[Congressional Record Volume 168, Number 186 (Thursday, December 1, 2022)]
[House]
[Pages H8686-H8693]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     PREGNANT WOMEN IN CUSTODY ACT

  Mr. NADLER. Mr. Speaker, pursuant to House Resolution 1499, I call up 
the bill (H.R. 6878) to address the health needs of incarcerated women 
related to pregnancy and childbirth, and for other purposes, and ask 
for its immediate consideration in the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 1499, the 
amendment in the nature of a substitute recommended by the Committee on 
the Judiciary, printed in the bill, modified by the amendment printed 
in part C of House Report 117-587, is adopted and the bill, as amended, 
is considered read.

[[Page H8687]]

  The text of the bill, as amended, is as follows:

                               H.R. 6878

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Pregnant Women in Custody 
     Act''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) In custody.--The term ``in custody'', with respect to 
     an individual, means that the individual is under the 
     supervision of a Federal, State, Tribal, or local 
     correctional facility, including a pretrial, juvenile, 
     medical, or mental health facility and a facility operated 
     under a contract with the Federal Government or a State, 
     Tribal, or local government.
       (2) Other pregnancy outcome.--The term ``other pregnancy 
     outcome'' means a pregnancy that ends in stillbirth, 
     miscarriage, or ectopic pregnancy.
       (3) Postpartum recovery.--The term ``postpartum recovery'' 
     has the meaning given that term in section 4051(c) of title 
     18, United States Code, as added by this Act.
       (4) Restraints.--The term ``restraints'' means any physical 
     or mechanical device used to control the movement of an 
     incarcerated pregnant woman's body, limbs, or both.
       (5) Restrictive housing.--The term ``restrictive housing'' 
     has the meaning given that term in section 4322 of title 18, 
     United States Code, as added by this Act.

     SEC. 3. DATA COLLECTION.

       (a) In General.--Beginning not later than 1 year after the 
     date of enactment of this Act, pursuant to the authority 
     under section 302 of title I of the Omnibus Crime Control and 
     Safe Streets Act of 1968 (34 U.S.C. 10132), the Director of 
     the Bureau of Justice Statistics shall include in the 
     National Prisoner Statistics Program and Annual Survey of 
     Jails statistics relating to the health needs of incarcerated 
     pregnant women in the criminal justice system at the Federal, 
     State, Tribal, and local levels, including--
       (1) demographic and other information about incarcerated 
     women who are pregnant, in labor, or in postpartum recovery, 
     including the race, ethnicity, and age of the woman;
       (2) the provision of pregnancy care and services provided 
     for such women, including--
       (A) whether prenatal, delivery, and post-delivery check-up 
     visits were scheduled and provided;
       (B) whether a social worker, psychologist, doula or other 
     support person was offered and provided during pregnancy and 
     delivery and post-delivery;
       (C) whether a pregnancy or parenting program was offered 
     and provided during pregnancy;
       (D) whether a nursery or residential program to keep 
     mothers and infants together post-delivery was offered and 
     whether such a nursery or residential program was provided;
       (E) the number of days the mother stayed in the hospital 
     post-delivery;
       (F) the number of days the infant remained with the mother 
     post-delivery; and
       (G) the number of days the infant remained in the hospital 
     after the mother was discharged;
       (3) the location of the nearest hospital with a licensed 
     obstetrician-gynecologist in proximity to where the 
     incarcerated pregnant woman is housed and the length of 
     travel required to transport the woman;
       (4) whether a written policy or protocol is in place--
       (A) to respond to unexpected childbirth, labor, deliveries, 
     or medical complications related to the pregnancies of 
     incarcerated pregnant women; and
       (B) for incarcerated pregnant women experiencing labor or 
     medical complications related to pregnancy outside of a 
     hospital;
       (5) the number of incarcerated women who are determined by 
     a health care professional to have a high-risk pregnancy;
       (6) the total number of incarcerated pregnant women and the 
     number of incarcerated women who became pregnant while 
     incarcerated;
       (7) the number of incidents in which an incarcerated woman 
     who is pregnant, in labor, or in postpartum recovery is 
     placed in restrictive housing, the reason for such 
     restriction or placement, and the circumstances under which 
     each incident occurred, including the duration of time in 
     restrictive housing, during--
       (A) pregnancy;
       (B) labor;
       (C) delivery;
       (D) postpartum recovery; and
       (E) the 6-month period after delivery; and
       (8) the disposition of the custody of the infant post-
     delivery.
       (b) Personally Identifiable Information.--Data collected 
     under this section may not contain any personally 
     identifiable information of any incarcerated pregnant woman 
     or woman in postpartum recovery.

     SEC. 4. CARE FOR FEDERALLY INCARCERATED WOMEN RELATED TO 
                   PREGNANCY AND CHILDBIRTH.

       (a) In General.--The Director of the Bureau of Prisons 
     shall ensure that appropriate services and programs, as 
     described in subsection (b), are provided to women in 
     custody, to address the health and safety needs of such women 
     related to pregnancy and childbirth. The warden of each 
     Bureau of Prisons facility that houses women shall ensure 
     that these services and programs are implemented for women in 
     custody at that facility.
       (b) Services and Programs Provided.--The services and 
     programs described in this subsection are the following:
       (1) Access to complete appropriate health services for the 
     life cycle of women.--The Director of the Bureau of Prisons 
     shall ensure that each woman of reproductive age in custody 
     at a Bureau of Prisons facility--
       (A) has access to contraception and testing for pregnancy 
     and sexually transmitted diseases, upon request of any such 
     woman; and
       (B) is administered a pregnancy test on the date on which 
     the woman enters the facility, which the woman may decline.
       (2) Compliance with protocols relating to health of a 
     pregnant woman.--On confirmation of the pregnancy of a woman 
     in custody by clinical diagnostics and assessment, the chief 
     health care professional of the Bureau of Prisons facility in 
     which the woman is housed shall ensure that--
       (A) a summary of all appropriate protocols directly 
     pertaining to the safety and well-being of the woman are 
     provided to the woman;
       (B) such protocols are complied with; and
       (C) such protocols include an assessment of undue safety 
     risks and necessary changes to accommodate the woman where 
     and when appropriate, as it relates to--
       (i) housing or transfer to a lower bunk for safety reasons;
       (ii) appropriate bedding or clothing to respond to the 
     woman's changing physical requirements and the temperature in 
     housing units;
       (iii) regular access to water and bathrooms;
       (iv) a diet that--

       (I) complies with the nutritional standards established by 
     the Secretary of Agriculture and the Secretary of Health and 
     Human Services in the Dietary Guidelines for Americans report 
     published pursuant to section 301(a)(3) of the National 
     Nutrition Monitoring and Related Research Act of 1990 (7 
     U.S.C. 5341(a)(3)); and
       (II) includes--

