When Shawanna Nelson gave birth to her second child, her ankles were shackled to either side of her bed. She was unable to move her legs or stretch during the most painful and stressful part of [labor] . The chains caused Shawanna more than mere discomfort. Shawanna suffered extreme mental anguish and pain, permanent hip injury, torn stomach muscles, and an umbilical hernia requiring surgical repair ... [T] he shackling injured and deformed her hips, preventing them from going back into the place where they need to be. She also alleged damage to her sciatic nerve--the largest nerve in the human body. Not only will Shawanna's injuries cause her lifelong pain, but she can no longer enjoy ordinary activities' such as playing with her children or participating in athletics. She is unable to sleep or bear weight on her left side or to sit or stand for extended periods. Nelson's physicians have also warned her against having any more children because of the many injuries that resulted from her traumatic labor.

Shawanna Nelson was not a slave woman giving birth on a plantation. She was an inmate at the McPherson Unit of the Arkansas Department of Corrections giving birth in an Arkansas hospital in 2003. Shawanna was convicted of the nonviolent offenses of credit card fraud and writing bad checks. At the time of her conviction, she was six-months pregnant.

Nelson went into labor at 5:00 a.m. on September 20, 2003. After laboring in her cell for twelve hours, she was finally admitted to the infirmary at 3:00 p.m. By that time, her contractions were so powerful that she could barely walk without gasping for breath and leaning on the wall. The infirmary nurses ordered her to be immediately transported to a contracting civilian hospital to deliver her child. In fact, the guard who accompanied Nelson to the hospital, Officer Turensky, states that she was instructed to RUSH [Nelson] to the hospital [and] to NOT to [sic] take time for cuffs.

Upon her arrival at the hospital, Nelson's prison jumpsuit was dripping wet with amniotic fluid. Officer Turensky shackled Nelson's legs to a wheelchair and took her to the maternity ward. There, Nelson changed into a hospital gown and Turensky shackled both of her ankles to opposite sides of her hospital bed. By that time, Nelson was already dilated to seven centimeters--in the final stages of labor. Nelson requested an epidural for her pain, but the nurses told her they needed Dr. Hergenroeder's approval before administering any anesthesia. By the time Dr. Hergenroeder arrived at the hospital, Nelson was already dilated to between eight and nine centimeters--too late for an epidural. Therefore, Nelson received only two Tylenols for her pain. According to Nelson's testimony, this pain was magnified by the shackles that kept her from moving her legs, stretching, or changing positions.

Not only did the shackles cause Nelson pain, but they also interfered with her medical care. The shackles impeded the nurses who had to ask Officer Turensky to remove the shackles each time they needed to measure Nelson's dilation and check her vital signs. A nurse even told Officer Turensky that [s] he wished that they wouldn't have to put those restraints on [Nelson] . Although the nurses repeatedly requested that Turensky remove the shackles, Nelson testified that Turensky hooked [her] right back up after each cervical measurement. The shackles were finally removed at Dr. Hergenroeder's request when Nelson was brought to the delivery room at 6:15 p.m. Nelson's son was born only eight minutes later, at 6:23 p.m. He weighed 9 lbs, 7 3/4 oz.