PREGNANT INMATES D-150 FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: PREGNANT INMATES NO: D-150
FILE: PREGNANT INMATES
EFFECTIVE DATE: 12-16-19 REVISED: 12-16-20
AUTHORITY: Sheriff M. Mims APPROVED BY: Assistant Sheriff T. Gattie
REFERENCE: Penal Code Sections 3407, 3440, 4002.5, 4023.5, 4023.6, 4023.8, 4028,
and 6030; Health and Safety Code Sections 125107, 120685, 120690,
125085, and 125090; and California Code of Regulations, Title 15, Sections
10297 1058.57 12067 1241, and 1248.
PURPOSE:
The purpose of this policy is to ensure medical care and custody concerns are met
regarding pregnant inmates.
POLICY:
It is the policy of the Fresno County Sheriffs Office Jail Division to ensure the safety of
female inmates and the unborn child during pregnancy.
PROCEDURES:
I. INTAKE
A. At intake, all females are queried during the initial screening process
regarding pregnancy. Inmates may choose to have a pregnancy
assessment and urine pregnancy test performed within 24-hours of
booking. The pregnant inmate's medical care is initiated at the time of
intake upon self-report or physical appearance, confirmed by physical
examination and laboratory test results.
B. The RadPRO SECURPASS body scanner shall not be used to scan a
female who is known or alleged to be pregnant. Any statement made by
a female identifying herself as pregnant is sufficient to exempt the
individual from a body scan at the time of booking, unless otherwise
refuted by Medical staff.
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FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: PREGNANT INMATES NO: D-150
FILE: PREGNANT INMATES
II. PREGNANT INMATES — SPECIAL ACCOMMODATIONS & EXTRA ISSUE
A. Pregnant inmates will have a "Pregnant"ALERT created by Medical staff.
B. All pregnant females shall be issued maternity smocks.
C. Pregnant inmates are to be issued two (2) mattresses.
D. Pregnant inmates housed in a multi-tier housing unit are to be assigned
to lower tier housing. ALERTs are to be made for "Low Bunk Needed"
and "Low Tier Needed" by Medical staff.
E. Pregnant and lactating inmates are to receive an 8-ounce container of
milk with each meal, as well as a protein snack and an additional serving
of milk.
F. To facilitate breast milk feeding, lactating inmates are permitted to retain
the following supplies in their housing unit (absent misuse).
1. A manual breast pump and a storage container for the breast pump
(e.g., the packaging box, or issued storage bag).
2. A supply of pre-labeled plastic storage bags to store the breast milk.
3. A small supply of dish soap and paper towels for cleaning the breast
pump.
4. An extra sheet (to use as a temporary privacy screen when pumping).
[Refer also to policy E-490/Inmate Lactation Program (FILE:
LACTATION)]
III. EDUCATION
A. Upon confirmation of an inmate's pregnancy, the inmate must be advised
orally or in writing of the standards and policies governing pregnant
inmates. The Pregnancy Services pamphlet explains the standards and
policies governing pregnant inmates. The pamphlets are issued by
Medical staff, but are also available on the female housing floors.
B. Medical staff will provide pregnant inmates with educational information
and counseling to include exercise, nutrition, personal hygiene, safety
precautions, and other appropriate health education materials, as well as
information pertaining to childbirth education and infant care.
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FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: PREGNANT INMATES NO: D-150
FILE: PREGNANT INMATES
C. Inmates are provided with a copy of "What to Expect When You're
Expecting." The book helps to explain everything about pregnancy,
childbirth, postpartum, managing complications and breastfeeding.
Inmates are encouraged to read the book and ask questions during their
health appointments.
D. Parenting classes and a variety of pregnancy-related pamphlets are
available to all inmates through the Offender Programs Unit.
IV. MEDICAL CARE
A. Medical Services will provide timely and appropriate prenatal, pregnancy
and postpartum information and health care, and specialized obstetrical
services (when indicated). [Refer to Medical Service's policies and
procedures.]
