Reproductive Justice and Midwifery on the US-Mexico Border

On August 29th, Kevin Sieff of the Washington Post published an article about the citizenship status of Americans born near the U.S.-Mexico border. According to Sieff, the State Department has been denying U.S. citizens passports, citing citizenship fraud via forged birth certificates certified by (likely) Mexican American midwives in rural areas of the Southwest. Following the article’s publication, a deluge of criticisms questioned the claims alleged by Sieff, noting both distortions of facts and failure to contact key figures related to the story. In particular, both Slate and HuffPost wrote responses asserting that what the Washington Post characterized as a new phenomenon actually began during the George W. Bush administration. As Roque Planas of HuffPost argued, “The Post’s report remains misleading. It relies on anecdotal evidence … [that] implies that years-old practices are new.”¹

https://twitter.com/RoqPlanas/status/1041739964055269376?ref_src=twsrc%5Etfw

Certainly, the Washington Post article is still significant, and there could still be some veracity to Sieff’s claims, even if, as Planas asserts, Sieff’s arguments were not reflected in official State Department documents. The HuffPost article acknowledged that “several lawyers interviewed by HuffPost, including some whose comments formed the basis of the Post’s report, share the paper’s skepticism of the State Department’s accounting and say their caseloads of passport denial claims are rising.”²

Regardless, Planas touched upon an important point to consider in this case. Denying U.S. citizens passports based on their birthing experience is not new. In fact, this skepticism of the capabilities and trustworthiness of midwifery in the Southwest predates the Bush administration and connects to a much earlier narrative that concerns reproductive justice and medical practice throughout the twentieth century and into the twenty-first.

Midwives in the American Southwest

In Mexican American folk healing practices, curanderismo, midwives have a particular name that differentiated their work from other practitioners: partera. As with other curanderismo healers, parteras treated the mind, body, and spirit of their patients through herbal remedies, rituals, and therapeutic massage.³ The birthing practices of a partera were as cultural as they were medicinal. Home births with a partera often included prenatal and postnatal treatment for the mother, and the birth occurred in a cultural and religious setting that emphasized faith within a female-centered space.⁴

For many Mexican American families in the Southwest, having a midwife attend a birth was both a necessary decision and a personal one. This was especially true in rural communities. These towns were often isolated from hospitals, with dirt roads and long distances between the nearest professional medical facility. Further, especially at the beginning and middle of the twentieth century, doctor visits were expensive, and language and cultural differences further reinforced the barrier to access.⁵ This medical climate and Progressive-era concern about infant mortality inspired state-based initiatives and legislation to address these limitations. The State Board of Health in New Mexico, for example, established a certification program in the northern region of the state to train and certify midwives, while also ensuring that parteras had access to medical resources.⁶

One partera in particular, Jesusita Aragon, was known for her continued care throughout the twentieth century and her work alongside western medical practitioners. She reportedly delivered more than twenty thousand babies over the course of her seven decades of practice, participated in the midwife certification program, and cared for expectant women throughout northern New Mexico.⁷ According to Aragon in one interview, she “used to deliver nine or ten [babies] a night … 200 to 215 a year.”⁸ Spectacular practitioners like Aragon and stories about their significance to rural Mexican American communities were pervasive throughout this medical landscape. Accusing such figures of falsifying documentation not only ignores the historical necessity of midwives due to a lack of medical infrastructure and accessibility, but also disrespects their work.

Reproductive Justice and Autonomy

This issue is an infraction against reproductive justice and autonomy as well as a historical experience. Home births are increasingly touted as the ideal option for a birthing experience as a way to combat the sterile, isolating, and c-section-prone setting of a hospital. Given the growing concern of maternal mortality in the U.S., turning to more personal care provided by midwives appears to be a more viable option. It is a service that is often restricted to those with a higher socioeconomic status in urban areas, since most insurances do not cover home birth.

