Introduction: Federal welfare reform enacted in August 1996 mandated that prenatal care (PNC) would no longer be provided to undocumented immigrants, effective in Arizona July 1, 1997. We hypothesized that the resultant decrease in PNC would lead to increased use of the Neonatal Intensive Care Program (NICP) administered by the MCH Office of the Arizona Department of Health Services. NICP insures transport for sick mothers and neonates, as well as care for neonates requiring > 72 hours of neonatal intensive care. Methods: We linked birth certificate data (N=323,681) with the NICP database (N=17,465), 1994-8 (match 90%). We calculated rates of poor PNC: no or third trimester initiation of PNC and <5 PNC visits in three subgroups: white non-Hispanic (WNH), US-born and Mexico-born Hispanic. Rates were contrasted for three time periods (see table). Results: As shown in the table, rates of poor PNC increased among Mexico-born Hispanics versus other subgroups after July 1997 (p=.02). Likewise, NICP enrollment increased most in this subgroup (p=.03). Discussion: Indices of poor PNC increased among the subgroup with the largest numbers of undocumented immigrants, Mexico-born Hispanics. Simultaneously, enrollment in the NICP program for sick mothers and neonates disproportionately increased among these individuals. This natural experiment through legislation supports the value of prenatal care.
Learning Objectives: 1. Recognize change in prenatal care use since the defunding of prenatal care for undocumented immigrants. 2. Identify the consequences in terms of usage of a state-sponsored intensive neonatal care program
Keywords: Access to Health Care, Maternal and Child Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.