Breaking down the structural challenges undermining maternity care for migrant women in the UK, the US, and beyond
By Rhea Panwar
Pregnancy is often viewed as a time of protection and care, but for many migrant women, it unfolds under the shadow of bureaucracy, borders, and structural neglect. In the UK, the reproductive and maternal healthcare needs of asylum seekers, undocumented migrants, and displaced women are consistently sidelined, revealing a systemic failure in the healthcare system. From delayed antenatal appointments to the fear of immigration enforcement, these women navigate a journey marked by layers of vulnerability, racial discrimination, legal precarity, isolation, poor detention conditions, language barriers, and trauma. Their experiences are not isolated, but part of a wider crisis in maternal health shaped by the intersections of migration, race, and gender injustice.
Isolation, Risk, and the Cost of Asylum
A 2022 report by Maternity Action, based on in-depth interviews with women navigating pregnancy while seeking asylum, sheds light on the toll this system takes. One woman described the confusion and fear of being transferred without support: “They would just like, tell you, you have an appointment, in this hospital… and for your first time in the country, you don’t know, where is [the] hospital, there is not somebody to direct you, or to even take you there”. The report reveals how policies meant to manage asylum claims are instead compounding health risks, particularly for pregnant women, by stripping them of continuity, stability, and access to the most basic care. This lack of continuity and support during pregnancy, documented in multiple testimonies, exacerbates the dangers of giving birth in exile and exposes deep systemic failures in the UK’s treatment of pregnant asylum seekers.
Women seeking asylum face one of the highest risks of poor maternal and neonatal health outcomes. Research shows they experience higher rates of maternal mortality and complications compared to the general population.
A case series review found that pregnant migrant women in detention were seven times more likely to have a high-risk pregnancy than the average woman in the UK (Pallotti and Forbes, 2016). Many enter pregnancy with existing physical and mental health issues (malnutrition, trauma, chronic illness), which often go untreated and further elevate pregnancy risks. Despite this, their access to care remains systematically blocked. The 2016 MBRRACE report found that non-UK-born women accounted for one-quarter of maternal deaths in the UK, with 12% of these women being refugees. However, more recent data suggest the situation has worsened. The 2024 MBRRACE-UK report reveals that around 30% of women who died during pregnancy between 2020 and 2022 were born outside of the UK. Women from some countries were disproportionately represented, pointing to persistent structural inequalities in maternal care. This rise comes as the number of migrant births continues to climb: in 2022, almost one in three babies born in England and Wales had a mother born abroad—the highest proportion ever recorded.
Despite increasing awareness, the gap in maternal outcomes for migrant and refugee women is not closing. If anything, it’s widening.
Healthcare Hostility and Barriers to Care
Undocumented women and those awaiting asylum decisions in the UK are often too afraid to access maternity care, trapped between the fear of immigration enforcement and the urgency of their health needs. Despite NHS guidance stating that maternity care should never be denied, real-world practice tells a different story. Charging policies remain in place for certain treatments, and frontline staff often miscommunicate or misapply the rules. For many women, the threat of being reported to the Home Office or facing bills they cannot pay is enough to keep them away from clinics altogether.
The barriers are not only legal but also financial. Asylum seekers in the UK are expected to survive on just £49.18 per week per person. Pregnant women receiving this support are entitled to an additional £5.25 a week to buy healthy food, an amount widely criticised as inadequate. A one-off maternity grant of £300 is also available, but only under strict conditions: the baby must be due within 11 weeks or be under six weeks old.
However, these provisions are often inadequate, and many women either do not know about them or find them difficult to navigate, resulting in missed opportunities for vital support.
For some women, the strain of the UK’s asylum system begins to manifest in their bodies and in the health of their unborn children. One mother, interviewed in Maternity Action’s Lived Experiences of Pregnant Women Seeking Asylum report, described being placed in a cramped room with her children, surviving on little more than cornflakes, bread, and tea. Repeated relocations, lack of nutritious food, and the absence of rest took a toll.
At 35 weeks, a scan revealed her baby was no longer growing properly. When questioned by health staff, she broke down: “They asked me, ‘What is the problem?’ And I said the problem is this accommodation, this movement, this movement is too stressful. I don’t even have food to eat, you are moving me up and down, I can’t even sleep, I can’t even rest. The basic things I need when I am pregnant…. I can’t sleep well, I can’t rest well, I can’t even eat well, so how will the baby grow?”.
