We’re asking government watchdogs to investigate ICE’s treatment of pregnant women in its custody.

In July 2017, a 31-year old asylum seeker, Teresa,* was arrested and placed in immigration detention. She was four months pregnant. After her arrest, she began to experience severe pain and bleeding. Despite the emergency nature of her medical needs, she reports that her pleas for assistance were ignored. Instead, she was transferred from a Border Patrol holding facility to an Immigration and Customs Enforcement detention center in southern California. She miscarried there.

Despite these tragic circumstances and repeated requests for her release, ICE has declined to release her. Teresa is still detained and continues to experience serious medical issues, including bleeding, vomiting, and headaches even as she copes with the loss of her pregnancy. But it never should have come to this. Under ICE’s policy, Teresa should have been released and should have received adequate medical care. Instead, ICE is ignoring its own policy as it rapidly expands immigration detention across the country.

The ACLU is taking action against ICE for its failure to abide by its own policy on detaining pregnant women, the shocking detention conditions, and the lack of quality medical care provided to them. Together with our immigrant rights partners, we have filed an administrative complaint with the Department of Homeland Security’s Office for Civil Rights and Civil Liberties and the Office of Inspector General, asking them to investigate ICE’s treatment of pregnant women in its custody. Several women in our complaint report that they were ignored and denied immediate medical care even in cases of extreme bleeding and pain. Others said that they were concerned about their pregnancies because of previous health issues and miscarriages.

Recent media reports indicate that immigration arrests of women increased by 35 percent in the first four months of 2017 compared with the same period in 2016, resulting in 292 pregnant women detained by ICE in that time. With the Trump administration’s plans to expand and accelerate the arrests and deportations of immigrants nationwide, we can only expect an increase in the number of women, including the most vulnerable, detained by ICE.

Some of the women who shared their experiences in this complaint are long-time residents of the United States. Others are asylum seekers, seeking protection from abuse and trauma in their home countries. Many of them have young children who have been detained with them in family detention centers. Some of them were raped, either in their home country or during their migration. They are all in detention while they wait for asylum interviews or hearings with immigration judges — a legal and administrative process that can take anywhere from a few months to several years.

The U.S. immigration detention system is the largest in the world, holding more than 400,000 people every year. It is not intended to be punitive. Rather its main stated purpose is to ensure that people appear for their civil immigration proceedings.

But people detained in these facilities rarely emerge unscathed. Navigating the uncertainty of the immigration legal process in a remote facility — often without a lawyer, and far from family and community support — takes a mental and physical toll that can have devastating, long-lasting effects. Inhumane conditions in detention only compound the harms suffered by people who are dealing with prior abuses and trauma.

In detention centers, people with medical needs, including pregnant women, are entirely dependent on facility staff for medical care. They cannot, for example, access their regular doctors or other outside medical professionals. So, if ICE chooses to deny necessary medical care, these women have no alternative.

In August 2016, ICE issued a policy advising its field offices across the country to handle pregnant women’s cases with particular care. The policy instructs that pregnant women should only be detained if they are subject to the statutory requirement of mandatory detention or if “extraordinary circumstances” exist. In all cases, including those in which mandatory detention applies, ICE field offices must seek approval for continued detention from legal counsel or field office directors. Under this policy, ICE offices are also required to ensure that pregnant women receive appropriate prenatal care and that their health and detention status are monitored weekly.

Teresa’s case and others across the country, however, tell a different story about their treatment. The implementation of the 2016 policy seems to vary greatly from facility to facility, raising serious concerns about ICE’s oversight.

The immigration detention system is already rife with abuse and mistreatment, and inadequate medical care has rightly been the subject of great criticism. The cases of these women show yet again ICE’s inability to provide safe and humane conditions for people in detention.

*Names in the complaint are pseudonyms to protect identities.