Iliana is an asylum-seeker from El Salvador who has been detained by Immigration Customs Enforcement (ICE) since mid-January. She is about two months pregnant.

Iliana says she did not know that she was pregnant until a pregnancy test conducted while in detention came back positive. According to a press release published by Pueblo Sin Fronteras, a collective that fights for migrant and refugee rights, Iliana began experiencing bleeding and pain around the time she crossed the border. While in the custody of border officials, she bled heavily for several days. Still, she was not taken to see a doctor until a pregnancy test came back positive. Around Jan. 23, when she was finally taken to see a doctor, she was told that her fetus’ heartbeat was abnormally slow. A follow-up appointment was scheduled, but it never happened. Instead, Iliana was transferred to the Otay Mesa Detention Center in San Diego, California. There, a nurse administered an ultrasound.

Neta spoke with Iliana to ask if there had been any updates or changes in her care. She communicated that although she has continued to experience strong pains, she has yet to be told the results of her test or to be taken to see a doctor again. When she complains about the pain, she says she is told to drink more water and go lie down.

Iliana’s story is far from rare.

In September 2017, seven civil rights and legal service organizations, among them the American Civil Liberties Union (ACLU),  the American Immigration Lawyers Association (AILA), and the Refugee and Immigrant Center for Education and Legal Services (RAICES), submitted a formal complaint against ICE with the Office of Civil Rights and Civil Liberties (CRCL), another sub-agency of the Department of Homeland Security.

The complaint, which contains personal testimonies, sheds light on the conditions pregnant immigrant women are facing in detention centers. Despite being detained in centers hundreds of miles apart, detained women report similar issues: lack of timely and qualitative medical services & treatment by specialized professionals, frequent transfers limiting mobility and access to appropriate care, and non-nutritious and limited food options.

For two of the women interviewed for the complaint, the trauma endured in their journeys to the U.S. combined with the the stress induced by having to fight their deportations from within detention and the inadequate care and conditions experienced while in detention likely contributed to their miscarriages. Their testimonies stand in stark contrast to existing internal guidelines like an August 2016 ICE policy which states, among other things, that ICE should not detain pregnant women unless the mandatory detention statute applies or “extraordinary circumstances” exist.

Four months since the complaint was filed, detainees and advocates insist not much has changed. Negligence and maltreatment, they say, remains the norm.

Jenneye Pagoada is one of the women speaking out on detention conditions. In July 2017, she arrived at the San Ysidro Port of Entry seeking political asylum.

According to Pagoada, both she and her legal representative informed San Ysidro officials on multiple occasions she was pregnant, even providing them with copies of a recent pregnancy blood test and ultrasound. They also informed officials that a doctor in Salvador had deemed her pregnancy high-risk. Although Pagoada let officials know that she was experiencing abdominal pains and requested to see a doctor, her requests were ignored and she was placed in a temporary detention cell. The night after she entered custody, around 2 AM, Pagoada remembers the pain was so unbearable it woke her up. Shortly after, she began to bleed profusely. According to Pagoada, she and other detainees made several attempts to get help but her requests were denied or ignored. On one occasion, the agent that approached her told her she did not speak Spanish. Another time, an agent told her that because there was no doctor on the premises there was nothing that could be done. The last time she tried calling for help, Pagoada remembers no one responded.  The next day, Jenneye was transferred to Otay Mesa. There, she was told she would have to wait for officers to go through their processing system before she could see a doctor.

According to Pagoada, she and other detainees made several attempts to get help but her requests were denied or ignored.

About 48 hours after she was transferred to Otay Mesa, in the late hours of the night, Pagoada was finally taken to go see a doctor in the facility. According to Pagoada, the doctor did not conduct any extensive testing but she did order a urine test to confirm Pagoada was pregnant. When a bloody urine test returned positive, the doctor decided further tests were needed. About 48 hours later, a blood test was conducted. This time, five days after Pagoada entered detention, the test results indicated she had miscarried. According to Pagoada, the doctor told her she was sorry. Pagoada says did not receive any medicine or aftercare.

