Optimizing the perinatal period for Latina immigrants through promotoras-based education, outreach and evaluation

Latinos are the most likely to lack health insurance and the least likely to have access to culturally and linguistically relevant health care. The perinatal period offers an opportunity to link Latinas with the health care system, while providing education and health advocacy training to assist them in navigating the health care system for both themselves and their families. The purpose of the Guías de Nuestra Señora de Guadalupe project was to train a cohort of immigrant, Spanish-speaking peer educators to administer a 10 visit promotores-based health and social support program to Latinas 13 to 25 weeks pregnant through 6 months post partum at St. Francis Medical Center in Los Angeles. Promotoras visits were designed to: 1) increase adherence to, and understanding of, prenatal care; 2) educate participants about maternal and child health issues, particularly as they related to breastfeeding and infant feeding and care; 3) improve health advocacy skills; and, 4) provide the social support often lost as a result of immigration. Of the 125 participants, 103 were Mexican-born, and the remaining 22 were from various Central and South American countries. Findings indicated that depression (as measured by the Edinburgh Postnatal Depression Scale) significantly decreased during participation in the program, even at post partum. Additional quantitative and qualitative findings will be reported pertaining to self-rated health, readiness for the birth experience, breastfeeding, and other infant feeding and care practices. Moreover, post-partum assessments of the prenatal and birth care experiences will be discussed.