       (aa) any appropriate dietary supplement, including prenatal 
     vitamins;
       (bb) timely and regular nutritious meals;
       (cc) additional caloric content in meals provided;
       (dd) a prohibition on withholding food from the woman or 
     serving any food that is used as a punishment, including 
     nutraloaf or any food similar to nutraloaf that is not 
     considered a nutritious meal; and
       (ee) such other modifications to the diet of the woman as 
     the Director of the Bureau of Prisons determines to be 
     necessary after consultation with the Secretary of Health and 
     Human Services and consideration of such recommendations as 
     the Secretary may provide;
       (v) modified recreation and transportation, in accordance 
     with standards within the obstetrical and gynecological care 
     community, to prevent overexertion or prolonged periods of 
     inactivity; and
       (vi) such other changes to living conditions as the 
     Director of the Bureau of Prisons may require after 
     consultation with the Secretary of Health and Human Services 
     and consideration of such recommendations as the Secretary 
     may provide.
       (3) Education and support services.--
       (A) Pregnancy in custody.--A woman who is pregnant at 
     intake or who becomes pregnant while in custody shall, not 
     later than 14 days after the pregnant woman notifies a Bureau 
     of Prisons official of the pregnancy, receive prenatal 
     education, counseling, and birth support services provided by 
     a provider trained to provide such services, including--
       (i) information about the parental rights of the woman, 
     including the right to place the child in kinship care, and 
     notice of the rights of the child;
       (ii) information about family preservation support services 
     that are available to the woman;
       (iii) information about the nutritional standards referred 
     to in paragraph (2)(C)(iv);
       (iv) information pertaining to the health and safety risks 
     of pregnancy, childbirth, and parenting, including postpartum 
     depression;
       (v) information on breast-feeding, lactation, and breast 
     health;
       (vi) appropriate educational materials, resources, and 
     services related to pregnancy, childbirth, and parenting;
       (vii) information and notification services for 
     incarcerated parents regarding the risk of debt repayment 
     obligations associated with their child's participation in 
     social welfare programs, including assistance under any State 
     program funded under part A of title IV of the Social 
     Security Act (42 U.S.C. 601 et seq.) or benefits under the 
     supplemental nutrition assistance program, as defined in 
     section 3 of the Food and Nutrition Act of 2008 (7 U.S.C. 
     2012), or any State program carried out under that Act; and
       (viii) information from the Office of Child Support 
     Enforcement of the Department of Health and Human Services 
     regarding seeking or modifying child support while 
     incarcerated, including how to participate in the Bureau of 
     Prison's Inmate Financial Responsibility Program under 
     subpart B of part 545 of title 28, Code of Federal 
     Regulations (or any successor program).
       (B) Birth while in custody or prior to custody.--A woman 
     who, while in custody or during the 6-month period 
     immediately preceding intake, gave birth or experienced any 
     other pregnancy outcome shall receive counseling provided by 
     a licensed or certified provider trained to provide such 
     services, including--
       (i) information about the parental rights of the woman, 
     including the right to place the child in kinship care, and 
     notice of the rights of the child; and
       (ii) information about family preservation support services 
     that are available to the woman.
       (4) Evaluations.--
       (A) In general.--Each woman in custody who is pregnant or 
     whose pregnancy results in a birth or any other pregnancy 
     outcome during the 6-month period immediately preceding 
     intake or any time in custody thereafter shall be evaluated 
     as soon as practicable after intake or confirmation of 
     pregnancy through evidence-

[[Page H8688]]

     based screening and assessment for substance use disorders or 
     mental health conditions, including postpartum depression or 
     depression related to pregnancy, birth, or any other 
     pregnancy outcome or early child care.
       (B) Risk factors.--Screening under subparagraph (A) shall 
     include identification of any of the following risk factors:
       (i) An existing mental or physical health condition or 
     substance use disorder.
       (ii) Being underweight or overweight.
       (iii) Multiple births or a previous still birth.
       (iv) A history of preeclampsia.
       (v) A previous Caesarean section.
       (vi) A previous miscarriage.
       (vii) Being older than 35 or younger than 15.
       (viii) Being diagnosed with the human immunodeficiency 
     virus, hepatitis, diabetes, or hypertension.
       (ix) Such other risk factors as the chief health care 
     professional of the Bureau of Prisons facility that house the 
     woman may determine to be appropriate.
       (5) Unexpected births rulemaking.--The Director of the 
     Bureau of Prisons shall provide services to respond to 
     unexpected childbirth deliveries, labor complications, and 
     medical complications related to pregnancy if a woman in 
     custody is unable to access a hospital in a timely manner in 
     accordance with rules promulgated by the Attorney General, 
     which shall be promulgated not later than 180 days after the 
     date of enactment of this Act.
       (6) Treatment.--The Director of the Bureau of Prisons shall 
     use best efforts to provide a woman in custody who is 
     pregnant and diagnosed with having a substance use disorder 
     or a mental health disorder with appropriate evidence-based 
     treatment.

     SEC. 5. USE OF RESTRICTIVE HOUSING ON INCARCERATED PREGNANT 
                   WOMEN DURING PREGNANCY, LABOR, AND POSTPARTUM 
                   RECOVERY PROHIBITED.

       (a) In General.--Section 4322 of title 18, United States 
     Code, is amended to read as follows:

     ``Sec. 4322. Use of restrictive housing on incarcerated women 
       during the period of pregnancy, labor, and postpartum 
       recovery prohibited

