This issue brief outlines evidence of the mistreatment of pregnant immigrants and people seeking asylum at the U.S.-Mexico border and in U.S. immigration detention, and discusses how existing policies have created the conditions for escalating human rights abuses during COVID-19. This issue brief supports public health guidance and human rights standards directing the release of all people in immigration detention during the pandemic, but focuses on a subset of reforms that are urgently needed to ensure the health and safety of pregnant asylum seekers and immigrants during and long after the pandemic.