---
kind: "section"
citation: "18 U.S.C. § 4322"
title: "18"
title_heading: "Crimes and Criminal Procedure"
number: "4322"
heading: "Use of restraints on prisoners during the period of pregnancy, labor, and postpartum recovery prohibited"
release: "119-102"
url: "https://uscodex.org/usc/18/4322"
units:
  - "Part III — Prisons and Prisoners"
  - "Chapter 317 — Institutions for Women"
---

# §4322. Use of restraints on prisoners during the period of pregnancy, labor, and postpartum recovery prohibited

- (a) **Prohibition.—** Except as provided in [subsection (b)](#b), beginning on the date on which pregnancy is confirmed by a healthcare professional, and ending at the conclusion of [postpartum recovery](#g-1), a [prisoner](#g-2) in the custody of the Bureau of Prisons, or in the custody of the [United States](/usc/18/5.md) Marshals Service pursuant to [section 4086](/usc/18/4086.md), shall not be placed in [restraints](#g-3).
- (b) **Exceptions.—**
  - (1) **In general.—** The prohibition under [subsection (a)](#a) shall not apply if—
    - (A) an appropriate corrections official, or a [United States](/usc/18/5.md) marshal, as applicable, makes a determination that the [prisoner](#g-2)—
      - (i) is an immediate and credible flight risk that cannot reasonably be prevented by other means; or
      - (ii) poses an immediate and [serious](/usc/18/2441.md?p=d-2-E-i) 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](#g-2) determines that the use of [restraints](#g-3) is appropriate for the medical safety of the [prisoner](#g-2).
  - (2) **Least restrictive restraints.—** In the case that [restraints](#g-3) are used pursuant to an exception under [paragraph (1)](#b-1), only the least restrictive [restraints](#g-3) necessary to prevent the harm or risk of escape described in [paragraph (1)](#b-1) may be used.
  - (3) **Application.—**
    - (A) **In general.—** The exceptions under [paragraph (1)](#b-1) may not be applied—
      - (i) to place [restraints](#g-3) around the ankles, legs, or waist of a [prisoner](#g-2);
      - (ii) to restrain a [prisoner](#g-2)’s hands behind her back;
      - (iii) to restrain a [prisoner](#g-2) using 4-point [restraints](#g-3); or
      - (iv) to attach a [prisoner](#g-2) to another [prisoner](#g-2).
    - (B) **Medical request.—** Notwithstanding [paragraph (1)](#b-1), upon the request of a healthcare professional who is responsible for the health and safety of a [prisoner](#g-2), a corrections official or [United States](/usc/18/5.md) marshal, as applicable, shall refrain from using [restraints](#g-3) on the [prisoner](#g-2) or shall remove [restraints](#g-3) used on the [prisoner](#g-2).
- (c) **Reports.—**
  - (1) **Report to the director and healthcare professional.—** If a corrections official or [United States](/usc/18/5.md) marshal uses [restraints](#g-3) on a [prisoner](#g-2) under [subsection (b)(1)](#b-1), that official or marshal shall submit, not later than 30 days after placing the [prisoner](#g-2) in [restraints](#g-3), to the Director of the Bureau of Prisons or the Director of the [United States](/usc/18/5.md) Marshals Service, as applicable, and to the healthcare professional responsible for the health and safety of the [prisoner](#g-2), a written report that describes the facts and circumstances surrounding the use of [restraints](#g-3), and includes—
    - (A) the reasoning upon which the determination to use [restraints](#g-3) was made;
    - (B) the details of the use of [restraints](#g-3), including the type of [restraints](#g-3) used and length of time during which [restraints](#g-3) were used; and
    - (C) any resulting physical effects on the [prisoner](#g-2) observed by or known to the corrections official or [United States](/usc/18/5.md) marshal, as applicable.
  - (2) **Supplemental report to the director.—** Upon receipt of a report under [paragraph (1)](#c-1), the healthcare professional responsible for the health and safety of the [prisoner](#g-2) may submit to the Director such information as the healthcare professional determines is relevant to the use of [restraints](#g-3) on the [prisoner](#g-2).
  - (3) **Report to judiciary committees.—**
    - (A) **In general.—** 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](/usc/18/5.md) 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)](#c-1).
    - (B) **Personally identifiable information.—** The report under this paragraph shall not contain any personally identifiable information of any [prisoner](#g-2).
- (d) **Notice.—** Not later than 48 hours after the confirmation of a [prisoner](#g-2)’s pregnancy by a healthcare professional, that [prisoner](#g-2) shall be notified by an appropriate healthcare professional, corrections official, or [United States](/usc/18/5.md) marshal, as applicable, of the restrictions on the use of [restraints](#g-3) under this section.
- (e) **Violation Reporting Process.—** The Director of the Bureau of Prisons, in consultation with the Director of the [United States](/usc/18/5.md) Marshals Service, shall establish a process through which a [prisoner](#g-2) may report a violation of this section.
- (f) **Training.—**
  - (1) **In general.—** The Director of the Bureau of Prisons and the Director of the [United States](/usc/18/5.md) Marshals Service shall each develop training guidelines regarding the use of [restraints](#g-3) on female [prisoners](#g-2) during the period of pregnancy, labor, and [postpartum recovery](#g-1), 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)](#b) would apply;
    - (C) in the case that an exception under [subsection (b)](#b) applies, how to apply [restraints](#g-3) in a way that does not harm the [prisoner](#g-2), the fetus, or the neonate;
    - (D) the information required to be reported under [subsection (c)](#c); and
    - (E) the right of a healthcare professional to request that [restraints](#g-3) not be used, and the requirement under [subsection (b)(3)(B)](#b-3-B) to comply with such a request.
  - (2) **Development of guidelines.—** In developing the guidelines required by [paragraph (1)](#f-1), the Directors shall each consult with healthcare professionals with expertise in caring for women during the period of pregnancy and [postpartum recovery](#g-1).
- (g) **Definitions.—** For purposes of this section:
  - (1) **Postpartum recovery.—** 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](#g-2), following delivery, and shall include the entire period that the [prisoner](#g-2) is in the hospital or infirmary.
  - (2) **Prisoner.—** 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) **Restraints.—** The term “restraints” means any physical or mechanical device used to control the movement of a [prisoner](#g-2)’s body, limbs, or both.

## Source credit

(Added Pub. L. 115–391, title III, § 301(a), Dec. 21, 2018, 132 Stat. 5217.)

## Notes

### 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.