       ``(a) Prohibition.--Except as provided in subsection (b), 
     during the period beginning on the date on which pregnancy is 
     confirmed by a health care professional and ending not 
     earlier than 12 weeks after delivery, an incarcerated woman 
     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 held in restrictive housing.
       ``(b) Exceptions.--
       ``(1) Restrictive housing.--Subject to paragraph (4), the 
     prohibition under subsection (a) relating to restrictive 
     housing shall not apply if the Director of the Bureau of 
     Prisons or a senior Bureau of Prisons official overseeing 
     women's health and services, in consultation with senior 
     officials in health services, makes an individualized 
     determination that restrictive housing is required as a 
     temporary response to behavior that poses a serious and 
     immediate risk of physical harm.
       ``(2) Review.--The official who makes a determination under 
     subparagraph (A) shall review such determination daily for 
     the purpose of removing an incarcerated woman as quickly as 
     feasible from restrictive housing.
       ``(3) Restrictive housing plan.--The official who makes a 
     determination under subparagraph (A) shall develop an 
     individualized plan to move an incarcerated woman to less 
     restrictive housing within a reasonable amount of time.
       ``(4) Prohibition on solitary confinement.--An incarcerated 
     woman who is placed in restrictive housing under this 
     subsection may not be placed in solitary confinement if the 
     incarcerated woman is in her third trimester.
       ``(c) Reports.--
       ``(1) Report to directors and health care professional 
     after placement in restrictive housing.--Not later than 30 
     days after the date on which an incarcerated woman is placed 
     in restrictive housing under subsection (b), the applicable 
     official identified in subsection (b)(1), correctional 
     officer, or United States Marshal shall submit to the 
     Director of the Bureau of Prisons or the Director of the 
     United States Marshals Service, as applicable, and to the 
     health care professional responsible for the health and 
     safety of the woman, a written report which describes the 
     facts and circumstances surrounding the restrictive housing 
     placement, and includes the following:
       ``(A) The reasoning upon which the determination for the 
     placement was made.
       ``(B) The details of the placement, including length of 
     time of placement and how frequently and how many times the 
     determination was made subsequent to the initial 
     determination to continue the restrictive housing placement.
       ``(C) A description of all attempts to use alternative 
     interventions and sanctions before the restrictive housing 
     was used.
       ``(D) Any resulting physical effects on the woman observed 
     by or reported by the health care professional responsible 
     for the health and safety of the woman.
       ``(E) Strategies the facility is putting in place to 
     identify more appropriate alternative interventions should a 
     similar situation arise again.
       ``(2) Report to congress.--Not later than 180 days after 
     the date of enactment of the Pregnant Women in Custody Act, 
     and every 180 days thereafter for a period of 10 years, the 
     Attorney General shall submit to the Committee on the 
     Judiciary of the Senate and the Committee on the Judiciary of 
     the House of Representatives a report on the placement of 
     incarcerated women in restrictive housing under subsection 
     (b), which shall include the information described in 
     paragraph (1).
       ``(d) Notice.--Not later than 24 hours after the 
     confirmation of the pregnancy of an incarcerated woman by a 
     health care professional, that woman shall be notified, 
     orally and in writing, by an appropriate health care 
     professional, correctional officer, or United States Marshal, 
     as applicable--
       ``(1) of the restrictions on the use of restrictive housing 
     placements under this section;
       ``(2) of the right of the incarcerated woman to make a 
     confidential report of a violation of restrictions on the use 
     of restrictive housing placement; and
       ``(3) that the facility staff have been advised of all 
     rights of the incarcerated woman under subsection (a).
       ``(e) Violation Reporting Process.--Not later than 180 days 
     after the date of enactment of the Pregnant Women in Custody 
     Act, the Director of the Bureau of Prisons and the Director 
     of the United States Marshals Service shall establish 
     processes through which an incarcerated person may report a 
     violation of this section.
       ``(f) Notification of Rights.--The warden of the Bureau of 
     Prisons facility where a pregnant woman is in custody shall 
     notify necessary facility staff of the pregnancy and of the 
     rights of the incarcerated pregnant woman under subsection 
     (a).
       ``(g) Retaliation.--It shall be unlawful for any Bureau of 
     Prisons or United States Marshals Service employee to 
     retaliate against an incarcerated person for reporting under 
     the processes established under subsection (e) a violation of 
     subsection (a).
       ``(h) Education.--Not later than 90 days after the date of 
     enactment of the Pregnant Women in Custody Act, the Director 
     of the Bureau of Prisons and the Director of the United 
     States Marshals Service shall each--
       ``(1) develop education guidelines regarding the physical 
     and mental health needs of incarcerated pregnant women, and 
     the use of restrictive housing placements on incarcerated 
     women during the period of pregnancy, labor, and postpartum 
     recovery; and
       ``(2) incorporate such guidelines into appropriate 
     education programs.
       ``(i) Definition.--In this section, the term `restrictive 
     housing' means any type of detention that involves--
       ``(1) removal from the general inmate population, whether 
     voluntary or involuntary;
       ``(2) placement in a locked room or cell, whether alone or 
     with another inmate; and
       ``(3) inability to leave the room or cell for the vast 
     majority of the day.''.
       (b) Clerical Amendment.--The table of sections for chapter 
     317 of title 18, United States Code, is amended by striking 
     the item relating to section 4322 and inserting the 
     following:
``4322. Use of restrictive housing on incarcerated women during the 
              period of pregnancy, labor, and postpartum recovery 
              prohibited.''.

     SEC. 6. TREATMENT OF WOMEN WITH HIGH-RISK PREGNANCIES.

       (a) In General.--Chapter 303 of title 18, United States 
     Code, is amended by adding at the end the following:

     ``Sec. 4052. Treatment of incarcerated pregnant women

       ``(a) High-Risk Pregnancy Health Care.--The Director of the 
     Bureau of Prisons shall ensure that each incarcerated 
     pregnant woman receives an evaluation to determine if the 
     pregnancy is high-risk and, if so, receives healthcare 
     appropriate for a high-risk pregnancy, including obstetrical 
     and gynecological care, during pregnancy and postpartum 
     recovery.
       ``(b) High-Risk Pregnancies.--
       ``(1) In general.--The Director of the Bureau of Prisons 
     shall transfer to a Residential Reentry Center with adequate 
     health care during her pregnancy and postpartum recovery any 
     incarcerated woman who--
       ``(A) is determined by a health care professional to have a 
     high-risk pregnancy; and
       ``(B) agrees to be transferred.
       ``(2) Priority.--The Residential Reentry Center to which an 
     incarcerated pregnant woman is transferred under paragraph 
     (1) shall, to the extent practicable, be in a geographical 
     location that is close to the family members of the 
     incarcerated pregnant woman.
       ``(3) Transportation.--To transport an incarcerated 
     pregnant woman to a Residential Reentry Center, the Director 
     of the Bureau of Prisons shall provide to the woman a mode of 
     transportation that a healthcare professional has determined 
     to be safe for transporting the pregnant woman.
       ``(4) Service of sentence.--Any time accrued at a 
     Residential Reentry Center or alternative housing as a result 
     of a transfer made under this section shall be credited 
     toward service of the incarcerated pregnant woman's sentence.
       ``(c) Definitions.--In this section:
       ``(1) Health care professional.--The term `health care 
     professional' means--
       ``(A) a doctor of medicine or osteopathy who is authorized 
     to diagnose and treat physical or mental health conditions 
     under the laws of the State in which the doctor practices and 
     where the facility is located;
       ``(B) any physician's assistant or nurse practitioner who 
     is supervised by a doctor of medicine or osteopathy described 
     in subparagraph (A); or
       ``(C) any other person determined by the Director of the 
     Bureau of Prisons to be capable of providing health care 
     services.
       ``(2) High-risk pregnancy.--The term `high-risk pregnancy' 
     means, with respect to an incarcerated woman, that the 
     pregnancy threatens the health or life of the woman or 
     pregnancy, as determined by a health care professional.
       ``(3) Postpartum recovery.--The term `postpartum recovery' 
     means the 3-month period beginning on the date on which an 
     incarcerated pregnant woman gives birth, or longer as 
     determined by a health care professional following delivery, 
     and shall include the entire period that

[[Page H8689]]

     the incarcerated pregnant woman is in the hospital or 
     infirmary.
       ``(4) Residential reentry center.--The term `Residential 
     Reentry Center' means a Bureau of Prisons contracted 
     residential reentry center.''.
       (b) Conforming Amendment.--The table of sections for 
     chapter 303 of title 18, United States Code, is amended by 
     adding at the end the following:
``4052. Treatment of incarcerated pregnant women.''.

     SEC. 7. REPORTING REQUIREMENT REGARDING CLAIMS FILED BY 
                   PREGNANT INMATES.

       The Director of the Federal Bureau of Prisons shall make 
     publicly available on the website of the Federal Bureau of 
     Prisons on an annual basis the following information:
       (1) The total number of Administrative Remedy appeals 
     related to pregnant inmates that were filed during the 
     previous year.
       (2) The total number of institution-level Requests for 
     Administrative Remedy related to pregnant inmates that were 
     filed during the previous year.
       (3) The total number of informal requests for 
     administrative remedy related to pregnant inmates that were 
     filed during the previous year.
       (4) The total number of requests or appeals related to 
     pregnant inmates during the previous year that were not 
     resolved before the inmate gave birth or that were mooted 
     because the inmate's pregnancy ended.
       (5) The average amount of time that each category of 
     request or appeal took to resolve during the previous year.
       (6) The shortest and longest amounts of time that a request 
     or appeal in each category that was resolved in the last year 
     took to resolve.

