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Obstetrician Dr. Jack Ludmir, center, performs an ultrasound on a young woman from Nicaragua who is also an undocumented immigrant at Pennsylvania Hospital in Philadelphia.
mct photo
PHILADELPHIA — Twelve years ago, Lizbeth Ramos and her common-law husband, Juan, left their hometown near Puebla, Mexico, and set out on foot across the desert for the Arizona border, to slip into new lives as illegal immigrants. • He found work in a produce market in the Philadelphia area, she in a boutique. They saved up to start a family.
Now 30, she lies on an examination table in Pennsylvania Hospital, at a weekly obstetrics clinic for immigrant women, no status questions asked. As a doctor slides an ultrasound wand over her bulging belly, her eyes are transfixed by the monitor. She is carrying twins.
The moment they enter the world, they will be what their parents are not: U.S. citizens.
Such is their birthright, granted by the 14th Amendment to an estimated 340,000 babies born annually to undocumented immigrants.
But in the marathon fight over immigration control, that 143-year-old constitutional guarantee has become the latest target and the delivery room the new front. The pejorative “anchor babies” already is in the lexicon.
“Once a child is born here, the parents make the argument that they should be allowed to stay as that child’s guardian. They are using that child as an anchor (to) play on our heartstrings,” said Pennsylvania state Rep. Daryl Metcalfe, a Butler County Republican who has built a national reputation as a crusader against what he calls “illegal alien invaders.”
Immigrant advocates dismiss his contention as myth, and point to a recent study that found that undocumented immigrants generally “come for work and to join family members.” The Washington-based, nonprofit Immigration Policy Center concluded “they do no come specifically to give birth” and game the immigration system.
Such assertions have not tempered the efforts of immigration-control proponents to effectively do away with “birthright citizenship” for the offspring of illegal immigrants.
On the federal level, two Republican senators, David Vitter of Louisiana and Rand Paul of Kentucky, want to accomplish it by amending the Constitution — allowing automatic citizenship only if a child has at least one parent who already is a citizen, a legal permanent resident or an active-duty soldier.
On the state level, Metcalfe, joined by lawmakers from 40 others states, is promoting a package of model legislation under the rubric “National Security Begins At Home.” Among those suggested bills: In lieu of automatic citizenship, states would issue distinctly marked birth certificates for the newborns of illegal immigrants, to distinguish them from U.S. citizens.
Pointing out that immigration policy is a federal prerogative, immigrant advocates say that such proposals are beyond the scope of state lawmakers’ authority, not to mention unconstitutional.
Metcalfe’s “model (birth certificate) statute claims not to confer any particular benefit or penalty on the basis of the different markings,” said Alison Parker, U.S. program director for Human Rights Watch, an international advocacy group. But “differentiating citizens on the basis of their parents’ immigration status would inevitably result in discriminatory treatment.”
Supporters of birthright citizenship — including the American Civil Liberties Union, the Mexican American Legal Defense and Education Fund, Migration Policy Institute and the Constitutional Accountability Center — have hit back hard, issuing white papers on the 14th Amendment’s intent, organizing pro-immigrant rallies and running radio ads.
According to a 2010 Pew Hispanic Center analysis, undocumented immigrants comprise slightly more than 4 percent of adults in the U.S. But because of their youth and high birthrates, they produce an estimated 8 percent of the approximately 4.3 million babies born annually.
What is the real anchoring power of “anchor babies?” Advocates contend it is overblown.
U.S.-born children cannot “protect their parents from deportation,” the Immigration Policy Center’s analysis stated. “Every year the U.S. deports thousands of parents of U.S. citizens.”
Those children can sponsor their parents for permanent residency, but not before age 21. In most cases, if the petition is granted, the parents would still have to leave the U.S. for at least 10 years — the penalty for having been here illegally in the first place.
The center’s report concluded: “Undocumented immigrants do not come to the U.S. to give birth as part of a 31-year plan.”
But birthright citizenship does have its benefits.
In households with typically low incomes, the infants are immediately eligible for Medicaid and other government benefits — even though their parents are not.
In arguing for his legislative agenda, Metcalfe stresses the economic impact.
The estimated 140,000 illegal immigrants in Pennsylvania, he said, drain state coffers to the tune of $1.4 billion a year — much of it to cover uncompensated emergency-room services for people “who shouldn’t be on our soil in the first place.”
In 2006, Jack Ludmir, chief of obstetrics at Pennsylvania Hospital, founded a pre-natal clinic for immigrant women, Latina Community Health Services.
He sees about 50 women a week, who pay on a sliding scale that averages $5, but nothing at all if they can’t afford it. He writes their names in an old-school notebook. Not all are Latina; he has had patients from Egypt and Pakistan.
Ludmir doesn’t ask their immigration status. But based on their lack of Social Security numbers, he estimates that at least 14 percent of the women who deliver there are undocumented.
“I didn’t bring these people here,” he said. “They are here, in my backyard, and they are coming to my hospital.”
Not every hospital has such a clinic, and fewer hospitals — citing high costs — are providing maternity services at all. Pennsylvania Hospital happens to be near the immigrant-dense neighborhoods of South Philadelphia, though Ludmir gets referrals from Puentes de Salud, a free clinic in Center City that he co-founded in 2004 with Steve Larson, an associate professor of emergency medicine at the Hospital of the University of Pennsylvania.
From childhood, Ludmir was imbued with a global, immigrant-friendly sensibility. He was born in America when his Romanian parents came here for his father’s medical residency, and raised in Peru, where the family made its home.
But, he said, he does not provide hundreds of thousands of dollars of subsidized care purely from the goodness of his heart. It is in Pennsylvania Hospital’s self-interest to provide preventative care against gestational diabetes, high blood pressure and other complications, he said, than to incur astronomical unreimbursed costs when a woman in a life-or-death crisis needs an emergency delivery.
Although illegal immigrants are not entitled to publicly funded health benefits, hospitals cannot turn away any woman in labor.
“I am not a politician,” Ludmir said. “I am not here to argue that the borders should be tighter. That is not my fight.
“But the law is the law, and unless Metcalfe and others change it,” he said, these children “are U.S. citizens.”
One of his patients is 27-year-old Navora Popoca, who has children born on both sides of the border in what demographers call a “mixed-status” family.
Like Lizbeth Ramos and most other Mexican immigrants in the Philadelphia area, Popoca comes from a town near Puebla, where she gave birth to a son in 2001. That year, her husband Roberto, a laborer on a corn farm in Mexico, made his way into the U.S.; working in factories and as a landscaper, he could earn as much per hour here as in a whole day in Mexico.
In 2003, Navora crossed the Sonora Desert into Arizona and eventually arrived in Philadelphia. About a year later, she gave birth to twin girls at Temple University Hospital.
On a recent day, Ludmir performed an ultrasound examination for what will be her fourth child, due in June.
Because of low income, the U.S.-born twins are eligible for Medicaid, but not the rest of the family, including the Mexican-born son.
“With the girls, if they have any medical issues they can just go to the doctor” and it will be paid, she said. “My boy can’t.”