AAP Voices Blog

Reflections from Minnesota: How Pediatricians Are Supporting Immigrant Families  

There are many things I never thought I’d have to explain as a pediatrician in Minnesota.  Yet, as our communities faced a surge in aggressive immigration enforcement, I found myself needing to speak out and elevate basic truths about what we know children need: 

Children deserve to feel safe in their communities. Spaces like schools, clinics and hospitals should be safe spaces for children and families. Children should never be detained.  

In so many ways, that just scratches the surface.  

The First Signs

There is one moment I remember vividly last December. A Somali adolescent, who was born at my hospital, said during a visit with her mom and siblings, “We’re not garbage. This is our home.” My heart broke from the pain in her voice. I tried to provide reassurance, telling her, “You were born here. You’re a Minnesotan. They can’t send you anywhere. We all stand with you and your family.”  

In hindsight, this reassurance was misguided. As Operation Metro Surge launched just a few weeks later, and several thousand federal agents were sent to Minnesota, it became clear that my patient’s fear was justified. It became unsafe for Black and Brown families to move around without risking a potentially dangerous encounter, independent of legal status. And the dehumanizing rhetoric about immigrants from federal government officials left so many of our immigrant families feeling hurt, angry, and confused.  

From what my colleagues and I were seeing, there was no doubt that the fear was getting to our patients – the fear of their families being targeted– and they needed extra support.  

How It Progressed  

As Operation Metro Surge began, I was working in the newborn nursery, preparing to send a healthy baby home with mom and dad. In preparation for discharge, I explained they would need to return the next day for a routine jaundice follow-up. 

This should have been a happy day, but the mood in the room was somber.  

“Can we do the check at home?” the abuela asked in Spanish. “Do we have to leave right now? Can we wait?” asked the mother. “La migra esta afuera.” (“Immigration is outside”). She pointed to the Immigration and Customs Enforcement (ICE) vehicles on the street outside her hospital room window.   

Our hospital was no longer viewed as safe with agents outside and sometimes inside the hospital.  

Our clinic saw a surge in fear among nearly all Black and Brown families, especially those who were immigrant and refugees. To be clear, that fear had been present and growing for some time but escalated once Operation Metro Surge was announced.  

Families began moving with heightened caution. People were afraid to come in for medical visits. We started to get calls about infants in respiratory distress, their families afraid to bring them in to be evaluated. Moms were afraid to come in to give birth. Teens were in mental health crisis but staying at home. Parents were scared to leave their home to get groceries. Children and adolescents from immigrant families came to our clinic without their parents.  

In the face of injustice and growing fear, families need to know that their pediatricians stand by them, even when so much is against them. 

We did what we could to offer support. We moved visits to virtual spaces and mobilized home visits. We advocated for hospital policies that protected patients, families, and staff. 

We told families we were still here for them. We held our patients as they cried. 

In the face of injustice and growing fear, families need to know that their pediatricians stand by them, even when so much is against them.

What Pediatricians Can Do  

As pediatricians, we see first-hand how aggressive immigration enforcement is impacting the health and well-being of the children we care for – and are uniquely suited to shine a light on it and push for change.  

At the institutional level, we can advocate for clear policies that provide clarity on when ICE can legally enter medical spaces and ensure that our patients and their families have their legal rights to care and privacy honored and respected, even when they are in ICE custody. These policies should also protect the rights of healthcare workers, who often fear they would be targeted by ICE agents in hospitals while caring for patients in custody. Pediatricians can leverage guidance from the National Immigration Law Center and Physicians for Human Rights when discussing plans with their institution.  

When it comes to providing care, we can mobilize to meet families where they are, whether that be virtually, at home, or in the community. 

Teamwork is essential. Organizing with interdisciplinary healthcare professionals and healthcare worker unions can help elevate advocacy efforts within institutions to implement patient-friendly policies. Training on how to respond during encounters with ICE in their workplaces to protect their patients and themselves is critical for healthcare workers from across disciplines. 

At the federal level, we can advocate for policies that limit immigration enforcement occurring at or near locations where children get medical care, learn, play or receive vital social services. The Protecting Sensitive Locations Act would do just that.  

We can also advocate for policies that protect the rights of children and adolescents who are detained, including the right to adequate medical care and humane conditions. We know that no amount of time spent in detention is safe for a child. Children must be released from these facilities and able to grow and thrive in their own communities.   

Healthcare is a basic human right. No child or family should be afraid to access the care they need to be healthy. Pediatricians can play a critical part in emphasizing what it means when a child misses out on vital care, is scared to leave their home to go to school, or is worried about their classmates.  

The Hippocratic Oath tells us to, “Do no harm or injustice.” As such, we are obligated as healthcare professionals to speak up against both, whenever we see it. Protecting all children - regardless of immigration status - from violence and trauma is a moral obligation, not a political act. 

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.