     SEC. 8. EDUCATION AND TECHNICAL ASSISTANCE.

       The Director of the National Institute of Corrections shall 
     provide education and technical assistance, in conjunction 
     with the appropriate public agencies, at State and local 
     correctional facilities that house women and facilities in 
     which incarcerated women go into labor and give birth, in 
     order to educate the employees of such facilities, including 
     health personnel, on the dangers and potential mental health 
     consequences associated with the use of restrictive housing 
     and restraints on incarcerated women during pregnancy, labor, 
     and postpartum recovery, and on alternatives to the use of 
     restraints and restrictive housing placement.

     SEC. 9. BUREAU OF PRISONS STAFF AND UNITED STATES MARSHALS 
                   TRAINING.

       (a) Bureau of Prisons Training.--
       (1) In general.--
       (A) Initial training.--Not later than 180 days after the 
     date of enactment of this Act, the Director of the Bureau of 
     Prisons shall provide training to carry out the requirements 
     of this Act and the amendments made by this Act to each 
     correctional officer at any Bureau of Prisons facility that 
     houses women who is employed on the date of enactment of this 
     Act.
       (B) Subsequent training.--After the initial training 
     provided under subparagraph (A), the Director of the Bureau 
     of Prisons shall provide training to carry out the 
     requirements of this Act and the amendments made by this Act 
     twice each year to each correctional officer at any Bureau of 
     Prisons facility that houses women.
       (2) New hires.--
       (A) Definition.--In this paragraph, the term ``covered new 
     correctional officer'' means an individual appointed to a 
     position as a correctional officer at a Bureau of Prisons 
     facility that houses women on or after the date that is 180 
     days after the date of enactment of this Act.
       (B) Training.--The Director of the Bureau of Prisons shall 
     train each covered new correctional officer to carry out the 
     requirements of this Act and the amendments made by this Act 
     not later than 30 days after the date on which the covered 
     new correctional officer is appointed.
       (b) United States Marshals Training.--
       (1) In general.--On and after the date that is 180 days 
     after the date of enactment of this Act, the Director of the 
     United States Marshals Service shall ensure that each Deputy 
     United States Marshal has received trained pursuant to the 
     guidelines described in subsection (c).
       (2) New hires.--
       (A) Definition.--In this paragraph, the term ``new Deputy 
     United States Marshal'' means an individual appointed to a 
     position as a Deputy United States Marshal after the date of 
     enactment of this Act.
       (B) Training.--Not later than 30 days after the date on 
     which a new Deputy United States Marshal is appointed, the 
     new Deputy United States Marshal shall receive training 
     pursuant to the guidelines described in subsection (c).
       (c) Guidelines.--
       (1) In general.--The Director of the Bureau of Prisons and 
     the United States Marshals Service shall each develop 
     guidelines on the treatment of incarcerated women during 
     pregnancy, labor, and postpartum recovery and incorporate 
     such guidelines in the training required under this section.
       (2) Contents.--The guidelines developed under paragraph (1) 
     shall include guidance on--
       (A) the transportation of incarcerated pregnant women;
       (B) housing of incarcerated pregnant women;
       (C) nutritional requirements for incarcerated pregnant 
     women; and
       (D) the right of a health care professional to request that 
     restraints not be used.

     SEC. 10. GAO STUDY ON STATE AND LOCAL CORRECTIONAL 
                   FACILITIES.

       The Comptroller General of the United States shall conduct 
     a study of services and protections provided for pregnant 
     incarcerated women in local and State correctional settings, 
     including--
       (1) policies on--
       (A) obstetrical and gynecological care;
       (B) education on nutritional issues and health and safety 
     risks associated with pregnancy;
       (C) mental health and substance use treatment;
       (D) access to prenatal and post-delivery support services 
     and programs; and
       (E) the use of restraints and restrictive housing 
     placement; and
       (2) the extent to which the intent of such policies is 
     fulfilled.

     SEC. 11. DETERMINATION OF BUDGETARY EFFECTS.

       The budgetary effects of this Act, for the purpose of 
     complying with the Statutory Pay-As-You-Go-Act of 2010, shall 
     be determined by reference to the latest statement titled 
     ``Budgetary Effects of PAYGO Legislation'' for this Act, 
     submitted for printing in the Congressional Record by the 
     Chairman of the House Budget Committee, provided that such 
     statement has been submitted prior to the vote on passage.

  The SPEAKER pro tempore. The bill, as amended, shall be debatable for 
1 hour equally divided and controlled by the chair and ranking minority 
member of the Committee on the Judiciary or their respective designees.
  After 1 hour of debate, it shall be in order to consider the further 
amendment printed in part D of House Report 117-587, if offered by the 
Member designated in the report, which shall be considered read, shall 
be separately debatable for the time specified in the report equally 
divided and controlled by the proponent and an opponent, and shall not 
be subject to a demand for a division of the question.
  The gentleman from New York (Mr. Nadler) and the gentleman from 
Wisconsin (Mr. Fitzgerald) each will control 30 minutes.
  The Chair recognizes the gentleman from New York (Mr. Nadler).


                             General Leave

  Mr. NADLER. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material on H.R. 6878.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  There was no objection.
  Mr. NADLER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, H.R. 6878, the Pregnant Women in Custody Act, is 
bipartisan legislation that would help ensure that women receive the 
pregnancy, delivery, and postpartum care that they need while in 
Federal custody.
  The number of women incarcerated has grown significantly in recent 
decades, and most women are incarcerated during their reproductive 
years. There are an estimated 58,000 admissions of pregnant women into 
jails and prisons every year.
  It is vital for the health of these women and their newborns that 
they have access to appropriate healthcare, nutrition, and postpartum 
recovery support.
  In addition, research shows that Black women already have a 43 
percent higher risk of miscarriage than White women. Since women of 
color are disproportionately impacted by the criminal justice system, a 
lack of support and care for pregnancy and reproductive health while 
incarcerated can lead to increased risk of negative pregnancy outcomes.
  By establishing a national standard of care for incarcerated pregnant 
women, as well as by prohibiting the use of restrictive housing and 
providing for transfers to residential reentry centers for women with 
high-risk pregnancies, this bill will help protect the health and 
safety of pregnant women and their newborns. Restrictive housing and 
solitary confinement have been called psychological torture, and the 
use of solitary confinement can further damage the physical and mental 
well-being of pregnant women.

