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MANA Health Policy Statement on Passport Denials


Midwives Alliance of North America (MANA) is concerned about recent news reports of the revocation or denial of US passports for American citizens born at home near the US-Mexico border, particularly if a midwife attended their birth. Furthermore, there have been reports of people being detained and their citizenship questioned, even leading to deportation proceedings and denaturalization. This attack is a heightened renewal of a Bush administration era policy, the impact of which denied passports to US citizens of Hispanic descent.

The policy began after a number of doctors and midwives in Texas were indicted in decades past for providing fraudulent US birth certificates to Mexican nationals and triggered extreme scrutiny of the passport applications of those who were born at home with a midwife in attendance. The Bush era policy led to an ACLU class action suit against the US State Department, alleging that the government had violated due process and equal protection rights statutes by requiring additional documentation from some people solely because they were Latino citizens whose births occurred in a border state with a midwife attendant. (A pdf of the class action suit is available for download here.)

The policy was formally ended by the Obama administration in 2009 following a settlement agreement (pdf available here) with the ACLU. In spite of the settlement agreement, the practice of passport denial is continuing to happen now, affecting midwives and their clients in border states.

Midwives Alliance condemns any involvement in the provision of fraudulent vital records. Of greater concern is that American born citizens are having their citizenship questioned, their rights violated, and their passports denied or confiscated because of their race or ethnicity and for being born outside of an institution.

Those being targeted in this crackdown are predominantly Latino people with increasingly less access to healthcare services in one of the poorest regions of the United States. Families choose home birth for a variety of reasons, including respect for cultural practices, because hospital care is unaffordable or unattainable, or due to institutionalized racism in the hospital setting. Midwives provide much needed care in areas where there are often no other providers of high quality maternity care. The life saving services midwives offer to mothers and babies should be welcomed, not viewed with suspicion.

MANA abhors the blatant racial profiling, rights violations and systematic discrimination being used to intimidate those affected, as well as the deep disrespect of the integrity of the midwives serving them. We implore the Trump administration to end this practice of discrimination against people of color by treating existing vital records as legitimate.

Endorsements (as of 10/1/2018):

American College of Nurse-Midwives (ACNM)



National Association of Certified Professional Midwives (NACPM)


Colleen Donovan-Batson, CNM, MS

Colleen Donovan-Batson, CNM, MS

ICM section Chair
Director of Health Policy and Advocacy

Colleen is a certified nurse midwife/women’s health nurse practitioner and midwifery activist with 25 years of maternal-child healthcare experience in home, hospital, and birth center settings, both nationally and internationally. As an empty nester, Colleen lives with her husband in far northeast WA, where she has a small rural home birth practice and is also involved in advocacy for women veterans. Early in her career, Colleen developed an educational track for nurses to train as midwives in order to decrease the high pre-term birth and teen pregnancy rates in Kern county, CA. She has served on the faculty of both direct entry and nurse midwifery programs, and as a preceptor for nurse midwifery distance learning midwifery programs. Colleen is active in state and national midwifery organizations, promoting unity in the midwifery profession. She is a member of the Midwifery Advisory Committee for WA State Department of Health, the US MERA workgroup, and currently serves as the director of the Midwives Alliance Division of Health Policy and Advocacy.