On Sixth Avenue, across the street from the block-long Family Court building, stands a row of converted single-family Victorian homes, their yards parking lots, their windows barred. Today those residencies are family-mediation agencies and immigration law offices. In the lawyers’ waiting rooms, one finds a new class of clients: illegal immigrants, most from Mexico, who’ve been in San Diego for years and whose chances of gaining citizenship are getting as slim as winning the lottery. They’re seeking attorneys’ aid, frightened by the anti-immigration movement in American politics, and especially the d word: deportation.

During the 1980s and 1990s, Mexicans who were in the country illegally traveled back and forth at Christmas: take a bus to the border, walk into Tijuana, fly home for the holidays and fly back, then sneak into America through a hole in the fence or a long hole in the ground. In recent years, for a host of reasons — stronger border surveillance, double the number of Border Patrol agents, widened barriers and sealed tunnels, tougher restrictions on Mexican visas, overloaded U.S. clinics where pregnant women receive prenatal care, and a political will in Washington to revise immigration law — crossing from Mexico has become more perilous than ever, particularly along the 45-mile border between the San Ysidro and Tecate crossings.

A border that is less porous has meant a boon for immigration lawyers. Their clients, many of whom have hidden out in America for years, are now seeking a lawful path toward residency and/or citizenship, though the way, in such an inflamed political climate, is strewn with legal roadblocks and ablaze with constant anxiety.

One such client I meet in a Sixth Avenue law office is a fortyish Mexican woman, here illegally for eight years. She — and her lawyer — agree that she may speak anonymously. Lupe, as I’ll call her, came to America from Mexico with six of her seven children. The seventh, now seven years old, is the only one born here, and thus a U.S. citizen.

Lupe is accompanied by her soon-to-be daughter-in-law, who is an American citizen. The young woman’s Mexican-born fiancé, one of Lupe’s seven children, was deported last June. The two hope that by working with an immigration attorney, they can bring him back and get him and Lupe on the road to residency status.

Lupe is distraught about her son’s expulsion. She has no idea when she’ll see him again. Worse, she says, is her fear that if she went to visit him in Tijuana, where he lives, she could not get back across the border — not today’s clamped-down border. Such a journey might mean abandoning her six children in the United States. It’s a classic bind, between the rock of one child and the hard place of the other six.

Still, with a trusting smile, Lupe says she wishes “there were a better opportunity in the U.S. for everyone here illegally to become, at least, temporary residents.”

In 2003, after borrowing a brother-in-law’s passport, she crossed with her family by car. (Her husband has had a green card for 20 years.) They did so not to give birth to more children here but to seek “greater opportunities” for her Mexican-born kids. The crossing was not difficult, but she was nervous. Now, she says, it’s much harder. Customs officials are more vigilant, and the way back is “a lot riskier than before,” especially if you need a coyote: “It costs 7000, 8000 dollars.”

She says she didn’t cross legally because, in years past, such an undertaking was impossible. To emigrate from Mexico, one needed a passport, a business, and a steady income, none of which Lupe or her husband had. The Mexican government would issue a passport only if it believed you were coming to America to earn money and would, in effect, send some portion of it home.

Lupe takes care of the kids while her husband works construction. So far, his residency has not helped her alter her status. In fact, only recently has she come out of the shadows and sought legal aid. Neither she nor her family members have been asked about their status. (Her son, who was deported, was detained after a car crash and, without an ID, admitted he was not a citizen. Immigration and Customs officials deported him immediately.) If Lupe drives — she has no license — she is very careful. She lives in fear that any police car driving slowly by her home is there either to spy on her or arrest her.

The soon-to-be daughter-in-law often takes Lupe’s seven-year-old daughter with her to visit her brother in Tijuana. She says the seven-year-old, who understands her mother can’t go to TJ without papers, tells her when she leaves, “I will tell him ‘hi’ for you, since you can’t go, okay, Mom?”

In parting, Lupe says that, despite the new law in Arizona, which has made her fearful of driving in California, she still hopes to become a resident and citizen “because the government here is much better than it is in Mexico.”

Tough Decisions

Lupe’s attorney is Jacob Sapochnick, who told her up front that any resolution of her case might take “two to three years.” On a recent dress-down Friday, Sapochnick, a gracious and talkative man, spoke with me about Lupe and other clients. Silencing his buzzing iPhone, he says his presence online and a frantic immigration environment has added a dramatic pop to his business.