                              {time}  1315

  In addition to setting a national standard of care, this bill also 
requires the Government Accountability Office to study the services and 
protections provided to pregnant women incarcerated at the State and 
local levels.
  The impact of incarceration of pregnant women is complex and far-
reaching. The reality of pregnancy, delivery, and postpartum recovery 
while incarcerated requires significant mental and physical health 
interventions and broader protections in order to address the trauma 
both mothers and newborns experience.
  This bipartisan bill is supported by a broad range of organizations 
across the ideological spectrum, including the

[[Page H8690]]

American Psychological Association, the National Alliance on Mental 
Illness, the Association of Maternal and Child Health Programs, Dream 
Corps, the Vera Institute for Justice, R Street Institute, and the 
American Conservative Union.
  Mr. Speaker, I thank our colleague, Representative Karen Bass, for 
her leadership on this issue and on so many criminal justice issues 
throughout her career in Congress. I thank her bipartisan cosponsors 
for introducing this important legislation with her.
  Mr. Speaker, I urge all of my colleagues to support the bill, and I 
reserve the balance of my time.
  Mr. FITZGERALD. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, each year, an estimated 58,000 pregnant women pass 
through jails and prisons in the United States. H.R. 6878 would expand 
on existing programs within the Bureau of Prisons to provide certain 
health and wellness-related services for pregnant incarcerated women. 
This legislation will help these women receive necessary medical care, 
nutrition, and support while in Federal custody.
  In addition, H.R. 6878 builds upon President Trump's leadership in 
the First Step Act, which prohibited the use of restraints on pregnant 
women in Federal custody.
  H.R. 6878 would prohibit pregnant women in Federal custody from being 
placed in restrictive housing unless their behavior poses a serious and 
immediate risk of physical harm. It also would prohibit the use of 
solitary confinement for pregnant women in their third trimester.
  The bill also expands data reporting on the health needs of pregnant 
incarcerated women and requires guidelines for the treatment of 
incarcerated women during pregnancy, labor, and postpartum recovery.
  We all believe that pregnant incarcerated women should be well cared 
for while they are in Federal custody. However, I would like to note 
the concern that the bill could require the Bureau of Prisons to 
provide abortifacients to pregnant inmates. However, the word 
``contraception'' is not defined in the bill, and the internal Bureau 
of Prisons policy does not define ``contraception.''
  Because the word ``contraception'' is not defined, this ambiguity 
leaves open the reasonable interpretation that the term 
``contraception'' could include abortifacients or other substances that 
induce abortion.
  Mr. Speaker, I reserve the balance of my time.
  Mr. NADLER. Mr. Speaker, I yield 3 minutes to the distinguished 
gentlewoman from Texas (Ms. Jackson Lee), a member of the committee.
  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 6878, the 
Pregnant Women in Custody Act, because women's lives matter, pregnant 
women's lives matter, their babies' lives matter, as do the lives of 
incarcerated women and their babies.
  I have worked on this issue for a very long time and am delighted to 
be able to support this legislation introduced by my friend and 
colleague, Congresswoman Bass.
  This works to ensure that we recognize the increasing population of 
women incarcerated. Unfortunately, women are the fastest-growing 
segment of the incarcerated population in the United States. 
Conversations about criminal justice reform often overlook their unique 
experiences and the needs of women and girls within the criminal 
justice system.
  For instance, Mr. Speaker, the United States has the second highest 
rate of women incarcerated in the world, with 64 women per 100,000 in 
custody and nearly 60,000 pregnant women admitted into American jails 
and prisons every year. That is a lot.
  Some States have yet to prohibit the shackling of women when they are 
giving birth. We have to do something.
  This bipartisan legislation would establish Federal policies to 
prohibit the use of restrictive housing on incarcerated pregnant women 
and develop a national standard of care to add to the pregnancy-related 
needs of incarcerated women, including access to prenatal and post-
delivery care and support.
  My legislation, the SIMARRA Act, also complements this by creating a 
pilot program in the Federal system for mothers to stay with their 
infants for a period of time. This humane response and the humane 
response of this bill are what we need to do.
  Oftentimes, pregnant women lack access to appropriate nutrition while 
incarcerated, and the use of restrictive housing can have detrimental 
effects on a woman's health, as well as the health of her baby. While 
women of color are disproportionately impacted by incarceration, they 
also face higher risks of both miscarriage and maternal mortality.
  This bill would make certain that incarcerated pregnant women receive 
vital prenatal healthcare and postpartum support and ensures the Bureau 
of Prisons and the Marshals Service protect the health and safety of 
incarcerated women through their pregnancy, when they deliver their 
child, and as they receive postpartum care. They should not be 
shackled, and they should not be intimidated or frightened.
  The one thing I want to say, Mr. Speaker, even though many of us have 
different views--and I am an avid supporter of the right to choose--
this is not an abortion bill. This is a healthcare bill.
  We also know that the prisons make their determinations on how they 
help women in their contraceptives. H.R. 6878 would allow BOP to 
collect data on healthcare needs of pregnant women so that we may have 
a better understanding.

  Let me clearly say that separating a newborn from its mother gives it 
less chance for both survival and success in life.
  We know in Harris County, Texas, there are approximately 1,000 women 
incarcerated in the Harris County Jail. This bill would require a GAO 
study, setting national standards, and endeavor to do a landscape to 
understand reproductive freedom in this country.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. NADLER. Mr. Speaker, I yield an additional 30 seconds to the 
gentlewoman from Texas.
  Ms. JACKSON LEE. Mr. Speaker, that is why I was glad to see my bill, 
the Stop Infant Mortality And Recidivism Reduction Act of 2021, or the 
SIMARRA Act, included in the Violence Against Women Act, which passed 
earlier this year. That bill established a pilot program to allow women 
incarcerated in Federal prisons and their babies to reside with each 
other while the mother is incarcerated for a period of time.
  Mr. Speaker, let us continue to be innovators in the treatment of 
those who are incarcerated, and let us make sure that we give every 
newborn a healthy life. I ask my colleagues to support the underlying 
legislation.
  Mr. Speaker, I rise in support of H.R. 6878, the ``Pregnant Women in 
Custody Act,'' because women's lives matter, pregnant women's lives 
matter, their babies' lives matter--as do the lives of incarcerated 
women and their babies.
  Although women are the fastest growing segment of the incarcerated 
population in the United States, conversations about criminal justice 
reform often overlook the unique experiences and needs of women and 
girls within the criminal justice system.
  The United States has the second highest rate of women incarcerated 
in the world, with 64 women per 100,000 in custody, and nearly 60,000 
pregnant women admitted into American jails and prisons every year, 
while some states have yet to prohibit the shackling of women when they 
are giving birth.
  This bipartisan legislation would establish federal policies to 
prohibit the use of restrictive housing on incarcerated pregnant women 
and develop a national standard of care to address the pregnancy-
related needs of incarcerated women, including access to prenatal and 
post-delivery care and support.
  Oftentimes pregnant women lack access to appropriate nutrition while 
incarcerated and the use of restrictive housing can have detrimental 
effects on a woman's health as well as the health of her baby. And 
while women of color are disproportionately impacted by incarceration, 
they also face higher risks of both miscarriage and maternal mortality.
  This bill would make certain that incarcerated pregnant women receive 
vital prenatal healthcare and post-partum support and ensure the Bureau 
of Prisons and the Marshal's service protect the health and safety of 
incarcerated women throughout their pregnancy, when they deliver their 
child, and as they recover post-partum.
  H.R. 6878 would also require BOP to collect data on the healthcare 
needs of pregnant