B. Counseling and assistance are provided in accordance with the pregnant
inmate's expressed desires regarding her pregnancy, whether she elects
to keep the child, terminate the pregnancy, or use adoption services.
C. Sterilization for the purpose of birth control, including, but not limited to,
during labor and delivery is prohibited by law.
V. SECURITY AND RESTRAINTS
A. Staff shall supervise pregnant inmates in the same manner as other
female inmates, with the exception of application of restraints and
physical restraint of pregnant inmates with force. Restraint equipment
(handcuffs) and physical restraint shall only be utilized when a pregnant
inmate poses a threat to the physical safety of herself or others (including
the unborn child), threat of substantial damage to county property, or
attempted escape. Shackles and waist/belly chains shall not be
applied. In every instance, special effort shall be made to avoid harm
to the unborn child. If handcuffs are applied, the inmate's arms are to be
brought to the front of her body for application.
B. When transporting a pregnant inmate off grounds for medical care and
treatment, the application of restraints shall be restricted to handcuffs to
the front of the inmate only.
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FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: PREGNANT INMATES NO: D-150
FILE: PREGNANT INMATES
C. A pregnant inmate in labor, during delivery, or in recovery after delivery,
shall not be restrained by the wrists, ankles, or both, unless deemed
necessary for the safety and security of the inmate, the staff, or the public.
(Recovery is the length of time the inmate stays in the hospital after giving
birth.)
D. Restraints shall be removed when a professional who is currently
responsible for the medical care of a pregnant inmate during a medical
emergency, labor, delivery, or recovery after delivery determines that the
removal of restraints is medically necessary.
VI. NUTRITION
A. Pregnant inmates shall be provided a balanced, nutritious diet and
necessary vitamins approved by a doctor.
B. Pregnant and lactating inmates are required to receive four 8-ounce
servings of milk or milk products and a protein snack each day.
VI I. SUPPORT PERSON
A. Pregnant inmates may request to have one support person present
during labor and childbirth. Inmates are encouraged to submit the name
of at least one alternative support person (should the primary support
person be denied, or is unable to be contacted at the time of labor).
Pregnant inmates may submit up to three names for approval by
completing a Childbirth Support Person form (Addendum A).
B. The approval for the support person will be made on a case-by-case
review by the Compliance Lieutenant (or on-duty Watch Commander in
cases of emergency). The lieutenant is responsible to ensure-
1. The form is scanned into the inmate's records in Laserfiche (under
Pregnant/Lactation).
2. The name and contact information for the primary and any alternative
support person Is logged In Offendertrak. [PERSON—.REQUEST (REQUEST
TYPE=Writing;SUBMITTER=(Name of lieutenant who approved); STATUS=Approved; REQUEST
DETAILS=name and contact information of support person in order of preference.]
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FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: PREGNANT INMATES NO: D-150
FILE: PREGNANT INMATES
3. A copy of the form is returned to the inmate, notifying them of the
results. If a support person is denied, the reason for denial must be
provided in writing within fifteen (15) working days of receipt of the
request. Reason for denial must address the safety/security
concerns for the inmate, infant, public and/or staff.
C. If an inmate does not have a support person available, or their support
person is denied, the inmate may elect to have an approved "doula"
accompany them and assist during labor and childbirth. A doula is a birth
companion who can provide emotional, physical, and informational
support during labor and childbirth. The doula may be a professionally
trained volunteer from within the community, or a designated female Jail
staff member.
D. The on-duty Watch Commander shall ensure that the support person has
been notified at the time the inmate is transported to the hospital.
Vill. CHILDBIRTH
A. Pregnant inmates will be transported to Community Regional Medical
Center (CRMC) for labor and delivery whenever possible. A pregnant
inmate away from the facility who requires transport due to imminent
delivery or other emergent condition will be taken to the nearest
emergency department with obstetrical services.
B. After giving birth, the appointed guardian of the infant and/or family
members may be permitted to visit the inmate in the hospital with the
approval of the on-duty Watch Commander.
