Asking for Donations: Help Us at the US-MX Border

Welcoming Asylum Seekers at the Texas-Mexico Border

By Anna Haas, published January 17, 2025

For the past 3 and a half years, I’ve been working at a clinic/ birth center in the Rio Grande Valley (RGV) on the Texas- Mexico border. Through this organization, Holy Family Services, we run a part-time clinic at the Catholic Charities Respite Center, which is a temporary shelter for newly arriving immigrants from many countries. 

In 2018, my co-worker Annie, also a certified nurse-midwife, began volunteering at the shelter in her free time in partnership with Dr. Griffin, who was operating the shelter clinic through University of Texas (UTRGV). Seeing the need for perinatal care in this population, they were able to secure funding through Every Mother Counts for Annie to continue the services on a regular basis. I joined her in 2022, and we have been able to help thousands of pregnant people as well as parents with newborns. Our services primarily include basic prenatal and postnatal care, transfer to the hospital when needed, breastfeeding support, provision of medications, vitamins, and clean clothes. In collaboration with Migrant Clinicans Network, we are able to connect people with healthcare providers at their destination, which is across the whole U.S.

I have had the privilege of meeting some of the most wonderful, resilient, hard-working people. I meet people mostly from Central /South America and the Caribbean (Haiti, D.R., and Cuba), but I’ve also met people from as far as Afghanistan, Angola, Congo, and Russia. I hear stories about their months of travel in unimaginable circumstances, while pregnant and many times with small children and/or newly postpartum. The patients I see tell me of the great sense of relief they feel to have made it to this point, as many do not survive the journey, though there is a simultaneous sadness for having had to leave their home and family, for the traumas experienced before and during their journey, and the knowledge that navigating life in a new country will bring its own challenges. 

I have been greatly inspired by these people and by the work of these organizations that are connecting people to the resources that they need. I have been able to see the good in humanity and the love that bridges people across cultures, religions, and  languages. I feel honored to be a part of this work. I hope, despite ever-changing government administrations, that I will be able to continue this work for years to come, whether in Texas or elsewhere. 

Update on 02/19/25

On January 21st, I was happy, greatly relieved, to see 3 pregnant patients at the clinic, 2 from Venezuela and 1 from Brazil. All of them were at the shelter alone, as their husbands were all deported at the border (and one patient’s step-father and 9 year old sister as well). I saw another pregnant patient from Brazil on the 24th with her husband (which is rare to see as CBP usually deports the father/husband), and one more who came alone from the Democratic Republic of Congo on the 31st. The last pregnant patient I saw was on February 5th. She came from Bolivia with her 10 year old child and her husband who was deported at the border. Since then, the border has been completely closed, with the shelters having little to no people, and the shelter where I work having zero. It pains me to know that there are moms and babies that I could be caring for, who are likely dying because they cannot access adequate care.

I have many medications, prenatal vitamins, clothes, and toys for kids that I don’t want to go to waste. I am working with the birth center to see how we can continue helping this population locally here in the RGV, and I am looking to work on the Mexico side now, in Reynosa (which is close to where I live) with my friends from Refugee Health Alliance. The conditions are only getting more dire with more crowded spaces and no sanitary or safe living conditions. The pregnant/postpartum people as well everyone else including babies and children, have limited or no access to healthcare, and kidnappings and tortures such as sexual assault and rape are common, leading to severe physical and mental trauma, and sometimes death. 

If you would like to help my efforts, all the organizations that I wrote about are linked below. If you send me a check or supplies for my patients- literally anything for pregnant/ postpartum/ babies/ kids, you can mail it to me: 

Holy Family Services 

Attn: Anna Haas 

5819 N FM 88

Weslaco, TX. 78599

You can also send your tax-deductible gift directly to Holy Family, with a memo that it is for Anna Haas, and please let me know if you do, so I can make sure I get the funds and use 100% of them to help these families. Thank you for reading. May we all do for one person what we wish we could do for everyone.

