Amanda Isabel Fanego Cardoso was about 11 weeks pregnant when she was detained last September, then transferred between five immigration facilities over several months. Because her medical care was so limited, she said, it was only after her release this February that she learned she had developed potentially life threatening pregnancy-related conditions. 

Cecil Elvir-Quinonez was about eight weeks pregnant and still breastfeeding her 5-month-old when she was detained in January. She received emergency room care on January 6 after experiencing heavy bleeding and cramps in federal custody. The next day, she was transferred to a detention facility in Louisiana, where, though her bleeding continued, she received no follow-up medical attention or prenatal visits, according to her family.

A pregnant woman in Minnesota was pulled over by immigration officials on her way to work in January. While detained, she developed abdominal pain, according to her lawyer. She, her husband and two children were sent to a Texas detention facility that did not have an OBGYN on staff. A nurse she saw took her blood pressure, but did not do anything to address the stomach pain, said her lawyer, who asked that The 19th not name her or her client, who fears retaliation for speaking about her experience in detention.

Marianela Leon Espinoza, who was detained last July in California while pregnant, had only one medical visit during her detention — which was just shy of two months — according to court filings. 

Government detention standards say that when pregnant people are detained, they should receive comprehensive health care, including routine prenatal visits, specialized follow-ups if needed, prenatal vitamins and proper nutrition and exercise. But court documents and interviews with pregnant detainees and immigration attorneys across the country paint a different picture: Pregnant people in detention facilities say they are receiving sporadic medical visits and slow or limited medical care even when they experience bleeding, pain and other complications that could threaten their pregnancies. Some who have received medical visits say they were not given test results.

Allegations of improper medical care for pregnant people are piling up. The 19th has spoken to two women who were pregnant while detained and four attorneys whose clients were pregnant while detained, and reviewed court records related to another similar case from last summer. A new report suggests that lack of medical care is endangering pregnant immigrants, who suffer complications in detention and do not receive timely treatment. 

For a report published Wednesday from two advocacy groups, the Women’s Refugee Commission and Physicians for Human Rights, researchers traveled to Honduras to spend a week interviewing recently deported people, including three women who were “visibly pregnant” and four who said they were recently postpartum. All four postpartum women had been separated from their children, including one who was just two months old, according to the report. None of the women’s names were published.

Three pregnant women said they had “little to no medical care, and lack of access to clean water or healthy food,” according to the report, which did not specify where they were detained. Only one said she was taken to a medical facility for prenatal care; she said she was shackled for the entire appointment and monitored by guards even when providing a urine sample.

In the same report, Honduras-based medical personnel at a center that receives deported immigrants described additional instances of people arriving in the country after receiving limited care for pregnancy-related complications experienced in detention. 

Medical staff described a woman who was deported 10 days after being diagnosed with a missed miscarriage — in which a pregnancy is lost but tissue remains in the uterus, raising the risk of infection. She did not receive treatment in the United States, and required emergency medical care upon arriving in Honduras, clinic staff said. Another medical worker described a pregnant woman who, like Elvir-Quinonez, experienced bleeding while in detention but said she did not receive medical care even after informing guards about her condition. She also required hospital care upon reaching Honduras, the worker said. 

The 19th was not able to speak with any of the women in the report or medical personnel referenced in it.

“You’re putting large numbers of people who might suffer from all kinds of health or life-threatening conditions in this place and then not being attentive to how their bodies might be having health or life-threatening infections,” said Zain Lakhani, a lawyer and director of migrant rights and justice for the Women’s Refugee Commission and one of the report’s authors. “With pregnant people and lactating women, there’s an additional level to the fact that pregnancy is always dangerous.”

A spokesperson for the Department of Homeland Security said that detention of pregnant people is “exceedingly rare,” and that as of February 16, .18 percent of detained people were pregnant.

“Pregnant women receive regular prenatal visits, mental health services, nutritional support, and accommodations aligned with community standards of care,” the spokesperson said. “This includes medical, dental, and mental health intake screening within 12 hours of arriving at each detention facility, a full health assessment within 14 days of entering ICE custody or arrival at a facility, and access to necessary medical appointments and 24-hour emergency care. This is the best healthcare many of these individuals have received in their entire lives.”

The same spokesperson said that use of restraints on a pregnant person only occurs “in the exceedingly rare situation where doing so would protect the life and safety of the detainee.” 

But the spokesperson did not specifically answer questions about how the agency responds to incidents such as missed miscarriage or bleeding, including in Elvir-Quinonez’s case. ICE said that Elvir-Quinonez received “full medical treatment” while in detention.