Pagoada was released from detention in January 2018. She continues to be outspoken about what she lived and saw while detained.

“My case,” Pagoada shared, “is not the only one.”

In fact, Pagoada knows of at least 3 cases similar to hers that also ended in miscarriage.

“The treatment that they provide pregnant women has to be better. They should not treat us as if we’re nothing. What we have inside of us is a human being. It’s not nothing.” Citing the lack of medical equipment, nutritious food, and on-site gynecologists, Pagoada stated, “if they are going to keep us detained they should at least be able to provide us with the services and treatment we need.”

They should not treat us as if we’re nothing. What we have inside of us is a human being. It’s not nothing.”

According to the National Institutes of Health, symptoms of a miscarriage include “low back pain or abdominal pain and vaginal bleeding, with or without abdominal cramps” and advises to see a doctor immediately if bleeding occurs.

Iliana is currently about two months pregnant. It’s been more than two weeks since she last saw a doctor. “They don’t take me to the doctor because they say that I’m always complaining about the same thing,” Iliana shared. Still detained, Iliana fears that, like Pagoada and so many of the other women she has met, a miscarriage might be hours away.  According to Pagoada, she was past three months pregnant when she miscarried.

Alex Mensing, the Project Coordinator at Pueblo Sin Fronteras, told Neta that he learns of about three to four new cases of pregnant women detained each month.

“Unfortunately, [Iliana and Pagoada’s] are not even the most egregious cases,” he told Neta. According to Mensing, a lot of women don’t speak out because of a fear of retaliation.

When asked whether he believed ICE could be intentionally denying Iliana medical care, Mensing replied, “ICE is willfully careless about providing medical attention…it’s retaliation by the entire immigration system against people from other places, against brown people, against refugees who are coming to the U.S…. the entire immigration detention and deportation system and private system is retaliatory.”

Mensing shared an audio clip of Reina Hernandez, a woman with serious health issues also detained at Otay Mesa. Although Hernandez is not pregnant, she has befriended detained pregnant women. Speaking about the miscarriages of women around her, she can be heard asking, “With what can [ICE] fill the void they’ve left? What can the replace that loss with? You cannot replace it with anything, not with money. It can’t be replaced with anything. It’s not just anything.” With a broken voice she states,”Here they treat you badly, they discriminate against you, they look at you as if you are nothing…The things they tell you sometimes hurt more profoundly than what [dangerous criminals] told us. At least back home we knew perfectly well that the people who hurt us were bad people…But here the people who harm us, who discriminate against us, who see us as less, are educated people, who have never suffered [and] who have never lived a life like the one we have lived. [They are people] who have had the great privilege of being born in a free country with many opportunities.”

Pointing out the irony of a sub-agency investigating a fellow sub-agency, Mensing called ICE an agency with “no oversight and no accountability.” The government, he added, is “not going to hold itself accountable…it’s going to take people organizing and holding them accountable.” For Mensing that means, joining community campaigns aimed at the expansion of prisons and detention centers, contacting elected officials, applying pressure to local ICE Field Offices, and opening up homes and/or community spaces to detained immigrants without a place to go to are tangible ways community members can support detained women. “We have to rely on our own standards of human decency and human rights..and we have to watch out for one another,” Mensing stated.

What can the replace that loss with? You cannot replace it with anything, not with money. It can’t be replaced with anything. It’s not just anything.”

As Trump officials discuss ways to reverse a recent decision to protect undocumented women’s right to receive an abortion, the hypocrisy is not lost that the same administration looks the other way as undocumented pregnant women who desire to see their pregnancies to term are subjected to harsh and inhumane conditions which contribute to miscarriages

In the Rio Grande Valley, there is only one detention center that houses women: the Puerto Isabel Processing Center. Like the San Ysidro center, it serves as a temporary center. In 2015, it ranked in the top one percent nationwide in the number of individuals it transferred on to larger centers like the South Texas Detention Center and the Karnes County Detention Center in Dilley and Karnes City, Texas.

Neta reached out to ICE for information on their policies and protocols for detained pregnant women. A response was not provided in time for the publishing of this article.