[[Page H8691]]

women, so that we may better understand the challenges incarcerated 
women face and determine how to address the needs of this vulnerable 
population.
  In Harris County, Texas, on average, there are approximately 1,000 
women incarcerated in the county jail and on average 25 to 30 of them 
are pregnant. The jail offers specific programs for mothers to reduce 
recidivism and help them support their families upon release.
  This bill would require GAO to study state and local corrections 
facilities to understand the services and protections provided for 
pregnant women, like the program offered in Harris County.
  Setting national standards for the treatment of incarcerated pregnant 
women in federal custody would set an example for state and local 
facilities to follow and the data collected by BOP would farther inform 
Congress of the additional health and safety needs of this vulnerable 
population.
  As we endeavor to navigate a new landscape for reproductive freedom 
across the country, we must recognize that incarcerated women will 
continue to face challenges in carrying healthy pregnancies to term.
  That is why I was glad to see my bill, the ``Stop Infant Mortality 
and Recidivism Reduction Act of 2021'' (or the ``SIMARRA Act''), 
included in the Violence Against Women Act which passed earlier this 
year. That bill established a pilot program to allow women incarcerated 
in Federal prisons and their babies born during their incarceration to 
reside together with while the mother is incarcerated.
  Let us continue to be innovators in the treatment of those who are 
incarcerated. And let us make sure women receive proper health care and 
humane treatment whether they are incarcerated or not--because all 
women deserve proper health care and to be treated with dignity--no 
matter their circumstance.
  I thank Representative Karen Bass for her steadfast commitment to 
addressing this important issue. I urge my colleagues to join me in 
support of this long overdue legislation.
  I include in the Record a Prison Policy Initiative document titled: 
``Unsupportive environments and limited policies: Pregnancy, 
postpartum, and birth during incarceration.''

             [From Prison Policy Initiative, Aug. 19, 2021]

Unsupportive Environments and Limited Policies: Pregnancy, Postpartum, 
                     and Birth During Incarceration

                             (By Leah Wang)

       Making up for a serious gap in government data collection 
     and understanding, researchers are discovering what pregnant 
     incarcerated women should expect when they're expecting (or 
     when they give birth while in custody). Findings indicate 
     that jails, prisons, and youth facilities have yet to 
     adequately recognize pregnancy and postpartum needs either in 
     policy or in practice.
       Recently published findings from the groundbreaking 
     Pregnancy in Prison Statistics (PIPS) Project and other 
     datasets shed light on a common but rarely discussed 
     experience: being pregnant, postpartum or giving birth while 
     incarcerated. Spearheaded by Dr. Carolyn Sufrin of the Johns 
     Hopkins University School of Medicine and School of Public 
     Health, this series of studies is our best look yet at 
     pregnancy prevalence and outcomes in U.S. jails, prisons, and 
     youth facilities.
       In total, 22 state prison systems, all federal prisons, 6 
     jails, and 3 youth confinement systems participated in the 
     PIPS Project, a systematic study of pregnancy and its 
     outcomes among incarcerated women. Historically, the 
     government has not collected data about carceral pregnancy on 
     a regular basis, meaning no national effort has been made to 
     understand maternity care for thousands of incarcerated 
     pregnant women. The project's sample represents 57 percent of 
     all women in prison, 5 percent of all women in jail and about 
     3 percent of young women in youth facilities.
       Our takeaway: Carceral pregnancy, whether in jail, prison, 
     or youth confinement, is characterized by a lack of 
     supportive policies and practices. Some of the major findings 
     to come out of these publications are:
       There are an estimated 58,000 admissions of pregnant women 
     into jails and prisons every year, and thousands give birth 
     or have other outcomes while still incarcerated. Pregnancy 
     rates among confined youth were similar to those among 
     adults.
       In some state prison systems, miscarriage, premature birth, 
     and cesarean section rates were higher than national rates 
     among the general population.
       Only one-third of prisons and jails had any written policy 
     about breastfeeding or lactation, and even where policies 
     supporting lactation did exist, relatively few women were 
     actually breastfeeding or pumping.
       There are an estimated 8,000 admissions of pregnant women 
     with opioid use disorder (OUD) into prisons and jails each 
     year, but long-term treatment using medication is the 
     exception, not the rule.
       A related (non-PIPS Project) study finds paternal 
     incarceration is also linked to adverse birth outcomes like 
     low birth weight, which are widely known to impact long-term 
     health.
       The researchers' findings add complexity to a growing body 
     of literature and consensus linking incarceration to negative 
     health impacts. And although PIPS Project data can't be 
     broken down by race, ethnicity, or gender identity, measuring 
     the scale and outcomes of pregnancies in prison and jail is a 
     major public health research accomplishment. The fact that 
     academic researchers had to conduct this research to fill the 
     data gap--and the shortage of appropriate policies they 
     found--makes it clear that many correctional agencies have 
     yet to even acknowledge the needs of pregnant incarcerated 
     women.


every year, thousands of incarcerated expecting mothers and babies face 
            adverse outcomes from exposure to incarceration

       Over the 12 months of the Pregnancy in Prison Statistics 
     (PIPS) study period, there were nearly 1,400 admissions of 
     pregnant women to participating state and federal prisons 
     with over 800 pregnancies ending in custody (births, 
     miscarriages, and others), and over 1,600 admissions of 
     pregnant women to jails with 224 pregnancies ending in 
     custody. Unsurprisingly, given the short length of most jail 
     stays, more pregnant women are admitted to jails each year, 
     but more births take place in prisons, where the average stay 
     is longer. Based on their data, the authors estimate that, 
     nationally, 4 percent of women entering prison (in line with 
     Bureau of Justice Statistics 2016 estimates) and 3 percent of 
     women admitted to jail (lower than BJS' most recent 2002 
     estimates) are pregnant.
       Pregnancy outcomes in prisons and jails in some places were 
     worse than national trends across the general population. 
     When pregnancy did end in custody, in some states like 
     Arizona, Kansas and Minnesota, rates of miscarriage ranged 
     from 19 to 22 percent, exceeding estimates of the national 
     rate. In Ohio and Massachusetts, premature births exceeded 
     the general population rate of about 10 percent. Among live 
     births, which were 92 percent of birth outcomes in custody, 
     one-third (32 percent) of these were caesarean section 
     births, in line with the national average rate. In some 
     states, the C-section rate was much higher, suggesting that 
     C-sections may be taking place when not medically necessary, 
     risking short- and long-term health problems in babies.


  pregnancy among confined youth is not uncommon, and better testing 
                 might reveal it's even more widespread

       Upon hearing about the Pregnancy in Prison Statistics 
     (PIPS) Project, three juvenile justice systems (one state-
     level, and one county-level system) volunteered to complete a 
     survey about pregnant adolescents in the custody of 17 of 
     their ``juvenile residential placement'' facilities, 
     providing a window into this population for the first time. 
     One takeaway from the survey's findings was that adolescent 
     pregnancies--both in confinement, and upon release--may risk 
     poorer outcomes because of a lack of continuity of medical 
     care between confinement facilities and the community. Even 
     though all three state systems provided basic prenatal care, 
     with the typical length of stay for young women lasting a few 
     months or less, justice-involved youth would benefit 
     enormously from consistency in medical care throughout 
     pregnancy.
       The survey also showed that the rate of pregnancy among 
     confined youth (3.3 percent) was similar to that of the adult 
     incarcerated population (3.5 percent). However, the youth 
     facilities reported less routine pregnancy testing, 
     bolstering a 2004 study revealing that only 15-17 percent of 
     1,255 juvenile facilities nationwide tested youth for 
     pregnancy at admission (with about two-thirds of facilities 
     providing tests only if requested). Therefore, it's possible 
     the youth carceral pregnancy rate is a very conservative 
     estimate, and that thousands of pregnant youth are going 
     without prenatal care when their health needs are likely 
     complicated.
       Eight pregnancies ended among youth confined in the 
     surveyed facilities during the 12-month study period, 
     including four miscarriages, three induced abortions, and one 
     live full-term birth. It would be misleading to view these 
     outcomes as representative of all pregnant confined youth, 
     but the authors advise youth confinement facilities to be 
     prepared for high rates of miscarriage and other adverse 
     birth outcomes, seeing as justice-involved pregnant youth are 
     going through highly stressful life experiences.
       Services and policies regarding prenatal and postpartum 
     care were variable: All three juvenile systems allowed 
     abortion, and some covered the cost; all three systems also 
     allowed lactation through either breastfeeding or pumping. 
     Still, the small sample size (which represented just 2.8 
     percent of all confined female youth) and the potential 
     influence of self-selecting facilities make it difficult to 
     draw conclusions about the experience of pregnant youth in 
     confinement.


