On March 7, 2025, NWLC and co-counsel Gibson Dunn led an amicus brief on behalf of the Law Center, Disability Rights North Carolina, Legal Action Center, and Pregnancy Justice to the U.S. Court of Appeals for the Fourth Circuit in Edwards v. Witherspoon. Our brief urged the Court to clarify two important rights for prisoners: First, to shackle a pregnant person before, during, and immediately after childbirth violates a constitutional right to be free from cruel and unusual punishment. And second, that it violates the Americans with Disabilities Act to withhold medication for opioid use disorder (MOUD) from prisoners with diagnosed opioid addiction—especially, when, as here, the prison permits some people who are incarcerated (only those who are pregnant) to access this care, but only because of the prison’s asserted interest in the prisoner’s fetus.

Tracey Edwards, the plaintiff-appellant in this case, first learned that she was pregnant when she was required to take a pregnancy test upon beginning her sentence at the North Carolina Correctional Institution for Women (NCCIW). Because she was pregnant, NCCIW permitted Ms. Edwards to continue taking her MOUD treatment plan. MOUD was generally barred from people incarcerated at NCCIW, but the prison made an exception for those with opioid use disorder (OUD) while those prisoners were pregnant—based on the prison’s purported interest in protecting the fetus.

Contrary to that stated interest, however, and in violation of the prison’s own policies, NCCIW later shackled Ms. Edwards while she was in transit to the hospital to give birth her daughter, putting her at well-known risk of falling and injuring herself and her fetus. Ms. Edwards was also shackled by one arm and one leg to her hospital bed during the first twelve hours of labor; the prison guard removed Ms. Edwards’ shackles only after she was instructed to push. Soon after Ms. Edwards delivered her daughter, she was again chained to her bed, which constricted Ms. Edwards’ ability to care for her newborn. Finally, while in transit back to the prison just two days after giving birth, while Ms. Edwards was still vulnerable and swollen postpartum, the prison again put her in jeopardy by shackling her.

Once Ms. Edwards returned to NCCIW, she faced a new ordeal: The prison immediately ceased her MOUD, requiring her to “taper off” her medication by using oxycodone. With her OUD insufficiently treated, Ms. Edwards suffered extreme physical symptoms, including pain that Ms. Edwards described as greater than giving birth, diarrhea, insomnia, vomiting, and anxiety that she might relapse.

Our brief explains that the risks and harms of the prison’s treatment of Ms. Edwards were obvious and predictable, and the prison lacked penological justification for restraining Ms. Edwards or for refusing to provide her with an adequate accommodation for her OUD. We ask the Court of Appeals to confirm that shackling pregnant people is unconstitutional to ensure that the practice ceases to continue. And we explain that the prison’s policy decision to dismiss the needs of pregnant people and only consider those of the pregnant person’s fetus is not only disability discrimination, but it also follows a dangerous and demeaning trend of fetal personhood.