I still remember what the grandmother said when I told them the baby’s heart had stopped. I was a chief resident, covering labor and delivery in the midst of a Boston blizzard. The patient had called that morning in early labor, but it had taken her family four hours to dig out the car and drive to the hospital. They were too late. The grandmother asked, “So you’re going to do a C-section, and then start the heart up again?” I shook my head. “No. The baby has died.” She began to wail.
A stillbirth at term still hits me in the gut, despite more than a decade as a high-risk obstetrician. It triggers a litany of what if’s – what if she had come in the night before?
What if it hadn’t been snowing? A natural disaster can keep a pregnant woman from timely access to care, and that delay can stop a baby’s heart.
This winter, an unnatural disaster is keeping pregnant women from timely access to care: the indiscriminate enforcement of immigration laws. Secretary John F. Kelly’s orders have spread fear among our undocumented patients. In 2006, North Carolina began requiring a Social Security number to get a driver’s license, making it so undocumented immigrants could not drive legally. In multiple counties, undocumented drivers are routinely stopped, ticketed and fined simply for driving without a license. With the new executive order, these traffic stops may mean deportation.
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This fear of being stopped and deported is keeping my patients from coming to prenatal appointments. I have pregnant patients with diabetes who are taking insulin and need frequent checkups. Uncontrolled diabetes increases the risk of stillbirth; it also increases the chances that the newborn will have dangerously low blood sugars after birth and be admitted to the neonatal critical care center, doubling costs for newborn care.
My pediatric colleagues tell me that this same fear is keeping undocumented parents from taking children to sick visits and well-child checks, undermining preventive care and causing small problems to fester until they become medical emergencies. This same fear is stopping undocumented victims of domestic violence from calling the police, lest they attract the attention of the legal system.
In the abstract, it’s easy to argue that undocumented families broke the law, and breaking the law has consequences. If undocumented pregnant women want healthy babies, this argument goes, then they should pack up and go back to where they came from. But we don’t live in the abstract; we live in the real world where undocumented immigrants live and work among us. They also pay taxes: If you’re over 65, every time you cash a Social Security check, make sure to thank the undocumented immigrants who contribute $12 billion a year in payroll taxes, according to the Social Security Administration. They grow the economy: Removing all undocumented immigrants would reduce the gross domestic product by $1 trillion, according to the American Action Forum. Many undocumented immigrants work long hours, and they give birth to and raise children that will become the taxpaying citizens, entrepreneurs and inventors of the next generation. Above all, they are human beings, and we are morally obligated to treat them with dignity and compassion.
Indiscriminant immigration enforcement is harming real people in North Carolina, right now. Our state’s leaders must act immediately to prevent needless harm to families and children.
I don’t want to have to tell another mother that her baby’s heart has stopped, and wonder, “What if we’d intervened to prevent this unnatural disaster?”
Dr. Alison Stuebe is an obstetrician and maternal-fetal medicine specialist. She lives in Chapel Hill.