Using ACOG guidance to handle immigration enforcement in ob-gyn care, with Rose Molina, MD

Building on the American College of Obstetricians and Gynecologists’ (ACOG) recent call for safe, equitable obstetric and gynecologic care for immigrants, Rose Molina, MD, MPH, FACOG, a fellow of ACOG and lead author of the committee statement, emphasized that clear institutional policies and staff training are essential when immigration enforcement issues arise in health care settings. Molina discussed these themes during an interview following her remarks this week at the Society for Maternal-Fetal Medicine 2026 Pregnancy Meeting in Las Vegas, Nevada, where she highlighted how the committee’s recommendations apply in day-to-day clinical practice.^1,2

Molina said advocacy around this issue has increasingly focused on helping institutions prepare clinicians and staff for potential encounters with immigration enforcement. “Absolutely, this has been a central area of advocacy within local institutions for developing clear policies and trainings for how to respond,” she said. She underscored that clinicians remain bound by the Health Insurance Portability and Accountability Act (HIPAA), noting, “Clinicians are bound by HIPAA, which is a federal law, and we should never disclose protected health information without explicit patient consent or a valid court order.”

On a systems level, Molina said clinicians should push leadership to establish clear, written protocols. “Clinicians really should advocate for leadership within their hospitals and clinic settings to have clear policies that outline how to respond if there is ever a request from immigration enforcement officers within the health care setting,” she said. Based on her experience, those policies typically require that any request be escalated immediately. “The general steps are often to escalate the request to the designated institutional leadership or legal counsel,” she explained, adding that this could involve public safety officers or an office of general counsel, depending on the facility’s infrastructure.

Molina cautioned that frontline staff should not engage directly with enforcement officers without guidance. “Frontline staff should avoid interacting directly with enforcement officers without guidance,” she said. While leadership or legal counsel are reviewing a request, she noted that staff still have an important role. “It’s important to take an active role in documenting and recording the encounter from a safe distance, in case that information will ever be needed in the future.”

She stressed that while response plans must be tailored locally, education should be universal.

“It’s important that these policies be created clearly, locally within each institution,” Molina said, “but the training should really be disseminated broadly so that the entire staff know how to respond if there ever is a request for immigration enforcement information within that health care facility. It’s also important to reassure patients that the clinic really prioritizes their safety and confidentiality and that immigration enforcement is not permitted direct access to clinical spaces without legal authorization.”

According to Molina, preparedness and transparency are critical to protecting patient privacy and maintaining trust. “Training and preparedness are really essential, so that every staff member knows how to respond to those types of requests in order to protect patient privacy.”

References:

1. Fitch J. ACOG calls for safe, equitable ob-gyn care for immigrants. Contemporary OB/GYN. February 4, 2026. Accessed February 11, 2026. https://www.contemporaryobgyn.net/view/acog-calls-for-safe-equitable-ob-gyn-care-for-immigrants
2. ACOG Committee. Advocating for safe and equitable obstetric and gynecologic care for immigrants. Obstet Gynecol. Published online February 3, 2026. doi:10.1097/AOG.0000000000006213