Mexican American families are still targeted and punished for midwife deliveries, whether necessary or voluntary. Debbie Weingarten recently wrote to the New York Times about her experience with home births and the question of citizenship as it applied to her own children (born in 2012 and 2014), who both have their father’s Spanish surname. According to Weingarten, her “sons have never been outside the United States, but their passport applications were denied by the State Department, pending more evidence of their citizenship, just hours after news broke that the Trump administration is denying thousands of passport applications submitted by midwife-delivered American applicants from border states.”⁹ The letter Weingarten received specifically cites the fact that the evidence of her children’s U.S. citizenship was not acceptable because the document she submitted on their behalf (their official original birth certificate with a seal) occurred in a non-institutional setting.

In another news article from Texas, Yoojin Cho details the anxiety of one Mexican American family in Pflugerville, TX, who were planning a trip abroad, but were having difficulty with passport processing. Similar to the cases detailed in the Washington Post, the family believed that their issues with documentation were due to being born at home in a border state. According to Daniel Jimenez, one member of the family in question, he had submitted a baptism certificate, elementary school records, a birth affidavit, his father’s work records, his sister’s birth certificate, and his Army records, among other various forms of documentation to prove he is, in fact, a U.S. citizen. Up until this point, Jimenez noted that he had “always seen [himself] as a U.S. citizen. Never thought anything of it. … I went to the military. Jobs. Paid taxes like everybody else. I had no question as to what I was as far as American.”¹⁰

Why the citizenship status of certain U.S. residents is being questioned is unclear, as the State Department has cited no change to their enforcement policy. However, all cases detailed thus far appear to exclusively target Mexican American residents born at home with midwives as their birthing attendants. Some justification for claiming fraudulent birth certificates in these cases referenced a series of federal court cases in the 1990s when a midwife pleaded guilty to selling birth certificates to families of children born in Mexico.

This case was settled in 2009 following a class action lawsuit filed by a coalition of civil rights and legal organizations that, according to the ACLU, “charged that the [Department of State] was violating the due process and equal protection rights of virtually all midwife-delivered U.S. citizens living in the southern border region by forcing them to provide an excessive number of documents normally not required to prove their citizenship. Then, even after the applicants supplied further proof of their citizenship, [the Department of State] responded by summarily closing their applications without explanation.”¹¹

These recent injustices stem from a string of related cases questioning the citizenship status of Latinx individuals throughout the country, from enforcing a Real ID system in New Mexico to ICE raids that increasingly include noncriminal arrests and devastate communities. As Susan Pearson argued in the Washington Post in September, this act of questioning the citizenship status of Mexican Americans born to midwives is a weapon to police race through government documentation.

Weingarten’s decision to give birth at home — like so many other mothers in the borderlands region — should have been supported. Her case in particular demonstrates both a personal desire to determine her birthing experience and a legitimate need based on her distance from the closest hospital. As she noted,

[gblockquote]“There are countless reasons I chose to give birth at home with a midwife. I was not a high-risk prenatal patient. I wanted autonomy — to walk around while in labor, not to be bothered by or restricted by machines or tubes, to eat something other than ice chips if I felt like it. We also lived in a rural area 90 minutes from the nearest hospital with a labor and delivery center.”¹²[/gblockquote]

And yet, she has to sort through years of tax records and official documents to verify the legitimacy of her children’s citizenship, just as Jimenez has done to verify his status as a third-generation Mexican American. In another account, an Army veteran born in Brownsville, Texas, attended by a midwife, had his passport renewal denied and was asked to submit “evidence of his mother’s prenatal care, his baptismal certificate, rental agreements from when he was a baby.”¹³ This is more than a case about reproductive autonomy and medical accessibility. It is also a concentrated effort to disenfranchise thousands of Mexican Americans along the U.S.-Mexico border and further punish and alienate Latinx communities in the United States.

Gianna May Sanchez

Gianna is a PhD history student at the University of Michigan. Her research examines the history of medicine in the 20th century American West with a focus on reproduction, women, folk healing, and medicine in Latinx communities. She also works on numerous public history, digital humanities, and museum projects.

• Gianna May Sanchez

  https://nursingclio.org/author/gianna-may-sanchez/

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