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Maria was 37 weeks pregnant — at full term — when Customs and Border Protection officers separated her from her husband, Alejandro, after they arrived at the U.S.-Mexico border seeking asylum, fleeing violence in Honduras. (I am using pseudonyms here to protect individual’s identities.) Alejandro was returned to Mexico to await his asylum hearing, but he was kidnapped there and held for ransom. Maria wasn’t sure if their family could pay to set him free.

Their baby would likely be born while Alejandro and Maria were apart; she was terrified that their baby might never meet his father.


Angela, a first-time mother in her second trimester, was having a panic attack at an immigration shelter in Texas after being released from CBP custody. She and her husband, Julio, had arrived at the border together seeking asylum after fleeing Cuba. They had already spent several months in Mexico, where her husband had been kidnapped and abused by a gang that threatened to kill him because he wouldn’t work for them. Now, assuming they had made it to safety in the U.S., CBP split apart the family.

Ana, a first-time mother in her third trimester, fled Honduras with her husband, Nestor, when the gang that had murdered Nestor’s father threatened to kill him. After arriving at the border seeking asylum, the couple was separated and Nestor was deported back to Honduras, more than 1,000 miles from his wife and soon-to-be-born daughter.

I work as a nurse-midwife in one of the largest immigration shelters on the U.S.-Mexico border. Maria, Angela, and Ana are my patients. More than 10% of my patients have been separated from their partners. Most are first-time mothers.


According to legal advocates, immigration authorities do not consider a pregnant woman and her partner to be a family unit — only after the baby is born do they become a family. If a pregnant mother who has other children but was unable to bring them with her to the U.S. arrives with the father of her children, they will be separated because no child is present with them.

As U.S. policy in recent years has shifted to reduce the number of asylum seekers who could await their asylum hearings in the U.S., pregnant patients are some of the very few who are permitted to stay here — but at the expense of being separated from their partner at a critical moment in their lives.

I care for asylum-seeking women every day who are traumatized from threats of violence in their homelands and their harrowing journeys to the border. After they arrive at the U.S. border, this country’s immigration policies compound their trauma by splitting up families. This undue stress augments the risk of harmful outcomes for mothers and babies.

Prenatal stress and trauma can considerably affect a mother’s health during pregnancy and beyond, a child’s health over its lifetime, and even the health of future generations that may result from prenatal stress. Increased stress during pregnancy can lead to impaired cognitive development, emotional disorders, and poorer immune function. Mothers suffering prolonged and compounded trauma are more susceptible to perinatal anxiety and depression, which can negatively affect bonding between mother and baby, the likelihood of successful breastfeeding, and the child’s behavioral development.

Perinatal depression and anxiety, as well as post-traumatic stress disorder, are significantly more likely in the setting of notable trauma, such as the separation of a pregnant person and their partner. A lack of adequate social support is strongly linked to postpartum depression. It is unimaginable to think about being torn away from one’s primary support person at such a vulnerable time.

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Many of these families were separated under Title 42, a U.S. public health policy that uses the pandemic as an excuse to deny people entry to the U.S. The Biden administration announced in early April it is ending Title 42 restrictions as of May 23 — but the policy of splitting up families will likely remain.

Even without Title 42, the administration still enforces Migrant Protection Protocols (some dub them as “Remain in Mexico”), which return asylum-seeking fathers across the border to await their asylum hearings in Mexico while their pregnant partners are permitted to stay.

None of these asylum-seeking mothers know when or if they will be reunited with their partners. By continuing this inhumane practice of family separation, the U.S. government is forcing asylum-seeking mothers to become single parents. They are left to struggle with the emotional consequences of separation and their children may spend years — or their entire lives — without meeting their fathers. This policy is unnecessarily setting in motion myriad health consequences for families that could last generations.

Widespread outrage ended the Trump administration’s policy of separating migrant children from their parents. But let’s be clear: The U.S. government is still separating families, stripping fathers away from mothers and newborn babies at a critical and life-changing time in their family’s lives. To prevent further trauma for asylum-seeking families, and to treat asylum seekers with the dignity they deserve, these separations must end immediately.

Annie Leone is a certified nurse midwife who provides care for asylum-seeking pregnant people at an immigration shelter in collaboration with Migrant Clinicians Network, which connects asylum-seeking pregnant people with prenatal care once they reach their destinations.

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