Pilot Grants

Investigating Disparities in Prenatal Care Access and Outcomes during COVID-19 Among Immigrant Mothers in Pennsylvania

Statement of Problem

Immigrant families have been among the most vulnerable groups that have endured increased health and socioeconomic concerns due to the COVID-19 pandemic. Many references to the impacts of the pandemic on immigrant families are based upon previous research that highlights risk factors in regards to health care access and outcomes, yet few studies have explored the lived experiences of immigrant mothers during this difficult time.

Description

Through this project, we will take a mixed-method, population-based approach to assess and understand the impact of the pandemic on immigrant mothers’ access to prenatal health care and outcomes. This includes disparities based on maternal nativity and between specific immigrant communities across Pennsylvania. Our team will also analyze institutional policies that may impact engagement with health care services among immigrant families so we can identify opportunities for local and health care system programs and policy changes to improve outcomes for this population.

To estimate change in prenatal care utilization and health outcomes after a COVID-19 outbreak, we will first begin to determine rates of adequate prenatal care service access and incidences of gestational outcomes between two groups: The “during-pandemic” pregnant women group, which will include women whose pregnancy began in February or March of 2020; and the “pre-pandemic” group, which will include women who gave birth before 2020. We will then examine the association between the COVID-19 pandemic and prenatal care utilization, after accounting for differences in demographic, social and clinical characteristics between the two groups. Afterwards, we will divide our study sample into two additional groups by mothers’ immigrant status, and will examine the impact of the pandemic on prenatal care utilization among immigrant and non-immigrant mothers separately. This approach will help us identify whether the change in the rate of adequate prenatal care during the COVID-19 pandemic is more pronounced among immigrant mothers.

Our team will also conduct 10 to 20 in-depth, semi-structured interviews with immigrant families and community leaders across Pennsylvania regarding perceptions and experiences of prenatal care before and during the pandemic—emphasizing barriers and facilitators for accessing care—specifically in regards to telehealth.

Furthermore, we will review local, federal, and health care system programs, policies and mechanisms, including, but not limited to, statutes, court rulings, reimbursement and telemedicine, to identify programs and policies that may impact engagement with prenatal health care services among immigrant families and sub-groups.

Next Steps

We will begin by accessing birth certificates as our main quantitative data source and designing our interview guides through engaging with and consulting experts from PolicyLab and stakeholders across Pennsylvania. By having a better understanding of the disparities in prenatal care access within the context of COVID-19 pandemic, we hope to address significant gaps in health care access and utilization and fortify a knowledge base to improve the health and well-being of immigrant families during and beyond the pandemic.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Investigating Disparities in Prenatal Care Access and Outcomes during COVID-19 Among Immigrant Mothers in Pennsylvania [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here]. 

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