Links:

• Refugee Health Alliance: https://www.refugeehealthalliance.org/

• Birth Center: https://www.holyfamilybirthcenter.com/

• Respite Center: https://catholiccharitiesrgv.org/

• MCN: https://www.migrantclinician.org/

• Every Mother Counts: https://everymothercounts.org/

• Articles from MCN about Annie & Anna’s work: https://www.migrantclinician.org/blog/2023/may/anna-and-annie-nurse-midwives-greet-pregnant-asylum-seekers-empathy-and-care.html

https://www.migrantclinician.org/blog/2022/mar/annie-leone-cnm-dedication-pregnant-asylum-seekers-border.html

 

Another Little Update

 Here I am once again for a little update... I've been blogging less and less frequently, that I am wondering if I will eventually give it up altogether. But probably I won't. 

We are still in Weslaco with Niko and Jackson (the pugs), and Wilbur (the pig). Kian is almost 2.5 years old, and he's starting to talk a lot. He's very adventurous, and in love with all animals and farm/ construction vehicles. His favorite books revolve around these large machines, until Aunt Mariah sent him Just Because which is his current favorite.

Kennet still works from home and stays busy caring for Kian and doing business in the US and Honduras. 

I am still at the birth center. After 2.5 years, I have officially decided that I don't like taking overnight call. I like working in the birth center clinic and at the Humanitarian Respite Center clinic where I get to see pregnant and postpartum clients who have just immigrated to the US. I have decided that birth work is fine and I am so happy to help people try to have the birth experience that they want and to have a good experience in general, but I do feel like it's not something that I will do forever. I'm so grateful to the people who do it for the long-haul. They are underappreciated. 

I am now doing the ARDMS ultrasound certification. I often think about how the one good thing that came out of my time of living in Guatemala was the training I received from the MFM doctor and physician assistant from New York in OB ultrasound. It came in handy for countless 2nd and 3rd trimester scans, and some 1st trimester ones. Most of our clients where very late to care, so there weren't many early ultrasounds. From the mostly traumatic experience of living there, I look back and appreciate that skill I was able to learn, being able to offer people a service they could otherwise never afford. 

Fast forward from 2018 when I left there until 2021 when I graduated and got my first CNM job. I hadn't done ultrasounds during that whole time. As with any skill, if you don't use it, you lose it, though mostly it's like riding a bike where the muscle memory kicks back in. I'm now able to do the comprehensive training which I hope will be used to help many clients for years to come. 

______________________________________________________________________________

*Trigger warning: infant loss/ stillbirth*

Other than remembering the many days I spent doing ultrasound, moreso now that I'm in the training again, I often remember the traumatic experiences I witnessed during my time as an RN there. As a CNM now, I often cannot believed the things I witnessed as a new RN who was entirely clueless about rural OOHB (out-of-hospital birth). When the thoughts come to me at the most inopportune times, usually when I'm trying to fall asleep at night, I try to console myself by reminding myself that none of it was my fault, I was not the primary provider, but the observer and learner of the Guatemalan comadrona (midwife). Still, I am hardly consoled with the memories of the cold, deceased babies in my arms. If only I knew then what I know now. The memories often haunt me, those babies remind me of my baby brother Daniel when he came home from the hospital, stillborn. He was my mom's last biological child, number 10 of her 12 kids. I remember the unimaginable grief. I not only felt it in myself, but all around me. I remembering thinking that if I felt this sad, how much more devastating must it be for the mother. And I remember those mothers in Guatemala.

If you want to read the stories of the death of two babies that affected me the most, they are below. 

When I first went to San Juan to learn about home births with the comadrona and opening a birth center, I would go with her to the tiny dirt-floor homes of her clients. She normally attended the births alone, so I think she appreciated a second set of hands. This particular patient was giving birth for the first time. A young couple, late teens/early twenties, as mostly all of our clients there were. It was a long night, I don't remember much other than Christian worship music playing, and her asking the comadrona over and over and over again, "is the baby almost here?" She finally got the patient up on in a squatting position. As a side note, ALL of the patients I saw give birth with her were supine, flat on their backs (even after the birth center was open and I tried to teach about optimal positioning in labor). If you don't know how bad it is to be flat on your back for the duration of labor, it's very bad. Anyhow, the baby's head was finally born with her squatting on the floor, but the body never came. It was suddenly a complete panic and the comadrona was screaming for them to get the pickup truck to go to the centro de salud  Family members laid her on something that looked a makeshift cot and carried her to the truck. Somewhere during that time the baby was born, all the jostling of the mother got the baby's shoulders' loose. I remember because as we were in the back of the pickup, I gave her the shot of Pitocin in her leg as the comadrona had given it to me prior and I was still holding onto it. By the time we arrived to the nearby centro de salud, I watched the doctor try to resuscitate the baby, but it was far too late. I remember the comadrona blaming the death on the fact that the centro didn't have oxygen available. I helped the nurse wrap the baby as the comadrona delivered the terrible news to the waiting family. Looking back, I have no idea what, if any, resuscitation measures were attempted after the baby was born. If only I knew back then what I know now. Whenever the topic of should dystocia comes up now, that story always haunts me.

