HHS Directs Pregnant Migrant Minors to Single Texas Shelter Amid Concerns Over Care and Abortion Access

The U.S. Department of Health and Human Services (HHS) has directed pregnant unaccompanied minors apprehended by immigration enforcement to a single group shelter in San Benito, South Texas. This decision has been implemented despite objections from some administration health and child welfare officials, who assert that both the facility and the region lack the specialized medical care required for these minors.

The Office of Refugee Resettlement (ORR) within HHS, which is responsible for children crossing the border without parents or guardians, has placed more than a dozen pregnant minors at the Texas facility since late July. Some individuals were as young as 13, and at least half of the reported cases involved pregnancies resulting from rape. Officials have characterized these pregnancies as inherently high-risk, particularly for the younger girls.

Policy Shift and Mounting Concerns

This approach represents a significant shift from previous federal practice, which involved placing pregnant, unaccompanied migrant children in various ORR shelters or foster homes across the country equipped for high-risk pregnancies. Officials and advocates have expressed concern that the administration's action may be intended to restrict access to abortion, given Texas's stringent abortion laws.

HHS has stated that such allegations are "completely inaccurate" and that ORR's placement decisions are guided by "child welfare best practices."

ORR's acting director, Angie Salazar, instructed agency staff to send "any pregnant children" to San Benito starting July 22, 2025, according to an internal email. While officials reported no major medical problems among pregnant girls at the San Benito facility since July, with some having given birth while detained with their infants, concerns persist about the potential for future incidents.

Facility Details and Medical Risks

Identified Health Risks

Medical professionals and public health experts have identified several risks associated with concentrating pregnant minors in San Benito, Texas:

Limited Specialized Care: The region has limited specialized obstetric care, which is predominantly available in larger cities hours away.
Impact of Abortion Ban: Texas's near-ban on abortion has led to confusion among doctors regarding exceptions, potentially delaying or denying emergency care for complications like ectopic pregnancies, miscarriages, or premature water breaks.
Adolescent Health Risks: Adolescents are prone to early births, and younger girls may face labor and delivery complications due to undeveloped pelvises.
Migrant-Specific Vulnerabilities: Pregnant girls who have endured the journey to the U.S. may have additional risks, including sexually transmitted infections, lack of prenatal care, malnutrition, and trauma.

Shelter Operations and Past Issues

The San Benito shelter is operated by Urban Strategies, a for-profit company. Although HHS cited Urban Strategies' record of delivering high-quality care, ORR officials reported that in 2024, staff at the shelter failed to arrange timely medical appointments and share health information for pregnant girls. This led to a temporary restriction on the shelter receiving pregnant girls, which was lifted after a remediation plan that did not include additional staffing or enhanced qualifications.

Policy Evolution and Future Implications

Jonathan White, former head of ORR's unaccompanied children program, suggested this directive continues an anti-abortion policy shift initiated in 2017. During that period, efforts were made to deny abortions to girls in ORR custody, leading to a class-action lawsuit by the ACLU, which was settled in 2020. The Biden administration subsequently formalized a regulation requiring ORR to transfer pregnant minors seeking abortion to states where it is legal.

With the current administration, policymakers have explored restricting abortion rights for unaccompanied minors. Project 2025, a conservative blueprint, recommended ORR cease facilitating abortions and avoid detaining children in states where abortion is available. Following an executive order regarding federal funding for abortion, the Department of Justice re-evaluated the Hyde Amendment, concluding that federal funds cannot be used to transport detainees for abortion access, except in cases of rape, incest, or to save the mother's life.

ORR is now working to rescind the Biden-era regulation that mandates moving pregnant girls for abortion access. The proposed change was submitted on January 23. While HHS states it will comply with federal laws, experts suggest the San Benito directive and the proposed regulatory changes are designed to work together, potentially concentrating pregnant children in Texas and restricting their ability to access abortion services.