In a short statement released to the media on Mar. 11, Customs and Border Protection (CBP) reported that a pregnant Guatemalan woman died after falling Mar. 7 from a steel mesh border barrier in Clint, Texas. Her name was Miriam Estefany Girón Luna. She was 19 years old, 30 weeks pregnant, and thousands of miles from home. When she fell 18 feet onto her back, her partner, Dilver Israel Díaz García, could do nothing but watch. Girón Luna’s story was swallowed by news of the quickly-spreading global pandemic, but her death matters and it’s important to understand the deadly immigration policies and practices subjecting migrants to incredible harm.

A life cut short

The details of Girón Luna’s life are sparse, but according to social media posts from friends, she was a social worker and beauty pageant winner in her hometown of Quetzaltenango. She and her partner made the more than 3,000-mile journey to the U.S.-Mexico border in hopes of finding work to financially support her family. Their journey ended tragically when Girón Luna attempted to scale an 18-foot portion of the border wall and fell onto her back. Diaz Garcia carried Girón Luna until he found Border Patrol agents, who called for an ambulance.

In a statement from CBP to Prism, the agency said Girón Luna “was in pain” when Border Patrol agents encountered her, “but [she] was answering questions about her condition.” According to the federal immigration agency, both Diaz Garcia and the mortally injured Girón Luna were considered under arrest and in CBP custody when they were found and when Girón Luna died Mar. 10 in a Texas hospital. Local news outlets report that the 19-year-old suffered a brain bleed, lacerations to the liver and kidneys, and a broken pelvis. CBP told Prism that upon Girón Luna’s arrival at the hospital, doctors performed an emergency C-section, followed by surgery for a fractured pelvis and internal bleeding. CBP said Girón Luna was medicated, underwent a CT scan, blood transfusions, “another surgery [and] dialysis,” which stabilized her until her death. Medical staff were also unable to save Girón Luna’s baby.  

According to physicians, attorneys, and researchers who spoke to Prism, based on the scarce information the federal immigration agency has supplied, CBP appears to have taken appropriate action to save Girón Luna.

“If they decide that a pregnant patient is stable enough to undergo surgery and that the fetus is not stable and presumed to be a viable gestational age, they will perform C-sections before definitive care of other conditions,” said Emma Cermak, who works with immigrant populations as an obstetrician-gynecologist (OB-GYN) and an assistant professor at Washington University School of Medicine in St. Louis.

OB-GYN Lindsay Admon, an assistant professor in the Department of Obstetrics and Gynecology at the Institute for Healthcare Policy and Innovation at University of Michigan, agreed. Admon is an expert in maternal health disparities, particularly among women experiencing severe maternal morbidity and mortality.

“In a case like this where someone is injured, you wouldn’t perform a C-section for fetal distress unless she was in stable condition. The mom is the first patient, the fetus is the second patient,” Admon said. “In a trauma situation like this, it seems reasonable that a decision was made that the mom seemed stable and they made the decision for delivery because of a traumatic event, which can lead to a placental abruption.” Considered a serious pregnancy complication, a placental abruption is when the placenta detaches from the uterus.

Admon told Prism that the care CBP said Girón Luna received is consistent with the injuries she is said to have sustained. Pelvic fractures are a “serious, traumatic injury,” whether a person is pregnant or not, according to Admon. This injury can lead to severe complications including hemorrhaging, because it becomes more difficult to control blood loss.

“This is likely why she needed multiple surgeries and blood transfusions as part of her care,” Admon said. “During a pregnancy, this already serious injury is more dangerous because of the amount of blood that flows to the pelvis, which puts you at much greater risk of hemorrhaging.”

Ultimately, Cermak said that while Girón Luna’s death is “direct product of abhorrent policies at the border that lead people to desperation,” and that there is “nothing glaring” about the medical care she received.

Scapegoating smugglers

In March 2019, TheNew York Timesreported that an average of 2,200 migrants a day were crossing the nation’s 1,900-mile border with Mexico. Those who arrive at the border have endured grueling journeys, sometimes traveling thousands of miles across multiple countries on foot, often leaving them injured, sick, or badly dehydrated. Unknown numbers of migrants die in the borderlands each year, their bodies never found or recovered. CBP consistently blames smugglers—also known as coyotes—for migrants’ deaths, including Girón Luna’s. In her case, the agency has released conflicting information.

In the immediate aftermath of the 19-year-old’s death on Mar. 11, CBP said “someone in Mexico guided this eight month[s] pregnant woman from Guatemala to this section of the border and encouraged her and helped her climb the steel mesh border barrier.” However on Mar. 12, Mark Morgan, acting commissioner of CBP, told reporters that “the smugglers quickly left [Diaz Garcia and Girón Luna] alone, fading off in the darkness, leaving them to make the final legs of the journey by themselves.”

