Is Stephen Miller Making Medical Decisions for Pregnant Children in ICE Custody?
Inside the converted church in San Benito, Texas, where pregnant migrant children have no doctors, no advocates, no choices, and nowhere to go.
I’ve spent many years of my career taking care of pregnant patients, and I need you to understand something before you read another word. I am not writing this to inform you. I am not writing this to present both sides. I am writing this because children are being harmed on purpose, right now, with federal authorization, and I am so angry I can barely see straight.
In July, 2025, the federal government made a choice: Every pregnant migrant girl in its custody would go to one place — Urban Strategies, LLC at 250 N. Crockett St in San Benito, Texas. The authorities previously closed this place down because these girls were being neglected. We’ll expand on that a little later in the article.
Right next door is a museum dedicated to the Mexican-Tejano families and workers who built San Benito with their labor and their lives. These girls are part of that story. They always were. Instead of being welcomed into it, they were placed in a facility next door that had already proven it could not protect them.
Not some pregnant girls. Not only the straightforward pregnancies. Every pregnant migrant child in federal custody, no matter how far along, no matter how complicated her situation, was sent to the same facility.
THE GIRLS IN THE CONVERTED CHURCH
A church building. For girls being punished in the name of Christian values. The symbolism is doing a lot of work.
Some of these girls are 13 years old. Some are survivors of rape. Some spent weeks crossing the desert without receiving any medical care at all. They are now being housed in a converted Baptist church where no one has screened them for pregnancy complications, no one has checked whether their pregnancies are viable, and if they have an emergency?
San Benito does not have an emergency room.
The nearest one is ten miles away in Harlingen, about fifteen minutes on a good day, longer when it isn’t. The nearest Maternal-Fetal Medicine specialist, the kind of doctor these pregnancies require, is a hundred miles away. In obstetric medicine, every single one of these pregnancies is considered high-risk by definition. Very young girls who have survived significant trauma do not represent a gray area in medicine.
Ten miles, or fifteen minutes, is not a short distance when a fallopian tube ruptures and internal bleeding has already begun. It is not short when a miscarriage turns septic and a girl is going into shock. It is not short when eclampsia escalates into seizure. Gynecological emergencies do not wait. They do not give a patient time to be loaded into a vehicle, driven across city limits, and checked in.
No one has ruled out ectopic pregnancies, where a pregnancy grows outside the womb instead of inside it. It cannot survive. It will rupture. When it does, the bleeding happens on the inside, where no one can see it. The girl goes into shock. She needs emergency surgery within hours or she will die.
One early ultrasound catches it before any of that happens.
For a majority of these girls, no one has done that scan.
And I am not ‘nit-picking’ these girls are at serious risk for this deadly pregnancy complication, and the reason is straightforward. Amnesty International reports that up to 60% of girls and women who cross the border are sexually assaulted and/or raped.
Sexual violence often leads to infections that cause no symptoms — up to 70% of women infected with Chlamydia or Gonorrhea are asymptomatic — so many of these girls would have no way of knowing they are infected.
Left untreated, those infections scar the inside of the reproductive system. That scarring is what causes a pregnancy to grow in the wrong place. Women with that kind of scarring are more than six times more likely to have an ectopic pregnancy than women without it.
That is not speculation. That is not worst-case thinking. That is the predictable, medically certain outcome for at least some of the girls sitting in that converted church right now. The question is not whether it will happen. The question is which girl it happens to, and whether anyone reaches her in time.
Young girls’ bodies are not finished developing. Pregnancy in adolescence carries significantly higher rates of dangerous blood pressure complications and surgical delivery.
These girls also risk losing their fertility permanently. The rape was not enough. The detention was not enough. Now the conditions of their confinement may take from them the ability to ever have children of their own choosing.
Seven anonymous senior health officials within the government itself objected in writing and proposed alternatives. They were career professionals, not political appointees, whose expertise was specifically in child welfare and the care of unaccompanied minors.
They were overruled without explanation by those above them, and it has Stephen Miller's fingerprints all over it.
The order to overrule these seven officials was issued by ORR Chief of Staff Matt O'Neill Levine, under the authority of Angie Salazar, a career ICE agent with no child welfare background who gets their orders from Stephen Miller.
Yes, that Stephen Miller.
They knew this would hurt these girls. They did it anyway. These are not just numbers. These are children who are going to die.
A SYSTEM BUILT TO FAIL THEM
This facility had been shut down months earlier. Federal investigators found staff had failed to get these girls basic prenatal care. Biden's ORR lifted the ban anyway, accepting a remediation plan that added no new clinical staff and upgraded no one's qualifications.
Then Trump's team installed two consecutive ICE enforcement agents to run a child welfare agency. Four months in, they chose that same facility, with that same record, in one of the worst healthcare deserts in the country, in a state with a near-total abortion ban, and made it the only place in America for every pregnant migrant girl in federal custody.
This is a system that predates any single president, any single administration, any single person in power. What is happening at Urban Strategies was built over time, by many hands, across many years.
