EU Border Care is a comparative study of the politics of maternity care among undocumented migrants on the EU’s peripheries. Empirical analysis of personal and institutional relations of care and control in the context of pregnancy and childbirth will support an innovative critique of the moral rationale underpinning healthcare delivery and migration governance in some of Europe’s most densely crossed borderlands in France, Greece, Italy and Spain.
Unlike other categories of migrants, undocumented pregnant women are a growing phenomenon, yet few social science or public health studies address EU migrant maternity care. This subject has urgent implications: whilst recent geopolitical events in North Africa and the Middle East have triggered a quantifiable increase in pregnant women entering the EU in an irregular situation, poor maternal health indicators among such women represent ethical and medical challenges to which frontline maternity services located in EU borderlands have to respond, often with little preparation or support from national and European central authorities.
Why are pregnant migrant women increasingly crossing Europe’s external borders? Is pregnancy their motivation for embarking on a migration journey, is it a consequence of the increasing sexual violence which women migrants are subjected to while travelling, or is it to be a condition of womanhood regardless of their migration project? The steady increase in the proportion of migrant women entering the European Union in the past two decades is now well documented in social and political sciences, particularly in the case of domestic work and healthcare, family migration and human trafficking. A rapidly emerging phenomenon however, is the growing presence of pregnant women among the new influxes of migrants on some of the EU’s most densely crossed borderlands, in particular along the southern European border (southern Italy and southern Spain via North Africa) and the south eastern European border (eastern Greek mainland and islands via Turkey). The increase in pregnant migrant women on those three borderlands appears to be directly related to the emergence of conflicts across the North African and Middle Eastern region which followed the onset of the Arab Spring in 2011, but no study of this phenomenon has so far been produced. In more general terms, pregnant, mobile and undocumented women remain a strikingly under-researched population in Europe, and this applies not only to recent demographic trends in migration fluxes across the Mediterranean region, but also to those in Europe’s ultra-peripheral border regions. In the French overseas departments of Mayotte and French Guiana, located in the Indian Ocean and in South America respectively, there has been a significant increase in the number of pregnant women in a situation of irregularity crossing the border to seek maternity care on French territory over the past decade. On the basis of these common trends in the Mediterranean and in the French overseas territories, EU BORDER CARE will carry out a locally grounded study of pregnant migrants and maternity care in the borderlands of four EU Member States: France, Greece, Italy and Spain. Despite the prominent place of migrant maternity in popular media and political debate in these four countries, the motivation and experiences of these women – their physical and mental states – have for the most part eluded medical and social scientific analysis. This lack of scholarly research has direct implications on the delivery of maternity care in EU borderlands, because clinical and non-clinical staff delivering antenatal and perinatal care to migrant women have to devise new solutions to medical, personal and ethical challenges for which their professional training has not prepared them, ranging from medical complications to practical misunderstandings and bureaucratic shortcomings in healthcare delivery services towards patients in a situation of irregularity.
Despite national and regional specificities, European, governmental and non-governmental law enforcement and relief agencies operating in EU borderlands today have to approach and respond to a newcomer whose temporary health condition challenges normative ethical guidelines in migration governance. Pregnant migrant women represent some of the world’s most vulnerable populations entering the European Union today. Their maternal health indicators are consistently poor: existing surveys show that they receive little to no routine antenatal care and experience more complications during labour and childbirth than their non-migrant counterparts. A lack of information about available services combined with a fear of prosecution – despite regulatory allowances excusing national medical and social care services from reporting undocumented healthcare seekers – suggest why these women slip between the cracks of universal routine antenatal care. Because of their specific medical histories, pregnant migrants also come to represent medical challenges to healthcare delivery. Women migrants who enter EU borderlands today as part of smuggling operations developed with little regard to human security are exposed to increasing health complications.
Migrant maternity thus represents a significant challenge to frontline services located in EU borderlands. As migrants who find themselves in a situation of irregularity, undocumented pregnant women are classified as vulnerable and eligible for various degrees of ‘free emergency care’ in the four European Member States in question. Pregnant migrants thus embody this striking ambivalence of being both subject to legal prosecution and beneficiaries of humanitarian protection under exceptional legal clauses. EU BORDER CARE’s objective is to explore anthropologically this unique and under-examined tension between care and control in the day-to-day governance of maternal migration in maternity care services located in EU borderlands, with a particular ethnographically-grounded focus on how the main actors involved, such as migrant patients, doctors, midwives and social care workers, experience close contact with one another in the intimacy of the labour ward and the delivery room in the moments preparing for the birth of a baby.