Her story is not an outlier. It is one of many in a system that prioritises control and containment over care. Where the conditions of pregnancy are shaped not by medical needs, but by policy decisions made far from the women they affect.
This is a stark example of how systemic neglect, combined with inadequate accommodation and lack of access to consistent care, directly threatens maternal and foetal health. But the lack of access to care is not solely about physical barriers. It is also exacerbated by language barriers, racial stereotyping, and medical indifference. Many migrant women, already vulnerable, report experiencing discriminatory treatment by healthcare professionals. Cultural differences around pregnancy and childbirth are rarely acknowledged or respected, which only serves to erode trust between migrant mothers and the healthcare system.
Detention, Trauma, and Reproductive Control
In the UK, pregnant women can still be detained in immigration centres, up to 72 hours, or up to a week with ministerial approval, despite mounting evidence of the harm this causes. The policy, introduced after a 2016 Home Office review, was intended to limit detention. Yet medical professionals and human rights advocates argue that even short periods behind bars can severely affect a woman’s physical and mental health, particularly during pregnancy.
Before the reform, an estimated 100 pregnant women were detained each year, often for prolonged periods. Many suffered anxiety, depression, and complications linked to inadequate care and the stress of confinement. In their 2013 report Expecting Change, Medical Justice researchers Natasha Tsangarides and Jane Grant warned that the practice placed women and unborn babies at serious risk, and called for an end to the detention of pregnant migrants altogether.
More than a decade later, critics say little has changed. Pregnant women continue to be detained, sometimes without clear justification, raising urgent questions about whether the UK is prioritising border control over basic maternal health.
In the United States, the Trump administration reversed a policy that had presumed pregnant detainees should not be held. As a result, Immigration and Customs Enforcement (ICE) began making “case-by-case” decisions about detaining pregnant women, leading to widespread mistreatment. Pregnant women in Border Patrol facilities have reported appalling experiences, including physical abuse, being denied medical care, and even being pressured to have abortions. Tragically, during the first two years of the Trump administration, the number of miscarriages among detained women nearly doubled.
Under President Trump’s second administration, policies affecting pregnant women in immigration detention have become even more stringent. In early 2025, U.S. Customs and Border Protection (CBP) rescinded internal policies that had previously ensured basic care measures for pregnant detainees, such as access to food, water, and medical care. This decision, outlined in an internal memo signed by acting CBP Commissioner Pete Flores, claimed the policies were “misaligned with the agency’s current guidance and immigration enforcement priorities”. The removal of these safeguards has raised significant concerns among civil rights advocates about the treatment of vulnerable individuals in detention facilities.
These policy changes will likely lead to increased reports of mistreatment, including the denial of medical care and other abuses against pregnant detainees. The American Civil Liberties Union (ACLU), along with the ACLU of San Diego & Imperial Counties and other partners, previously raised concerns about the lack of medical care and the appalling conditions that young children are subjected to in Border Patrol facilities.
After a woman was forced to give birth in a Border Patrol station while holding onto a garbage can, the ACLU advocated for the expedited release of individuals who are pregnant, postpartum, or nursing to ensure proper medical care. But now, with the recent reversal of these protections, the full effects on pregnant migrants remain uncertain. However, the situation will undoubtedly worsen as the absence of these critical protections sets the stage for further abuse, neglect, and suffering among those who are already in desperate need of care and compassion.
Inhumane Conditions and Unethical Medical Practices in Detention
In the United States, immigration detention centres remain hostile environments for pregnant women, spaces described by some as “Hell on Earth.” Built for single adult men, these facilities are fundamentally unfit for women, let alone those carrying children. Overcrowding, unsanitary conditions, and the absence of privacy create an atmosphere of constant anxiety. Access to basic hygiene, proper nutrition, and consistent prenatal care is often non-existent. Women report sleeping on cold concrete floors, going days without medical attention, and struggling to get even the most basic support during pregnancy.
