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one of the women who says she received a hysterectomy without her consent; Congress intervened to prevent her deportation after she was already on a plane, waiting on the tarmac. As a former immigration law attorney, I seethed when nurse Dawn Wooten reported that mass hysterectomies were performed on women without their meaningful consent at an immigration detention facility in Georgia. Much like other abuses in the broader United States, abuses of women’s health and rights in immigration detention fall hardest on women of color, women with disabilities, low-income women, transgender women, and young women and girls. At its core, all detention is separation—from family, from community, and from access to critical services. However, on appeal to the U.S. Court of Appeals for the District of Columbia, a three-judge panel led by now-Supreme Court Justice Brett Kavanaugh sent the case back to the district court to give the ORR time to find a sponsor to transfer Jane Doe out of custody. The right to access abortion care established under Roe v. Wade applies to all people in the United States, including those in immigration detention.151 The combination of restrictive state and federal laws and an administration that is actively working to undermine those rights violates the reproductive autonomy and constitutional rights of people in immigration detention.

; Freedom for Immigrants, “Detention by the numbers.”, Office of Refugee Resettlement, “Facts and Data,” available at, HealthyPeople.gov, “Access to Health Services,” available at, Abigail Hauslohner and Maria Sacchetti, “Hundreds of minors held at U.S. border facilities are there beyond legal time limits,”, U.S. Immigration and Customs Enforcement, “Detention Management: Detention Statistics,” available at. Community support, access to services, and freedom from violations of bodily autonomy are key to realizing reproductive justice for women and girls in the U.S. immigration system. The Flores settlement set national standards for the safety and treatment of children in federal custody, including an emphasis on reuniting children and families as quickly as possible and a requirement to place children “in the least restrictive setting appropriate.”69 While the Trump administration has attempted to undermine the Flores settlement and detain children and families indefinitely, its efforts have been blocked in the courts.70, In addition to these standards, ICE and the ORR have protocols under the Prison Rape Elimination Act (PREA), to prevent, detect, and respond to sexual abuse and assault in detention, including medical care.71 PREA was passed in 2003, but HHS and ICE were not directed to create PREA standards until the passage of the 2013 Violence Against Women Reauthorization Act. Yet the U.S. immigration detention system is nowhere near providing the best circumstances. In its place, community-based alternatives to detention can connect people with key legal, health, and social services; improve compliance with immigration proceedings; and are significantly less expensive than detention.5 Maintaining the status quo of unnecessarily detaining vulnerable groups in substandard conditions will have disastrous consequences for the health of immigrant women and girls and will facilitate the Trump administration’s efforts to dehumanize immigrant women of color.

She decided to return to El Salvador after her miscarriage, when she realized that the United States would not be a safe haven for her.79, From October 1, 2017, to August 31, 2018, ICE detained a reported 1,655 pregnant women.80 As of August 31, 2018—the most recent data available—there were 60 pregnant women in ICE custody.81 News outlets and advocates have reported stories of pregnant women across ICE, CBP, and U.S. The standards developed by the advisory board should include: Evidence-based health care standards must be adopted across facilities in the departments of Homeland Security and Health and Human Services, and must be binding and apply to all facilities, without the option to waive compliance. Congress has rightly called for an investigation of these reports.

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