Pregnancy Care Utilization, Experiences, and Outcomes Among Undocumented Immigrants in the United States: A Scoping Review

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2024-07-01 DOI:10.1016/j.whi.2024.02.001
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Abstract

Background

Undocumented immigrants face many barriers in accessing pregnancy care, including language differences, implicit and explicit bias, limited or no insurance coverage, and fear about accessing services. With the national spotlight on maternal health inequities, the current literature on undocumented immigrants during pregnancy requires synthesis.

Objective

We aimed to describe the literature on pregnancy care utilization, experiences, and outcomes of undocumented individuals in the United States.

Methods

We performed a scoping review of original research studies in the United States that described the undocumented population specifically and examined pregnancy care utilization, experiences, and outcomes. Studies underwent title, abstract, and full-text review by two investigators. Data were extracted and synthesized using descriptive statistics and content analysis.

Results

A total of 5,940 articles were retrieved and 3,949 remained after de-duplication. After two investigators screened and reviewed the articles, 29 studies met inclusion criteria. The definition of undocumented individuals varied widely across studies. Of the 29 articles, 24 showed that undocumented status and anti-immigrant policies and rhetoric are associated with lower care utilization and worse pregnancy outcomes, while inclusive health care and immigration policies are associated with higher levels of prenatal and postnatal care utilization as well as better pregnancy outcomes.

Conclusions

The small, heterogeneous literature on undocumented immigrants and pregnancy care is fraught with inconsistent definitions, precluding comparisons across studies. Despite areas in need of further research, the signal among published studies is that undocumented individuals experience variable access to pregnancy care, heightened fear and stress regarding their status during pregnancy, and worse outcomes compared with other groups, including documented immigrants.

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美国无证移民的孕期保健使用情况、经历和结果:范围审查》。
背景:无证移民在获得孕期保健方面面临许多障碍,包括语言差异、隐性和显性偏见、保险范围有限或没有保险,以及对获得服务的恐惧。随着全国对孕产妇健康不平等问题的关注,需要对目前有关孕期无证移民的文献进行综合:我们旨在描述有关美国无证人士孕期保健利用、经验和结果的文献:我们对美国的原始研究进行了一次范围界定审查,这些研究专门描述了无证人群,并考察了孕期保健的利用、经验和结果。由两名调查人员对研究报告的标题、摘要和全文进行审查。采用描述性统计和内容分析法对数据进行提取和综合:结果:共检索到 5940 篇文章,去重后剩余 3949 篇。经过两名调查人员的筛选和审查,29 项研究符合纳入标准。不同研究对无证人员的定义差异很大。在这 29 篇文章中,有 24 篇表明,无证身份和反移民政策及言论与护理利用率降低和妊娠结局恶化有关,而包容性医疗保健和移民政策则与产前和产后护理利用率提高以及妊娠结局改善有关:关于无证移民和孕期保健的文献数量少,内容杂,定义不一致,因此无法对不同研究进行比较。尽管有需要进一步研究的领域,但已发表研究的信号是,与其他群体(包括有证移民)相比,无证人士获得孕期护理的机会不尽相同,在怀孕期间对其身份的恐惧和压力增加,结果更差。
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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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