S.F. 2019 Section 1. LEGISLATIVE FINDINGS. The general assembly 1 finds all of the following: 2 1. There are serious known medical risks associated with the 3 use of restraints on pregnant women. 4 2. The vast majority of female inmates or detainees in this 5 state are nonviolent offenders. 6 3. Restraining pregnant prison inmates increases the 7 potential for physical harm from an accidental trip or fall. 8 4. Freedom from physical restraints is especially critical 9 during labor, delivery, and postpartum recovery after delivery, 10 because a woman often needs to move around during labor and 11 recovery. 12 5. Restraints on a pregnant woman can interfere with the 13 ability of medical staff to appropriately assist in childbirth 14 or to conduct sudden emergency procedures. 15 Sec. 2. NEW SECTION . 904.1001 Definitions. 16 As used in this division, unless the context otherwise 17 requires: 18 1. “Correctional institution” means any state correctional 19 institution under this chapter, county jail or municipal 20 holding facility under chapter 356, county detention facility 21 under chapter 356A, or other detention facility that is used to 22 detain or restrain a person, including a juvenile, under the 23 laws of this state or the United States. 24 2. “Corrections officer” means the official who is 25 responsible for oversight of a correctional institution or the 26 official’s designee. 27 3. “Detainee” means any adult or juvenile person detained or 28 restrained under the immigration laws of the United States at 29 any correctional institution. 30 4. “Inmate” means any adult or juvenile person incarcerated 31 or detained in a correctional institution who is accused 32 of, convicted or adjudicated guilty of, or sentenced for, a 33 criminal or immigration law violation including persons on 34 probation, parole, or pretrial release, or in any diversionary 35 -1- LSB 5391XS (4) 85 jm/nh 1/ 7

S.F. 2019 program. 1 5. “Labor” means the period of time before a birth during 2 which contractions are of sufficient frequency, intensity, and 3 duration to bring about effacement and progressive dilation of 4 the cervix. 5 6. “Postpartum recovery” means, as determined by the 6 attending physician, the period immediately following delivery, 7 including the entire period a woman is in the hospital or 8 infirmary after birth. 9 7. “Restraint” means any physical restraint or mechanical 10 device used to control the body or limb movement of an inmate 11 or detainee, including but not limited to flex cuffs, soft 12 restraints, hard metal handcuffs, a black box, chubb cuffs, leg 13 irons, belly chains, a security chain, or a convex shield. 14 Sec. 3. NEW SECTION . 904.1002 Restraint of pregnant inmates 15 or detainees. 16 1. A correctional institution shall not use restraints on 17 an inmate or detainee known to be pregnant, including during 18 labor, delivery, or postpartum recovery, unless any of the 19 following apply: 20 a. The inmate or detainee refuses to undergo a urine-based 21 pregnancy test, if not visibly pregnant. 22 b. The inmate has been confined for less than twenty-four 23 hours at a correctional institution other than a state 24 correctional institution. 25 c. A corrections officer makes an individualized 26 determination that the use of a restraint on the inmate or 27 detainee is necessary due to an extraordinary medical or 28 security circumstance described under subsection 2. 29 2. A corrections officer may make an individualized 30 determination that use of a restraint is necessary for a 31 pregnant inmate or detainee because the inmate or detainee is a 32 substantial flight risk or some other extraordinary medical or 33 security circumstance dictates the use of restraints to ensure 34 the safety and security of the inmate or detainee, the staff of 35 -2- LSB 5391XS (4) 85 jm/nh 2/ 7