The other one happened after the birth center was opened. They called me in after a baby was born (it was a very confusing time, when I as the "assistant to the director" [located in the US] was supposed to be on call 24/7 for births, but I wasn't always called in). Upon my arrival, one of the attendants was doing very poor PPV. The comadrona asked me to call the ambulance across the lake so we could meet it there by boat, cutting the normal 2 hour travel time in half. Being the middle of the night, it was hard to find a willing lancha (boat) driver. Finally we did, and I held that cold, blue baby in my arms as another person tried to continue doing PPV with the oxygen tank that was much too large. It was freezing, wind blowing as we sped across the lake. It was impossible to do adequate PPV. Why do we not have proper transport equipment? The emergency team took over in the ambulance. I tried not to vomit from motion sickness as we spend up the winding mounting to the hospital. Upon arrival they announced what we all already knew. It was too late to save the baby.  

This week happens to be National Midwifery Week. I was asked "what drew you to midwifery?" I suppose it actually started from when my mom birthed me, which was a homebirth (her second one) attended by her friend and my dad. From there my mom continued to have "freebirths." As I grew up I tried to find the balance between no medical care and too much medical care in the world of obstetrics. During my RN training, I didn't know where I would land in the world of nursing. I guess it was my time in Guatemala that brought me back to midwifery. While I wish none of those experiences happened, I want to honor them, and I hope by being a CNM I can do that. 

Update

I seem to say this every time I post... time flies! I was surprised to see that my last post was about Kian's birth, and now he's a big 25 pound 10 month old! 

He's an active boy, high-speed crawling, pulling himself up to standing, cruising along whatever he can use to support him, and even has tried standing on his own. 

He got 8 teeth before he was even 8 months, and he's still rocking those 8 teeth. He's drooling everywhere and everything goes in his mouth, so I always think he's going to be getting more teeth at any moment. We've had great success with "baby-led weaning," and he loves to eat a wide variety of foods. 

The major thing we are struggling with at this time is sleeping at night. It seems like the older he gets, the more he wants to nurse at night! He wants to nurse about every 2 hours (anywhere from 1-3 hours) from about 7PM to 7AM. Needless to say, it is very tiring for me. 

He's also going through an extreme "mommy" phase right now, which is both sweet but more so tiring. Developmentally he seems to be getting "stranger danger" and wants to only be with me or Kennet, and this is compounded by the fact that he isn't out and about much or exposed to many people. 

In December, he finally got to meet Kennet's family. He was totally overwhelmed at first with all the attention and excitement, but got over that after a few days.

We went to the beach in Roatan (Honduras) over the Valentine's holiday, getting to see Kennet's family again! That was the first time his parents/family got to vacation there, so that that was a really fun time. My brother-in-law also came, and it was nice to see him after nearly a year. 

We are now here in Weslaco, in the same town where I work, so my commute is less than 10 minutes as opposed to 25- 30 minutes when we lived at the apartment in Edinburg. Below, us outside our apartment on the day we moved out. 

As far as work, Kennet is still working from home with the stock market and taking care of Kian when I am at work. He is quite the super dad and Kian is very fortunate to have him. 

I will complete the whole year of the nurse-midwife fellowship, ending July 1. They offered me a position to stay on as a fulltime CNM, but I will likely stay on part-time and work 3 days week between the clinic/ birth center, and respite center (for people immigrating to the US). 

I feel fortunate to be able to work and live here. The hardest part is being very far from family and friends in PA and Maryland. Most of my family is spread out very far across the US and beyond, so this situation isn't entirely new to us. I would still like to live closer to a larger airport such as DFW or Houston, as travel domestically and to Honduras would be much easier. Traveling with baby takes quite the physical and mental toll! 