An Israeli, Sapochnick came to America on a student visa in 1997 to attend law school. He first worked for a firm, translating documents for Israeli clients. Eventually, sponsored by his employer, he got a permanent resident or green card (a color identity the document no longer carries). Today, he holds dual citizenship and has, for the past seven years, specialized in helping immigrants, legal and illegal, become permanent residents and citizens.

Beginning alone, with a one-room office, he has now “taken over the second floor” of a house at 1552 Sixth Avenue. He’s one of three lawyers and five paralegals; the practice includes web pages and videos explaining immigration law. Sapochnick, who speaks in rapid-fire sentences, almost as if he can conjure the arc of my questions, says that he reaches potential clients all over the country because immigration law is federal and involves filing the requisite paperwork with the U.S. government, as well as with embassies in the emigrant’s homeland.

Sapochnick recites a typical recent email. “I’m a U.S. citizen and I’m planning to marry. My spouse is here illegally for the last 10 or 20 years. What are the steps?” Another reads, “I’ve been here for 10 or 20 years, and I married a U.S. citizen, I want to fix my papers. What am I going to do?”

A growing request is “I was born here but my parents who are still here are illegal. How can I sponsor them?” These emails are often crafted with an imploring tone: “My child is a U.S. citizen. He’s over 21. Shouldn’t he be able to help me?” Sapochnick says no, the child can’t help. This appeal he calls the “hot topic of the day” — birthright citizenship.

The first section of the Fourteenth Amendment to the U.S. Constitution states: “All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United Sates and of the State wherein they reside.” This “citizenship clause” overturned the Dred Scott decision, the pre–Civil War law that denied blacks citizenship.

In recent years, Congress has tightened immigration law, funded border security, beefed up penalties for businesses hiring illegals, and denied citizenship to the children of foreign nationals (those brought here at a young age) by defeating the Dream Act. What’s more, many politicians and activists have called the citizenship clause into question; they label those who receive automatic citizenship “anchor babies.” The designation, which critics call racially tinged, implies that parents come here illegally to insure their own presence in America via childbirth.

I ask Sapochnick for reasons his clients cite about their illegal entry. “To give their kids a better future,” he says, “is always the line.” He knows of many pregnant women who cross the border for superior medical treatment and the birthright but then return to Mexico. Later, their children come back (with birth certificate and Social Security number) to work or to attend school. Nowadays, the children must get a passport to go back and forth. This new passport requirement squeezes the children: if they are underage, both parents have to sign the application. Many don’t want to, fearing they’ll be found out and deported. Whenever Sapochnick explains the bureaucratic process to the parents of children born here, “they get depressed.” To illustrate the maze of immigration regulations, Sapochnick diagrams it on a sheet of paper.

“We have a three-step process. First, they file a ‘relative petition’ in the U.S.,” a phrase he writes out and circles. “This takes about five months.

“Once the relative petition is filed, if they are illegal, the case is then sent to the National Visa Center,” a second phrase he writes out and circles.

“What [the attorney does] is to prepare a case for an interview at the U.S. embassy in Mexico.” This, the final step, gets a third circle.

He next draws arrows between the circles. “The whole thing is going to take about one year. In the meantime, they are still here in the U.S.”

For the petitioner, it gets more complicated. “If the person decides to go back to Mexico” to report to the U.S. embassy in Mexico where his or her petition is being processed, with no guarantee that the request will be honored, “he or she will be barred from returning to the U.S. for ten years.” Sapochnick, who has the ultra-patient mien of one who has made this tripartite drawing hundreds of times, draws an arrow on the diagram pointing down to indicate the worst news: returning to Mexico may mean never returning to the U.S. The possibility of a ten-year wait to see their children or to be permanently exiled, he says, stops most parents in their tracks. They must decide whether to leave and take their chances or stay in America in the shadows.

“That’s a very tough decision,” he says.

His success rate for achieving resident or citizenship status for spouses (who marry a U.S. citizen) is 80 percent. “But if it’s a parent, whose child is a citizen” — his tone darkens — “it’s very difficult.”

What Sapochnick would like to see — “I can tell you, in the next ten years, amnesty is not going to happen” — is a return to a short-lived period in early 2001, when immigrants with undocumented status could pay a fine and begin the citizen process without fear of deportation. Signed into law by President Clinton as he left office, section 245i declared that if you proved you’d been in the country for a long time, you could pay a $1000 fine and, as Sapochnick notes, “We’ll let you become legal.” A revival of that law, which ended in April 2001, would, for his clients, mean a kind of pocket amnesty.

