Records show a blanket placement directive despite HHS denials
The Trump administration is still detaining pregnant migrant girls in a region of South Texas where the lack of specialized obstetric care can be life-threatening for them, an investigation by The Texas Newsroom and The California Newsroom has found. The practice continues despite vocal concern from current and former government officials and from members of Congress.
Government records show that in the first ten months of the policy, four of the 21 pregnant girls placed in the region had to be transferred out of state to receive specialized medical care, including at least one abortion, that is unavailable in Texas.
“The first time that happened should have been a wake-up call for the administration, and they should have stopped placing kids in any remote area where they can’t get care,” said Jen Smyers, who during the Biden administration helped oversee the Office of Refugee Resettlement, the agency responsible for migrant youth apprehended by immigration authorities without a parent or guardian. Smyers called the policy of sending all pregnant children to South Texas “enraging.”
This spring, the two public-radio collaborations published a joint investigation revealing the administration’s practice of detaining pregnant unaccompanied minors — some as young as 13, at least half of them pregnant as a result of rape — at a single shelter in San Benito, near Texas’ border with Mexico. That investigation detailed serious concerns raised by health experts inside and outside government, given that adolescent pregnancies are inherently high risk and specialized obstetric care is scarce in the region.
The administration has denied that any such policy exists and said it is ensuring the girls have access to the care they need. In an email in September, the Department of Health and Human Services, which oversees ORR, wrote that “ORR’s policies for placing children in its custody into care provider facilities are based on child welfare best practices in order to provide a safe environment and place the child in the least restrictive setting appropriate for the child’s needs. This is especially true for expectant minors in ORR care.”
Yet documents obtained through a public records request show ORR explicitly directed its staff in July 2025 to send all pregnant youth to the San Benito shelter, just outside Brownsville at the extreme southern tip of Texas. Several months later, internal agency data showed pregnant girls being sent to a different shelter nearby instead, according to three ORR officials who asked not to be named because they feared retaliation.
Forty-eight Democratic members of Congress demanded transparency about the policy in a pointed letter to HHS in April. In September, Alex J. Adams, an assistant secretary at the department, responded that ORR “does not make placement decisions for pregnant youth based on a blanket rule or one-size-fits-all approach” and that it “takes seriously its responsibility to protect the health, safety, dignity, and well-being of every unaccompanied alien child in its custody.” HHS did not respond to requests for comment about the discrepancy between Adams’ letter and the government’s own records.
“Obviously, they’re not being honest about their policy,” said U.S. Rep. Joaquin Castro, a Democrat from San Antonio whose office authored the letter. “It’s irresponsible that they would wait several months to respond to basic questions about the care of some of the most vulnerable people within the system,” Castro said, adding that the administration failed to explain “what seems to be an informal but strict policy of sending these girls to deep South Texas, which lacks the medical care that the girls need.”
Unaccompanied migrant children have historically been placed in shelters across the United States, but this summer the administration began detaining far more of them in Texas. Internal reports provided independently by two ORR officials who spoke on the condition of anonymity showed that 95% of the roughly 300 children apprehended by immigration officials in September were placed in detention in Texas, up from 45% in June. Advocates for unaccompanied migrant children, former government officials and some members of Congress have criticized the shift, arguing the state is not prepared to handle an influx of vulnerable children, some of whom need special care.
For Chu, the out-of-state transfers prove the critics’ point. “If the government had to fly or transport these pregnant children across the country to get them the medical care they need, why on earth did it deliberately send them to Texas in the first place?” said U.S. Rep. Judy Chu, a Democrat from Southern California who signed the congressional inquiry letter. “If there is a 13-year-old girl who has survived rape, she should be met with compassion, safety and appropriate medical care. Instead, this administration is placing children like her in a state where they will be deprived of access to basic healthcare. It’s dangerous, and it’s cruel, and there’s no excuse for treating children this way.”
Unlike Immigration and Customs Enforcement, which detains migrant adults and families in large, prison-like facilities, ORR holds unaccompanied children in group or foster homes overseen by private contractors. Laws, agency regulations and court orders require that the children receive comprehensive health care and appropriate education while detained. In an emailed statement last month, HHS said placing children in Texas is “operationally efficient” and that ORR’s facilities in the state “provide all requirements and more.”
The records show that between July 2025, when ORR began placing pregnant girls in South Texas, and May 2026, four of them had to be transferred to other states for medical treatment — roughly one in five of the 21 pregnant girls the agency placed in the region in that period, according to one of the ORR officials who requested anonymity. In detailed notes for one case, ORR staff wrote that a pregnant 12-year-old girl was transferred from the Rio Grande Valley to a shelter in New York on the recommendation of ORR’s division of health, because she needed access to specialists whose availability in South Texas is “extremely limited.” A note for another case recorded a transfer to California for an unspecified “high risk medical need.” In at least one case, a girl was transferred out of Texas because she had requested an abortion.
