A new ACOG Committee Statement outlines how immigration status affects health outcomes and calls for enforcement-free health care settings.
The American College of Obstetricians & Gynecologists (ACOG) has released updated guidance calling on clinicians, health systems, and policymakers to ensure safe, equitable obstetric and gynecologic care for immigrants living in the United States. The new Committee Statement, published February 3, 2026, in Obstetrics & Gynecology, outlines how immigration status functions as a structural determinant of health and details steps clinicians can take to protect patient access, safety, and trust amid increasingly restrictive immigration policies.1,2
According to ACOG, immigrants face persistent barriers to reproductive health care, including limited insurance eligibility, fear of immigration enforcement, and policies that restrict access to prenatal, postpartum, and abortion care. ACOG noted that these barriers contribute to worse outcomes, such as increased risk of preterm birth and reduced access to preventive services. The guidance emphasizes that quality obstetric and gynecologic care should be available regardless of immigration status or ability to pay.
“Immigrants—both documented and undocumented—face tremendous barriers in accessing essential reproductive and pregnancy care, because only a handful of states offer comprehensive prenatal and postpartum coverage and even fewer offer abortion care, regardless of immigration status,” said Rose Molina, MD, MPH, FACOG, lead author of ACOG’s committee statement.
“To make matters worse, many categories of lawfully present immigrants are now no longer eligible to receive care through Medicaid or the ACA Marketplace after the passage of H.R. 1,” added Molina. “Those who do still qualify for coverage may fear that enrolling could jeopardize their immigration status, which may result in delayed care, untreated and preventable health conditions, and worse health outcomes.”2
A central focus of the updated guidance is ACOG’s opposition to immigration enforcement activities within health care facilities. The statement argues that such practices discourage patients from seeking care and undermine clinicians’ ability to provide evidence-based treatment. ACOG encourages hospitals and clinics to proactively develop clear policies guiding interactions with federal immigration and other law enforcement officials, including staff training and clear distinctions between public and private areas.1
“When people see a hospital or their doctor’s office as a dangerous place instead of one where they can safely find care, this obviously hinders our ability to provide patient care,” said Yvonne Butler Tobah, MD, FACOG, a co-author of the guidance, in a press release from the college. “As clinicians, it’s important that we become familiar with our institution’s policies regarding interactions with law enforcement and consult legal counsel to avoid unnecessarily putting our patients at legal risk.”2
“The American College of Obstetricians & Gynecologists opposes policies that require documentation of immigration status in the medical record. Clinicians should not seek or document information that may put a patient at legal risk, especially when the information is not clinically relevant to the care plan. Unless mandated by law, health care professionals should document only information related to a patient's migration history that is necessary for the ongoing clinical care. Clinicians who are required to document sensitive and private patient information that compromises patient safety are at risk of developing moral distress,” the statement read in part.
Beyond individual clinical encounters, ACOG reiterates its longstanding opposition to policies that separate families, target individuals for detention based on pregnancy status, or allow abuse or coercion in immigration custody. The organization supports community-based alternatives to detention and calls for detained individuals to receive obstetric and gynecologic care consistent with accepted clinical guidelines.1
The Committee Statement urges ob–gyns to engage in advocacy at local, state, and national levels to improve health care access and quality for immigrant patients. It also highlighted the need for research that evaluates how immigration policies affect reproductive health outcomes, patient experiences, and trust in the health care system.
“As clinicians, we need to take an active role in advocating for improved health care access and quality for immigrants, regardless of immigration status,” said Molina. “This includes advocating for and supporting research that evaluates the effects of immigration policies on reproductive health outcomes, which is essential to creating evidence-based solutions to health inequities. Immigration status is a structural determinant of health that affects not only access to health care but also trust in the health care system for populations who, in many cases, have already been harmed. We as ob-gyns are uniquely positioned to advocate for these patients, and doing something as small as writing your legislator or participating in collective actions with community-based organizations can make a big difference.”2
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