Humane treatment of pregnant detained noncitizens while in detention and custody

(a) Prohibition on restraint of pregnant detained noncitizens (1) Prohibition Except as provided in paragraph (2), restraints may not be used on a noncitizen who is in the physical custody of the Department of Homeland Security, including during transport, if the noncitizen is known to be— (A) pregnant, including during labor and delivery; (B) lactating; or (C) postpartum. (2) Exceptions (A) In general Notwithstanding paragraph (1), and subject to subparagraph (B), use of a restraint on a detained noncitizen described in paragraph (1) may be permitted only in an extraordinary circumstance, except in the case of a medical contraindication, in which the facility administrator has ordered the use of the restraint after making an individualized determination that— (i) credible, reasonable grounds exist to believe the detained noncitizen poses an immediate and serious risk of physical harm to others; or (ii) reasonable grounds exist to believe the detained noncitizen presents an immediate and credible risk of escape that cannot be reasonably minimized through any other method. (B) Requirement for least restrictive restraints In the rare event of an extraordinary circumstance described in subparagraph (A), only the least restrictive restraint necessary shall be used, except that— (i) if a doctor, nurse, or other health professional treating a detained noncitizen requests that a restraint not be used, the detention officer accompanying the detained noncitizen shall immediately remove any restraint; and (ii) under no circumstance shall— (I) a leg, waist, or 4-point restraint be used; (II) a wrist restraint be used to bind the hands of such a detained noncitizen behind the back of the detained noncitizen or to another individual; (III) a detained noncitizen be restrained in a face-down position or on their back; or (IV) any restraint be used on any detained noncitizen who is in labor or delivering. (3) Record of extraordinary circumstances (A) Requirements If a restraint is used on a detained noncitizen pursuant to paragraph (2)(A), not later than 5 days after the date on which the restraint was used, the facility administrator shall— (i) record in writing the finding that describes the medical purpose or extraordinary circumstance that dictated the use of the restraint; and (ii) submit the finding to the Director. (B) Retention (i) Facility With respect to a written finding under subparagraph (A)(i), the facility administrator shall— (I) keep the finding on file at the applicable facility for not less than 5 years after the date on which the restraint was used; and (II) make a copy of the finding available for public inspection on request, only after making appropriate redactions so as to protect personally identifiable information. (ii) U.S. immigration and customs enforcement The Director shall maintain a written finding submitted to the Director pursuant to subparagraph (A)(ii) and make such finding available for public inspection only after making appropriate redactions to protect personally identifiable information. (b) Prohibition on presence of nonmedical staff (1) In general Except as provided in paragraph (2), nonmedical staff may not be present in a room in which a pelvic or breast exam, labor, delivery (whether vaginal or by cesarean delivery), or treatment of any other symptom relating to a pregnancy of a detained noncitizen is occurring unless their presence is specifically requested by medical personnel and only for a duration that is actually required to fulfill such request. (2) Exception If the presence of nonmedical staff is requested by medical personnel, the nonmedical staff shall— (A) be of the detained noncitizen’s gender of choice, if practicable; and (B) remain at a reasonable distance from the detained noncitizen and face toward the detained noncitizen’s head to protect the privacy of the detained noncitizen. (3) Use of restraints If a restraint is used on a detained noncitizen pursuant to subsection (a)(2)(A), an employee of the Department of Homeland Security shall remain immediately outside the room at all times so that the employee may promptly remove the restraint if requested by medical personnel pursuant to subsection (a)(2)(B)(i). (c) Access to services (1) U.S. immigration and customs enforcement custody A detained noncitizen in the custody of U.S. Immigration and Customs Enforcement shall have access to health care services, including comprehensive counseling and services relating to reproductive health care and pregnancy, including— (A) routine and specialized prenatal care, including adequate nutrition and exercise, HIV testing and treatment, and prenatal vitamins and vaccines; (B) labor and delivery; (C) treatment for complications from pregnancy; (D) substance use disorder treatment; (E) postpartum physical and mental health care, including postpartum reversible contraceptive methods; (F) no-cost supply of menstrual hygiene products; (G) lactation services; and (H) family planning, continuation of pre-detention contraceptive methods, and abortion services. (2) U.S. customs and border protection custody The Commissioner shall ensure that minimum standards of care are met for pregnant detained noncitizens who are in the custody of U.S. Customs and Border Protection. (d) Requirement for informed medical consent Services described in subsection (c)(1) may not be performed on a detained noncitizen until the provider of such services obtains informed consent from the noncitizen. Medical treatment may not be administered to a detained noncitizen against such noncitizen’s will. (e) Medical center arrangements Each facility administrator shall maintain— (1) an arrangement with the nearest maternity hospital and ensure facility staff know where to take pregnant detained noncitizens in case of emergency; and (2) a policy to ensure the provision of proper care if a detained noncitizen cannot be moved with immediacy to a medical center.