   breastfeeding and lactation are not guaranteed to new mothers and 
         babies, ignoring the enormous benefits of breast milk

       When the cohort of 22 prison systems and 6 jail systems 
     described their lactation-related policies to the 
     researchers, they painted a discouraging picture of how 
     correctional facilities largely don't support breastfeeding, 
     a practice chosen by some mothers for its unique benefits.
       To begin, only one-third of prisons and jails had any 
     written policy on lactation, leaving many incarcerated women 
     to the whims of facility staff who may not be

[[Page H8692]]

     trained in this area or understand its importance. Even where 
     women were formally allowed to lactate, milk was sometimes 
     discarded at the study sites due to mother-infant separation, 
     providing only a benefit to the mother of maintaining milk 
     supply.
       Because it is a matter of health equity to provide the 
     opportunity to lactate and breastfeed (among other parental 
     choices), researchers extend the ``further research is 
     needed'' statement in order to understand the probable racial 
     disparities within carceral pregnancy: ``. . . research in 
     collaboration with current and formerly incarcerated women, 
     specifically Black, Indigenous, and women of color, is needed 
     to fully understand breadth of experiences and perspectives 
     related to breastfeeding and lactation while in custody.''


  opioid use disorder among incarcerated women is treated under some 
       circumstances, but leaves mothers without help postpartum

       In addition to known medical needs during pregnancy, some 
     women enter incarceration with other health problems. 
     Researchers accessed six months of activity and policy 
     related to opioid use disorder (OUD) treatment of pregnant 
     women in the Pregnancy in Prison Statistics (PIPS) study 
     sites and found that 26 percent of those entering prison and 
     14 percent entering jail had OUD. The gold standard of care 
     for these women would be medication for opioid use disorder 
     (MOUD), which is linked to better pregnancy outcomes and 
     increased engagement with addiction treatment and other 
     medical care.
       Twenty-two of 28 sites did offer this avenue for treatment 
     of pregnant women in some way, but the narrow window in which 
     they could be treated for OUD leaves much room for 
     improvement. In most facilities offering MOUD, it would not 
     be initiated in the facility; they would only continue 
     someone on MOUD if they were already on it. This unfairly 
     excludes women who were unable to begin treatment before 
     admission; for example, if someone was in jail before being 
     transferred to prison, their access would then depend on the 
     jail's policy. Postpartum, most facilities providing MOUD 
     would discontinue treatment, showing a clear disregard for 
     the mother's well-being after birth.
       Still, one-third of surveyed sites managed OUD among 
     pregnant women through detoxification, some with and some 
     without medication to manage symptoms. Detox, or ``medically 
     supervised withdrawal,'' can be a painful process and has a 
     high rate of failure for pregnant women, increasing the risk 
     of future overdose.
       These exclusionary policies and practices are troubling 
     given the fact that opioid overdose is a major cause of death 
     for pregnant and postpartum women in the United States, and 
     remains a huge concern for formerly incarcerated people. In 
     Rhode Island, where MOUD has been implemented comprehensively 
     in their unified prison-jail system, there has been a huge 
     reduction in post-release overdose deaths; replicating their 
     initiative would have a great impact on carceral pregnancy 
     and postpartum outcomes.


  the incarceration of fathers is also linked to worse birth outcomes

       As if it's not bad enough that incarceration prevents 
     expecting mothers from receiving care and providing care to 
     their babies, another recent study finds that incarcerating 
     fathers during pregnancy or at the time of birth is also 
     harmful to babies' health.
       In another recent study--unrelated to the Pregnancy in 
     Prison Statistics (PIPS) project--Youngmin Yi and fellow 
     researchers matched hundreds of thousands of birth records to 
     jail records in New York City between 2010 and 2016, 
     observing trends in birth weight, preterm (premature) birth, 
     admission to the NICU (neonatal intensive care unit), and 
     more. Paternal incarceration was associated with nearly all 
     adverse outcomes, even after other characteristics of mother 
     and father were accounted for statistically. ``Exposed'' to 
     their fathers' incarceration--even for as little as one day--
     babies were born with these vulnerabilities, such as low 
     birth weight, known to have an impact later in life.


incarcerated pregnant people and their babies deserve better care that 
                         is codified in policy

       The findings by Sufrin, Asiodu, Kim and fellow researchers 
     offer a desperately-needed look into pregnancy during 
     incarceration. And the findings by Yi et al. contribute to an 
     even more holistic picture of what it means to be a growing 
     family entangled in the criminal legal system. Families 
     experiencing pregnancy are impacted by incarceration whether 
     the mother or the father is incarcerated, and whether or not 
     the baby is born during the mother's incarceration.
       Both adolescents and adults in confinement should be 
     afforded comprehensive prenatal care, including education, 
     lactation support, and opioid use disorder treatment that 
     continues beyond the end of pregnancy. And babies born right 
     after or during their parents' incarceration, who risk health 
     issues like lower life expectancy and social and emotional 
     challenges, deserve the chance to begin life with one or both 
     parents as much as possible. These efforts and programs 
     should be clearly written into agency policy so that facility 
     staff can be trained and expected to provide care.
       One way that prisons and jails can begin to assess and 
     improve their care for pregnant women is by reviewing the 
     American College of Obstetricians and Gynecologists' recently 
     updated comprehensive set of guidelines for carceral 
     reproductive health care. Facilities should also consider 
     subscribing to the National Commission on Correctional Health 
     Care's standards for health services, which have clear ways 
     of addressing many of the above topics. Prisons and jails 
     should make their policies publicly available, and create 
     ways to keep healthy mothers and their babies together.


                      note about the language used

       Throughout these publications, the terms ``pregnant women'' 
     and ``mother'' described those people who were pregnant in 
     custody during the study period. While we've deferred to the 
     terminology used by the authors, we acknowledge that 
     pregnancy can overlap with multiple gender identities, and 
     our conclusions and recommendations apply to all pregnant 
     people.

