What a mother’s voice taught me about mental health and systemic inequities in health care 

“I feel like I’m dead alive; I don’t feel well. I’m not the person I used to be,” these haunting words came from Silvia, a Zapotec woman who had a miscarriage. 

Sitting in a hospital room surrounded by medical staff speaking a language she didn’t understand, Silvia tried to piece together their words through gestures and tone. It wasn’t enough. She left the hospital with more questions than answers, a piercing pain in her pregnant belly, and the vague understanding that her baby had died inside her.

When Silvia later experienced a miscarriage at home after taking misoprostol, she didn’t know what to expect. No one had explained that the medication could cause the remains of the fetus to be expelled, let alone what to do if that happened. Alone, confused and heartbroken, Silvia buried the remains in a pot, unsure how else to honor her loss.

Silvia’s story is a devastating example of a larger issue faced by Mexican Indigenous women in San Joaquin County, California: Women who suffer miscarriages and navigate profound grief without the ability to communicate with their doctors. These women speak Mexican Indigenous languages that the health care system is ill-equipped to address.

As a Latina journalist, discovering this issue blew my mind. How could such a large, essential part of the community be so overlooked? These women come from communities where as many as 68 languages are spoken in addition to Spanish, yet hospitals often fail to provide interpreters. This silence isn’t just neglect; it’s a violation of California law.

Under California law, hospitals must provide translation services if 5% of their patient population speaks a specific language. Yet in San Joaquin County — where Latinos make up 43% of the population — Indigenous languages are overlooked because the census doesn’t differentiate them from Spanish. Without this clarity, hospitals fail to prioritize Indigenous language translators, even though many Mexican essential workers in the area speak these languages.

For women like Silvia, this gap goes beyond language. It results in the inability of patients like her to express fears, to ask questions, to understand their own bodies during one of life’s most vulnerable moments. Miscarriages are already devastating, but imagine enduring that pain with no one to explain why it happened — or what comes next.

This isn’t just a communication issue — it’s a mental health crisis. Studies show that 20% of women who experience miscarriages develop long-term depression and anxiety, lasting up to three years. Nine out of 10 women want follow-up care after such a loss, but only three out of ten receive it. Younger, low-income, or Hispanic women face even higher risks of mental health challenges.

The health care system’s failure to address these barriers not only deepens trauma but also perpetuates a cycle of silence and neglect. It leaves these women feeling invisible, their experiences dismissed.

California’s SB 1016, authored by state senator Lena Gonzalez, enacted in 2024, seeks to reduce health disparities in Latino and Indigenous populations by collecting detailed demographic data, including ethnic origin and ancestry of California residents, for reports on major diseases and leading causes of death.

My investigation of this story pointed to systemic neglect. Many health care providers lack the resources or training to assist Indigenous language speakers. Meanwhile, the cultural stigma around miscarriages often prevents these women from seeking emotional support in their communities.

California’s health care system has the tools to make a difference. The law is clear: translation services must be provided. But laws mean little without implementation or accurate census data. Understanding and being understood is a basic human need. These women don’t just need interpreters — they need compassion, care, and a health care system that sees their humanity.

How many more women like Silvia will have to endure this silent suffering before something changes? It’s a question that shouldn’t need asking, but until these voices are heard, we must keep asking it.