Immigration Enforcement Creates Maternal Health Crisis as Pregnant Women Avoid Care
Veronica Fregoso, a doula in the San Francisco Bay Area, faced a heartbreaking scene with a patient in labor. The woman, terrified of leaving her home and potentially encountering immigration agents, resisted going to the hospital. Her husband had been deported weeks earlier, leaving her alone in the United States with their five-year-old child. After persistent pleading, Fregoso successfully escorted the patient to the hospital where she safely delivered her baby. However, the trauma from her husband's deportation was so severe that the new mother stayed only one day before returning home—a pattern Fregoso observes increasingly among her pregnant clients.
Dramatic Shift in Doula Work Amid Immigration Crackdown
Fregoso, who has worked as a doula since 2018 and directs the Birth Companions Community Center overseeing nearly 70 doulas, finds her role transformed. "It's very hard for us, because how can we completely say that you're gonna be fine? We cannot do that," Fregoso explained. "So what do we say? We say God is going to protect us and we're here for whatever you want to do." Her organization supported 746 newborn deliveries last year, with 95% serving low-income immigrant families. Now, she spends significant time counseling patients too frightened to seek maternal healthcare due to U.S. Immigration and Customs Enforcement (ICE) presence.
This fear is causing widespread disruptions in reproductive and sexual healthcare nationwide. Healthcare providers report patients missing prenatal appointments, not collecting necessary prescriptions, and avoiding hospitals during labor. Some even decline to enroll newborns in Medicaid or share medical information with hospital systems, fearing immigration consequences.
National Impact on Reproductive Healthcare Access
Paula Avila-Guillen, a human rights lawyer and executive director of the Women's Equality Center, stated: "There is enough evidence that has come out that tells us there is a group of specifically Latina women who are caught in an intersection of aggressive immigration enforcement and shrinking reproductive access. They are being forced to choose between their freedom or their health."
The situation worsened after President Donald Trump rolled back protections barring ICE arrests at sensitive locations like hospitals and clinics. A recent poll of over 500 pregnant women found one in five reported immigration enforcement activity prevented them from seeking prenatal care. In Minneapolis, Planned Parenthood clinics saw an 8% increase in no-show appointments for abortion, contraception, and STI testing during recent federal immigration surges.
Dr. Josephine Urbina, a San Francisco OB-GYN working with Fregoso, observed: "This fear of criminalization is real. This is what it looks like in real time: patients disengaging from care and families struggling to meet their basic needs."
Concrete Consequences and Alarming Statistics
The dangers are tangible. In February, a pregnant woman was detained by ICE while waiting for her Uber after a prenatal visit and later deported. Last summer, another pregnant woman and her mother were detained outside her OB-GYN's clinic following a check-up. According to the Department of Homeland Security, between January 2025 and February 2026:
- 363 pregnant, postpartum, or nursing women were deported
- 498 pregnant, postpartum, or nursing women were detained
- 16 reported miscarriages occurred during detention
Amber Pugh, a hotline case manager at the National Abortion Federation for 11 years, works with abortion-seekers coordinating travel to states where abortion remains legal. Since Roe v. Wade fell, most callers are from the Southeast traveling north for care. Pugh noted many complete extensive planning—securing funds, arranging travel and lodging, taking time off work, finding childcare—only to cancel appointments last minute. "They are making their own assessment as to whether they can risk deportation, at best, or incarceration and death, at worst, to access an abortion," Pugh said.
Community Networks Become Critical Lifelines
Fregoso reports increased requests for home births, decreased prenatal visits, and delays in labor and delivery care as patients fear leaving home. Typically, nurses conduct home visits, but now many patients refuse to answer doors without doulas confirming the nurse's identity, fearing ICE officers posing as medical staff. "We have many, many cases where the moms don't want to go to the hospital to have the babies, but they don't want to open the door for the nurses," Fregoso shared.
Physicians and care providers increasingly rely on community networks to help patients access reproductive healthcare. Fregoso and her doulas perform numerous tasks outside hospitals:
- Driving patients to clinic appointments
- Making home visits
- Delivering food, diapers, and formula
- Accompanying mothers to obtain birth certificates
- Connecting women with immigration attorneys
- Creating emergency plans for family separation
- Serving as interpreters for Spanish-speaking clients
Now common practice includes calling ahead to midwives and trusted physicians to ensure ICE is not present before bringing patients to hospitals. These community networks, originally developed by the Green Wave feminist movement in Argentina and El Salvador, have expanded to the United States.
Physical and Emotional Toll on Patients
The escalating anxiety and fear are impacting patients' physical wellbeing. Physicians report more women experiencing high blood pressure or preterm labor due to chronic stress. "Taking care of your pregnancy is something that should be a right, not a privilege," Avila-Guillen emphasized. "It's one of the most essential protections that the state should care about, especially if states are now considering themselves pro-birth. But in reality, they know exactly what they're doing. They are specifically targeting the people they don't want to have children."
Even Fregoso, a U.S. citizen, carries her passport everywhere because she is Latina and fears being stopped. The relentless cycle of stress and surveillance creates unbearable conditions for immigrant families seeking basic healthcare, transforming what should be a joyful pregnancy journey into a period of terror and isolation.
