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Page’s executive order changes treatment of pregnant inmates in St. Louis County, earning bipartisan praise


St. Louis County Executive Sam Page signed an executive order Thursday morning adding a variety of protections for pregnant inmates — from changing shackling rules to allowing for appropriate space and materials for women who need to pump. 

The executive order ensures pregnant inmates in the care of the St. Louis County Department of Justice Services (DJS) receive nondirective counseling and educational materials; regular prenatal and postpartum care (including vitamins and an appropriate diet); clothing and other sanitary materials necessary; doula services if requested; and access to a mental health professional if diagnosed with postpartum depression. 

Additionally, inmates diagnosed with postpartum depression should not be subjected to isolation unless deemed a serious risk to herself or others, the order stated. Such a move would need to be explained in writing to the director of Justice Services. 

As for shackling, the order only allows inmates to be handcuffed in front of the body when transported to and from medical providers throughout the pregnancy and post-delivery recuperation. When in labor and delivery, inmates cannot be placed in restraints. 

Restraints for inmates in post-delivery recuperation are also prohibited unless under extraordinary circumstances — such as if the inmate poses an immediate and serious threat to herself or others. If such a circumstance arises, the inmate must be placed in the least restrictive restraints, the order stated.  

Exceptions can be made for safety concerns for the inmate or others and must be documented. The order does not prohibit physicians from requesting hospital restraints for safety reasons. 

The order also stated that corrections staff present during delivery should be “positioned in a location in the room that will ensure, to the extent possible without jeopardizing safety, patient privacy and dignity.” 

“The policies and treatment of those in our custody should reflect our fundamental respect for the dignity and human rights of each person,” Page, who became the county executive in April, said. “Yes, these folks are in our custody, but they are also in our care.” 

He noted DJS already had some policies regarding pregnant inmates, but the executive order “ensure[s] that our policies and procedures are strictly enforced and appropriate improvements are made.” 

The move garnered wide bipartisan applause from Missouri lawmakers. 

“It’s county government recognizing that when people are in our care, for whatever reason, that we have a responsibility to treat them humanely and ethically and provide proper medical care,” Democratic state Rep. Tracy McCreery told The Missouri Times. “This is broader than just an anti-shackling executive order. … It’s much broader than what I initially anticipated, and I’m so pleasantly surprised.” 

McCreery specifically praised the order requiring a private space and appropriate materials, such as refrigeration and a sink, for inmates who need to pump and store breast milk. It also mandates the milk be stored and delivered to whoever is caring for the inmate’s child in a timely fashion up until the age of one. 

She said St. Louis County is “very fortunate” Page, an anaesthesiologist, a is a medical professional because he “understands the science behind making sure babies and infants are taken care of properly.” 

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Liza Grote Weiss, executive director of the nonprofit Missouri Appleseed, commended Page for “making incarcerated women’s health an immediate priority.”  

“The executive order will improve the health of pregnant women and babies while not placing correctional staff at an increased risk. St. Louis City and Missouri Department of Corrections have already implemented similar policies,” she told The Missouri Times. “Missouri Appleseed hopes other Missouri counties will adopt similar policies as well.” 

McCreery said moves like this executive order could be a catalyst for lawmakers at the state level to implement protections for pregnant inmates across Missouri. 

“What things like this can do is help achieve a tipping point in Jefferson City where colleagues are energized and excited by this opportunity, and also where people see the writing on the wall. This is something that community volunteers and activists are not going to give up on,” she said. 

“In 2018, the Parson administration under the leadership of former Rep. Jean Evans took steps to ensure pregnant women in custody of the Department of Corrections are treated with dignity. I’d like to congratulate Saint Louis County for ensuring women in their custody have those same protections, and I encourage the legislature to extend these same protections to women in county justice systems across the state,” GOP state Rep. Mary Elizabeth Coleman said in a statement to The Missouri Times.

Shackling pregnant inmates who are in the third trimester and in the immediate aftermath of delivery is already banned in state prisons — thanks to legislation championed by Missouri Republican Party Executive Director Jean Evans when she served in the House — but lawmakers have hoped to expand that ban to local prisons. 

Prohibition of restraints used on inmates during pregnancy and postpartum recovery was included in the federal First Step Act, the large criminal justice reform bill President Donald Trump signed into law in 2018.

(Featured image provided to The Missouri Times by former Rep. Cora Faith Walker.)