This is the update in a nutshell, I hope 2022 is going well for you and I would love to hear from you and see you here at our house in beautiful south Texas! Remember, we are just an hour from beautiful beaches on South Padre Island, and 14 miles from Mexico! 

Kian's Birth: Photo Edition

Warning: some pictures display sensitive content.  

My constant support!

My favorite labor position 

Lavender

The big gush 

Ice

Resting with Stadol 

My 2nd favorite labor position

Getting close to the end

Getting closer to the end, beyond exhausted

Doubting that the end will ever come

Feeling like my body is being ripped apart 

Yelling out with all my strength, it helped me find the physical strength to push 

The moment I've been waiting for is almost here

Some feelings cannot be expressed with words

                    Beyond relieved 

Relieved and grateful 

The moment we've been waiting for

In awe

Dad and the midwife (Jess) cutting the cord 

Thank you, placenta, for all you've done for 36 weeks to grow and nourish my baby 

Papi (Dad) hold Kian for the first time

The postpartum journey begins

8 pounds, 20.5 inches tall!

A strong heart 

A very good breastfeeder from the start!

My family

Kian's Birth

On Tuesday afternoon, April 13, I was 38 weeks and 2 days pregnant. I started having several strong contractions, very spaced out. I was glad because although I had had some Braxton-Hicks during the early third trimester, I had them less and less until I wasn't having them at all by 36 weeks. I continued having the contractions all afternoon and through the night, waking up about every hour with the discomfort. 

The next day, April 14, it continued, and I struggled to get comfortable. That night, I tried sleeping in the recliner chair. The contractions continued to wake me up throughout the night, so I called the clinic. Since I did my prenatal care in Wilkes-Barre, they automatically transferred me to the on-call provider at that hospital. I forgot to tell them to connect me to the Scranton hospital (where the midwives are) which is where I planned to give birth. The OB at the Wilkes-Barre hospital asked "what's going on?" and I explained my situation. He replied, "with first-time moms, we like to try to wait until at least 39 or 40 weeks. Try drinking plenty of water and taking 1000 mg of Tylenol, and try to find a comfortable place to rest. If the contractions get stronger and closer together then call us back." I found him to be rather dismissive of what I was feeling. At the same time, many people going through this for the first time think that they are in labor when in fact their early labor is just very drawn out. 

Continuing to wake up with the contractions throughout the early morning of April 15, I called the Scranton hospital this time, and the midwife asked me several questions to gauge how I was doing. She told me I could come in a be checked if that would be make me feel better, and that I could go home if it wasn't active labor yet. I decided to try to wait and see if the contractions would start getting closer together. They didn't, but they were becoming so strong, and I soon vomited all the water I had been drinking. Around 04:00, I called the midwife again and told her I wanted to come in to be checked. I was getting desperate because I couldn't rest anymore and I wanted to know if I was making progress. Around 05:00 we arrived to the triage and when the midwife checked me, I was already 5cm and 100% effaced! (Meaning my cervix was half was to being completely dilated, and it had already thinned out completely). I was very relieved that I was to be admitted and that the baby would be born this day. I was 38 weeks and 4 days, and I had thought all along that I would surely go past my due date, per the usual for my family. 

The hospital unit was beautiful, and I felt very fortunate to be there. The nurses and midwives were very kind and attentive. I told them I wanted to to have the baby without an epidural. They were very supportive of me and helped me with position changes to help the labor progress and help me find the most comfortable positions. Nothing was comfortable, but I found that standing, leaning over the side of the bed was most tolerable and helped my back hurt the least. I also used the TENS unit (per the recommendation of my doula/photographer) on my lower back which helped, but I couldn't use this while the fetal monitor was on. When my legs tired too much, I laid in bed with the peanut ball between my legs. For some reason, I did not like sitting on the yoga ball as I felt like it put too much pressure on the perineal area. 

At some point in the morning my water broke with a large gush, soaking through my clothes. I was glad to see clear fluid. 

When several hours had passed and I only progressed 1cm, I began to feel discouraged. I hadn't slept well for the past 2 nights and I was worried my energy would run out before I the labor was over. They offered me the nitrous oxide to help me cope, but I was so uncomfortable in the bed and the mask or the gas had a scent that I did not like. After only about 2 contractions I didn't want that anymore, though now I wish I had tried to use it longer. They then gave me a dose of Stadol. That put me out and allowed me to rest though contractions for a while. 

