Pregnant detainees describe difficulty accessing prenatal care
US Immigration and Customs Enforcement recorded 18 miscarriages among pregnant detainees during the first nine months of President Donald Trump’s second term but has not maintained a count of pregnancy losses since October 3, 2025, according to government documents obtained by the Guardian through a Freedom of Information Act request and a subsequent lawsuit filed with the Reporters Committee for Freedom of the Press.
ICE released spreadsheets tracking the number of pregnant, postpartum and nursing women in detention from October 2024 through mid-January 2026, and the number of miscarriages per facility per month through September 2025. The agency told the Guardian it had no miscarriage data after October 3, 2025, attributing the gap to a change in its medical accounting system.
In response to follow-up questions, a Department of Homeland Security spokesperson first said the agency was tracking miscarriages in monthly reports, but later confirmed it does not have data on miscarriages from October 2025 through June 2026. DHS has never before acknowledged that it had lost count of miscarriages, according to the Guardian — not even when US senators requested the data.
The records show ICE held at least 87 pregnant women and adolescents in detention in October 2025 and 101 in November — the highest numbers recorded over the previous year, according to ICE data. According to the Guardian, the figures were recorded during a period of high-profile immigration enforcement operations in Minneapolis, Chicago and other cities last autumn and winter.
Most women of reproductive age who enter immigration detention receive pregnancy tests during an initial medical assessment, but not all do. Some detained women have said they were unable to access pregnancy tests, so ICE’s numbers could be an undercount. At least 18 women miscarried while in custody from January through September 2025. That figure is also likely an undercount, according to experts on healthcare within the immigration system, because some women who experience miscarriages early in pregnancy do not notice significant symptoms and therefore do not seek or receive emergency care.
The tracking gap coincided with the end of ICE’s contract with the Veterans Affairs Financial Services Center, which had handled medical billing for the agency. Acentra Health, a private Virginia-based company, was contracted to replace the VA-FSC starting in October 2025, but ICE’s medical claims processing has been delayed for months. Immigration attorneys and former DHS officials told the Guardian it was unusual that ICE was tracking miscarriages through its medical billing provider. Acentra did not respond directly to questions about whether it was tracking miscarriages on behalf of ICE; instead, it directed the Guardian to a statement clarifying that there were delays in implementing ICE’s new claims processing due to government shutdowns.
A 2021 federal directive instructs ICE to avoid detaining pregnant, postpartum and nursing immigrants “unless release is prohibited by law or exceptional circumstances exist.” If ICE does detain a pregnant individual, the directive obligates officers to consistently monitor and document their health. Agents or contractors at detention centers are to send monthly updates on these detainees to the executive associate director of enforcement and removal operations. The ICE health service corps, which oversees healthcare in detention, is to continuously evaluate whether it is medically advisable to keep them detained.
“In the very limited circumstances in which detention is necessary and appropriate, ICE must monitor individuals known to be pregnant, postpartum, or nursing detained in ICE custody for general health and wellbeing, including regular custody and medical reevaluation, to ensure appropriate pre- and/or postnatal and other medical and mental health care,” the directive states.
Department of Homeland Security spokesperson Chandler Rebel said the agency is still adhering to the directive. “The 2021 directive is still in place,” Rebel said. “Pregnant women receive regular prenatal visits, mental health services, nutritional support, and accommodations aligned with community standards of care.” Rebel did not engage with the Guardian’s questions about reports that women were not receiving essential prenatal, postpartum and miscarriage care.
Court records and interviews with US congress members, immigration attorneys and pregnant detainees reviewed by the Guardian indicate the administration has all but abandoned adherence to the directive. In more than a dozen cases reviewed by the Guardian, attorneys said they did not receive any clear explanation from ICE officers or from DHS as to how the detained women met the criteria of “exceptional circumstances.” Many were asylum-seekers with scheduled immigration hearings who had attended mandated ICE appointments.
The Guardian reviewed case details of eight pregnant women and teenagers who complained of medical neglect at the Dilley detention center in Texas — the country’s only ICE facility that holds families as well as single adults. Several of them alleged that language barriers made it difficult to access medical care. One woman who was four months pregnant stopped trusting the medical staff after a nurse shouted at her because she could not speak English, according to Raíces, a Texas-based humanitarian aid and immigration services non-profit. A woman who was pregnant with severe anemia and asthma was unable to get prescribed treatment. A woman who was six months pregnant with a high viral load of hepatitis B was unable to access the antiviral medications she needed to lower the risk of transmitting the infection to her baby.
Three women shared their accounts with the Guardian.
Anabell, 35, an asylum seeker from Nicaragua who has birthed three children and miscarried once before, said she did not know she was pregnant until she turned up for a mandated ICE check-in appointment on February 25 and was told she could not leave. She was given a pregnancy test during a medical examination at the Campbell County detention center in Newport, Kentucky, and the test came back positive. She said she was not given a blood test to confirm a healthy pregnancy, prenatal vitamins or an ultrasound, but did receive a special meal labeled “Medical Diet - Pregnancy High Protein w/ PM Snack” — typically an extra peanut butter sandwich and a small carton of milk.