  Mr. FITZGERALD. Mr. Speaker, I reserve the balance of my time.
  Mr. NADLER. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Rhode Island (Mr. Cicilline), a member of the committee.
  Mr. CICILLINE. Mr. Speaker, I rise in strong support of H.R. 6878, 
Pregnant Women in Custody Act of 2022.
  While Congress made important progress on this issue through the 
First Step Act, which prohibited the use of restraints on pregnant 
women in the Bureau of Prison's custody, more clearly needs to be done 
to protect pregnant women.
  Many incarcerated women do not have access to the prenatal care they 
need. They are often unjustly placed in restrictive housing, which can 
lead to unfair and unequal treatment just because a woman is pregnant. 
Shockingly, this is still legal and widely used in Bureau of Prison 
facilities.
  By passing H.R. 6878, we will establish a much-needed and long-
overdue national standard of care to address pregnancy-related needs of 
incarcerated women while also ending the Bureau of Prison's restrictive 
housing policies for pregnant women.
  Being incarcerated should not strip these expectant mothers of their 
dignity.
  Mr. Speaker, I strongly support passage of this legislation and thank 
Congresswoman--and future mayor--Karen Bass for her leadership on this 
issue.
  Mr. FITZGERALD. Mr. Speaker, I reserve the balance of my time.
  Mr. NADLER. Mr. Speaker, I yield 2 minutes to the distinguished 
gentlewoman from Florida (Ms. Lois Frankel).
  Ms. LOIS FRANKEL of Florida. Mr. Speaker, I thank our distinguished 
Judiciary Committee chairman and Representative Karen Bass for their 
leadership on this bill.
  Mr. Speaker, all of our children should have the opportunity to 
thrive. Getting them off to a good start in life is critical for their 
well-being, as well as for society as a whole. That is why prenatal 
care and safety for pregnant women are so important. It lowers the risk 
of complications that can affect the ability of a child to thrive and 
can have far-reaching impacts on their future.
  Alarmingly, recent reports indicate that Federal prisons are not 
aligned with national guidance for the treatment of pregnant women, and 
in extreme cases, Mr. Speaker, women have been shackled to their beds 
during and after childbirth.
  I think we can all agree that children should not be punished for 
their mother's mistakes or misdeeds. The Pregnant Women in Custody Act 
will strengthen and promote the health and safety of pregnant inmates, 
providing a national standard of care allowing children to have the 
opportunities they deserve.
  Mr. Speaker, I urge passage of the bill.
  Mr. FITZGERALD. Mr. Speaker, I urge my colleagues to support this 
bill, and I yield back the balance of my time.
  Mr. NADLER. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, H.R. 6878 is bipartisan legislation that would support 
the health and safety of women in Federal custody by establishing a 
national standard of care and prohibiting the use of restrictive 
housing for incarcerated pregnant women.
  Mr. Speaker, I urge all of my colleagues to support this important 
legislation. I also want to take this opportunity to express my dual 
feelings--on the one hand, the sponsor of this legislation, Ms. Bass of 
California, will no

[[Page H8693]]

longer be with us in the next Congress, which is, on that level, 
unfortunate. On the other hand, the reason she won't be with us is 
because she is the mayor-elect of Los Angeles, and that is not 
unfortunate. I am very happy about that, but I have mixed feelings 
because we won't be seeing her here again.
  Mr. Speaker, I urge all of my colleagues to support this important 
legislation, and I yield back the balance of my time.
  Ms. LEE of California. Mr. Speaker, I rise today in support of H.R. 
6878, the Protecting the Health and Wellness of Babies and Pregnant 
Women in Custody Act of 2022. I am proud to support this bill and thank 
my good friend and colleague Congresswoman Bass for her leadership. I 
also thank the Speaker and Chairman Nadler for bringing this bill to 
the floor.
  Our prison system was not designed with the medical needs of women 
and pregnant people in mind. This holds especially true for women and 
pregnant people of color, who are often subjected to harsher treatment 
at more frequent rates.
  This bill moves us in the right direction by establishing safeguards 
for incarcerated pregnant and postpartum individuals and their children 
by guaranteeing access to essential prenatal and post-delivery support.
  As a champion of reproductive and women's rights, I hope to continue 
joining my colleagues on a bipartisan basis to ensure incarcerated 
women and pregnant people have the right to access the quality health 
services they deserve.
  I urge my colleagues to vote `yes' on this bill.

  The SPEAKER pro tempore. All time for debate has expired.


         amendment no. 1 offered by ms. lois frankel of florida

  The SPEAKER pro tempore. It is now in order to consider amendment No. 
1 printed in part D of House Report 117-587.
  Ms. LOIS FRANKEL of Florida. Mr. Speaker, I rise as the designee for 
the gentlewoman of Massachusetts (Ms. Pressley), who is a great 
advocate for justice and women. I have an amendment at the desk.
  The SPEAKER pro tempore. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 13, line 7, strike ``and''.
       Page 13, line 10, strike the period and insert ``; and''.
       Page 13, after line 10, insert the following:
       (iii) postpartum health conditions.

  The SPEAKER pro tempore. Pursuant to House Resolution 1499, the 
gentlewoman from Florida (Ms. Lois Frankel) and a Member opposed each 
will control 5 minutes.
  The Chair recognizes the gentlewoman from Florida.
  Ms. LOIS FRANKEL of Florida. Mr. Speaker, this amendment makes one 
addition to the bill to ensure that incarcerated women have access to 
essential postpartum healthcare and support.
  The Pregnant Women in Custody Act includes a provision related to 
women who give birth while in custody or immediately prior to 
incarceration. This provision requires that women be given access to 
counseling services related to parental rights and family preservation.
  The amendment will add an additional component to ensure women also 
receive counseling services related to postpartum care because we know 
that women are physically and emotionally vulnerable after giving 
birth.
  This addition to the bill will help women navigate that often complex 
and difficult time period and ensure adequate access to healthcare.
  Mr. Speaker, I urge my colleagues to support this amendment, and I 
reserve the balance of my time.
  Mr. FITZGERALD. Mr. Speaker, I claim the time in opposition to the 
amendment, although I am not opposed.
  The SPEAKER pro tempore. Without objection, the gentleman from 
Wisconsin is recognized for 5 minutes.
  There was no objection.
  Mr. FITZGERALD. Mr. Speaker, this amendment allows certain women in 
Federal custody to receive counseling related to postpartum health 
conditions. Postpartum women in Federal custody will be eligible to 
receive counseling services related to postpartum health conditions.
  After giving birth, many women struggle with postpartum depression 
and other psychological and physical conditions. This amendment will 
ensure that women in Federal custody have access to these services.
  While many of us have concerns with some of the other language in the 
bill, this amendment is a commonsense amendment.
  Mr. Speaker, I urge support for the amendment, and I yield back the 
balance of my time.

                              {time}  1330

  Ms. LOIS FRANKEL of Florida. Mr. Speaker, I yield myself the balance 
of my time.
  Mr. Speaker, it really pleases me that we have this very good 
bipartisan legislation; and I know it is probably heartening to the 
citizens of our country that we can come together on important matters.
  This is about the children. This is about getting children off to a 
good start so that they can thrive; so they can have opportunities for 
success; and there is nothing more important, really, than having good 
caregivers, their parents, especially their mom, who gives birth.
  This amendment will make sure that women who have been incarcerated 
get the postpartum care that they need and that their children deserve.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. Pursuant to the rule, the previous question 
is ordered on the the bill and on the amendment offered by the 
gentlewoman from Florida (Ms. Lois Frankel).
  The question is on the amendment offered by the gentlewoman from 
Florida (Ms. Lois Frankel).
  The amendment was agreed to.
  The SPEAKER pro tempore. The question is on the engrossment and third 
reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.
  The SPEAKER pro tempore. The question is on passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. FITZGERALD. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

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