The AAFP recommends that state and federal governments adopt policies that limit the use of restraints in incarcerated pregnant women to situations where there is imminent risk of harm to others or of escape because restraints can negatively impact maternal and fetal outcomes. Restraints, often called shackling, can include any physical restraint or mechanical device to control the movement of a prisoner's body or limbs, such as handcuffs, leg shackles, and belly chains. When restraints are determined to be necessary for public safety, the least restrictive approach should be utilized. (Dec. 2019 BOD) (2020 COD)