Meanwhile, the head of North Carolina’s state prisons has ordered an end to a policy allowing pregnant women prisoners to be shackled while in labor. At least eight U.S. states have no laws preventing the practice, while many other states have loopholes that allow it. In 2010, the American Medical Association condemned the practice, writing, “The use of shackles to restrain a pregnant woman during the birthing process is a barbaric practice that needlessly inflicts excruciating pain and humiliation.”