Throughout most of the active labor, I was frequently nauseous and vomited a lot. They gave some smelling oils which helped (lavender, peppermint, eucalyptus), and I also got one dose of Zofran. 

As the hours passed, I kept feeling like I needed to push, but with each cervical check I was getting more discouraged that I was only progressing by 1cm... so much time and pain only to be at 7cm... hours later, 8. 

The rest with the Stadol gave me a bit of energy and I was up again, on my knees leaning over the head of the bed. I had to be leaning forward with pressure on my lower back to relieve the pain. The whole time, Kennet was there to offer this support and give me ice chips for my parched mouth.  

At 14:10, 9 hours after arriving to the hospital, I was finally completely dilated, but the baby hadn't moved down much in my pelvis. He was at -1 when I arrived, and had only moved down to 0 by the time I was completely dilated. I pushed for an excruciating 2 and half hours. I tried several positions, including leaning over the head of the bed, squatting in the bed leaning over a support bar, and finally laying back when I didn't have the energy to hold myself up anymore. My contractions never got very close together, so I had long breaks in between pushes, but by the end waiting for the next contraction felt like an eternity. His head came out ever so slowly and I felt as though my body was tearing apart. I do remember asking the midwife if she could just pull him out, which is funny looking back now. In that moment I wanted anything to be done to relieve the pain; it felt like this would never end. 

He was finally born at 16:42, April 15, 2021, at 8 perfect pounds (the exact weight that I was at my birth!). Kian Demesio Silva Haas. The relief and gratitude I felt the moment he was out and laid on my abdomen is something can only be understood by experience. He cried immediately and had beautiful Apgars of 9 and 9! I could not contain my tears of relief and gratefulness to be holding him in my arms

We waited until his placenta was birthed to cut the cord. 

I am very thankful that he had no problems latching to the breast and has been a good eater from day 1! 

My postpartum care was excellent. We stayed 48 hours, and I was so grateful for the continued supply of perineal ice packs, clean pads, and ibuprofen and Colace around the clock. The nurses, midwives, pediatrician, and lactation consultant were very attentive. The nurses helped Kennet change the baby's diaper throughout the day and night. I was so grateful the support, the electric bed, and the meals delivered to us. 

Kennet was a constant support during the entire experience. I love to hear him recount the birth from his perspective; all of this was a first-time experience for him and he has been loving being a dad since the moment Kian was born, and even before while he was still growing inside of me. 

During this time, I began thinking of all the people who birth around the world every day in less-than-ideal circumstances. I thought of those who didn't plan or want to become pregnant, the young girls and teens I cared for in Guatemala. Those who birth alone at home, with no running water or electricity. They don't have medical care, much less any form of treatment for the pain of labor and the recovery. No ice packs, no ibuprofen, no disposable pads, no nipple cream or breastfeeding support, no warm showers, no comfortable nursing bras, no education or provision of contraception postpartum. I had so much discomfort, and am still recovering, almost 2 weeks later. How do people manage without all of theses extra supports that I had? I also thought of all the people who long to have the experience of birthing their own baby but have never been granted this privilege.

I can definitely say that going through this experience has informed me very much and will help me better care for my own patients. 

Update 2021

Every time I go to write a new blog post, I cannot believe how much time has passed by since my last post. During the last 9 months, a lot  has happened! 

-In mid-August 2020, I found out I was pregnant. In early December, we found out that we are having a boy. I was very excited by this news! 

-At the end of December, I graduated with my master's degree as a CNM-- certified nurse-midwife. I finished my clinical time on Jan 6th, and on Feb 6th, I passed the AMCB board exam! I was very thankful and very relieved!

Pictured here at 29 weeks with the paper stating I had passed the exam (right) and when my diploma came (left, around 31 weeks). 

