Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 1;62(6):404-415.
doi: 10.1097/MLR.0000000000002002. Epub 2024 Apr 26.

Philadelphia Latine Immigrant Birthing People's Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization

Diana Montoya-Williams  1   2   3 , Alejandra Barreto  1 , Alicia Laguna-Torres  1 , Diana Worsley  1   2 , Kate Wallis  2   3   4 , Michelle-Marie Peña  5 , Lauren Palladino  6 , Nicole Salva  7 , Lisa Levine  3   7 , Angelique Rivera  8 , Rosalinda Hernandez  9 , Elena Fuentes-Afflick  10 , Katherine Yun  2   3   11 , Scott Lorch  1   2   3 , Senbagam Virudachalam  2   3   11
Affiliations

Philadelphia Latine Immigrant Birthing People's Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization

Diana Montoya-Williams et al. Med Care. .

Erratum in

Abstract

Research design: Community-engaged qualitative study using inductive thematic analysis of semistructured interviews.

Objective: To understand Latine immigrants' recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization.

Background: Decreased health care utilization among immigrants due to punitive immigration policies (ie, the "chilling effect") has been well-documented among Latine birthing people both pre and postnatally.

Patients and methods: Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants' pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants.

Results: Participants' recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants' rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants' rights to health care. Participants also suggested training non-medical office staff in the use of interpreters.

Conclusion: Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants' suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability.

PubMed Disclaimer

Conflict of interest statement

D.M.W. is supported by the National Institutes of Health K23HD102526. The remaining authors declare no conflict of interest.

Figures

Figure 1:
Figure 1:
Potential policy adaptations of the subthemes that emerged from participants’ suggestions for improving healthcare systems’ abilities to meet the unique needs of pregnant immigrant patients.
See this image and copyright information in PMC

References

    1. Carbajal PC. From Hispanic to Latine: Hispanic Heritage Month and the Terms That Bind Us [Internet]. The New York Public Library. 2020. [cited 2022 Oct 3]. Available from: https://www.nypl.org/blog/2020/09/29/hispanic-heritage-month-terms-bind-us
    1. Velasco-Mondragon E, Jimenez A, Palladino-Davis AG, Davis D, Escamilla-Cejudo JA. Hispanic health in the USA: a scoping review of the literature. Public Health Rev. 2016. Dec 7;37:31. - PMC - PubMed
    1. Castañeda H, Holmes SM, Madrigal DS, Young MED, Beyeler N, Quesada J. Immigration as a social determinant of health. Annu Rev Public Health. 2015. Mar 18;36:375–92. - PubMed
    1. Young MEDT, Crookes DM. Dismantling Structural Racism by Advancing Immigrant Health. Am J Public Health. 2023. Jan 1;113(S1):S16–20. - PMC - PubMed
    1. Budiman A, Tamir C, Mora L, Noe-Bustamante L. Facts on U.S. immigrants, 2018 [Internet]. Pew Research Center. 2020. [cited 2022 Nov 1]. Available from: https://www.pewresearch.org/hispanic/2020/08/20/facts-on-u-s-immigrants/

Publication types