October 20, 2017

The Honorable Scott Lloyd

Director, Office of Refugee Resettlement
Administration for Children and Families
U.S. Department of Health and Human Services
330 C Street, SW
Washington, DC 20201

Dear Mr. Lloyd:

On behalf of the American Congress of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the
Society for Adolescent Health and Medicine, we write to express serious concerns about reports of women and
adolescents in Office of Refugee Resettlement (ORR) shelters being denied access to reproductive health care,
specifically access to abortion. 1 All women and adolescents held in federal custody should be able to access evidence-
based, comprehensive reproductive health services, including abortion care. 2

Every woman should be able to access the reproductive health care she needs, including abortion, no matter their age,
income, incarceration, or immigration status. 3 Safe, legal abortion is a necessary component of womens health care.
When abortion care is illegal or highly restricted, women resort to unsafe means to end an unwanted pregnancy,
including self-inflicted abdominal and bodily trauma, ingestion of dangerous chemicals, self-medication with a variety of
drugs, and reliance on unqualified abortion providers. 4 By obstructing basic access to safe and legal abortion, ORR is
risking the health and lives of women and adolescents in its custody. ORRs action also appears to be a violation of the
terms of the Flores v. Reno Settlement Agreement.

No woman or girl should face political interference in their health care decisions, including while she is in an ORR shelter,
or held in any federally-funded detention facility. 5 In addition, children, whether unaccompanied or accompanied,
should receive timely, comprehensive medical care that is culturally and linguistically sensitive by medical providers
trained to care for children. This care should be consistent throughout all stages of the immigration processing pathway.

Sincerely,

Haywood L. Brown, MD, FACOG Fernando Stein, MD, FAAP Tamera Coyne-Beasley, MD, MPH, FSAHM
President President President

1
Trump Official Halts Abortions Among Undocumented, Pregnant Teens. (October 16, 2017). Retrieved from:
http://www.politico.com/story/2017/10/16/undocumented-pregnant-girl-trump-abortion-texas-243844
2
Reproductive health care for incarcerated women and adolescent females. Committee Opinion No. 535. American College of
Obstetricians and Gynecologists. Obstet Gynecol 2012;120:4259.
3
Health care for unauthorized immigrants. Committee Opinion No. 627. American College of Obstetricians and Gynecologists.
Obstet Gynecol 2015;125:7559.
4
Increasing Access to Abortion. Committee Opinion No. 613. American College of Obstetricians and Gynecologists. Obstet Gynecol
2014;124:10605.
5
Ibid.