Constitutional Precedent and Paradox

Though the challenge to birthright citizenship is fervently embraced by the Tea Party, amending the Fourteenth Amendment has a long and largely impotent career in Congress. In 1993, Nevada Democratic senator Harry Reid wrote a bill clarifying the citizenship clause of the Constitution, stating, in part, that any child born to a mother not of U.S. citizenship is subject to the jurisdiction of the mother’s home country and not the jurisdiction of the United States. His bill never got out of its Senate committee. Since Reid’s proposal, a bill to end or redefine the Fourteenth Amendment has been introduced into each Congress. In the late 1990s, during his first stint on the Hill, Republican Brian Bilbray proposed legislation ending birthright citizenship. (As the representative of San Diego’s 50th district, Bilbray still supports such legislation.) In 2006, President Bush told the states that they would lose federal matching funds for Medicaid — in California, the money funds part of the state-run program, Medi-Cal — if the states failed to document legal residency of their clients. H.R. 1940, called the “Birthright Citizenship Act of 2007,” which would have amended the Fourteenth Amendment, never got out of committee, even in a Republican-controlled Congress. What’s more, neither President Bush nor Senator John McCain supported the bill. Last year, at a Tea Party rally in Ramona, Representative Duncan Hunter, R-El Cajon, called for the deportation of illegal parents and their U.S.-born children, saying, “We’re not being mean. We’re just saying it takes more than walking across the border to become an American citizen. It’s what’s in our souls.”

With a new 2011 Congress, the fight is again joined. Representative Gary Miller, a Republican whose district runs from Mission Viejo to Diamond Bar, has with several House colleagues reintroduced the Birthright Citizenship Act, H.R. 140. The OpenCongress.org summary states that the bill would “eliminate birthright citizenship for children born to undocumented immigrants in the U.S. Current law automatically recognizes any person born on American soil as a natural born citizen. Under the bill, only children with at least one parent who is a U.S. citizen, a legal permanent resident, or an undocumented immigrant serving in the military would be considered citizens.”

According to a press release from Miller’s office, “Currently, there are 3.4 million U.S.-born children of illegal immigrants between the ages of 5 and 18, representing more than 70 percent of the population of children of illegal immigrants. The cost of childbirth and prenatal care is often paid for by American taxpayers, and illegal immigrant parents receive government benefits via their U.S. citizen child. In fact, this exploitation of the Fourteenth Amendment costs American taxpayers over $5.6 billion annually at the federal level, and it costs billions more at the state and local level.”

What are the human numbers? The Pew Hispanic Center reports that an estimated 340,000 children were born in America in 2008, the “offspring of unauthorized immigrants.” This is roughly 8 percent of the 4.3 million babies born that year. About two-thirds of the parents of the 340,000 births have been in the United States for at least five years. This would suggest that some portion of the parents of 117,000 babies may have entered the U.S. illegally to have a child. In total, there are currently 4 million U.S.-born children of unauthorized immigrants residing in the country.

The issue is grounded as much in constitutional precedent as it is in a design paradox. This is delineated best by Lino Graglia, professor of law at the University of Texas. Graglia writes: “It is difficult to imagine a more irrational and self-defeating legal system than one which makes unauthorized entry into this country a criminal offense and simultaneously provides perhaps the greatest possible inducement to illegal entry.”

It still seems that the advantages outweigh the disadvantages. There are plenty of programs in America for pregnant women and nursing mothers, legal and illegal alike, such as Women, Infants, and Children; Medicaid (Medi-Cal in California); and a chance at relief from deportation: some 4000 unauthorized immigrants are given such status each year, but the parent must have been in the country at least ten years.

Locally, Jeff Schwilk, cofounder and spokesman for the San Diego Minutemen, agrees that these advantages have to be curbed. He and his group rally on the border with banners, speeches, and a lot of media coverage, calling for beefed-up border security. Schwilk tells me by phone that his 800 members are fed up with federal immigration policy. While building a fence “takes years and billions of dollars,” which the Minutemen favor, Congress, he notes, can change this loophole “in an afternoon. It’s hanging fruit — easy to do.”

