Despite international human rights guidelines that prohibit the practice, thirty-eight states and the Federal Bureau of Prisons currently allow corrections officials to shackle pregnant inmates during the third trimester of pregnancy. Of these, twenty-three states and the Bureau also allow restraints to be used during active labor. Only two state legislatures, Illinois and California, have addressed the issue of using physical restraints on pregnant inmates; the vast majority of states rely on corrections officials to craft policy.

This article analyzes both states' justifications for shackling policies as well as the Constitutional and human rights arguments that have been posed by inmates and their advocates for eliminating the use of physical restraints during pregnancy and childbirth. A historical overview of the treatment of female prisoners as well as an analysis of the current impact of pregnancy in American prisons will reveal that shackling policies are impractical at best, and in the worst scenarios, seriously life-threatening. The second section addresses potential judicial remedies for female inmates who have been affected by shackling policies. Until the mid-1990s, prisoners seeking redress for civil rights violations such as inhumane and senseless use of physical restraints were most likely to turn to § 1983 litigation. Since the passage of the Prison Litigation Reform Act in 1996, prisoner plaintiff's access to the courts has been limited by heightened procedural and evidentiary requirements that do not apply to the general public. Therefore, in the final section, this paper concludes that female prisoners and their advocates will most likely have to turn to alternative methods of relief, including innovative prison programs like Catch the Hope, implemented in the Massachusetts state prison systems to provide adequate prenatal and postnatal care within the limitations of a correctional environment.