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A coalition of organizations is calling for an end to shackling after at least two pregnant women were restrained while giving birth in hospitals in North Carolina. The fight to stop shackling —which can include handcuffs, leg irons and chains placed around the waist — during childbirth in prisons is heating up ahead of Mother’s Day.

Two North Carolina women inmates, who were not publicly identified, were shackled during their labor in January, Monica Simpson, executive director of SisterSong, an Atlanta-based organization that promotes reproductive rights for women of color, said in a release. The women were jailed at the North Carolina Correctional Institute for Women in Raleigh, the News & Observer reported. SisterSong, along with other state organizations, wrote a letter and fought against the detestable practice, which allowed for women to be shackled during transportation from prison to hospital and during labor.

Their work paid off when North Carolina Department of Prisons changed their policy to end the restraint of incarcerated pregnant and laboring people in March, replacing a rule adopted in 2015.

Shackling is inhumane and unsafe, Simpson also said.

“It [shackling] increases the risk of injury when walking and while in labor, and can cause blood clots and serious delays in medical access,” Simpson said. “That’s why nearly every major medical association and maternal health organization opposes the practice.”

About 220,000 women are incarcerated in the U.S., according to an October 2017 Prison Policy Initiative report. More than 60 percent of women in jail have a child under the age of 18, the Sentencing Project reported.

Jailed Black women who are pregnant and deliver babies are at higher risk than other racial groups of being shackled due to systematic racism within the criminal justice system, Simpson also said. The message sent to women, in particular, Black women, is that they are prisoners first and mamas second.

Shawanna Nelson, an inmate at the McPherson Unit in Newport, Arkansas in September 2003, had already been in labor for 12 hours before she arrived at Newport hospital with her legs shackled together, The New York Times reported. She had been given nothing for her labor pain but Tylenol, and her doctors requested that her shackles be removed though a guard refused. After giving birth, the shackles caused her to soil the bed sheets because she was unable to reach a bathroom in time. Her story, including her lawsuit to ban the use of restraints on Arkansas prisoners in labor and delivery, helped to further the debate about shackling in recent years, according to the outlet.

In light of horrific birth experiences like Nelson, more than 20 states have passed laws that prohibit the shackling of people in childbirth, according to the News & Observer. The American Congress of Obstetricians and Gynecologists has also stated its opposition to using restraints during childbirth.

The movement to stop the practice, reaching across the world, has also included advocacy to provide overall better health care for jailed women. There have been some gains with this work: The federal Bureau of Prisons announced that feminine hygiene products had to be provided to inmates free of charge last year.

Shackling, inadequate health care and other inhumane treatments of jailed pregnant women are blows to reproductive justice. Activists are calling for thousands to join their campaign to stop shackling in every jail, prison, hospital and detention center nationwide.

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