Montoya-Williams and her co-authors interviewed about 20 pregnant or recently pregnant Latina immigrants about their experiences receiving or not receiving prenatal care.
The researchers recruited Spanish-speaking interviewers from local community health groups. Maternity Care Association and Puentes de Salud They also refrained from directly asking participants about their immigration status (although Montoya-Williams says most participants revealed they were undocumented during the interview process).
The researchers identified several common themes regarding reasons for delaying or forgoing prenatal care.
“We’re finding that even in our city, people are very scared and they’re still reporting significant discrimination in their perinatal experiences,” Montoya-Williams said. “This shows us that there’s a lot we can work on here within the health care system about how we can actually provide trauma-informed, culturally humbling care to a population that’s been made vulnerable by all the grand schemes that are going on at the federal, national level.”
Participants also cited confusion about the health care system and insurance coverage, concerns about rising medical costs, especially for childbirth, and fears that their immigration status might be reported to authorities.
“They would ask for my passport and as soon as they realized I didn’t have it, they would call Immigration and Customs Enforcement and I would be separated from my child who is already in this country and a citizen,” Montoya-Williams said. “So people were hearing these stories and debating whether or not they should get prenatal care, and even though they were hearing these stories and there was a risk, what they felt was a very real risk of being deported or not getting a green card.”
Montoya-Williams also asked what Philadelphia’s health care workers and health care system can do to overcome these barriers.
Some of the interventions suggested in the study are relatively easy to implement, such as posting signs in Spanish welcoming immigrants and having doctors directly address immigrants’ concerns.
“Some participants shared that they had doctors who told them it didn’t matter what their documentation status or immigration status was, for example,” she said. “Having those words spoken out loud changed the atmosphere of fear for the rest of their pregnancy. To me, this is a very practical thing that can be incorporated into medical education.”