The consequences go beyond neglect. A 2022 investigation by the U.S. Senate’s Permanent Subcommittee on Investigations uncovered deeply troubling patterns of what experts called “aggressive and unethical gynaecological care.” Among the findings: detained migrant women were subjected to unnecessary and invasive procedures, including hysterectomies, without proper explanation or consent. In some cases, women did not even understand what had been done to them until after their release. These practices reflect a systemic disregard for bodily autonomy, leaving many pregnant detainees traumatised, uninformed, and stripped of the ability to make decisions about their care.
Page 1 of a letter from a woman detained at Krome North Processing Centre in Miami, Florida – written to her fiancé in February during her incarceration.
Intersectionality and Mental Health
Migrant women live at the intersection of multiple systemic failures. They are not only racialised, but are disproportionately affected by poverty, undocumented, linguistically isolated, and disconnected from social support. Many are housed in accommodations that are damp, overcrowded, or unsuitable for raising infants. Access to nutritious and culturally appropriate food during pregnancy is often limited, while administrative delays routinely disrupt timely antenatal care. These challenges are further made worse by the psychological toll of uncertain immigration status, heightening the risk of poor perinatal mental health outcomes.
Among migrant women, those furthest from whiteness, particularly Black women and others affected by colourism, face layered forms of discrimination in healthcare, rooted in colonial hierarchies that continue to shape medical institutions. These racialised experiences are not peripheral but central to understanding the disparities in maternal care. Clinical biases, stereotyping, and systemic neglect often mean that those most marginalised receive the poorest treatment, with devastating consequences during pregnancy and childbirth.
Mental health concerns such as postpartum depression, anxiety, and deep isolation are also widespread. But loneliness is not accidental. It is often engineered through dispersal policies that sever women from their linguistic, cultural, and social support systems. Many are moved far from any community ties, forced to navigate labour and early motherhood in isolation. As researchers Nellums et al. (2021) describe, this creates an “ongoing cycle of precarity,” a structural vulnerability that persists long after the baby is born, embedding stress into the earliest stages of maternal life.
Care in the Margins: Voluntary Support Amid Systemic Failures
Voluntary organisations have become lifelines where the system fails. Groups like Happy Baby Community, Women for Refugee Women, and The Migrant Women’s Rights Service offer a space of refuge, providing emotional support, practical advice, and peer companionship for pregnant women and new mothers navigating the asylum process. Midwives and maternity support staff often step in where state services are absent, providing culturally sensitive, trauma-informed care.
While administrative barriers such as complex forms written in inaccessible English, missing documentation, and unclear eligibility rules continue to block access to care, community-led initiatives like these often step in, offering the translation, empathy, and persistence that the formal healthcare system fails to provide.
A Reproductive Rights Emergency
Motherhood should be a universal moment of safety, care, and dignity, not one shadowed by immigration status, legal barriers, or systemic neglect. Around the world, migrant women face profound challenges in accessing maternal healthcare, from the UK’s restrictive charging policies to the brutal conditions of US detention centres. For millions, reproductive rights are meaningless without accessible, culturally competent care, and maternal health risks escalate when protections fail.
Governments globally must go beyond policy statements and targets to confront and dismantle the structural obstacles that deny migrant women the care they need. This includes ending punitive practices like detention during pregnancy, ensuring language and cultural support throughout maternity services, and reforming healthcare systems to address racial and social inequities.
No woman anywhere should live in fear of detention, deportation, or financial hardship while seeking maternity care. The realities of motherhood in transit expose deep, systemic failures that demand urgent, coordinated reform.
Migrant women and their children are not inherently less healthy than host populations. Instead, it is the legal, social, and economic barriers they face: barriers compounded by xenophobic rhetoric and exclusionary policies that fuel inequalities and place mothers and babies at risk.
If the world is to safeguard the health of future generations, it must first protect the women who bring them into being, ensuring that no mother anywhere sacrifices her safety to access the care she needs.
List of Voluntary and Community-Based Organisations Supporting Migrant Mothers:
- Happy Baby Community: https://www.happybabycommunity.org.uk/
- The Migrants Women’s Rights Service / Maternity Action: https://maternityaction.org.uk/
- Women For Refugee Women: https://www.refugeewomen.co.uk/
This article is part of the series “Women On The Move. Fleeing, Fighting, Forgotten” To read more inspiring stories of everyday women making a real difference in the world, be sure to check out the latest edition of Wempower magazine, or listen to our podcast.
