Melissa and her husband, both Christian missionaries from Mexico, had been living outside Austin for about a year when they discovered she was pregnant. Melissa planned to deliver her baby at a birthing center -- a licensed facility that accepts cash payments from low-income women.
But Ms. Rojas, who was helping her by providing naturopathic prenatal care, worried that Melissa would not make it nine months without requiring a medical intervention. She had seen it happen with other undocumented patients who developed stress-related ailments that can lead to premature birth and other problems. Melissa was constantly fretting, she said, and struggled to sleep at night.
About seven months into her pregnancy, Melissa was rushed to a hospital with pre-eclampsia, a dangerous condition that threatens the life of both the mother and the baby. Her son, Josias, was delivered via emergency C-section and weighed only four pounds. A nurse carried him directly to an incubator.
The next evening, in the darkness of her hospital room, Melissa asked about paying her bill in cash. A nurse explained that Josias would need to live in the hospital for at least a month, and that it would likely cost hundreds of thousands of dollars to keep him alive.
After months of avoiding it, she would have to apply for public benefits.
As the nurse turned down the lights in her room, Melissa closed her eyes, trying not to think about the future, but she could not sleep all night.
Lynsey Addario contributed reporting from McAllen, Texas.