EDINBURG, Texas — Britani first learned there was something wrong with her pregnancy late one night in July 2019 when she started bleeding and rushed to an emergency room.
The doctor on duty said she had an infection that could cause her to miscarry. Britani agreed to find an obstetrician to treat the problem, knowing that she would not keep her word.
As an undocumented immigrant, Britani, now 20, had no health insurance and could not afford to pay for her treatment in cash. Her only option would be to apply for public benefits, but she had heard from friends that doing so could make her a target for deportation or jeopardize her pending green card application. So she sat tight, hoping the infection would go away on its own.
A few weeks later, Britani shook her husband awake in the middle of the night and told him to get his mother in the next room. They returned to find Britani doubled over in pain, her face wet with tears.
“There’s a lot of blood,” Britani said.
When President Trump unleashed his crackdown on immigration, people without legal status scrambled to erase the traces of their existence to avoid being swept up. They stayed home to hide from aggressive new street arrests. And thousands dropped out of welfare programs to steer clear of a policy that posed a less visible threat. Under an expansion of the limits on “public charge,” the administration said it would withhold legalization for undocumented immigrants who had used certain public benefits.
Though undocumented immigrants are ineligible for most welfare programs and have been shown to use those that are available at lower rates than American citizens, the Trump administration said the expansion was necessary to discourage people who could not support themselves financially from moving to the United States. “Give me your tired and your poor who can stand on their own two feet and who will not become a public charge,” Kenneth T. Cuccinelli II, the acting director of United States Citizenship and Immigration Services, said at the time.
The policy contained exemptions for some vulnerable groups, including pregnant women. But doctors and public health officials say that many undocumented women are convinced nonetheless that their chances of legalization will be diminished, and they worry that immigration officers, who are often seen at hospitals along the border, could target them for deportation.
The result, they say, is an escalating climate of fear that is having disastrous consequences for the health of pregnant women and their babies.
Within days of when the public charge policy became public, followed by wall-to-wall coverage on Spanish-language news outlets and dire warnings on social media, medical clinics saw no-show rates for prenatal care appointments rise sharply. Midwives say that requests for home births from undocumented women who wanted to avoid going to a hospital soared. Doctors said they saw a spike in the number of women arriving in emergency rooms with serious complications, or already in labor, without having