CBP regularly points to smugglers as a way of explaining the dangerous conditions migrants are subjected to in the borderlands. While it is well-documented that smugglers may abuse, exploit, extort, or completely abandon migrants attempting to reach the U.S., it is also true that U.S. immigration policies intended to “deter” migrants from entering the U.S. are deadly—and they were designed to be.

Death as a means of deterrence

A 2016 report from two Tucson, Arizona-based immigrants’ rights organizations—Derechos Humanos and No More Deaths—showed that there has been a “crisis of disappearance” happening since Border Patrol launched its “Prevention Through Deterrence” strategy in 1994. As TheNew York Timesreported, the policy shifted “migrant traffic into remote areas where migrants would not only be easier to spot, but also be forced to traverse terrain so brutal that they would simply stop trying.” Humanitarian organizations predicted it would displace, kill, and disappear thousands of people—and so did Border Patrol, noting the policy would place migrants in “mortal danger.” They were right. In 2016, Border Patrol alleged that more than 6,000 migrants had died crossing into the U.S. since the 1990s, but audits of the data at the time suggested the figure was closer to nearly 9,000 people. Because there is no consensus on how to count the total number of deaths and whether people who have disappeared should be included, the full extent of the crisis is unknown.

But make no mistake: prevention through Deterrence was designed to kill people. A follow-up report on the policy that was produced by Border Patrol listed “death of aliens” as an indicator of the policy’s effectiveness.

U.S. immigration policies have only become more deadly under the Trump administration, which has further militarized the border, created a years-long backlog in immigration courts, given Border Patrol agents unbelievable discretion over migrants’ lives, and implemented policies like Migration Protection Protocols (MPP), which essentially makes migrants sitting ducks in Mexico, subjecting them to kidnapping, sexual assault, extortion, and sometimes death. For all of the federal immigration agency’s handwringing over smugglers, immigration attorneys who work at the U.S.-Mexico border have said Trump is “the best thing that could have happened to organized crime.”

In Brownsville, Texas, the Trump administration has set up “tent courts,” the sole purpose of which seem to be funneling people into Mexico indefinitely as part of MPP. There, just a few days after Girón Luna died, Dr. Michele Heisler, the medical director at Physicians for Human Rights (PHR) and a professor of internal medicine and of public health at the University of Michigan, and her PHR colleague, attorney Joanna Naples-Mitchell, spent several days observing court proceedings where they saw migrants cry and sometimes beg not to be returned to Mexico. Heisler told Prism that the Trump administration put Girón Luna and other migrants like her in an “untenable situation.”

“People know there is nothing they can do to navigate this situation, so they take dangerous routes or make risky decisions” Heisler said. “People will continue to fall. I fear people will continue to die. The United States has created this system of torture. If you know your only chance at making it is to scale something designed to kill you, what do you call that? The U.S. has created a system where this is the case; it’s created public infrastructure designed to make people fall, to gravely injure them, or to kill them.”

Naples-Mitchell echoed those comments. As part of her work with PHR, the attorney investigates, documents, and exposes human rights violations at the U.S.-Mexico border. She told Prism that given all of the evidence surrounding policies and practices intended to “deter” people from migrating to the U.S., it is reasonable to assume that deaths like Girón Luna’s are “supposed to happen.”

Girón Luna’s death is one of many tragic stories tied to Trump administration. Last year, 25-year-old Óscar Alberto Martínez Ramírez drowned with his young daughter while attempting to cross the Rio Grande. Martínez, his wife, Tania Vanessa Ávalos, and their daughter arrived at the U.S.-Mexico border from El Salvador, hoping to ask for asylum. Once at the international bridge, they were told by officials that the immigration office was closed and there were countless others ahead of them waiting for asylum interviews. Martinez decided to cross the Rio Grande in order to apply for asylum from Texas. Martinez reached the U.S. side and left Valeria on the riverbank to go help his wife. But Valeria didn’t understand and followed her father back into the river. The current took them both.

“This is what these policies and practices are designed to do,” Naples-Mitchell said. “I know there are ongoing conversations between federal agencies and human rights groups to partner in order to try to identify the remains of people who are found. It was astounding to learn there is this great willingness from agencies to collaborate when someone is dead and they’re a body that needs to be identified. What about when someone is alive and their well-being is trying to be protected? Why is there no willingness to do the right thing then?” It’s important to note that Border Patrol has a history of destroying gallons of water and other humanitarian aid left in the borderlands for migrants.

Naples-Mitchell said that given the dangerous conditions that people are fleeing and how dire the situation is becoming at the border, she would not be surprised if there were more deaths like Girón Luna’s.

“I don’t even want to say that because I don’t want it to be the norm. It shouldn’t be the norm. Every death should be an aberration,” the attorney said. “It’s never okay when something like this happens. This shouldn’t be the expectation or the projected outcome.”

Tina Vásquez is the editor-at-large at Prism. She covers gender justice, workers' rights, and immigration. Follow her on Twitter @TheTinaVasquez.