Doctors Fear ICE’s Unremovable Monitoring Devices Are Going to Harm Pregnant Women

Lost, perhaps unsurprisingly, among the headlines on the Trump administration’s cruel treatment of undocumented immigrants in detention, whether that’s punishing them in 2×2 metal boxes in the Florida heat or simply losing track of where the hell they went, is that so many other years or even decades-old programs of ICE continue to operate as they have been, without much particular attention, but sometimes all new problems. One among said programs is Alternatives to Detention (ATD), which since 2004 has served as a “more humane” option for lower risk individuals facing removal from the United States, allowing those in the program to wait for their court date at home rather than being stuffed into a detention facility. The trade off, of course, is intense surveillance from ICE, through monitoring devices exclusively provided and operated by BI Inc., whose private prison-building parent company Geo Group has a not-at-all incestuous habit of hiring former ICE and DHS officials. Trouble is, given the frenzy of additional deportation activity, detentions and fully justified fear whipped up by Trump Admin 2.0, the monitoring devices long employed by ICE through ATD are causing a new spate of problems when it comes to providing medical care for immigrants coming to U.S. hospitals, and doctors/hospital officials are sounding the alarm that it could lead to serious harm for those patients.

That’s the consensus of a new piece in The Guardian, which among other things details the technology that ICE is using to track both pregnant women and the rest of its “participants” (as if they really have a choice) in the ATD program. Core to the issue is the fact that patients are clearly very hesitant at this moment to visit the hospital/see their doctor for anything less than a life-threatening emergency, because they’re afraid of being detained by ICE’s haphazard, shock-and-awe urban sweeps when they leave their homes or go to public places. Chicago volunteer-based health center CommunityHealth concluded as much this summer, finding that “Rapid and frequent deportations of immigrants by the Trump administration — sometimes without legal cause — are driving fear among immigrants and their families across the U.S., putting their health and that of their communities at risk.” This resulted in a major drop in both patients coming to appointments (30% decrease) and picking up prescribed medication (40% decrease) at CommunityHealth since Trump took office, a clear indication that many undocumented immigrants are sacrificing their own health out of fear of the potential consequences of falling into ICE’s clutches.

This becomes a potential problem for the roughly 180,000 individuals in the ATD program, because they tend to wait until the last minute to seek medical aid, which can result in emergency visits where decisions must be made by doctors or nurses quickly, for the sake of their patient. And those decisions sometimes involve the necessary removal of monitoring devices that literally can’t be removed without cutting them off, which the immigrant patients understandably fear will be taken by ICE as an infraction that could lead to their immediate detainment and deportation. It creates potential scenarios of chaos, in which some kind of lifesaving procedure is immediately needed, but a patient is simultaneously panicked about the need to remove their monitoring device, without any way to quickly contact ICE in order to receive permission.

Why not just ask ICE for these permissions in advance? Well, sometimes they apparently just respond by detaining you for asking about it. Included in the same Guardian piece is the account of a Bangladeshi man from a court petition filed on his behalf by an immigrant rights group. It describes an incident where the man, assigned an ankle bracelet, requested to have the bracelet transferred to the opposite leg due to nerve damage. During a visit to BI Inc.–which originally began as a cattle monitoring company, if you can pause a moment to bask in that grimly appropriate reality–to inquire about moving the bracelet, the man was allegedly informed that ICE officers were coming to arrest him.

Pregnant women, meanwhile, are afforded the relative luxury by these former cattle herders of using a still unremovable and uncomfortably tight smartwatch as their monitoring device, rather than the ankle monitors that have a much more robustly documented history of causing health complications, both on their own and in the course of trying to give medical care/emergency procedures. It has been ICE policy since 2009 to not use ankle monitors for pregnant women due specifically to the high rate of complications they are associated with, but The Guardian‘s report states that former BI Inc. staff say they are “concerned that these exceptions are not always enforced,” which sounds like a nice way of saying that there may indeed be pregnant women subjected to them. Current ICE policy, for what little it is worth, directs that wrist-worn monitoring devices be employed for pregnant women in the ATD program, but even these can come with some potential health issues, especially in emergency scenarios where ICE has not provided any guidance for medical caregivers on how to proceed.

For example, The Guardian‘s story cites hospital workers’ account of a central Asian woman who walked into the emergency obstetrics unit of a Colorado hospital, already in labor, wearing one of the ICE/BI Inc. monitoring watches. The watch was beeping, low on charge, and the woman in the midst of labor was fretting that if the battery died, ICE agents would be dispatched to find her and take her child. She reportedly told hospital workers that she had been initially placed on a deportation flight to Mexico only days earlier, but that the pilot had refused to transport her because the birth of her child was so clearly imminent. Amid complications in her labor, doctors decided that the woman needed a C-section, a procedure that involves the use of a cauterizing tool to stop bleeding. However, to prevent the threat of burning and electrocution, a patient undergoing a C-section is required to remove all jewelry or metals, including wristwatches. Hospital staff, meanwhile, had no idea how to take off the smartwatch monitoring device, and no idea of how to get a timely reply from ICE about asking permission. Despite the mother’s panic, the staff were ultimately forced to cut off the device, and the woman eventually left the hospital with her newborn baby.

This particular woman is far from the only one experiencing such a scenario–at the very same Colorado hospital, staff speaking to The Guardian noted that there had been several other, similar cases in the last few months. One woman in particular, who also required a C-section, was diagnosed with preeclampsia, a serious condition that often involves sudden swelling. Staff feared, in this case, that the monitoring device on her wrist could dangerously cut off her circulation should this swelling occur, but the woman fought against its removal, again out of fear that ICE would cite it as a violation of the ATD program and separate her from her newborn child.

“She was in tears about it,” said the quoted hospital staff. “She had this deep fear that ICE was going to come to the hospital and take her baby.”

The lack of preparation as to how to handle these scenarios on the part of ICE, and the difficulty of contacting anyone with authority to remove them, is a major aspect of the problem. Immigrants in the ATD program don’t know what to do in the case of medical emergencies, and BI Inc. staff reportedly aren’t authorized to remove the devices without getting express permission from ICE. It’s not like they’re the only ones employing ankle monitors or other monitoring devices, but the Colorado hospital staff point out that in the case of monitoring devices required by the Department of Corrections, there are clear protocols in place for how to remove those devices in advance of medical procedures, when medically necessary. With ICE, on the other hand, it’s just one more oversight among the many that are nigh unavoidable when the department in question has been tasked with ramping up the pace of detainment, deportation and intimidation to unprecedented levels.

It’s a problem that is apt to become that much worse over time, given Geo Group’s stated intention to ultimately expand the company’s surveillance program to monitor not just hundreds of thousands of people, but millions or tens of millions of them in the United States. How wrong do things have to go, before this fusion of governmental and corporate cruelty remembers that the units it’s dealing with represent actual human brings? Does a pregnant woman need to die because of a monitoring device in order for anyone to care? Or would they even care then?