-Next came the time of waiting for the licensure to process, and in the meantime, searching for employment. Filling out all the forms, paying all the fees, updating the CV, cover letters, phone interviews, video interviews...etc, etc. The lapse between graduation/passing the board exam and waiting for licensure to be completed and finding a job feels long. Because I am not currently working as an RN, I have all this free time so I am trying to take advantage of continuing learning with taking classes such as OBGYN ultrasound and participating in various webinars on topics of women's health. I know that soon I will be busy with a new baby and a job, so I am trying to enjoy the time of sleep, ample time for exercise and yoga, and wandering the groceries store aisles looking for new recipe ideas (I am not naturally a good cook so this is good for me!) 

-My last semester of grad school (Sept 3, 2020 to Jan 6, 20201) was difficult as I was very fatigued and nauseous until about week 14/15 of the the pregnancy. I would often have to go to the bathroom to vomit while caring for a patient in labor, or in between seeing patients in the office. It was so difficult to find food/drink that I could tolerate, and I felt so dehydrated all the time because I could not keep water down. The typical textbook recommendations for first-line treatments for nausea and vomiting did not seem to work for me, so every day it was trial and error and trying to eat/drink what I could tolerate, even if that was just ice cubes and diet Coke. 

I never did end up getting prescription medication, but if I ever had a second a pregnancy, I would consider it early on to avoid going through this again.  

However, before going straight to prescription antiemetics, there is an option that works for most people. To avoid nausea and vomiting before it starts, I do highly recommend taking vitamin B6 (10-25 mg up to 3x daily) along with 1/2 tab or 1 tab (12.5/ 25 mg) of Unisom before bed. This is sold as a prescription called Diclegis, but these can easily be bought over-the-counter as separate supplements. These have to be taken daily in order to the prevent the nausea/vomiting. I started taking this around week 6/7, and if I forgot to take it one day, I noticed a huge difference. Next time I know to start taking them right away, before the nausea sets in. By week 16 I didn't need it anymore. 

-Other than some musculoskeletal discomforts, I haven't had any major issues during my second trimester. I am now almost 32 weeks, so we will see how these last 2 months go! 

Since week 29, I have had pain in my symphysis pubis. This has been causing my quite a bit of discomfort with certain movements, even rolling from side to side when in bed, and when I go for walks for extended periods of time. Sadly it is too painful that I cannot jog/run at all. Thankfully, I can still do many exercises with no discomfort. 

-When it was time for the glucose tolerance test around 27 weeks to screen gestational diabetes, I had a high result of 171. For reference, this number should be below 130 ideally, some guidelines use 140. While many people do not pass the first screen, most people pass the second (diagnostic) screen. Still, this high result motivated me to begin exercising every day, and for the past ~5 weeks I seldom have missed a day, even if it's an easy day of prenatal yoga. Below are the links to the routines that I have enjoyed. Although I enjoyed working out daily before becoming pregnant, after I was over the extreme fatigue and sickness of the first trimester, I never reincorporated regular exercise other than occasional walks or hikes. 

Do you have a favorite indoor workout (for when the weather is freezing/icy/terrible) for pregnancy, postpartum or otherwise?

- THIS is my favorite prenatal YouTube channel

- THIS is my favorite prenatal/postpartum routine

- THIS is my favorite overall quick & effective workout, but may need modification during the 3rd trimester. 

- THIS is a fun stretch! 

- THIS is for a calmer, easier day (and to work on flexibility) 

- THIS routine has helped with symphysis pubis pain

I had also gotten used to eating anything I could tolerate, not focusing on nutrient-dense foods. Thus, after my initial glucose screen, I began monitoring my blood sugar levels daily (for 1 week to diagnose/rule out gestational diabetes) then every morning I continue to check my fasting glucose level out of my own curiosity. 

These became my favorite protein-dense snacks/meals. Do you have any favorite protein recipes?

-Sugar-free beef/turkey jerky 

-Turkey & cheese rolls 

-Greek yogurt (with low-sugar granola)

-Tuna (skipjack or other low-mercury type!) 

-Eggs (in every form!) 

-Peanut (or any nut) butter with celery/apples 

-Almonds, pistachios, pumpkin seeds

-Roasted chickpeas/ hummus

-Cottage cheese

-Chia seed pudding (chia seeds mixed with almond milk and a bit of stevia, refrigerated overnight) 

-Avocado & chicken 

-Lentil salad

-Oatmeal 

-Peanut butter balls (favorite recipe here)

Until next time, when I will likely have a baby in my arms and hopefully employment as a CNM!