Annie Leone, CNM: A Dedication to Pregnant Asylum Seekers at the Border

Annie Leone, CNM, provides a check-up to a pregnant asylum seeker.

A pregnant asylum seeker, recently released from detention, is due any day but has been separated from her partner, who was deported to Mexico to wait for his hearing while she was released to an immigration shelter on the US side.

Another pregnant woman, fleeing for her life from gangs in her community who threatened her family, is in her third trimester when she arrives at the border. She has gestational diabetes but has never received any prenatal care. 

A newborn, just a few days old, was born on the trip to the US-Mexico border where her parents asked for asylum. Her parents lost everything in a hurricane last year and decided to flee the violence and instability in the wake of the climate-fueled disaster in their home country.

These are just some of the patients who are seen every day by Annie Leone, a Certified Nurse Midwife working at one of the largest immigration shelters in the nation at the US-Mexico border through an MCN collaboration with funding from Community for Children, Inc. and Every Mother Counts. When pregnant asylum seekers are released from detention after asking for asylum, they are often dropped off at the immigration shelter. They rarely receive care during their stay in detention nor during their migration to the border; Leone may be the first clinician these mothers have seen during their pregnancy.  

Most of the mothers are grappling with trauma, shock, and grief.

“She’s very compassionate, she’s affectionate with everyone – she’s very good at what she does,” noted Nahiely “Pinky” Garcia, a Health Network Associate with MCN who worked closely with Leone. “But also, she’s very detailed, which is important. We send medical records to the patients’ new provider [after the patient leaves the shelter], and she goes deep on the patient’s needs, that she has trauma, and will need a lot of support. Annie really does make a difference in many women’s lives.”

After Leone cares for the expecting mother and completes her notes, she passes her care to an MCN Health Network Associate, who enrolls the patient in Health Network, MCN’s virtual case management system. Usually, mothers leave within a day or two after she has evaluated them, traveling to new communities all around the US as they wait for the court hearing for their asylum request. A Health Network Associate helps the patient find prenatal care and a hospital for giving birth in her new location, and assists her with signing up for programs and services to get her the support she needs.

Leone sees women, often traumatized and after long, horrendous journeys, day in and day out, but the shelter never knows who they will care for on a given day, or what the circumstances will be. “Sometimes it’s really hot, sometimes cold, we might have six or seven patients, or maybe 20 or 25. Every day, it changes,” noted Enedelia Basurto, a Health Network Associate with MCN who works closely with Leone at the immigration shelter, who noted that, despite the circumstances, Leone treats every patient with humility, patience, and kindness. “I admire Annie. There’s no ‘no’ for Annie – with her, it can be possible. It can be done. She’s a very hardworking, smart, unique woman.”

Leone, originally from Ohio, studied public health, Spanish, and international studies, but didn’t discover her calling until her senior year in college, when she learned about midwives in a global women’s health course. While studying for her master’s degree in midwifery, she learned about a fellowship at a birth center on the border. After graduation, she worked in a hospital in the South Bronx for three years. Then, in 2018, she felt ready to head to the US-Mexico border.
  

“It sounded like an amazing place and it aligned with my values and interests,” Leone said in a 2020 interview. “I thought I was coming for a fellowship – most midwives stay six to nine months – but it quickly became clear that I didn’t want to leave.” Her initial work was at Holy Family, a birth center that served the entire community. She received a living stipend and free housing at the birth center. But Leone wanted to do more. In November 2018, she sought out a volunteer role at a makeshift clinic within a nearby local immigration shelter that serves people newly released from detention after requesting asylum. The immigration shelter provides a warm meal, a hot shower, and a clean bed, as well as help coordinating their next leg of travel. There, she met Dr. Marsha Griffin, from MCN’s Board of Directors, who coordinated and oversaw the fledgling clinic. The clinic serves as a triage for asylum seekers, to ensure that they are healthy enough to continue their journeys to their next destination within the United States. A midwife was much needed, to serve the pregnant women who arrived. Leone began volunteering there weekly, but she recognized that all her volunteer work at the border could not sustain her long-term; she needed a job. In September 2019, Dr. Griffin and MCN secured funding to support her position as a midwife serving pregnant asylum seekers at the tiny clinic within the larger immigration shelter, supported by Holy Family as the employer of the position. Over her time with MCN, Leone has served at least 1,990 asylum seekers. 

In March 2022, Leone announced that she was going to move on from her position, although she assures her MCN team that if she stays on at the border she will stay involved with MCN. Her work at the border has supported pregnant asylum seekers at some of the most important moments in their lives – vulnerable, traumatic, and terrifying, and also beautiful, heartwarming, lifegiving, and life-affirming, thanks to Leone’s empathetic, loving care.

“Annie brings an approach that is unique to midwives. She is able to make a connection with these women in one encounter that just amazes me,” said Candace Kugel, FNP, CNM, Migrant Clinicians Network’s Clinical Specialist says. “And she does it in a way that I can tell she’s making a personal connection, but she’s also a grounded clinician. She gives us information about the trauma they’ve experienced, the reasons they’ve made the journey, as well as really detailed clinical information. We’ve been blessed to have her.”

Holy Family accepts applications for the midwife position in McAllen, TX. Learn more at:  https://www.holyfamilybirthcenter.com/ or email holyfamilyclinical@gmail.com.

MCN’s much-needed work at the US-Mexico border is supported by individual donations. Please support pregnant asylum seekers by donating to MCN.