S.F. 2019 the correctional institution or medical facility, the general 1 public, or other inmates or detainees. 2 3. Notwithstanding subsections 1 and 2, restraints shall 3 not be used under the following circumstances: 4 a. If a physician, nurse, or other health professional 5 treating the inmate or detainee requests the restraints not be 6 used. If such a request is made pursuant to this paragraph, 7 the corrections officer accompanying the inmate or detainee 8 shall immediately remove the restraints, unless the corrections 9 officer determines that removing the restraints would pose an 10 imminent extraordinary security circumstance described under 11 subsection 2. 12 b. If the correctional institution has actual and 13 constructive knowledge of the pregnancy and the inmate or 14 detainee is in at least the twenty-first week of pregnancy. 15 However, in such circumstances leg or waist restraints may be 16 used under the direction of the physician, nurse, or other 17 health professional treating the inmate or detainee. 18 c. During labor or childbirth. 19 4. If a corrections officer is requested to be present 20 in the birthing room during the labor or childbirth, the 21 corrections officer shall be female if practicable. 22 5. a. If a restraint is used pursuant to this section, the 23 restraint used shall be used in the least restrictive manner. 24 b. A corrections officer making the determination to use a 25 restraint pursuant to this section shall make written findings 26 within ten days of the decision to use such a restraint. The 27 findings shall be kept for at least five years and are public 28 records, except no individually identifying information of an 29 inmate or detainee shall be made public without the written 30 consent of the inmate or detainee. 31 Sec. 4. NEW SECTION . 904.1003 Transportation of a pregnant 32 inmate or detainee. 33 A correctional institution shall use a wheelchair to 34 transport a known pregnant inmate or detainee to or from a 35 -3- LSB 5391XS (4) 85 jm/nh 3/ 7

S.F. 2019 transport vehicle or to or from any appointment unless directed 1 otherwise by the physician, nurse, or other health professional 2 treating the inmate or detainee. 3 Sec. 5. NEW SECTION . 904.1004 Birth plan. 4 1. A correctional institution shall develop a birth 5 plan with a known pregnant inmate or detainee if the inmate 6 or detainee is likely to be confined at the correctional 7 institution during the childbirth. The birth plan shall 8 include a support person designated by the inmate or detainee 9 who may be present in the birthing room with the inmate or 10 detainee during labor and childbirth. 11 2. The correctional institution may, for good cause, reject 12 the support person designated in the birth plan from being 13 present in the birthing room. If the correctional institution 14 rejects the support person, the correctional institution shall 15 specify the reasons for rejecting the support person in writing 16 to the inmate or detainee as soon as possible if practicable 17 under the circumstances, in order to allow the inmate or 18 detainee to designate a new support person to be present in the 19 birthing room. 20 Sec. 6. NEW SECTION . 904.1005 Damages. 21 In addition to any other remedy authorized by law, a 22 correctional institution that restrains an inmate or detainee 23 in violation of this division may be liable for civil damages 24 and reasonable attorney fees and costs. 25 Sec. 7. NEW SECTION . 904.1006 Report. 26 The department of corrections, in conjunction with the 27 other entities supervising inmates and detainees in the state, 28 shall file a report with the general assembly by August 1 of 29 each fiscal year, detailing every instance in which restraints 30 were used on a pregnant inmate or detainee pursuant to this 31 division. The report shall not contain personal identifying 32 information of any inmate or detainee. 33 Sec. 8. RULES. The department of corrections, in 34 conjunction with other entities supervising inmates and 35 -4- LSB 5391XS (4) 85 jm/nh 4/ 7