In 2018, ProPublica obtained police reports and call logs from more than 70 of the approximately 100 immigrant youth shelters run by HHS’s Office of Refugee Resettlement. What those records showed was a system already failing the children in its care — not through chaos or underfunding alone, but through structural neglect that went largely unaddressed. Police had responded to at least 125 calls reporting sex offenses at shelters that primarily served immigrant children over five years. Dozens more calls came from facilities that also housed at-risk American youth, making it impossible to determine the full scope.
“If you’re a predator, it’s a gold mine. You have full access and then you have kids that have already had this history of being victimized.” — Lisa Fortuna, Director of Child and Adolescent Psychiatry, Boston Medical Center
The children in those 2018 reports were described in almost identical terms to the girls in San Benito today: survivors of violence, malnourished after dangerous journeys, afraid that speaking up would damage their immigration cases. The system that was supposed to protect them was understaffed, undertrained, and largely unaccountable.
The largest shelter operator, Southwest Key Programs, had received over $1.3 billion in federal contracts. Its CEO declined to be interviewed. That was 2018.
Now, in 2026, the same machine roars on. These girls are adolescents, some barely teenagers, whose still-developing bodies are now also sustaining pregnancies. They arrived malnourished after weeks in brutal terrain. Many were raped. Many carry untreated infections that can cause pregnancy loss and cause permanent damage to their reproductive health. Almost none of them have had a single prenatal appointment.
THE LOCATION IS THE POLICY
A local doctor told me she was blown away by how dangerous this is. She was trying to stay calm and clinical about it. I am not a doctor, and I am not going to do that.
These girls are in Texas. Abortion in Texas is not mostly illegal or illegal with exceptions. It is illegal. Full stop. Rape is not an exception. Being thirteen years old is not an exception. Whatever exception you are currently trying to construct in your head, it does not exist in Texas law.
This is under Texas Health and Safety Code Section 170A.002, enacted as House Bill 1280, commonly called the Trigger Ban. It took effect August 25, 2022, thirty days after the Dobbs decision overturned Roe v. Wade.
And this part of Texas where these girls are being held is a place where even physicians who would want to intervene are too frightened of arrest, too frightened of losing everything they have built, to do it.
There was a rule that said if one of these girls needed to end her pregnancy, the government had to help her get somewhere she legally could. That rule is being taken away right now. The money to pay for that travel has already been cut.
Nobody has to say it out loud to a 13-year-old rape survivor. Nobody has to look her in the face. The location says it for them. No doctors, no money, and no legal protection. There is nowhere to go. That is not incidental to this policy. That is the entire architecture of it.
Jonathan White ran this program during Trump’s first term. He was asked about it directly, he admitted it is 100% and exclusively about preventing abortion. White also described Scott Lloyd, Trump’s first-term ORR Director, personally blocking pregnant minors from terminating their pregnancies and calling White late at night to demand that a specific girl be transferred to Texas to prevent her from having an abortion.
This policy tells girls: We don’t want you here. We don’t want your children here. But we will force you to carry a rape pregnancy to term. You fled violence, you were assaulted on the way here, you are thirteen years old — and the position of the United States government is that the fetus matters more than you do. That is not pro-life. That is pro-punishment.
And then what? We’ll detain you through your entire pregnancy in a facility that couldn’t manage basic prenatal appointments. We’ll make sure you give birth in one of the worst healthcare regions in the country. And then we’ll deport you — back to the place so dangerous you left it with nothing, except now you’re recovering from childbirth and you have a newborn in your arms.
There is no version of this that is about protecting children. They are not protecting the girl. They are not protecting the baby. They are using both of them as instruments of a policy whose actual purpose is control.
When these girls go into labor, they will do it in a converted church ten miles from the nearest emergency room, in a facility that could not manage basic prenatal appointments. They will be transported to a hospital for delivery. That hospital is ten miles away, in a region with some of the worst maternal care infrastructure in the country. When they arrive, they will be alone. No family. No advocate. No one who speaks their language in any way that matters. They will be a detained minor, in federal custody, in a state where the doctors in that building are legally prohibited from discussing certain options with them. They will give birth under guard. And then they will be transported back.
And that is the version where they stay. There is nothing that legally stops the government from deporting a girl in her ninth month. Some of them will go into labor in the country they were running from, in the exact circumstances they risked everything to escape. They will not give birth in a hospital ten miles away. They will give birth there.
Wherever there is. Whatever that means for them.
I have spent years fighting for patients who get chewed up by systems that were supposed to serve them, and I know the difference between a system that is trying and falling short and a system that is working exactly as it was designed. These girls were not overlooked. They were found, and processed, and placed with precise, deliberate, documented intention somewhere their options would disappear before anyone ever had to officially admit those options existed.
WHAT HAPPENS WHEN NO ONE IS WATCHING?
And underneath all of this is something that should make every single person in this country unable to sleep.
A congressional investigation found over 1,000 credible reports of life-threatening abuse inside immigration facilities in a single year. People being denied food. Denied water. Denied sleep. Reports of guards physically and sexually abusing detainees. In 2025, 36 people died in custody in one year, more than any year in the past two decades.
