Latina immigrants' perceptions of access to family planning in a new settlement state

Background: Reproductive health is an integral part of women's self-determination and overall health and wellbeing. Public policies can strengthen or undermine reproductive health. Immigration and welfare policies have significant and often unexplored public health implications. Objective: This study looked at how foreign-born Latina immigrants' perceptions of access to and experiences with family planning in an urban center in Kentucky can inform community-based policy initiatives to improve the reproductive health of Latinas. Methods: Twenty in-depth key informant interviews were conducted from June to August 2011. Nine foreign-born, Latina informal community leaders and 11 social and health service providers, and policy professionals were interviewed in Spanish and English, respectively. Qualitative analysis using an emergent theme approach was conducted using qualitative analysis software. Results: Findings were categorized into 6 areas: social, political, and cultural context of Kentucky; scope and meaning of family planning; instrumental and perceived barriers; instrumental and perceived facilitators; role of policies in access to family planning; and potential impact of the Affordable Care Act on foreign-born Latinas' access to family planning. Both participant populations made the connection between non-health policies (especially immigration, transportation, and language-access) and family planning access. This study's findings suggest that Latina immigrants' perception of access is affected by immigration and transportation policies at the state and federal level, by local attitudes towards immigration, and language access practices at service agencies. Findings also provide insights into culturally- and linguistically-appropriate approaches to increase knowledge and understanding of family planning among foreign-born Latina immigrants.