S.F. 2019 detainees in the state, and after reviewing the most current 1 accepted medical practices and standards relating to pregnant 2 women, shall commence rulemaking for the implementation and 3 administration of this Act within sixty days of the effective 4 date of this Act. The department shall not adopt emergency 5 rules under section 17A.4, subsection 3, or section 17A.5, 6 subsection 2, paragraph “b”, to implement the provisions of 7 this Act. 8 Sec. 9. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 9 immediate importance, takes effect upon enactment. 10 EXPLANATION 11 The inclusion of this explanation does not constitute agreement with 12 the explanation’s substance by the members of the general assembly. 13 This bill relates to the use of restraints on a pregnant 14 inmate or detainee. 15 The bill defines “correctional institution” to mean any 16 state correctional institution, county jail, municipal holding 17 facility, county detention facility, or other detention 18 facility that is used to detain or restrain a person, including 19 a juvenile, under the laws of this state or the United States. 20 The bill defines “inmate” to mean any adult or juvenile 21 person incarcerated or detained in a correctional institution 22 who is accused of, convicted or adjudicated guilty of, or 23 sentenced for, a criminal or immigration law violation 24 including persons on probation, parole, or pretrial release, 25 or in any diversionary program. 26 The bill defines “detainee” to mean any adult or juvenile 27 person detained or restrained under the immigration laws of the 28 United States at any correctional institution. 29 The bill prohibits a correctional institution from using 30 a restraint on an inmate or detainee known to be pregnant, 31 including during labor, delivery, or postpartum recovery, 32 unless any of the following apply: the inmate or detainee 33 refuses to undergo a urine-based pregnancy test, if not visibly 34 pregnant; the inmate has been confined for less than 24 hours 35 -5- LSB 5391XS (4) 85 jm/nh 5/ 7

S.F. 2019 at a correctional institution other than a state correctional 1 institution; or a corrections officer makes an individualized 2 determination that the use of a restraint on a pregnant inmate 3 or detainee is necessary due to an extraordinary circumstance. 4 A corrections officer may make an individualized 5 determination under the bill if any of the following 6 extraordinary circumstances apply: the inmate or detainee is 7 a substantial flight risk or some other medical or security 8 circumstance dictates the use of restraints to ensure the 9 safety and security of the inmate or other persons. 10 The bill prohibits the use of restraints on a pregnant 11 inmate or detainee under the following circumstances: when 12 medical personnel request the restraints not be used, unless a 13 corrections officer determines the inmate or detainee poses an 14 imminent security risk; when the correctional institution has 15 actual knowledge of the pregnancy and the inmate or detainee 16 is in at least the twenty-first week of pregnancy, except leg 17 or waist restraints may be used under the direction of medical 18 personnel; or during labor or childbirth. If a corrections 19 officer makes a determination that restraints be used because 20 the inmate poses an imminent security risk, the bill requires 21 the correctional officer to make written findings within 10 22 days of the decision to use the restraints. 23 The bill requires a correctional institution to use a 24 wheelchair to transport a known pregnant inmate or detainee 25 to or from a transport vehicle or to or from any appointment, 26 unless otherwise directed by medical personnel. 27 The bill requires the correctional institution to develop 28 a birth plan with a known pregnant inmate or detainee if the 29 inmate or detainee is likely to be confined at the institution 30 during the childbirth. The plan shall include a support person 31 designated by the inmate or detainee who may be present in the 32 birthing room with the inmate or detainee during labor and 33 childbirth. The bill permits the correctional institution to 34 reject, for good cause, the support person from being present 35 -6- LSB 5391XS (4) 85 jm/nh 6/ 7

S.F. 2019 in the birthing room. If the correctional institution rejects 1 the presence of the support person in the birthing room, the 2 bill allows the inmate or detainee to designate another support 3 person if practicable under the circumstances. 4 The bill specifies that in addition to any other remedy 5 authorized by law, a correctional institution that restrains an 6 inmate or detainee in violation of the bill may be liable for 7 civil damages and reasonable attorney fees. 8 The bill requires the department of corrections, in 9 conjunction with the other entities supervising inmates and 10 detainees in the state, to file a report with the general 11 assembly by August 1 of each fiscal year, detailing every 12 instance in which restraints were used on a pregnant inmate or 13 detainee pursuant to the bill. The report shall not contain 14 personal identifying information of any inmate or detainee. 15 The bill requires the department of corrections and other 16 entities supervising inmates and detainees to commence 17 rulemaking after reviewing the latest accepted medical 18 practices and standards relating to pregnant women, within 60 19 days of the effective date of the bill. The bill specifically 20 prohibits the adoption of emergency rules. 21 The bill takes effect upon enactment. 22 -7- LSB 5391XS (4) 85 jm/nh 7/ 7