“Obstetricians and public health leaders increasingly recognize preconception and postpartum periods as crucial to optimizing maternal and infant health outcomes.”
—Sheela Maru, Lily Glenn, Diksha Brahmbhatt, and Max Hadler
Utilization of Maternal Healthcare Among Immigrant Mothers in NYC, 2016–2018
Journal Article Nov-22-2021 , , , , , , , and 3-min read
Table of Contents
Table of Contents
Report Publish Date: November 22, 2021
This journal article highlights the disparities in maternal healthcare access among immigrant mothers in NYC, focusing on preconception, prenatal, and postpartum care.
Primary Takeaways
Immigrant women in NYC were significantly less likely to access preconception healthcare services compared to US-born women (43% compared to 27%), which may lead to worse maternal health outcomes.
Postpartum insurance loss is disproportionately higher among immigrant mothers, especially those from Central and South America, increasing their vulnerability to health complications after childbirth.
Disparities in maternal healthcare utilization are influenced by factors such as time in the US, geographic region of origin, and socioeconomic barriers, underscoring the need for targeted interventions.
Overview and Objectives
This research examines maternal healthcare disparities between immigrant and US-born women in NYC from 2016 to 2018. With immigrant women accounting for half of all births in the city, the study focuses on preconception, prenatal, and postpartum care utilization. The objective is to identify gaps and patterns of healthcare use among immigrant women and determine factors influencing those gaps. Disparities in healthcare access may lead to adverse maternal outcomes, highlighting the need for tailored interventions.
Hypothesis or Approach
The study hypothesized that immigrant women in NYC face significant barriers in accessing maternal healthcare, leading to disparities in health outcomes compared to US-born women. The study utilized data from the NYC Pregnancy Risk Assessment Monitoring System (PRAMS), linking survey responses to birth certificate data. Analysis included grouping by nativity, years in the US, and geographic regions of origin, to identify healthcare utilization patterns across different maternity care stages.
How This Influences Change
Actionable application of the findings The study’s findings can inform policies to improve healthcare access for immigrant women, particularly by expanding health insurance coverage before and after pregnancy. By collaborating with community-based organizations and advocating for policies addressing racial, socioeconomic, and immigrant status-related barriers, healthcare utilization disparities can be reduced. Future efforts should focus on increasing awareness and access to maternal health services in underserved immigrant populations.
Research: Go Deeper
Immigrant women represent half of New York City (NYC) births, and some immigrant groups have elevated risk for poor maternal health outcomes. Disparities in health care utilization across the maternity care spectrum may contribute to differential maternal health outcomes. Data on immigrant maternal health utilization are under-explored in the literature. We conducted a cross-sectional analysis of the population-based NYC Pregnancy Risk Assessment Monitoring System survey, using 2016–2018 data linked to birth certificate variables, to explore self-reported utilization of preconception, prenatal, and postpartum health care and potential explanatory pathways. We stratified results by maternal nativity and, for immigrants, by years living in the US; geographic region of origin; and country of origin income grouping. Among immigrant women, 43% did not visit a health care provider in the year before pregnancy, compared to 27% of US-born women (risk difference [RD]=0.16, 95% CI [0.13, 0.20]), 64% had no dental cleaning during pregnancy compared to 49% of US-born women (RD=0.15, 95% CI [0.11, 0.18]), and 11% lost health insurance postpartum compared to 1% of US-born women (RD=0.10, 95% CI [0.08, 0.11]). The largest disparities were among recent arrivals to the US and immigrants from countries in Central America, South America, South Asia, and sub-Saharan Africa. Utilization differences were partially explained by insurance type, paternal nativity, maternal education, and race and ethnicity. Disparities may be reduced by collaborating with community-based organizations in immigrant communities on strategies to improve utilization and by expanding health care access and eligibility for public health insurance coverage before and after pregnancy.
J Urban Health. 2021 Nov 22;98(6):711–726. doi: 10.1007/s11524-021-00584-5
Research Team
This study and report were conducted and created by the following people.
- Sheela Maru
- Lily Glenn
- Diksha Brahmbhatt
- Max Hadler
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