Pregnant migrants balance journey to delivery and asylum

(NewsNation) — Leticia Alvarez didn’t know she was pregnant when she left Venezuela, determined to leave political persecution and hardship for new opportunities elsewhere, like millions of other asylum seekers.

Alvarez discovered she was 13 weeks pregnant in Panama after experiencing severe abdominal pain during her family’s trek to the U.S.-Mexico border. The news thrust the 25-year-old into a population of migrant women who are navigating the already stressful process of giving birth while simultaneously seeking asylum in a new country.

In 2021, President Joe Biden reversed a Trump-era policy that allowed pregnant women or nursing mothers to be detained by border officials. Despite the change, the American Civil Liberties Union launched a petition with more than 900 signatures urging U.S. Customs and Border Protection to change the policy to minimize harm to women who are pregnant, have recently given birth, or are breastfeeding, as expectant mothers continue to face abuse.

But for Alvarez, the challenges of pregnancy and migration are nothing compared to what she could have endured if she had stayed home.

“If I had been pregnant in my country, I would be dead now with my baby,” Alvarez told NewsNation in Spanish.

Looking for a new life across the border

It took Alvarez and her family 15 days to reach the United States, traveling mostly by bus, thanks to money she and her husband Lisandro Escola had saved.

But the couple, along with Alvarez’s sister, niece and father, also hiked for two days, including through the treacherous jungle of the Darien Gap, a 60-mile stretch of rainforest that straddles the border of Colombia and Panama and connects Central and South America.

The area is known as dangerous due to its rugged terrain and steep mountains, but it has become a major transit route for migrants traveling to the southern border.

“It was exhausting because you’re fighting to get out of the jungle, and (it was) traumatic because you see endless things that are not told but are in your head,” said Alvarez, who fell in the jungle several times. “Once you start the journey, you don’t stop walking.”

When Alvarez learned she was pregnant, she was overcome with fear. She even feared she might lose her baby.

Leticia Alvarez gave birth to her first child, Sophie, at Cook County Hospital in Chicago after making the crossing from Venezuela. (Photo courtesy of Leticia Alvarez)

She and Escola were separated from her family, who remained in Mexico City when they ran out of money.

Alvarez and Escola crossed the border at McAllen, Texas, and surrendered to border officials. Alvarez was immediately released, but said Escola was held at the Joe Corley Detention Center for seven months. She said she doesn’t know why.

In late January, the Venezuelan government announced that it would no longer operate repatriation flights from the United States as of February 13. This was in response to the economic sanctions that the United States reimposed on Venezuela after lifting them in 2023, according to information from the American Civil Liberties Union of New Mexico.

With her husband in federal custody, Alvarez flew to Chicago and then drove to Indianapolis, where she worked construction. She says she worked from 8:30 a.m. to 6:30 p.m. Monday through Friday, cleaning and helping install ceramic tile and flooring in a new building, among other duties.

She saw a doctor only once every three months, fearing the cost. Alvarez saw her first doctor in Chicago in early January. Two months later, she gave birth to a baby girl, Sophia, who was born weighing 8 pounds, 9 ounces.

Leticia Alvarez and her husband Lisandro Escola have been married since 2021, but were separated for almost the entirety of Alvarez’s pregnancy (Photo courtesy of Leticia Alvarez)

Two weeks later, Escola was released, but by then Alvarez was already suffering from the emotional consequences.

“Going through pregnancy alone is very difficult and very sad,” Alvarez told NewsNation. “All you want is to have guidance at that moment, and I was alone.”

The costs of migrant pregnancies

Over the past two years, the health system serving Illinois’ largest county has treated more than 35,000 patients, including 670 pregnant women. The health system connects women with prenatal care and has spent more than $30 million on migrant health care since 2022, a Cook County Health spokeswoman told NewsNation.

Like Chicagoans struggling economically, immigrants are eligible for financial aid. Of those who apply, 99.5 percent receive a 100 percent discount, with the health system’s operating budget covering the cost, the spokeswoman said.

A migrant woman carrying a baby and DHS-issued release papers is taken by a volunteer to the Humanitarian Respite Center in downtown McAllen, Texas, on July 20, 2021. All migrants must prove they are COVID-free before entering the migrant shelter. (Sandra Sanchez/Border Report Photo)

In New York, which has processed more than 225,000 migrants, NYC Health + Hospitals helped 300 asylum-seeking babies in 2023 and donated 2.1 million baby wipes, 400,000 diapers and 100,000 bottles of baby food and formula, National Public Radio reported last year.

In Denver, city officials have spent $90 million on immigrants this year. Some newcomers who have just given birth are having trouble adjusting.

Denver Health, the city’s safety-net hospital, lost about $2 million in 2023, according to The Denver Post, which reported that the facility provided about $136 million in care for which it was not compensated. Last year, the hospital provided medical care to 8,000 Central American migrants, who made 20,000 visits to the hospital for care, including deliveries, the report said.

The hospital’s CEO told the newspaper that the facility is not reimbursed by the state or federal government to cover the cost of migrant health care, which runs into the millions. Hospital officials did not immediately respond to an email from NewsNation requesting details about the cost of migrant births absorbed by the health system.

Ivanni Herrera was eight months pregnant when her family’s shelter order in Denver ended. She was told she could seek care at a local hospital, where Medicaid would cover her appointments and the baby’s delivery, The Associated Press reported. She declined the help.

“How can I sleep in a warm place when my son is cold on the street?” she told AP.

Denver city officials have committed to keeping families off the streets and have in turn helped thousands of immigrants obtain work permits. While she waits, Herrera has no means of steady income. She told the AP that she owes $18,000 in medical bills because she forgot to sign up for Medicaid.

“I’m afraid they’re going to deport me,” she said.

Which Chicago migrant care looks like

Doctors working within the Cook County Health System in Illinois say they strive to provide migrants and asylum seekers with the same care as everyone else.

The biggest challenge, however, is that migrants are more likely to encounter fragmented care, due to the countries they come from and the time that may have passed since their last appointment.

“A pregnancy really can’t wait until you’re in the best possible position to get your care,” Dr. Mary Arlandson, an attending physician and gynecologist at Stroger Hospital in Chicago, told NewsNation.

Doctors can’t make up for lost time. But they can assess what care a woman needs at that moment and help her navigate a pregnancy that’s stressful even without challenges like adjusting to a new city, lack of work, and finding transportation to appointments.

“The type of person who would take that trip is probably categorically different than the person who decides he or she wants nothing to do with it,” Arlandson said.

Since Sophia’s birth, Alvarez has suffered from postpartum depression at times. The family has been living in a rented room while they wait for permanent housing. While Alvarez stays home with the couple’s daughter, Escola said her husband occasionally works construction and handles all of the young family’s expenses.

Alvarez says Sophia is adjusting while her parents wait for necessary things like work permits and immigration court appearances. She says that since she found out she was pregnant, all she has thought about is the opportunities that await her daughter if she and her husband can do their part.

For now, things are going as well as they can.

“The baby is doing fine, thank God,” she said.