Schwilk repeatedly uses the phrase “anchor baby.” It implies, as does Senator Lindsay Graham’s phrase “drop and leave,” a callousness on the part of families who use children to get something for nothing. Schwilk also employs the catch-phrase “jackpot babies.” That is, he says, where “baby equals money. On this side of the border, it’s big dollar signs.” He cites CalWorks as one program that pays the poor and unemployed a monthly stipend: many of its enrollees, he notes, are the citizen-children of illegals.

Schwilk is anti-Republican party, anti-amnesty, anti-George W. Bush. He calls the former president “pro-illegal” and himself a “constitutional conservative. I don’t trust Republicans,” he says, to solve this issue. He and the Minutemen focus on bulking up border security. What he’s seen is a “50 percent drop in border crossings.” In the previous decade, “95 percent got through.” Still, this drop is not significant for him: “To say you can’t get back is not even close. Estimates are that somewhere between 400,000 and a million people make it through every year. The Border Patrol says that they catch 450,000 but they have never claimed they catch more than one in two, or one in three. Nor do they even try. Their goal is to stop drug smuggling and terrorists. That’s their mission.”

Changing — or as it’s also termed, reinterpreting — the Fourteenth Amendment shouldn’t be hard for Congress, Schwilk says. He believes it was intended (upon ratification in 1868) to grant citizenship only to African-Americans; it was never intended to give citizenship to “the children of illegal aliens.” (The amendment excluded American Indians, whose tribes have sovereignty, and the children of diplomats.) Schwilk wants to follow the leads of every European country that has “closed this loophole” and make it a law that citizenship be conferred only on those born to parents of whom one is a citizen or legal resident. “That seems only fair to the 1.5 million who come here legally every year.”

Keeping Birthright Intact

By contrast, those opposed to amending the Constitution often describe the right wing’s attack as “political theater.” They argue the congressional action will do nothing to stop illegal immigration. Such is the view of John Skrentny, director for the Center for Immigration Studies at the University of California, San Diego. “Regarding your question,” he writes in an email, “I would say this: while I will not comment on the pros and cons of the birthright citizenship that we have in the United States, I will say that there is little reason to expect that eliminating it will significantly reduce the amount of illegal immigration that we attract. Very few countries provide for birthright citizenship, but all developed countries have problems with illegal immigration. Our problem may be worse in terms of numbers than developed states in Europe or Asia, but there are many reasons for this. It’s hard to make direct comparisons because America is unique in ways other than birthright citizenship. For example, I know of no developed countries in Europe or Asia that share a long land border with a country that is significantly poorer (as we share with Mexico). This fact alone almost certainly has more to do with illegal immigration than the 14th Amendment.”

Attorney Jacob Sapochnick is worried that if the Fourteenth Amendment is revised, “Where are you going to stop? How are you going to limit it?” In particular, many immigrant activists fear a caste system: children born of illegal parents have a limited citizenship, a second-class status, while children born to citizens get full privileges. What privileges might the inferior caste not receive? Will they be denied voting rights, civil rights, due process? Will challenges to this law clog the courts for years?

Besides, Sapochnick continues, birthright citizenship is not the most important immigration issue. It’s that the system is broken. “We have a ten-year wait for someone to apply for a green card — if they’re skilled. Why? Why not create a special category for skilled, educated workers. But they don’t do it. And these [qualified] people are leaving the country. The system is broken. Why not create a visa for entrepreneurs, for investment. People want to [come], but they can’t because it’s so complicated. Another issue: if you’re a resident with a green card, and you marry someone who is not a resident, you have to wait four or five years before you can join your husband or wife.”

It seems one intention of H.R. 140 is to have state legislatures deny birthright citizenship, which will provoke lawsuits and, in turn, push such cases into federal court. Since states cannot pass laws that redefine rights guaranteed by the Constitution, such cases will, it is hoped, cause the U.S. Supreme Court to act. With a Republican president in 2012 and a Supreme Court possibly restacked with a right-leaning majority, birthright citizenship might end or, at least, be amended in favor of a two-tier system and a whole new bureaucratic mess.

Overwhelmingly — This Is the Culture

It’s an untidy fact that people who are on the front lines of illegal immigration in San Diego County feel they cannot identify themselves, at least by name. A middle-aged woman I’ll call Alice tells me by phone, with halting and at times sardonic frustration in her voice, that talking to me about birthright citizenship is a big risk: “Oh, yes, we definitely have to do this anonymously.”

