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August 17, 2025

Navigating the Bureaucratic Dimensions of Reproductive Violence on the US‐Mexico Border During the COVID‐19 Public Health Emergency

Key Points

Bureaucratic exclusion undermines access to health services, perpetuating reproductive violence.
During the COVID-19 pandemic, federal policy prevented disenrollment from medicaid, affecting Latinas disproportionately.
Ethnographic work highlights how public programs meant to alleviate inequities may inadvertently maintain them.
The study emphasizes the need for policy reform to address social inequities and improve access to care for marginalized communities.

Abstract

ABSTRACT Medicaid for Pregnant Women is an important safety net program that covers nearly half of all births in Texas, the second most populous state in the United States. This article explores the bureaucratic mechanisms of exclusion from coverage under Medicaid for Pregnant Women for Latinas in the Texas–Mexico border region. It gives particular attention to exclusion during the COVID‐19 public health emergency, when federal policy prevented states from disenrolling Medicaid recipients. Ethnographic work conducted during the first 2 years of the pandemic shows how bureaucratic procedures tied to using publicly funded programs may undermine the potential for these programs to remedy social inequities. The bureaucratic exclusion that may result constitutes reproductive violence, given that the inaccessibility of health services can contribute to adverse reproductive health outcomes and undermine a person's ability to manage their reproductive lives with dignity. While the focus is on Medicaid policies, this analysis is relevant for understanding how bureaucracy has the potential to wield power in ways that perpetuate various manifestations of violence within society.

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