Allegheny County Sheriff Pete DeFazio said earlier this week he had never heard of the practice of his deputies shackling inmates in labor, and called the very idea of it "crazy."
But the procedural manual in the sheriff's office stipulates that any prisoner admitted to the hospital or medical facility must be shackled by leg restraints.
"There are NO EXCEPTIONS to this rule," the manual says.
Faced with grumbling by some deputies who said he was distancing himself from the official policy, Sheriff DeFazio yesterday lashed out at those who had restrained women by the wrist to their beds during labor at Magee-Womens Hospital.
The hospital said Tuesday that of the 15 to 20 inmates who were admitted for labor every year about half were shackled by one wrist.
"You have to use your brain," Sheriff DeFazio said. "If you don't have a brain, you shouldn't have the job to begin with.
You have to use common sense. These people want to be spoon fed. Even a lay person would know why you wouldn't shackle someone in labor.
Where is she going to go? If someone is going to escape, she is going to do more injury to the fetus and herself than anyone else. It's crazy.
"They are trying to say, 'That is the rule. We have to do it.' But that is stupid. ... They just want to shackle them so they don't have to worry about it, so they can sneak out and have a cigarette."
The manual, which has been in use for a number of years, says: "Any prisoner admitted to a hospital or medical facility as a patient shall be, at minimum, shackled to the bed with leg irons AT ALL TIMES. If the prisoner is unable to be shackled with leg irons due to a medical condition, the deputy will handcuff the prisoner to the bed.
If the prisoner is unable to be shackled with leg iron or handcuffs due to broken arms and legs, then the prisoner shall be secured with a waist belt or waist chain locked firmly to the hospital bed.
"There are NO EXCEPTIONS to this rule."
Before they go on active duty, uniformed staffers with the sheriff's office must sign a waiver that they have received a copy of what they refer to as "black book," and although they are not required to carry it around with them, many deputies keep a copy on hand for reference.
Sheriff DeFazio said yesterday he had halted the shackling practice, but he would not punish anyone who had shackled women during childbirth. He said the male deputies, not the female ones, were more likely to have restrained women during labor.
He said he had no idea that women were being shackled until he was asked about it by the Pittsburgh Post-Gazette.
The practice has prompted an outcry from advocacy groups, including the American Civil Liberties Union, Amnesty International and Lydia's Place, a Pittsburgh nonprofit organization that helps female offenders.
"A woman dilated 10 centimeters can barely stand up, much less run down the hallway," said Vicki Sirockman, executive director of Lydia's Place.
She and others said the practice was overkill, and was degrading to the women. They also said it posed a health threat to both the mother and baby.
Trish Nelson, Magee's unit director for labor and delivery, said she knew of no instance where the baby's or mother's health was compromised. Ms. Nelson, a nurse, said she preferred no restraints. But she said that if the medical staff asked that the restraint be removed as the labor progressed, the deputy usually complied.
A woman escaping during labor is not as preposterous as it sounds, said a nurse who formerly supervised a prison ward in Indianapolis. Tamara Wardell, 54, of Stowe, said you have to ensure the safety of the staff.
"A lot of women have false labor, before they have full blown labor," said Ms. Wardell, who is studying for a doctorate in nursing at Duquesne University and was formerly head nurse at Wishard Memorial Hospital. "Until they are in hard labor they are mobile.
"I think one handcuff is an acceptable level of restraint to ensure the safety of the staff. It is not as if we put them [prisoners] in this situation."
County Chief Executive Dan Onorato said that this was the first he had heard of the shackling of pregnant women.
He said he believes women should be able to give birth without restraints, but that there needs to be appropriate security.
"He is very glad the sheriff is going to look into the issue," said his spokesman, Kevin Evanto.