Alice is a midwife and has seen in the county, some of it near the border, hundreds of young women, some girls, who are here illegally and seek her help during pregnancy. With a laugh she calls herself “the only non-bleeding-heart health-provider who’s working in a clinic” in San Diego. “I didn’t feel this way when I first started,” she says, more than two decades ago.

The birth process for many women starts at a prenatal clinic where women sign up to receive healthcare; Medi-Cal coordinators staff many of these clinics. “That’s where the poor and the underserved come,” Alice says, “who are not citizens.”

All one needs for Medi-Cal, she notes, is proof of an address. A cell phone and a physical address will do. Alice says she’s never heard anyone ask whether the woman is a citizen or not. What’s more, she says none of her clients has ever expressed a fear of being deported.

In her observation, there are two reasons pregnant women come to America to deliver babies or, finding themselves pregnant here, seek help. One is for birthright citizenship. The other is because the state will pay for it. (Pregnant women also come to the United States legally on visas, typically to visit a relative who is a citizen, and then, while here, have the child. No hospital turns away a woman in labor, Alice notes.) She continues by saying that the state’s purpose in paying for prenatal care is to keep the long-term cost under control. The state decided it’s “real expensive for society to have a preterm baby,” which may be born with medical problems and whose costs the state ends up incurring. Alice says the patients she’s had have told her they’re unemployed, broke, and unable to pay. The women are house cleaners or homebodies, and the men (the fathers of these children) are in landscaping. That’s the profile.

A hospital can bill Medi-Cal for the delivery even if the mother has not signed up. And, Alice says, clinic visits are low-cost to begin with, somewhere between $35 and $50. She’s seen a few illegal mothers or their families return to the clinic to pay for the care they’ve received. But it’s rare. She’s also seen wealthy Mexican families who come over after infertility treatments in Mexico to have a multiple birth, what she calls, “high-risk pregnancies”; they pay for the birth or births, then go back to Mexico.

(I note in an article from Politifact.com that the Tucson Medical Center offered “birth packages” to well-off Mexican women. The woman must have a visa, while the hospital arranges everything: accommodations, hospital stay, birth services, the child’s U.S. birth certificate and Social Security number. The women and their families, of course, pay a hefty sum for this package. The practice has been tagged in the media as “birth tourism,” a gainful business, especially in New York City, where hotels provide the service for wealthy Europeans, Africans, and Middle Easterners.)

In a nutshell, Alice says, “Overwhelmingly, this” — taking advantage of the citizenship clause and free government funding — “is the culture.”

Her voice quavers. “I would love for this to go away.”

What exactly?

“The Fourteenth Amendment, it’s being so abused. That’s just my opinion.”

She says she’s conflicted by her opinion. “I love taking care of pregnant women. It’s a happy time, it’s a fun time,” for them. Still, she says, “I have a difficult time when they come in with their toes done and their nails done, and I’m working my rear off, trying to put my kids through college, and I don’t have the time or the money to get a manicure.”

Abusing a loophole is one thing; flaunting it is another. “If you didn’t have to spend money on healthcare, would you?”

Medi-Cal, Hospitals, Birth Records

Anyone applying for Medi-Cal benefits, citizen or not, must fill out Section 7, which asks for a Social Security number. Next on the form is an odd twist: “You may be able to receive Medi-Cal if you do not have a Social Security number.” Tony Cava, spokesperson for the California Department of Health Care Services, tells me that a Social Security number gets a person full Medi-Cal benefits; without a number, the person receives “limited scope” benefits. Undocumented immigrants can also get prenatal care, breast and cervical cancer screening, and nursing-home care; prenatal services include a hospital birth.

Because Medi-Cal pays for a host of services for the undocumented, I wonder whether Medi-Cal shares its information with Immigration and Customs Enforcement. Cava says no. “Medi-Cal provides care on the basis of medical necessity, and it [the program] doesn’t look at any other factors. This is confidential information and is not reported to any other agency.”

Still, the State of California keeps tabs on the cost of providing prenatal care for everyone based on the information applicants provide in Section 7. Cava says the costs in California for federally mandated medical treatment for the undocumented, for the current fiscal year, totaled $1.3 billion. That is paid for by the state and the federal government. Of that $1.3 billion, California expended $55 million on prenatal care for those women, about 4.2 percent.