Espinoza already knew about her pregnancy when she was detained in mid-July, and per court filings, her doctors deemed her high-risk because of a previous miscarriage. While detained, her lawyers wrote, her only medical attention was a “summary visit with a clinician where she received vitamins and folic acid.” 

When asked about Espinoza’s prenatal care specifically, the DHS spokesperson said she was released 23 days after her pregnancy was confirmed. Women are supposed to be tested for pregnancy upon being detained. 

Espinoza first petitioned for release on August 29, and a judge ordered her release at the beginning of September.

Some pregnant patients have received regular health care in detention facilities, including weekly prenatal visits, attorneys said. But just how common that is — versus how many are receiving limited medical care, at best — is difficult to ascertain. 

But under President Donald Trump, DHS has stopped providing reports tracking how many pregnant, postpartum or nursing immigrants are in detention facilities, or detailing the conditions of facilities. Dating back to fall 2019, DHS used to release reports every six months. Immigration and Customs Enforcement has not responded to repeated requests from The 19th for detailed reports, including one filed through the federal Freedom of Information Act.

“People do get taken for visits sometimes, and it depends on the whim of the officers taking care of them, whether or not the people working in the clinic inside the detention center advocate or push for it,” said Amanda Hefferman, a longtime nurse-midwife and professor of midwifery at Seattle University who has worked with many pregnant detainees and studied their treatment in government facilities. “It’s not set up for any type of consistency or regularity — which is exactly what prenatal care is.”

Immigrant rights advocates have raised concerns about the conditions and the consequences for immigrants’ health. Multiple facilities have been forced to impose quarantines because of measles outbreaks. Last year, ICE reported 31 detainee deaths, the highest number since 2004 and more than over the entire course of the Biden administration. At least 11 have died so far this year. Most detainees died after experiencing medical complications, including one man whose family said he died because of an infection stemming from an untreated toothache. None of these people were pregnant or postpartum.

“The extreme risk is clear,” Lakhani said.

Cardoso, 22, said she received few medical visits over the several months she was detained, with visits under supervision of facility guards. Clinical staff would use a stethoscope to check for cardiac activity, but did not perform any ultrasounds. When she received blood tests, she said, she was never informed of the results. Her doctors have not received any medical records from when she was detained, despite repeated requests, according to her lawyer. People detained by ICE have a legal right to their medical records, but the process of obtaining them can be complicated and cumbersome, Lakhani said.

The DHS spokesperson said that Cardoso saw an offsite OBGYN “regularly” while detained, and that the agency provides medical records to any detainee who requests them.

“One time I fainted and fell and I asked them to please make sure everything was good with the baby. And they only heard the heartbeat and they said everything’s OK,” Cardoso said in Spanish. 

Now back home in Florida, Cardoso is seeing a doctor who has diagnosed her with preeclampsia and gestational diabetes. She is not sure if she developed those conditions while detained or after her release. While detained, she received the same meals as everyone else: dishes like pasta, rice and chicken. 

“The days would pass, and I wasn’t able to know how my baby was,” she said.

Her doctors have given her a tentative due date of March 27. They are concerned about the health of her pregnancy, noting that the fetus has been losing weight. Cardoso said doctors are scheduling extra visits to ensure that her daughter is growing appropriately.

ICE has abandoned a guidance that discouraged the detention of pregnant, postpartum and nursing individuals — putting more people into facilities that may not have onsite medical specialists who are equipped for pregnancy care. Research examining 21 detention facilities from 2019 to 2022 found that most did not have a continuous doctor on staff for at least a year. Detention centers have pushed to hire more medical providers in the past year.

After being transferred to a Louisiana facility in early January, Elvir-Quinonez waited until the end of February for her first doctors’ visit, according to her cousin Genesis Turcio. At that visit, she was found to have high blood pressure and to be at risk of preeclampsia. Days later, on March 5, she was deported to Honduras. 

Elvir-Quinonez is now about 16 weeks pregnant. She has not received any treatment for her blood pressure. Her brother is visiting her in an effort to help her find long-term housing and appropriate medical care.

“They’re really providing no health care in there,” Turcio said. “She’s not really that good.”

Her two sons are still in Florida, staying with her family. They have been told their mom is traveling for work. Elvir-Quinonez’s baby, less than a year old, still doesn’t quite understand what’s happening, Turcio said. But her 5-year-old often asks where his mom is, and when she’ll be home. 

“He still asks for his mommy every night,” she said.