Marsha Griffin, a retired professor of pediatrics at the University of Texas Rio Grande Valley School of Medicine who oversaw medical students volunteering in ORR facilities in South Texas, said such outcomes were inevitable. The shelters have very few medical staff on hand and the region does not have enough specialized obstetricians, she said. “Young girls who are pregnant, especially those from 10 to 14 years of age, are automatically a high-risk population,” Griffin said.
The warnings came from inside the agency as well. Internal communications obtained through a public records request show officials in ORR’s own division of health cautioned the agency’s leadership about the lack of pregnancy-related health care in the Rio Grande Valley. “Texas has one of the worst rates of maternal mortality in the U.S.,” Joanna Gaines, who at the time was ORR’s acting health director, wrote in a July 18, 2025, email to Melissa Johnston, the agency’s head of operations. She added that the state “lack[s] access to quality perinatal healthcare” and that the Rio Grande Valley’s Cameron County “has one of the higher rates of infant mortality in Texas.” Four days later, ORR issued a directive to begin placing “any pregnant children” at the Urban Strategies San Benito shelter in Cameron County.
Tracey Wilkinson, a pediatrician in Indiana who specializes in reproductive health care access for minors, said that even when children are transferred for care, waiting until they need it puts them in danger. “When you’re talking about labor or pregnancy complications, every minute counts,” Wilkinson said. “If it was a medical emergency that required this young person to be transported out of the state, the risk to her survival would be lower for no reason other than she was placed in the middle of nowhere, far away from medical care.”
Shortly after the spring investigation revealed the policy, Castro launched an inquiry into the practice and arranged a visit to the San Benito shelter. By the time of his visit on April 7, internal agency data showed ORR had stopped placing newly detained children with known pregnancies at the facility and was sending them instead to a shelter in Los Fresnos, 13 miles away, according to the three officials who spoke anonymously. Castro said he was not told of the change at the time of his visit, nor was it mentioned in ORR’s formal response to the congressional inquiry last month. He described the agency’s handling of the visit as “very secretive” and said he was not allowed to see or speak with any children there.
Chu said she believes the administration made the location change in order to “deliberately mislead Congress members as well as the public from really knowing where these pregnant children have been.” An HHS spokesperson did not respond to that allegation, or to earlier questions about the location change, writing only that “there have been no operational changes regarding the placement of pregnant unaccompanied children.”
Compass Connections, the San Antonio-based nonprofit that operates the Los Fresnos shelter where pregnant girls are now held, is one of the largest ORR contractors, having been awarded more than $1.9 billion in federal grants to house and care for unaccompanied minors over the past four years, according to figures released on USASpending.gov. Asked whether it agreed to accept all pregnant unaccompanied children at the shelter and how they are being cared for there, the organization referred the newsrooms to HHS. In his letter, Adams wrote that “placement and transfer decisions are individualized and consider the child’s safety, medical and behavioral health needs, pregnancy-related needs, available services, legal access, family unity, least restrictive placement requirements, and the best interest of the child.”
In California, meanwhile, members of Congress and advocates said the state offers far more support for pregnant girls in federal custody than they can receive in Texas. As the administration has withdrawn federal support for legal representation of unaccompanied children and at the same time streamlined the process of deporting them, California and several of its cities and counties have ramped up funding for their own legal services programs for undocumented minors. “Pregnant unaccompanied children have rights to medical care, safety, family unity and due process, but those rights mean little without a lawyer to defend them,” said Marion “Mickey” Donovan-Kaloust, director of legal services at Immigrant Defenders in Los Angeles. “California’s support systems can provide pregnant unaccompanied children with the stability, dignity and specialized care they need to be safe and thrive.”
Advocates also allege the administration is knowingly putting pregnant children at risk to advance an ideological goal: denying them access to abortion by placing them in Texas, where abortion is virtually banned. Current federal regulations require the government to move detained minors who request abortions to states where it is legal; in January, the administration announced it plans to rescind that rule, though it has not yet done so. An HHS spokesperson said in February that claims the department is attempting to restrict unaccompanied children’s access to abortion are “completely inaccurate.” “In California, they would have more access to all reproductive healthcare, and then they could make decisions based on discussions with their healthcare professional and what’s best for them,” said Rep. Gil Cisneros, a Democrat from Southern California who also signed the inquiry letter.