Over the next weeks, Anabell said, she was often nauseous and could hardly eat or sleep. She would wake up to the cries and screams of other detainees or to the sound of officers yelling. About a month after her arrest, she began bleeding heavily — soaking through a new menstrual pad every 30 minutes. In an emergency medical request, she wrote in Spanish: “This is URGENT, please. I am pregnant and have been bleeding since yesterday … I am scared for the baby.” A day later, she was rushed to an emergency room. Shackled to a hospital bed and under the watch of three immigration officers, she said, she was told through a Spanish interpreter on the phone that she was no longer pregnant.
Hospital records Anabell shared with the Guardian show the ER doctor wrote that her pregnancy hormone levels were low, suggesting she may have lost the pregnancy even before she started bleeding heavily, and that she should return to the hospital if she experiences any new symptoms and should receive follow-up care at a women’s health clinic. Anabell said medical staff at the detention center have not offered any check-ups. She said she has continued to bleed, vomit and lose her hair in chunks, and has lost about 30 pounds. “I don’t know what is going to happen to me,” she said. ICE has repeatedly declined to release Anabell’s medical records to her and her lawyer. Her lawyer obtained the hospital record by calling nearby medical facilities after Anabell said she did not know which hospital she had been taken to. Anabell said she met two other pregnant women in detention, including another who seemingly miscarried.
Laura, 21, was in the second trimester of a high-risk pregnancy when she was sent to the Dilley detention center. Laura, who has a history of miscarriages, said she had gone to an emergency room two days before her detention with miscarriage symptoms and was diagnosed with a high-risk obstetric condition. After arriving at Dilley, a physician evaluated her and told her her condition requires a specialist, according to a legal declaration Raíces shared with the Guardian. “Despite this clinical determination, facility administration has failed to approve or schedule the consultation for me,” Laura stated in the declaration. Laura said she remains detained at Dilley along with her two-year-old son and has not been allowed to see an OB-GYN despite persistent abdominal pain and bleeding as she approaches her third trimester.
Laura was certified for a special visa for victims of crime after a stray bullet struck her and her son last year, according to Faisal Al-Juburi, co-chief executive of Raíces. Laura and her son should not have been detained in the first place, Al-Juburi said.
Angie, 26, learned she was pregnant a few weeks after she was booked into the Mesa Verde detention center in California. A few weeks after that, she said, she woke to large amounts of brown fluid. The medical staff at the detention center told her the miscarriage was not her fault, she said.
Christina Davidson, the chief medical officer of the American College of Obstetricians and Gynecologists, said in July that “placing and holding pregnant patients in detention poses serious medical and mental health risks for both the pregnant patient and fetus.” Lapses in care at detention facilities, she added, could escalate treatable conditions into life-threatening emergencies.
Deborah Ottenheimer, an obstetrician-gynecologist and medical expert with Physicians for Human Rights, said it is clear that detained women are not receiving the medical care they need when they experience miscarriage symptoms. Women who miscarry and do not receive proper treatment, including an ultrasound and other tests to ensure that pregnancy tissue has been vacated from their bodies, could experience infection and other severe complications, Ottenheimer said.
“These incarcerated women are not getting the prenatal visits that they’re supposed to get. They’re not getting high-risk prenatal visits if they need them. And if they do miscarry, the medical care they receive is minimal to none,” Ottenheimer said.
Sarah Decker, a senior attorney at the Robert and Ethel Kennedy Human Rights Center, said she has not encountered a pregnant or postpartum person who meets the definition of extraordinary circumstances. “I have yet to encounter a pregnant or postpartum person who I believe meets the definition of extraordinary circumstances, as it’s used in other areas of the law,” Decker said. Many of Decker’s clients are detained at the South Louisiana Processing Center in Basile, an all-women detention center with the highest number of pregnant detainees in the county, according to ICE data. Decker said many of the pregnant women she has met at Basile have told her they disclosed their pregnancy to ICE officers, had to advocate for access to prenatal care and a gynecologist, and needed emergency care for complications. Decker also raised doubts that ICE was unaware of how many women in its custody had experienced pregnancy complications or miscarried.
“ICE is clearly aware and I think their desire to kind of obfuscate the access that people have to this data is intended to cover up the level of life-threatening medical neglect that’s happening in these facilities,” Decker said.
“It is convenient for the administration that ICE cannot report how many women in its custody had miscarriages,” Al-Juburi said. “When you don’t track something of that magnitude, then you don’t have to be confronted with the reality of what your policies have yielded.”
The Guardian said it is not using full names for the pregnant women in this story to protect their privacy and safety.