C. Upon return to the Jail, any inmate who delivers a child via caesarean
section (C-section)will be admitted to the Outpatient Hospital Unit(OHU).
Any inmate who delivers a child vaginally will be assessed to determine
the appropriate housing and to initiate postpartum care.
IX. BREAST MILK FEEDING
A. Pregnant inmates shall be informed of the benefits of breastfeeding by
Medical staff. In addition to the benefits, inmates will be educated about
breastfeeding with active tuberculosis; Hepatitis B, Hepatitis C, HIV,
syphilis, and other infections which can transmit from mother to child;
illicit drug use; alcohol, tobacco and marijuana use; and while on certain
prescribed medications.
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FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: PREGNANT INMATES NO: D-150
FILE: PREGNANT INMATES
B. After giving birth, inmates will be issued a manual breast pump by the
hospital. Inmates may be permitted to retain possession of the breast
pump during the duration of need. "Need" considerations include
maintaining the milk supply, relieving discomfort, and preventing
infection.
C. Medical staff will be responsible to modify the inmate's "Pregnant"
ALERT, noting the issuance of the breast pump in the Remark section.
Upon cessation of lactation, the breast pump is to be retrieved and the
ALERT is to be inactivated.
[Refer to policy E-490/Inmate Lactation Program (FILE: LACTATION)for
breast milk expression, storage, and transfer procedures.]
X. REQUIRED POSTINGS AND NOTIFICATIONS
California law requires that inmates be advised of their rights involving
pregnancy, abortion, breastfeeding, and sterilization. The required
information and supporting laws are contained in the Pregnancy Services
pamphlet. [Refer to Addendum B.]
Penal Code Section 3407 addresses the use of restraints on pregnant
inmates and requires that upon confirmation of an inmate's pregnancy that
she be advised, orally or in writing, of the standards and policies governing
pregnant inmates, including the relevant regulations and the correctional
facility policies.
Penal Code Section 3440 prohibits sterilization for the purpose of birth
control and requires that notification be provided to all inmates. The required
information is also included in the Inmate Orientation Handbook.
Penal Code Section 4002.5 requires an infant and toddler breast milk
feeding policy and requires that the policy be posted in all locations where
medical care is provided and the provisions of the policy are communicated
to all staff persons who interact or oversee pregnant or lactating inmates.
[Refer to policy E-490/Inmate Lactation Program (FILE: LACTATION).]
Penal Code Section 4023.5 requires that every female be furnished with
information and education regarding the availability of family planning
services, and upon request, she shall be furnished with services necessary
to meet her family planning needs at the time of her release. This advisement
is included in the Inmate Orientation Handbook, and the information
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FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: PREGNANT INMATES NO: D-150
FILE: PREGNANT INMATES
concerning available community care services is provided on the Medical
Discharge Summary supplied to all inmates at the time of release.
Penal Code Section 4023.6 advises that female inmates have the right to
summon and receive the services of any physician and surgeon, which must
be posted in at least one conspicuous place to which all female prisoners
have access. The information is posted in the gymnasiums and included in
the Inmate Orientation Handbook. [Refer to Addendum C.]
Penal Code Section 4023.8 addresses all aspects of pregnancy care within
jail facilities. Must be posted in at least one conspicuous place to which all
incarcerated persons have access. The information is posted in the
gymnasiums. [Refer to Addendum D.]
Penal Code Section 4028 requires that the right to abortion be posted in at
least one conspicuous place to which all female prisoners have access. The
information is posted in the gymnasiums and included in the Inmate
Orientation Handbook. [Refer to Addendum E.]
Penal Code Section 6030 requires that pregnant inmates be advised, orally
or in writing, and provided all of the following:
• A balanced, nutritious diet approved by a doctor.
• Prenatal and postpartum information and health care, including, but not
limited to, access to necessary vitamins as recommended by a doctor.
• Information pertaining to childbirth education and infant care.
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