H.R. 4664 — Stop Shackling and Detaining Pregnant Women Act

This section defines terms used in the Act, including "appropriate committees of Congress" (i.e., specified Senate and House committees on Homeland Security and Governmental Affairs, Judiciary, and Appropriations); "Commissioner" (i.e., the Commissioner for U.S. Customs and Border Protection); "detained noncitizen" (i.e., any adult or juvenile detained by federal, state, or local law enforcement under the Immigration and Nationality Act); "detention officer"; "Director" (i.e., the Director for U.S. Immigration and Customs Enforcement); "facility"; "facility administrator"; "postpartum" (i.e., the one-year period, or longer as determined by a licensed health care provider, following delivery); "restraint" (i.e., physical or mechanical devices such as flex cuffs, handcuffs, leg irons, and shackles, excluding medical restraints); and "Secretary" (i.e., the Secretary of Homeland Security).

This section limits detention of pregnant, lactating, or postpartum noncitizens under the Immigration and Nationality Act by (1) requiring the Secretary of Homeland Security to provide pregnancy testing during initial medical screening for all individuals processed into custody; (2) prohibiting detention, arrest, or custody pending removal decisions (with immediate release required for detained individuals found pregnant), except in extraordinary circumstances involving an immediate serious risk of physical harm that alternatives to detention cannot mitigate or for removal execution (up to 5 days or the shortest period needed); and (3) mandating weekly individualized detention reviews (completed within 72 hours) and release within 24 hours if criteria are no longer met, including preparation of medical records, medications, supplies, and communication with the individual's attorney, sponsor, or post-release service provider.

This section prohibits the use of restraints on noncitizens known to be pregnant (including during labor and delivery), lactating, or postpartum while in the physical custody of the Department of Homeland Security (DHS), including during transport, except in extraordinary circumstances posing an immediate and serious risk of harm to others or escape. In such cases, only the facility administrator may order the least restrictive restraint necessary after an individualized determination, with prohibitions on leg/waist/4-point restraints, binding hands behind the back, face-down/back positioning, or any restraint during labor/delivery; medical personnel requests require immediate removal of restraints. Facilities must record such uses in writing within 5 days, retain records for 5 years (with public access after redaction), and submit to the ICE Director (also publicly available after redaction). This section further prohibits nonmedical staff from being present during a detained noncitizen's pelvic/breast exam, labor, delivery, or pregnancy-related treatment unless specifically requested by medical personnel for the minimum required time, in which case staff must be of the noncitizen's preferred gender (if practicable), remain at a reasonable distance facing the head, and stay immediately outside the room if restraints are used. This section requires U.S. Immigration and Customs Enforcement (ICE) to provide detained noncitizens access to specified pregnancy-related health services at no cost—including routine/specialized prenatal care (e.g., nutrition, exercise, HIV testing/treatment, vitamins, vaccines), labor/delivery, complication treatment, substance use disorder treatment, postpartum care (physical/mental, reversible contraceptives), menstrual hygiene products, lactation services, family planning, contraceptive continuation, and abortion services—and directs U.S. Customs and Border Protection (CBP) to meet minimum care standards for pregnant detainees. All services require informed medical consent, with no treatment administered against the noncitizen's will. This section requires each facility administrator to maintain arrangements with the nearest maternity hospital (with staff knowledge of emergency transport) and a policy for care if immediate transfer is not possible.

This section requires the Secretary of Homeland Security to provide each detained noncitizen with notice of their rights under the Act in a language or manner the noncitizen can understand. The section further requires the Secretary to provide training on the Act's requirements, at the time of hiring and annually thereafter, to Department of Homeland Security employees involved in the detention or care of a pregnant detained noncitizen or a postpartum parent of a newborn who is being detained under the Immigration and Nationality Act.

This section requires the facility administrator of each DHS detention facility holding pregnant noncitizens to submit a quarterly report to the Secretary, due not later than 30 days after the end of each calendar quarter, detailing (1) each use of restraints on pregnant detainees during pregnancy, labor, or postpartum recovery (including type, justification, and name of the authorizing administrator); (2) the number of pregnant noncitizens held and released; (3) average detention length; (4) the number detained 15-30 days; (5) the number detained longer than 30 days; and (6) pregnancy outcomes for those who gave birth in custody (e.g., live birth, stillbirth, miscarriage, abortion, ectopic pregnancy, maternal or neonatal death, preterm birth). It further directs the Secretary, not later than 90 days after the end of each fiscal year, to (1) audit data on pregnant detainee numbers, releases, and average detention lengths; (2) report summarized facility-specific data to congressional committees; and (3) issue regulations establishing minimum medical care standards for pregnant noncitizens based on national standards. Reports exclude individually identifying information and facility administrator names (for public versions posted online); separately, it requires the Secretary to issue regulations or policies implementing the Act at DHS detention facilities.