Inadequate Prenatal Care for an Undocumented Immigrant Desired Outcome and Evidence-Based Solution

PRENATAL CARE FOR UNDOCUMENTED IMMIGRANT

Inadequate Prenatal Care for an Undocumented Immigrant

Adequate access to prenatal care remains a major problem amongst undocumented immigrant women in the U.S. This difficulty arises from factors such as lack of health insurance, inability to meet costs relating to prenatal care, inaccessibility to sources of prenatal care, linguistic barriers, distrust in the healthcare system, and unusually rigid work schedules (Fabi, 2014; Lee, 2015). Other challenges include misinformation about the consequences of immigration as well as perceived and actual fear of encountering law enforcement or immigration authorities while seeking health care (Fabi, 2014). Inadequate access to prenatal care often increases the likelihood of poor reproductive, maternal, and neonatal health outcomes amongst undocumented immigrant women and their babies. With reference to an identified undocumented immigrant woman, this paper describes the problem of accessing prenatal care amongst illegal immigrants in the U.S. Relevant literature is particularly quoted to provide evidence of the problem among the population as well as its solution. The paper also critically explores the applicability of Lorraine M. Wright's and Maureen Leahey's Calgary Family Assessment Model (CFAM) to the problem.

Problem

Li Ying (not her real name) is a 29-year-old immigrant woman of Chinese origin living in the U.S. with her husband, who is also of Chinese origin. During her first pregnancy, Ying was not able to access prenatal care, due to lack of medical cover. In addition, Ying and her partner have not yet secured stable, well-paying jobs to allow them to subscribe to private or employer-sponsored medical insurance. In the seventh month of the pregnancy, Ying was admitted to emergency care at a local hospital after suffering from hypertension. She was immediately diagnosed with eclampsia, a serious medical condition that often develops in the course of pregnancy. The condition can cause complications such as preterm delivery, seizures, bleeding, and in some instances, death.

Eclampsia is usually detected during the early days of pregnancy, and can often be managed via basic antenatal care. Regrettably, Ying was not in a position to afford prenatal care, primarily due to her immigrant status. Due to the severity of the condition at the time it was diagnosed and the danger it posed to both her and the infant, a premature delivery became necessary. The infant was placed in a nursery for two months while the mother underwent three separate procedures to drain her brain of excess blood. The entire cost of taking care of Ying and her newborn child on the hospital exceeded $200,000. In the end, Ying suffered partial paralysis as a result of the condition, making it quite hard for her to mother the much-in-need infant, her new-born baby.

Through frequent checkups in the course of gestation, women are equipped with critical information about maternal physiological changes, nutrition, reproductive health, infant health, and other aspects relating to the health of the mother and the baby (Wolff et al., 2008). This reduces the possibility of miscarriage, birth defects, maternal death, low birth weight, neonatal diseases, infant mortality, and other avoidable health complications (Lee, 2015).
Owing to challenges such as financial constraints, undocumented immigrant women who comprise approximately 47% of the total unauthorized population in the U.S., are often not in a position to access prenatal care, which consequently predisposes them and their babies to potentially serious health complications (American College of Obstetricians and Gynecologists [ACOG], 2015). According to Fabi (2014), undocumented pregnant women are more likely to experience birth complications such as excessive bleeding, precipitous labor, cord prolapsed, and fetal distress compared to the rest of the pregnant women population. Furthermore, childbirth-related hospital admission as well as neonatal morbidities such as respiratory complications and seizures tend to be more widespread amongst unauthorized compared the general population (Reed et al., 2005; ACOG, 2015).

These complications may increase the risk of neonatal and maternal death. In fact, lack of access to prenatal care increases the risk of neonatal death by 40%, particularly for women who deliver at or after the 36th week of gestation (Rosenberg, 2002). Lack of access to prenatal care also increases the risk of maternal mortality, with undocumented immigrant women being the most affected (Molina, 2015). This challenge is further compounded by greater vulnerability to sexual assault and sexually transmitted diseases as well as language barriers, lack of social support, poverty, and occupational health hazards (Molina, 2015).

Essentially, the risks and outcomes associated with insufficient prenatal care can affect not only the health and life of mothers, but also their newborns; ultimately imposing a significant economic burden on individuals and families due to the costs involved in treating conditions that could have been avoided or managed prior to birth.

Desired Outcome and Evidence-Based Solution

The case of Ying is not isolated -- it is a representation of the difficulties experienced by undocumented immigrant women to access prenatal care. Statistics indicate that approximately 60% of illegal immigrants in the U.S. do not have medical insurance…