H.R. 6878 — what changed

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.

Services and programs provided— The services and programs described in this subsection are the following:

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 summary of all appropriate protocols directly pertaining to the safety and well-being of the woman are provided to the woman;

such protocols are complied with; and

such protocols include an assessment of undue safety risks and necessary changes to accommodate the woman where and when appropriate, as it relates to—

housing or transfer to a lower bunk for safety reasons;

appropriate bedding or clothing to respond to the woman’s changing physical requirements and the temperature in housing units;

regular access to water and bathrooms;

a diet that—

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

includes—

any appropriate dietary supplement, including prenatal vitamins;

timely and regular nutritious meals;

additional caloric content in meals provided;

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

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;

modified recreation and transportation, in accordance with standards within the obstetrical and gynecological care community, to prevent overexertion or prolonged periods of inactivity; and

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.

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—

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;

information about family preservation support services that are available to the woman;

information about the nutritional standards referred to in paragraph (2)(C)(iv);

information pertaining to the health and safety risks of pregnancy, childbirth, and parenting, including postpartum depression;

information on breast-feeding, lactation, and breast health;

appropriate educational materials, resources, and services related to pregnancy, childbirth, and parenting;

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

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).

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—

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-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.

Risk factors— Screening under subparagraph (A) shall include identification of any of the following risk factors:

An existing mental or physical health condition or substance use disorder.

Being underweight or overweight.

Multiple births or a previous still birth.

A history of preeclampsia.

A previous Caesarean section.

A previous miscarriage.

Being older than 35 or younger than 15.

Being diagnosed with the human immunodeficiency virus, hepatitis, diabetes, or hypertension.

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.

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.

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.