34 The Bangkok Rules procedures and following permission from the chief executive officer. Such searches should only be carried out in circumstances which do not violate the human rights and dignity of the child, as explained above. It should be noted that visitors are not prisoners, and can therefore refuse to be searched and guardians of children (as well as the children themselves) can refuse children to be searched. In such cases the prison administration has the right to deny them entry to the prison. Rule 22 The international instruments make clear that solitary confinement is not an appropriate punishment other than in the most exceptional circumstances; whenever possible its use should be avoided and steps should be taken to abolish it. These instruments also acknowledge the fact that, potentially, periods of solitary confinement are prejudicial to the mental health of the prisoner. Principle 7 of the Basic Principles for the Treatment of Prisoners calls for “…efforts addressed to the abolition of solitary confinement as a punishment, or to the restriction of its use…” Thus solitary confinement should be used only in exceptional circumstances in the case of all prisoners, and for the shortest possible period of time. Rule 22 takes account of the best interest of the children, in line with the Convention on the Rights of the Child and calls on member States to avoid using solitary confinement on certain categories of women prisoners altogether in order to avoid causing possible health complications to those who are pregnant or penalizing their children in prison by separating them from their mothers. Rule 23 Total prohibition of family contact, especially of contact with children, has a very harmful impact on the mental wellbeing of women prisoners, as well as the children involved, and should therefore be avoided, unless the child has particular protection needs. Rule 24 Rules 33 and 34 of the SMR place strict restrictions on the use of body restraints on prisoners. Firstly restraints may never be used as punishment, secondly they may be used in cases where there is genuine justification to believe that the prisoner may attempt escape during transfers and thirdly, following instruction from a medical officer, due to the imminent danger of harm or self-harm by the prisoner concerned. Nevertheless, in some countries body restraints, such as shackles, are used on pregnant women during transfers to hospitals, gynaecological examinations and birth. This practice violates international standards. Moreover, shackling during labour may cause complications during delivery such as haemorrhage or decreased foetal heart rate. If a caesarean section is needed, a delay of even five minutes may result in permanent brain damage to the baby.56 European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment has stated that “[…] from time to time, the CPT encounters examples of pregnant women being shackled or otherwise restrained to beds or other items of furniture during gynaecological examinations and/or delivery. Such an approach is completely unacceptable, and could certainly be qualified as inhuman and degrading treatment. Other means of meeting security needs can and should be found.”57 ___________ For example, the American College of Obstetricians and Gynecologists and the American Public Health Association have condemned the practice of shackling, recognising that it compromises women’s health and causes severe pain and trauma. The Center for Reproductive Rights points out that unrestrained movement is critical during labour, delivery, and the post delivery recovery period. Shackles hamper a woman’s ability to move to alleviate the pain of her contractions, which increases stress on the woman’s body and may decrease the flow of oxygen to her fetus. 57 The European Committee for the Prevention of Torture and Inhuman or Degrading Punishment, The CPT Standards, CPT/Inf/E (2002) 1 - Rev. 2006, Extract from the 10th General Report [CPT/Inf (2000) 13], para.27. In the U.S., in response to increasing concerns at the physical and psychological damage that can be caused by shackling during labour, there has been a move towards prohibiting shackling during labour and childbirth. In October 2008 the U.S. Bureau of Prisons policy, which applies to federal facilities in the U.S., barred the shackling of pregnant women, “except in the most extreme circumstances.” Since 2000, four states - California, Illinois, Vermont and New Mexico - have passed legislation restricting the unnecessary use of restraints on pregnant women in prison. At the time of writing, New York and Texas had bills backed by legislative support waiting to become law. The New York “Anti Shackling Bill” prohibits state and local correctional authorities from using restraints on a pregnant female inmate who is being transported for childbirth, during labour and delivery, and in post-natal recovery. 56