In 2022, a Guatemalan woman who sought asylum at a Border Patrol station in California gave birth in a bathroom while leaning against a garbage can. She pleaded with officers for medical attention but was left to endure labor with only her husband and two young daughters. Her story is just one of many about the sad state of the reproductive rights of immigrants and those who seek refuge here.
The same year, Human Rights First documented that pregnant people were detained in states like Texas, Georgia, and Florida, where abortion access has all but vanished. They were denied reproductive care while ICE tracked them with ankle monitors and GPS-equipped apps.
These stories are part of a real, documented pattern of reproductive rights violations against undocumented immigrants in U.S. custody. As a physician and advocate for reproductive justice, I believe we must examine the systems that enable such abuses and demand change.
What Are Reproductive Rights?
We must never see reproductive rights as a privilege enjoyed by American citizens. We must defend everyone’s human rights within our borders, including bodily autonomy, privacy, and personal health.
The Universal Declaration of Human Rights defines reproductive rights as follows:
- The right to have children
- The right not to have children
- The right to parent children in safe, sustainable communities
Where These Rights Break Down
Reproductive rights are enshrined in international frameworks like the Universal Declaration of Human Rights. In the U.S., they’re supposed to be upheld through constitutional protections, federal agency policies, and medical ethics. But for undocumented immigrants, especially those in detention, these rights are often denied.
Here are more examples of reproductive rights violations:
1. Denial of Medical Care in Detention
Detention itself is harmful, especially for pregnant and postpartum people. According to an American Public Health Association report, ICE detained pregnant people over 2,000 times in one year alone. Despite guidelines requiring appropriate care, reports show widespread neglect, such as miscarriages with no follow-up, inadequate prenatal care, and even shackling during labor and delivery.
One such case involved a Cuban doctor seeking asylum who miscarried while in CBP custody and was sent back to Mexico without any medical support, as documented in a brief by Human Rights First and others. These experiences don’t just violate ethical care. They also cause long-term trauma.
2. Coerced or Forced Medical Procedures
In 2020, a nurse at Irwin County Detention Center blew the whistle on a pattern of nonconsensual gynecological surgeries, including forced hysterectomies. More than 40 women gave sworn testimony. Some were deported before they could testify. According to an independent medical review, no medical justification existed for the surgeries performed.
Forced sterilization is a human rights violation, but sadly, it’s not new. From the 1920s through the 1970s, thousands of people of color — especially Black, Latino, and Indigenous women—were sterilized without consent in the U.S. What’s shocking is how similar these stories sound today.
3. Criminalization and Fear
A woman in the Rio Grande Valley, already under ICE supervision, wanted to leave Texas to seek abortion care in another state. But because she was enrolled in ICE’s Intensive Supervision Appearance Program (ISAP), which uses GPS ankle monitors and smartphone apps to track movement, she feared detention or deportation if she crossed state lines.
Over 240,000 immigrants are tracked through ISAP. Many of them are not allowed to travel without explicit permission from ICE. Even for those who might qualify for exceptions, there’s no guarantee ICE will approve travel in time to meet gestational limits.
Who’s Most at Risk?
These abuses don’t affect all people equally. The most vulnerable populations are:
- Pregnant and postpartum people
- Minors in government custody
- Transgender and gender-nonconforming immigrants
- Survivors of sexual violence
According to Human Rights Watch, transgender women in ICE detention have reported sexual assault by male guards, forced strip searches, and denial of hormone therapy. LGBTQ+ detainees made up only 0.14% of the detained population in 2017, but 12% of the sexual assault complaints.
Unaccompanied minors have also faced targeted restrictions. In 2017, the Office of Refugee Resettlement director was caught tracking girls’ menstrual cycles and blocking abortion access. While the policy has since changed, Dobbs reopens the door for a future administration to reinstate such surveillance and control.
The Public Health Impact
I’ve seen how stress, trauma, and lack of care can shape a pregnancy and a lifetime. Detention creates chronic stress, which increases the risk of preterm birth, low birth weight, and mental health disorders. A systematic review found high levels of anxiety, depression, and PTSD in detained immigrants. These effects ripple across generations.
What’s more, a lack of access to safe abortion care increases the likelihood of severe complications, intimate partner violence, and poverty. People denied abortions are more likely to stay in abusive relationships and suffer long-term health and financial harm, as shown by the 2022 Turnaway Study.
What’s Driving These Violations?
The core problem is a system that treats undocumented immigrants as disposable. Nearly three-quarters of immigrants in ICE detention are held in privately run facilities, where profit motives often override care. These facilities frequently operate without meaningful oversight.
In 2019, the Office of the Inspector General found egregious violations in ICE-run centers, including denial of medical services, moldy food, and abusive conditions.
What Needs to Change?
As a nation, we must demand a rights-based approach to immigration and reproductive care. That starts with accountability, oversight, and systemic reform. I support the recommendations issued by the American Public Health Association, including:
- A federal moratorium on contracts with abusive private detention facilities
- Robust investigations into medical abuse in ICE custody
- Presumption of release for pregnant and postpartum people
- Mandatory provision of medical interpreters and informed consent in all healthcare encounters
- Funding for public health research into detention-related reproductive outcomes
We also need to expand healthcare access for asylum seekers and undocumented immigrants. That means removing Medicaid restrictions, decoupling healthcare from immigration status, and restoring funding to community clinics.
Why This Matters to Me
I’ve dedicated my career to protecting reproductive freedom and fighting for bodily autonomy—values that should apply to every person, regardless of documentation status. I became a doctor to offer care, not judgment, to listen, not ignore, and to stand with those whose voices are silenced.
The U.S. must stop using detention as a tool of reproductive control. They’re systemic violations of human dignity. As long as they continue, I’ll keep raising my voice.
