• Pregnancy care behind bars is inconsistent.
  There is no national requirement that prisons or jails follow one standard for pregnancy and postpartum care. That means care can vary dramatically depending on where someone is held.

• Jails are a major gap.
  A national survey of more than 800 jails found that only 31% routinely tested for pregnancy at intake or within two weeks. If a facility does not identify pregnancy early, urgent medical needs can be missed.

• Shackling still happens.
  Even where anti-shackling laws exist, restraints are still used. One study of perinatal nurses found that 83% had cared for an incarcerated patient who was shackled at some point in a hospital perinatal unit.

• Birth is not just a medical event.
  Research shows that some facilities place officers in hospital rooms during labor and limit family or support people during childbirth and postpartum recovery. These practices undermine privacy, dignity, bonding, and trauma-informed care.

Oregon has taken an important step by limiting restraints during pregnancy and childbirth in state prison custody. But the research is clear: passing a law is not the same as ensuring safe care.

Across the country, pregnancy care in custody remains inconsistent, postpartum needs are often overlooked, and restraints continue to be used even in places with anti-shackling protections. These gaps are especially concerning for people held in county and city jails, where pregnancy may be newly identified, medical needs may be urgent, and legal protections may be less clear.

Campaign 4 Safe Births is working to close these gaps so that pregnancy, labor, childbirth, postpartum recovery, and medical transport are guided by medical judgment, dignity, and safety—not custody discretion.

Pregnancy does not pause when someone is incarcerated.

People in custody still need prenatal care, emergency medical attention, privacy during labor, postpartum recovery support, lactation accommodations, mental health care, and time to bond with their newborns. But research shows that prisons and jails often lack consistent standards for pregnancy and postpartum care.

For pregnant and postpartum people, this can mean delayed care, restraints during transport or medical treatment, officers present during childbirth, separation from newborns, and little support during recovery.

This is why Campaign 4 Safe Births is focused not only on what the law says, but on what actually happens in hospitals, prisons, jails, and transport.