Yeni knew something was wrong when she woke up feeling nauseous on a September morning at a shelter on Chicago’s South Side. Her baby was moving, but Yeni barely could.
After sending a few texts to her husband and a volunteer she had recently met, Yeni, a migrant from Venezuela who had entered the United States at the Texas border just two weeks earlier, heard the siren of an ambulance.Her body stiffened.
The 33-year-old expectant mother had no intention of getting in an ambulance; she wasn’t even sure it was an emergency. When the ambulance drove away, the expectant mother, who had come to the United States with little more than the clothes she wore, was left with few options. She had no car. She knew no number for a clinic or hospital. None of her neighbors, all of them migrants new to the city, seemed to have any information either. Nine months into her pregnancy, Yeni had barely seen a doctor. And now her baby, she feared, was ready to come out.
Regular prenatal care is a long established medical protocol that protects the health of mothers and babies – and Illinois even pays for it for up to one year postpartum no matter a person’s immigration status. Yet beyond putting expectant mothers on a priority list for shelter, Chicago “does not have specific protocol in place relating to women who arrive pregnant,” said Mary May, a spokesperson for the city’s Office of Emergency Management and Communication. And many migrant women are potentially not getting medical care, according to WBEZ interviews with new arrivals, volunteers and medical professionals across the city.
The chaos on the ground when it comes to prenatal healthcare underscores Chicago’s struggle to offer basic services to the 15,000 migrants who’ve arrived here since August 2022.
Officially, when it comes to migrant health, each night the city gives Cook County Health a list of 75 to 100 new arrivals to see in the county’s Northwest Side clinic. That list includes children who need vaccines, migrants with chronic or acute health issues and pregnant women.
So far, Cook County Health, the designated medical provider for new migrants, says it has seen 241 pregnant women.
But unofficially, neither the county nor the city can provide estimates of how many pregnant women have migrated here in the past year, nor what percentage of expectant mothers have seen medical professionals. Without easily accessible information, a culture of fear and rumor has taken root that can have dangerous, even life-threatening, consequences for women like Yeni.
“I talk to other women in the shelter and we share our experiences,” said Yeni, who delivered her first two children via cesarean section in her home country and expects to deliver her third baby the same way in Chicago. “I’m scared I will go into labor in the shelter without having a date for a C-section. Anything can happen in an operating room, but if I put my faith in God, I feel it will be OK.”
No guarantees of seeing a doctor
Pregnant migrant women who are fortunate enough to end up on the county health list are ushered through routine prenatal care — checkups, ultrasounds, bloodwork. (Read the WBEZ series on maternal health that chronicled the first 12 weeks of postpartum recovery for three mothers across Chicago.)
Who likely ends up on the list – and who does not – appears to depend on where a pregnant woman lands in the city. The rapid and unpredictable arrival of thousands of migrants has prompted Chicago to hastily assemble a menu of shelter options, from police station floors to converted park field houses and schools to motels. Women temporarily living in longer-established shelters — such as Yoxibel, 23, who is staying at the Broadway Armory in Edgewater — report that they have been receiving care.
By the time Yoxibel arrived in Chicago in July with her husband and toddler, she had been pregnant twice since leaving Venezuela. She miscarried just days after crossing into El Paso, Texas, earlier this year and now she is pregnant again and almost five months along.
By September, she had, with the help of a city social worker, already visited the doctor for three prenatal appointments and received the first of four iron infusions to treat her anemia.
Yoxibel also received free rides to every doctor visit. All she had to do was call a number in her phone and a car would arrive to take her to the Cook County clinic. The care, said Yoxibel, offered some sense of stability when so much remains uncertain.
“I have nowhere to live and my back hurts from sleeping on cots,” said Yoxibel in Spanish, “but they told me the baby is doing well. I hope for a boy.”
But not every pregnant migrant has been so lucky.
Noelismar lives in a South Side shelter and has not visited a doctor. She does not know how long she’s been pregnant, but counting backwards, the 20-year-old Venezuelan migrant estimates around seven months.
“This pregnancy has been the most difficult experience of my life because I’m all alone here,” said Noelismar, speaking through a translator. “I’ve had to do all of this alone with my belly.”
In the absence of established protocols — plus the challenge of language barriers — word of mouth has become the primary way some pregnant new arrivals share precious words of advice. Outside of shelters and hotels, there are parking lot whispers warning that new mothers will be stuck with large bills and prevented from leaving the hospital until they pay what’s owed. Some believe they won’t be able to leave the country until their child turns 21.
Others worry their babies will be taken away.
Rumors like these are one reason that Noelismar said she doesn’t want to visit a doctor before she gives birth. She shares a room at a shelter with her sister, Maria, who also traveled to the United States while pregnant. When describing the experience, Maria pulled up a TikTok video that shows her wading through a river in the Panamanian jungle, her baby strapped to her back and her pregnant belly visible through her white shirt.
Maria was sleeping in Humboldt Park on the city’s Northwest Side when she went into labor earlier this year. She gave birth in a hospital — she doesn’t know which one — and a neighborhood resident suggested Maria use her address to receive her baby’s social security card. When the card eventually came, said Maria, so did a bill for $30,000.
Half a year later, Maria has not returned to the doctor nor brought her son to one either. This means he has not received any of the standard immunizations that help protect babies from a long list of crippling bacteria and viruses from polio to rotavirus to whooping cough.
Maria fears her own experience has discouraged Noelismar from seeking care. “I tell her to go to the doctor, but she now fears that she’ll get an expensive bill just like me,” she said. “She only wants to go to the hospital when it’s time to give birth.”