That 2025 total — as absolutely horrible as it is — took a full year to reach. In 2026, we are three months in, and at least 13 people have died in ICE custody already. A complete list of ICE custody deaths from 2016 on is available by clicking here.
At one facility, a nurse called 911 because a pregnant woman was bleeding. The 911 dispatcher asked her to check whether the baby’s heart was still beating. The nurse said she did not have the equipment to do that. A pregnant woman was bleeding and the person responsible for her care did not have a basic tool that any small town clinic in this country would have on a shelf. That woman was inside a federal facility, in the custody of the United States government, bleeding, and the answer was that there was no equipment.
At least 14 women lost their pregnancies or suffered serious physical harm because of neglect while being held in government custody. Another woman who was coughing up blood had to wait more than two hours for an ambulance to be allowed through the facility’s security gates.
Two hours. While coughing up blood.
The government’s own lawyers documented over 100 reports of facility staff sexually abusing children as young as five years old across 29 shelters in Southwest Key. Five-year-old children, being abused by the adults the government hired to watch over them. The Trump administration looked at that documentation and dismissed the legal case in March 2025. They closed it. They threw it away.
Author’s Note: This is something I covered back in May of last year. It disgusted me then. It still disgusts me now. You can read my original article on the subject by clicking here.
For a 13-year-old who has already survived being raped to be placed inside a system where staff have abused five-year-olds and where the government just buried the only legal case that might have held anyone responsible, that is not protection. That is the government taking a child who has already been violated and placing her somewhere the violation can continue without interruption.
Every single protection for these children is being removed at the same time, and you need to understand that this is not an accident.
The agreement that sets the most basic legal standards for how migrant children must be treated — Flores Settlement Agreement (1997) — is being threatened.
The Flores agreement was not preventative policy. It was a consequence. Immigration officials abused a child in custody, and a years-long fight led to a federal settlement that forced the government to treat them as human beings.
Flores mandates state-licensed facilities. It caps detention at 20 days. And it requires oversight from outside DHS, because leaving DHS to oversee itself has never worked. Terminating this agreement does not just change the rules for how long a child can be held. It eliminates the last mechanism the public has for knowing what is actually happening inside these facilities.
In May 2025, the Trump administration filed a formal motion to terminate the Flores Agreement entirely.
This is not a new goal for the Trump Administration.
In 2019, Trump’s Justice Department stood before a panel of federal judges and argued, with a straight face, that the Flores Settlement did not require the government to provide detained children with basic hygiene supplies.
And this fight against Flores is starting to move in the wrong direction.
Part of Flores includes free legal help for these children. These lawyers who are often the only adults in this system actually fighting for them, and this was eliminated and only partially restored by a judge’s order, and even that partial restoration runs out at the end of April 2026.
The rules requiring that pregnant girls receive proper medical care are being proposed for elimination.
A senior government official told a federal court under oath that children in these facilities had been properly screened for danger. Whistleblowers from inside that same office said she was lying, that at least one in five children had documented red flags for danger that had been ignored. A federal official lied to a judge about whether children were safe. The children are still there.
And we already know what happens when the rules bend. We saw it in 2016.
America saw children sleeping on cold concrete under Mylar blankets. A sixteen-year-old boy dying of the flu while agents watched him on a monitor and never moved or helped. Unaccompanied minors injected with psychotropic drugs without consent. Children separated from their families and mocked for crying too loudly at night.
One girl, Dixiana, was ten-years-old when she testified about what happened to her inside an ICE detention facility during Trump’s first term. A male officer kicked her awake. She slept on the floor. She was denied water. The cell was so overcrowded that girls had to sleep sitting upright. She cried constantly. So did most of the other children. There were no windows. The lights never went off. She lost track of what day it was. She begged to see her mother. She caught chickenpox while in custody.
All of that happened while the Flores agreement was still in place. Now imagine what they will do without it.
If Flores is dismantled, the 20-day limit is gone. The requirement for licensed shelters is gone. The legal barrier to holding children indefinitely, in unregulated facilities run by cost-cutting contractors, is gone. And when children disappear, no one will be able to ask where they went, because there will be no legal framework requiring anyone to say.
These children survived rape. They survived being trafficked. They survived journeys across deserts and through dangers that most people reading this sentence have never had to imagine and never will. They made it through all of that. And the country that stopped them at the border took that survival and spent months carefully and deliberately building a situation designed to make sure it meant nothing.
They are children. They are pregnant. They are alone and scared and they have no idea that the system that told them it would protect them was being built, piece by piece, to be used against them instead.
I know what it looks like when someone is trying to help and falling short. I have seen that, and it is not this. What is being done to these girls is not a failure. It is a choice. It is a set of choices made by specific people with names and offices and salaries paid by your tax dollars, about children who have no power, no voice, and nowhere to go.
As the USA government “quietly” descends into the same depraved behavior and actions of the Nazis in the 30’s and 40’s, its citizens go to work and live their lives in ignorance of what is being done in their name. It’s disgusting and shameful and I have no idea how we get it stopped.
Stephen Miller will hopefully go to prison for life, if we can ever get accountability for all of his hateful crimes.
Thank you for writing about this.
America and the world need much more Dissent.