4023.8.
(a) An inmate of a county jail who is identified as possibly pregnant during an intake health examination shall be scheduled for laboratory work to verify pregnancy within three business days of arrival at the jail.(b) An inmate of a county jail who is confirmed to be pregnant shall be scheduled for an obstetrics examination with an obstetrician physician, obstetrical nurse practitioner, or certified nurse midwife within seven days of arriving at the jail. The examination shall include all of the following:
(1) A determination of the term of pregnancy.
(2) A plan of care.
(3) The ordering of diagnostic studies, if needed.
(c) Pregnant inmates shall be scheduled for prenatal care visits as follows, unless otherwise indicated by the obstetrician physician, obstetrical nurse practitioner, or certified nurse midwife:
(1) Every four weeks in the first trimester up to 24 to 28 weeks, inclusive gestation.
(2) Every two weeks thereafter up to 36 weeks gestation.
(3) Every one week thereafter until delivery.
(d) Pregnant inmates shall be provided access to all of the following:
(1) Prenatal vitamins, to be taken on a daily basis, with 600-800
micrograms of folic acid per day or four milligrams per day for persons with a family history of neural tube defect.
(2) Childbirth education and parenting options.
(3) Newborn care that includes access to appropriate assessment, diagnosis, care, and treatment for infectious diseases that may be transmitted from a birthing person to the birthing person’s infant, such as HIV or syphilis.
(4) Lactation education and support by a certified lactation educator, consultant, or specialist.
(5) Access to doula support during pregnancy, labor, birth, and for 12 weeks postpartum.
(e) Pregnant inmates housed in a multi-tier housing unit shall be assigned lower bunk and lower tier housing.
(f) Pregnant inmates who have used heroin within three days prior to incarceration, either by admission or written documentation by a probation officer, or who are currently receiving methadone treatment, shall be enrolled in a methadone maintenance program.
(g) (1) An eligible pregnant inmate or inmate who gives birth after incarceration in the jail shall be provided notice of, access to, and written application for, community-based programs serving pregnant, birthing, or lactating inmates. At a minimum, the notice shall contain guidelines for qualification, the timeframe for application, and the process for appealing a denial of admittance to those programs.
(2) If a community-based program is denied access to the jail, the reason for the denial shall be provided in writing to the inmate within
15 working days of receipt of the request. The written denial shall address the safety or security concerns for the inmate, infant, public, or staff.
(h) Each pregnant inmate shall be referred to a medical social worker who shall do all of the following:
(1) Discuss with the inmate the options available for placement and care of the child after delivery.
(2) Assist the pregnant inmate with access to a phone in order to contact relatives regarding newborn placement.
(3) Oversee the placement of the newborn child.
(i) A pregnant inmate may be temporarily taken to a hospital outside the jail for the purpose of giving childbirth and shall be transported in the least restrictive way possible. A
pregnant inmate in labor shall be treated as an emergency and shall be transported via ambulance to the outside facility, accompanied by jail staff.
(j) A pregnant inmate may elect to have a support person present during childbirth. The support person may be an approved visitor or the jail’s staff designated to assist with prenatal, labor, and postpartum care. The approval for the support person shall be made by the administrator of the jail or that person’s designee. If a pregnant inmate’s request for an elected support person is denied, reason for the denial shall be provided in writing to the inmate within 15 working days of receipt of the request. The written denial shall address the safety or security concerns for the inmate, infant, public, or staff. Upon receipt of a written denial, the pregnant inmate may choose the approved institution staff to act as the support person.
(k) All pregnant and postpartum inmates shall receive appropriate, timely, culturally responsive, and medically accurate and comprehensive care, evaluation, and treatment of existing or newly diagnosed chronic conditions including infectious diseases.
(l) All pregnant inmate patients who are hospitalized for prolonged periods of time or are experiencing regular, painful, and frequent labor contractions shall not to be shackled by the wrists, ankles, or both.
(m) Upon return to the jail, an obstetrician physician, obstetrical nurse practitioner, or certified nurse midwife shall provide a postpartum examination at one week, two weeks, six weeks, and 12 weeks postpartum and shall determine whether the inmate may be cleared for full duty or if medical restrictions are warranted.