According to Cava, Medi-Cal keeps track of costs to the undocumented, and because such payments are mandated by federal regulations, “there is no fraud occurring.” Fraud occurs only when people lie, give a false address, or show forged documents to confirm their status.

Whenever a baby is born in a San Diego County hospital, the time, date, and place of the child’s birth, along with the names of the parents, is recorded by a hospital clerk. Soon after, a record of this birth is sent to the San Diego Department of Health, which forwards the information to the County Recorder’s office and keeps the record for two years. The Recorder’s office records the birth on a paper form and this form is placed into an index of birth certificates. When a blood relative requests a copy of the birth certificate (say, a parent, grandparent, or sibling), the Recorder’s office makes an official birth certificate by printing it on banknote paper. This, according to Ernie Dronenburg, the county’s Assessor-Recorder-Clerk, is a particular “sophisticated paper bond,” used (and thus identified) as authentic birth-certificate paper.

Does his office ask for the citizenship status of the parent? Dronenburg says no, but his office does require that a “blood relative” produce some documentary proof of identity before the Recorder’s office makes a validated copy of the child’s birth certificate. Such ID includes a driver’s license, a passport, or a permanent resident card.

Dronenburg says that if they don’t have any ID, his office issues a copy, an “informational certificate,” stamped unofficial. These go to people who come in and say, “Take my word for it, that’s my child.” Otherwise, he says, his office will stretch the rules. “We’re pretty liberal on taking anything that shows us who they are.”

An SDG&E bill?

“Yes, that would do.”

I also spoke with John Cihomsky, vice president of public relations and communications at Sharp HealthCare, who took my questions to the staff at Sharp Mary Birch Hospital for Women and Newborns. After the birth, the parent or parents fill out a worksheet in the recovery room. The birth clerk types up the information and the parents sign it. This is forwarded via computer to the county and the state. “A souvenir birth certificate” is given to the parents when they leave. In 10–14 days they can pick up an official birth certificate at the county office. In the meantime, the information they provide at the hospital is processed by the Social Security Administration, and the family receives a card with the child’s number within six weeks.

According to Cihomsky, completing the worksheet’s “questions about the parents’ ethnicity, education level, type of employment, and so on” is optional. He notes that “citizenship is not a requirement for care and neither is insurance.” Finally, the hospital does not work with Immigration and Customs Enforcement to identify potential undocumented immigrants, and the agency has never come into the hospital inquiring about birth records.

Stupid Americans

Alice’s experience with illegal immigrant mothers giving birth is purely professional. What happens when the woman is both a legal immigrant who followed the lawful path to citizenship and a nurse who sees repeatedly young women taking advantage of the system?

This is the case of an extraordinary woman who also insists on anonymity — born in Mexico, and since 2005, a U.S. citizen. “Maria” is a San Diego County nurse whose politics have been transformed by the issue of birthright, which she believes has been a part of her entire political life.

Over a late-afternoon turkey sandwich and a green tea at Starbucks, Maria admits that her conflict is threefold: “Who am I as a Mexican? Who am I as an American? And who am I as a nurse who helps” all kinds of women, legal and illegal, “to give birth?”

Her tale begins six decades ago in Mexico City, where she was born and grew up in a politically active family. She says that she and her family has fought the Mexican government since she was 17. “My whole family comes with the idea that if you do not act as a citizen, then you [can’t complain] about the high prices for tortillas and frijoles. If you are on top of the government, then you may have control of the prices.” In essence, her family taught her to take citizenship seriously as a means, not an end.

As a young woman, she met an American traveling in Guadalajara on business; with her mother’s approval, the two decided to marry. Maria told the man that corrupt officials salivate when “they know you’re an American citizen.” Sure enough, the groom had such trouble establishing his residency in Mexico — “over and over and over, they wanted money, money, money” — they quit trying. They came to America and married.

The wife of an American, Maria soon had a green card. She was asked to check in at the post office once a month. She did so, telling me that, if this was what was required of a citizen, she was happy to comply. “They are giving me a set of rules that I...must respect.”

During the early 1990s, Carlos Salinas de Gortari was president of Mexico, the leader of the PRI, and the chief Mexican negotiator of NAFTA. Maria calls him “the father of industrialized illegal immigration.” Not only does she blame the Mexican government for killing its own people in Chiapas, but she also believes Salinas and the Mexican media — which advertise on radio and billboards that Mexicans have the “right to a better life” and should go to the United States to make real money — are in cahoots. (The New York Times cites an electronic billboard in Mexico below Nogales, Arizona, which flashes an American doctor’s message and phone number. “Do you want to have your baby in the U.S.?”) The Mexican government pushes Mexicans to travel north and enter America, legally or not, because the money they send home, some $21.2 billion in 2009, called remittances, is the second largest source of national income behind oil.

