Title 18Crimes and Criminal ProcedureRelease 119-73not60

§4322 Use of Restraints on Prisoners During the Period of Pregnancy, Labor, and Postpartum Recovery Prohibited

Title 18 › Part III— PRISONS AND PRISONERS › Chapter 317— INSTITUTIONS FOR WOMEN › § 4322

Last updated Apr 5, 2026|Official source

Summary

Pregnant people in federal custody (those held by the Bureau of Prisons or the U.S. Marshals Service) must not be put in restraints once a healthcare professional confirms the pregnancy and until after postpartum recovery ends. Restraints are allowed only if a corrections official or marshal decides the person is an immediate and real flight risk or an immediate danger to herself or others that can’t be stopped any other way, or if a healthcare professional says restraints are needed for medical safety. If restraints are used, only the least restrictive kind can be used. Even then, officials may not put restraints on the ankles, legs, or waist, bind hands behind the back, use 4-point restraints, or attach one prisoner to another. A healthcare professional can ask that restraints not be used or be removed, and officials must follow that request. The prisoner must be told about these rules within 48 hours of the pregnancy being confirmed. If restraints are used, the official who ordered them must send a written report within 30 days to the appropriate Director and the prisoner’s healthcare professional explaining why the restraints were used, what type and how long, and any physical effects seen. The healthcare professional may add relevant information. The Directors must report to the Judiciary Committees within 1 year and then every year, certifying compliance and including the required data without any personal identifying information. The Bureau Director must create a way for prisoners to report violations. The Bureau and the Marshals must also make training rules for staff (made with healthcare experts) about pregnancy signs, when exceptions apply, safe restraint use if needed, required reporting, and the healthcare professional’s right to stop restraints. Definitions: postpartum recovery — the 12-week period after delivery or longer if a healthcare professional says so; prisoner — someone serving a federal prison term or in BOP custody (including contracted facilities); restraints — any device that controls a prisoner’s body or limbs.

Full Legal Text

Title 18, §4322

Crimes and Criminal Procedure — Source: USLM XML via OLRC

(a)Except as provided in subsection (b), beginning on the date on which pregnancy is confirmed by a healthcare professional, and ending at the conclusion of postpartum recovery, a prisoner in the custody of the Bureau of Prisons, or in the custody of the United States Marshals Service pursuant to section 4086, shall not be placed in restraints.
(b)(1)The prohibition under subsection (a) shall not apply if—
(A)an appropriate corrections official, or a United States marshal, as applicable, makes a determination that the prisoner—
(i)is an immediate and credible flight risk that cannot reasonably be prevented by other means; or
(ii)poses an immediate and serious threat of harm to herself or others that cannot reasonably be prevented by other means; or
(B)a healthcare professional responsible for the health and safety of the prisoner determines that the use of restraints is appropriate for the medical safety of the prisoner.
(2)In the case that restraints are used pursuant to an exception under paragraph (1), only the least restrictive restraints necessary to prevent the harm or risk of escape described in paragraph (1) may be used.
(3)(A)The exceptions under paragraph (1) may not be applied—
(i)to place restraints around the ankles, legs, or waist of a prisoner;
(ii)to restrain a prisoner’s hands behind her back;
(iii)to restrain a prisoner using 4-point restraints; or
(iv)to attach a prisoner to another prisoner.
(B)Notwithstanding paragraph (1), upon the request of a healthcare professional who is responsible for the health and safety of a prisoner, a corrections official or United States marshal, as applicable, shall refrain from using restraints on the prisoner or shall remove restraints used on the prisoner.
(c)(1)If a corrections official or United States marshal uses restraints on a prisoner under subsection (b)(1), that official or marshal shall submit, not later than 30 days after placing the prisoner in restraints, to the Director of the Bureau of Prisons or the Director of the United States Marshals Service, as applicable, and to the healthcare professional responsible for the health and safety of the prisoner, a written report that describes the facts and circumstances surrounding the use of restraints, and includes—
(A)the reasoning upon which the determination to use restraints was made;
(B)the details of the use of restraints, including the type of restraints used and length of time during which restraints were used; and
(C)any resulting physical effects on the prisoner observed by or known to the corrections official or United States marshal, as applicable.
(2)Upon receipt of a report under paragraph (1), the healthcare professional responsible for the health and safety of the prisoner may submit to the Director such information as the healthcare professional determines is relevant to the use of restraints on the prisoner.
(3)(A)Not later than 1 year after the date of enactment of this section, and annually thereafter, the Director of the Bureau of Prisons and the Director of the United States Marshals Service shall each submit to the Judiciary Committee of the Senate and of the House of Representatives a report that certifies compliance with this section and includes the information required to be reported under paragraph (1).
(B)The report under this paragraph shall not contain any personally identifiable information of any prisoner.
(d)Not later than 48 hours after the confirmation of a prisoner’s pregnancy by a healthcare professional, that prisoner shall be notified by an appropriate healthcare professional, corrections official, or United States marshal, as applicable, of the restrictions on the use of restraints under this section.
(e)The Director of the Bureau of Prisons, in consultation with the Director of the United States Marshals Service, shall establish a process through which a prisoner may report a violation of this section.
(f)(1)The Director of the Bureau of Prisons and the Director of the United States Marshals Service shall each develop training guidelines regarding the use of restraints on female prisoners during the period of pregnancy, labor, and postpartum recovery, and shall incorporate such guidelines into appropriate training programs. Such training guidelines shall include—
(A)how to identify certain symptoms of pregnancy that require immediate referral to a healthcare professional;
(B)circumstances under which the exceptions under subsection (b) would apply;
(C)in the case that an exception under subsection (b) applies, how to apply restraints in a way that does not harm the prisoner, the fetus, or the neonate;
(D)the information required to be reported under subsection (c); and
(E)the right of a healthcare professional to request that restraints not be used, and the requirement under subsection (b)(3)(B) to comply with such a request.
(2)In developing the guidelines required by paragraph (1), the Directors shall each consult with healthcare professionals with expertise in caring for women during the period of pregnancy and postpartum recovery.
(g)For purposes of this section:
(1)The term “postpartum recovery” means the 12-week period, or longer as determined by the healthcare professional responsible for the health and safety of the prisoner, following delivery, and shall include the entire period that the prisoner is in the hospital or infirmary.
(2)The term “prisoner” means a person who has been sentenced to a term of imprisonment pursuant to a conviction for a Federal criminal offense, or a person in the custody of the Bureau of Prisons, including a person in a Bureau of Prisons contracted facility.
(3)The term “restraints” means any physical or mechanical device used to control the movement of a prisoner’s body, limbs, or both.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

The date of enactment of this section, referred to in subsec. (c)(3)(A), is the date of enactment of Pub. L. 115–391, which was approved Dec. 21, 2018.

Reference

Citations & Metadata

Citation

18 U.S.C. § 4322

Title 18Crimes and Criminal Procedure

Last Updated

Apr 5, 2026

Release point: 119-73not60