in federal prisons.
The Protecting the Health and Wellness of Babies and Pregnant Women in Custody Act was introduced by Senators Amy Klobuchar, (D-Minnesota), and Susan Collins, (R-Maine). Similar legislation was introduced by Karen Bass (D.California), in March.
This legislation prohibits pregnancy restraints, which was already prohibited by the 2018 First Step Act. It also bans the confinement of pregnant women in isolation during their third trimester.
The bill directs the Bureau of Prisons (which oversees all federal prisons) to provide regular water and bathroom access, nutritionally appropriate diets, prenatal vitamins, as well as information regarding parental rights and lactation. These protections are only available for pregnant women who are in federal prisons and jails.
Data shows that there are thousands of pregnant people in prisons, but most in state prisons.
Carolyn Sufrin works as an assistant professor at Johns Hopkins University School of Medicine. She is a medical anthropologist. Advocacy and Research on Reproductive Wellbeing of Incarcerated Persons (AARWIP) is her foundation. This organization studies the impact of prison conditions on reproductive health. ARRWIP found that about 4 percent of prisoners entering federal and state prisons were already pregnant. Only 3 percent of jail inmates were also pregnant during a 12-month period from 2016 to 2017.
“The vast majority of pregnant people who are incarcerated are not in the federal system,” Sufrin told Truthout. During ARRWIP’s 12-month data collection, there were 172 pregnant people in federal women’s prisons, comprising 0.3 percent of the federal women’s prison population. Those numbers have not changed significantly since then.
The 2018 First Step Act banned shackling during pregnancy. It also mandated data collection regarding pregnancy and the outcomes of pregnancy in federal prisons. Federal authorities reported that 180 pregnant women were held in federal prisons that year. Ninety four babies were born while in federal facilities. Federal authorities reported that one case of handcuffing a pregnant woman, allegedly because of disruptive behavior, was reported by federal authorities.
As COVID-19 spread across the country, 91 pregnant women were held in federal facilities. Thirty nine were released prior to giving birth. Of 52 women who remained, fifty had live births while one had a stillbirth. One maternal death was also reported. There were no reports about pregnant women being held back.
Many states don’t keep or report pregnancies, or the outcomes of pregnancy in their jails and prisons. The federal bill that was introduced today would close this gap. It directs the Bureau of Justice Statistics, which compiles and publishes data on Americans in prison, to include information regarding pregnancy, pregnancy-related treatment, and the use of solitary confinement during a pregnancy.
It is not always enough to ensure humane treatment.
The bill comes too late to help Muñoz, who was granted clemency by then-President Donald Trump and reunited with her now-teenage daughters in February 2020.
But even for future people who are pregnant behind bars, legislation doesn’t necessarily ensure that prison or jail officials will follow the new measures. Formerly incarcerated mothers and allies were able to pass legislation in New York in 2009 that would end shackling during labor and delivery, and after birth. But despite the law, as late as 2014, prison officials continued to clap pregnant people in handcuffs, leg irons and belly chains when transporting them to outside medical visits — and even restrained them in the hospital hours after they had given birth.
Maryland passed a law in 2018 that required jails and prisons to not only have written policies regarding child placement and pregnant women, but also to provide these policies to incarcerated persons. The state also passed legislation in 2019 prohibiting prisons and jails placing pregnant women in isolation confinement.
Kimberly Haven (executive director of Reproductive justice Inside) helped draft the bills and has been overseeing their implementation. Jazmin Valentine was put in solitary for probation violation in July 2021. This was two years after the prohibition on solitary confinement of pregnant women. After six hours of her desperate pleas for help from jail staff and nurses, she gave birth in her cell alone.
“The reason we wrote this bill was just for this reason,” Haven told Truthout. “We came to them [Maryland’s jails and prisons], offered our trainings and training materials, and we were rebuffed.”
The federal bill permits the use of restraints under extreme circumstances. However, federal prisons and federal jails must review their use every few minutes and report any violations.
But, noted Sufrin, “those [reporting requirements] After the fact. There are no mandatory sets of health care standards or system of oversight or accountability to entice jails and prisons to follow the standards.”
Ultimately, said Sufrin, the solution to inadequate and terrible pregnancy and postpartum care “is not to incarcerate pregnant people in the first place and to invest in access to adequate pregnancy and postpartum care in the community.” But, she added, “that’s going to take a long time. We need some mandatory standards and systems of oversight and accountability.”