"Don't Tell and They Won't Ask": Reproductive Health Care in Immigration Detention

Detained and Dismissed: Women's Struggles to Obtain Health Care in United States Immigration Detention, a report released today by Human Rights Watch, sheds much-needed light on the unique harms immigrant detention centers inflict on the reproductive health and lives of women detainees. The report arrives just in time to get detainees' reproductive health needs on the national agenda.

Responding to growing evidence of inhumane conditions and deplorable medical care for U.S. Immigration and Custody Enforcement (ICE) detainees, last month Representative Lucille Roybal-Allard (D-Calif.) introduced legislation to adopt humane and legally enforceable standards for immigration detention facilities. Also, last December ICE released enhanced medical standards that will become fully effective by 2010. Thus, as policymakers finally start to address the unacceptable treatment of immigrant detainees, today's report confirms the need to explicitly address women's reproductive health needs as part of those efforts.

Detained and Dismissed documents a disturbing patchwork of incomplete or inaccessible reproductive health services for female detainees. Basic services and options related to reproductive health, including emergency contraception, prenatal care, post-partum care, and abortion, are, according to today's report, available to some detainees, at some facilities, under some circumstances, if you know who, and how, to ask. For example, ICE officials told Human Rights Watch that postpartum and nursing mothers could obtain breast pumps, yet none of the interviewed women who were lactating while in detention were ever offered that option. Likewise, when pressed by the researchers, ICE officials indicated that emergency contraception and abortion care can be accessed, but as a practical matter, they are not offered or provided to detainees. As one interviewee explained "if I had the option I would have [had an abortion] . . . I didn't know that there were those kind of services available."

This "Don't Tell and They Won't Ask" approach to reproductive health care for detainees is simply unworkable and unacceptable. ICE must comprehensively and explicitly remedy the service and information gap regarding women's reproductive health needs. That may be no small task. But actually telling women detainees about the full range of reproductive health services to which they are entitled is one easy place to start.