A lack of consistency of care
The irony is, for pregnant migrants, Illinois isn’t a terrible place to end up. It’s one of only a few states that offer Medicaid coverage to women for their entire pregnancy and up to one year postpartum no matter their immigration status — Illinois Governor JB Pritzker has even said it’s his mission to make the state the best in the nation for raising a family. In Chicago, Mayor Brandon Johnson initially promised asylum-seekers that the city would embrace them, but by late September, long-brewing tensions had openly erupted in City Council as the daily busloads reached double digits and the city budget projection for the crisis hit $345 million.
The coverage should make it easy for pregnant migrants to see doctors and nurses of care. But that has proven difficult for many of Chicago’s asylum-seekers.
Recognizing the scramble and disorganization, many people are trying to step in and connect migrant mothers to care. A mobile migrant team, housed at the University of Illinois-Chicago and made up of mostly medical students, travels to police stations to offer care to migrants. Hospitals and community clinics operate their own mobile clinics, too.
Jaq Serrano Aguilar, a third-year medical student, has spent the past several months helping run the Mobile Migrant Health Team.
So far, Aguilar said they’ve met about 20 pregnant women, all of whom they reported to the Chicago Department of Public Health, which then fast-tracks their shelter placement. But the system, Aguilar said, is far from perfect. “There is really very little pre-existing network of care and little communication between groups,” said the medical student. “We’re trying our best but we’re all reinventing the wheel every time we go. There is a lack of consistency in how we provide care.”
Mary May, the city spokesperson, said the city coordinates with several mobile clinics to move pregnant migrant women into shelters better outfitted to support both mothers and newborn babies.
Still, playing an outsized role are robust volunteer networks that have formed on Facebook, through WhatsApp text threads, and via email chains.
Together, the groups function like an ad-hoc Spanish-speaking stork service, one that is nimble, messy and determined to find ways to connect women to the care they need.
Volunteers call OB/GYN doctors who offer real-time medical advice to migrant women. Doulas visit police stations to hand out donated baby formula and bottles. Volunteers also help migrants secure medications or make appointments at one of Chicago’s 160 Federally Qualified Health Care Clinics, which care for Medicaid patients and people without insurance.
And sometimes, in the most urgent cases, a volunteer drops everything and gets a pregnant woman to the hospital, fast.
But getting women to a doctor or clinic, said Dr. Erica O’Neill, an OB/GYN at Cook County’s Stroger Hospital, is just the start. Caring for pregnant migrant women often means trying to address nine months of blood work, ultrasounds, and genetic testing in as little as a couple weeks. “Many women who I see for the first time in their pregnancy are further along,” said O’Neill. “And with a due date looming, you don’t have a lot of time to fit in all that care.”
For many migrant women, even comprehensive care remains a race against the clock.
The benevolence of volunteers
The late afternoon sun cast blue shadows across the sidewalk when Yeni returned to the South Side shelter. She’d spent the last hour wandering a nearby park, and she was tired. Her hips ached, and her legs hurt. She could no longer see her feet when she looked down. Her friends, all of whom she met while sleeping on the floor at the 2nd police district station, joked that she must be carrying twins.
This pregnancy came as a surprise. Early pregnancy symptoms made the already arduous 3,000-mile trek from Venezuela to the United States even harder. “It was tough,” recalled Yeni, speaking in Spanish through a translator. “I had nausea all the time, and we weren’t eating right because you can’t eat well in the jungle.” Some days, her only meal was plain bread and canned tuna fish.
Yeni has seen a doctor twice, once in Texas after she crossed the border in El Paso, and again in Chicago after a volunteer offered to take her to a nearby clinic. “People here told me to get my baby bag ready,” she said, “but I have nothing.”
The expectant mother also didn’t have much information about where to go. Yeni’s only plan was to text a volunteer who offered to help. She was nervous because she’d heard rumors about American hospitals. Rumors that scared her.
A week later Yeni found herself in an alarming limbo with waves of nausea and dizziness. She’d rejected the ambulance that volunteers had called for her, but her symptoms didn’t improve. News that a pregnant woman needed immediate help quickly reached an active Whatsapp thread of volunteers.
I can leave my meeting and get there in 10 minutes. I speak Spanish, one volunteer messaged the group.
Fifteen minutes later, Yeni was in a car holding a water bottle and sitting on a plastic bag on her way to the UChicago Family Medicine Birth Center in Hyde Park. Her baby daughter arrived that night by C-section.
In the following days, Yeni saw a rotating door of nurses and doctors who checked her blood pressure, dosed her pain medicine and delivered her meals. Volunteers came by to drop off baby gifts. Sitting in her hospital bed, Yeni’s body hurt, and her baby cried often. She longed for her mother, who had been by Yeni’s side during previous births.
Five days after delivery, Yeni and her newborn daughter returned home to the shelter where she shares a single, second-floor room with seven people and sleeps on a bunk bed. There, Yeni missed her mother’s chicken soup while she endured a dizzying gauntlet familiar to any new parent: late-night feedings, dirty diapers and a body that is slow to heal. Outside her window, the long days began to shorten and cool. She turned to her faith and prayed.
Elly Fishman is a freelance writer and the author of WBEZ’s First 12 Weeks series, an intimate look at postpartum recovery within three Chicago-area families. Her book is “Refugee High: Coming of Age in America.”
Camila Guarda contributed translation, interviews and photography. Cianna Greaves contributed reporting. Molly Morrow contributed fact-checking and compiled this list of area health providers who offer prenatal care to people who are low-income, on Medicaid or uninsured.
CORRECTION: Jaq Serrano Aguilar is a third-year medical student.