Immigration Enforcement and Birth Outcomes: Evidence From North Carolina

Project Summary

This project team estimated the effects of Immigration and Customs Enforcement (ICE) activities, specifically 287(g) programs and Secure Communities, on the maternal and infant health of Mexican-born immigrant mothers in North Carolina. The team explored how immigration enforcement activities affect the health and well-being of immigrant mothers and their newborns, and if changes in birth outcomes arose due to changes in maternal behaviors and access.

Research Question(s)

  • Do immigration enforcement activities negatively affect the health and well-being of immigrant mothers and their newborns?
  • Do these negative impacts in birth outcomes arise because of changes in maternal health behaviors and access?
  • What are the implications of these results for practitioners and policy makers who are working in immigrant communities?


  • Inform immigration and other policies that seek to mitigate or remediate disadvantage generated before birth by providing a quantification of the likely human impact of both anti-immigrant sentiment and more direct policies that target undocumented populations and their communities.


  • The introduction of 298(g) programs, which increased local law enforcement’s discretion over immigration issues, led to worse health outcomes at birth, with reduced or delayed access to health care likely playing a potentially important mediating role.
  • Considering birth outcomes heavily influence health, education, and earnings trajectories, the findings suggest that current socioeconomic costs of the recent uptick in ICE activities under a conservative-leaning federal and local governments’ mentality can be long lasting and have deleterious effects on US-born citizens.


Adequacy of prenatal care (measured using the Kotelchuck index), smoking and alcohol consumption during pregnancy, birth weight, gestational age, and small-for-gestational age.


Difference-in-difference approach comparing variation in birth outcomes (or maternal behavior) for immigrant mothers before and after the time when a county enacted increased enforcement with those of similar mothers residing in a county that did not change its enforcement regulation around the same time.

newborn baby
Grantee and Partner organizations

Duke University Sanford School of Public Policy

Grant status
Principal investigators
Marcos Rangel, PhD
Christina Gibson-Davis, PhD
Start date
Award amount
$ 136,139
18 months

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