HOUSTON (AP) — The Honduran woman walked alone through the dark brush of the South Texas borderlands after being pushed across a nearby river in a tire.

Her labor pains were getting worse. From the other side of the river, the smugglers yelled at her to keep moving.

Finally, she fell to the ground and screamed for help.

Merín gave birth to her daughter next to the Rio Grande, attended to by two Border Patrol agents, showing how lives routinely end up at risk at the U.S.-Mexico border.

Increasing numbers of parents and children are crossing the border, driven by violence and poverty in Central America and growing desperation in migrant camps in Mexico. While crossings have not reached the levels seen in previous years, facilities that hold migrants are approaching capacity, which has been reduced because of the coronavirus pandemic.

U.S. Customs and Border Protection said Monday that it made roughly 4,500 apprehensions of unaccompanied immigrant children in November, more than six times the figure in April. In South Texas’ Rio Grande Valley, children and their parents are usually taken to a small station where some young people report having to use old masks and being detained in cramped quarters.

Merín and her daughter are safe after she gave birth on Nov. 22.

“They treated me well, thank God,” said Merín, who didn't want her last name used because she fears retribution if she's forced to leave the country.

Agents Chris Croy and Raul Hernandez were called to help by another agent who found her. Merín said the first agent told her to get up and keep walking, but she couldn’t. She says he accused her of lying.

“When I look, I see the head of a child,” Croy said. “I just kneel down to go ahead and support the child’s head.”

Hernandez saw that Merín's clothing was obstructing the baby’s head. He pulled out a small knife and carefully cut it away. Croy kept hold of the baby’s head.

“She had another big contraction and out came the baby,” he said.

It took another 10 minutes for an ambulance to arrive. Croy and Hernandez took clothes from Merín's bag to keep the baby warm in the meantime.

Mother and child were hospitalized for three days, then processed at a Border Patrol station before being released to Catholic Charities. They soon boarded a bus to join family in the U.S.

Hundreds of people die each year trying to cross the border. Photos last year of a father and daughter who drowned trying to cross the Rio Grande — not far from where Merín made her journey — were shared worldwide.

“There’s so many women in great danger,” said Sister Norma Pimentel, executive director of Catholic Charities of the Rio Grande Valley. “They must really think before they do what they do and risk the life of their unborn child.”

Why would a woman cross the river in labor? Law enforcement and human rights groups give sharply different answers.

The Border Patrol blames smugglers for using people in medical distress as decoys, drawing attention from others trying to sneak into the country. In Merín's case, agents said, the smugglers who pushed her across the river then brought through a group of five people. When agents chased the group, they went back across the river into Mexico.

The agency also said in a statement that U.S. birthright citizenship laws “could lead some to cross illegally as they are giving birth.” It didn't have numbers on how often that happens.

Under President Donald Trump, the Border Patrol has been criticized for its treatment of immigrant parents and children. Since 2017, six children have died shortly after being detained. Agents separated thousands of families in 2017 and 2018 and have been accused of refusing entry to pregnant women or forcing them to return to Mexico under government policies restricting asylum.

The Border Patrol defends how it treats immigrants and the medical care they receive. Its parent agency, U.S. Customs and Border Protection, said in a statement that agents’ priority in emergencies “is the preservation of life of everyone they encounter regardless of citizenship or background. The enforcement of laws becomes secondary.”

Advocates say government policies to deter migrants push desperate people into more dangerous situations.

Having fled Honduras with her teenage son when her then-husband threatened to kill her, Merín said she lived for several months in southern Mexico before trying to report drug dealers to police. That made her a target, and she fled again.

She settled in the northern city of Monterrey with her now-partner. Her son went to the border city of Matamoros and crossed a bridge in January as an unaccompanied child.

Thousands of other migrants are waiting in Mexican border cities for a chance to enter the U.S. — some for years. The Trump administration has turned away tens of thousands at legal border crossings, first citing a shortage of space and then telling people to wait for court dates under its “Remain in Mexico” policy.

So Merín used the river. Smugglers are known to control crossings on the Rio Grande and attack migrants who don't obey.

Merín reported one threat: “If you don’t pay and you try to cross, you’re going to die. We will cut your head off.”

Aside from the first agent, she said she was grateful for how she was treated in the U.S. She hoped to find work and support relatives in Honduras. She still could face deportation if she loses her case in immigration court.

Since the pandemic, the government has expelled more than 200,000 people within hours or days, citing a public-health declaration. In its final days, the Trump administration is formalizing new restrictions on asylum and other immigration protections that would take months or years for President-elect Joe Biden to unwind.

Pimentel, of Catholic Charities, wants reforms to allow people to enter the U.S. safely and pursue their immigration cases, reducing the chance that desperate families will risk their lives in the hands of smugglers.

“There needs to be a process for that, and it doesn’t exist at this point,” Pimentel said.