As a pediatric nurse — she has worked at various clinics, mostly south of I-8 — Maria has seen “firsthand evidence” of the Mexican government pushing, even sanctioning, a kind of birth emigration: “people with no shame at all,” bringing pregnant Mexican women across the border to have their babies here. She recalls one time, in the early 1990s, telling her doctor, jokingly, that he should rename the clinic where they worked “Clinica Tijuana.” She says this doctor had delivered some 35 babies for mothers who “didn’t want to have the child.”

His response is etched in her memory: “‘Stupid Americans,’ he said. ‘They go fight in the Persian Gulf, and they’re getting killed over there. But Mexico is invading us without shooting a single bullet.’”

Maria says she has seen, from an upper-story window in a clinic, women give birth on the street, right after they get out of a pickup truck. “Once I saw the baby’s head hit the sidewalk.”

The worst case she recalls was a patient who broke down after losing her baby. “I didn’t know what to say to make her feel better.” The young woman kept saying, “‘I didn’t want to walk that much,’ and I said, ‘What do you mean?’ And she said, ‘The person who was bringing me over the border forced me to lose the baby.’” Apparently, the female coyote had run the woman so hard that at the clinic the fetus had to be aborted to save the mother’s life.

“I was crying with her, because this was a woman who loves her baby, but then she loves the baby because she wants to have a better life? So then I start telling her, ‘You know,’ I said, ‘Mexicans don’t have abortions. They have big families.’ I was crying with her, and I didn’t know what to do. But then I said, ‘Let’s go take a shower,’ and I was crying with her in the shower, and holding her, and I said, ‘It’s not worth it, you know. It’s not worth it.’”

On occasion, Maria has been asked by a few Mexican women for financial help. “I tell them that I’m not allowed to get involved with my patients.” Maria says that one woman countered, “‘But you’re Mexican. You have to help me!’” The woman threatened to tell her supervisor that she, Maria, was about to call the Border Patrol.

“If I wanted to call the Border Patrol,” she says, jabbing her finger in the air, one-two-three, indicating different examining rooms, “I can [tell on] room and room and room, because I know they are all illegal.”

“How do you know that?”

“When you get the chart, you see where they should have a Social Security [number] or insurance, and they don’t.” Medi-Cal officials, she says, have come into a hospital to investigate the identity of the fathers of the babies and whether or not the men who come in with a woman are, in fact, related. They leave her instructions to report anything suspicious. But, she says, neither she nor other nurses have time to check on fathers and their identities.

Maria has also been asked by desperate women who present her with a false Social Security card to put this name or the name of a different father on the birth record. “I say, ‘I’m a nurse. I can’t do that.’” She says not only does she not snitch on anyone to Medi-Cal or immigration officials about such fraud, but she also believes that, even if she did, “nobody would care.”

Like the midwife Alice, Maria is also conflicted about her job, and feeling angry about the blatant lies that some women attempt.

Eventually, it was Maria’s political activism that drove her to take classes and pass her citizenship interview in 2005. She had waited a long time for several reasons. But when she understood how corruption, negligence, and the law work in both countries — government-encouraged crossing from Mexico, or lax security and a generous birthright from the United States — she decided she had to change sides.

Once she announced her loyalty to America, “it caused a shock to my [Mexican] family,” which she numbers at “about 1000.” Part of her decision to fight Mexican corruption was to do it more effectively from this side. She has no respect for people who say she has lost her Mexican-Americanness, because she calls herself an American first. In fact, at the courthouse ceremony where she and hundreds of other immigrants were sworn in, she wore a T-shirt of her own design that read: It’s Politically Corrupt to Call Me a Mexican-American. I Am an American. “I was making a statement how I was going to get politically active.”

The thing she personally despises is to have her politics judged “by the color of my skin.” She is almost always lumped in with the Democrats. In fact, one of her supervisors, who faulted Maria for not having the requisite left-wing opinions, asked her “to show proof of my U.S. citizenship eight times.”

Both the Minutemen and the Tea Party have got her support. “If I came to America legally,” she says, “so can anyone else.”