Skip to main content

Advertisement

Log in

The Impact of the State Children’s Health Insurance Program’s Unborn Child Ruling Expansions on Foreign-Born Latina Prenatal Care and Birth Outcomes, 2000–2007

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

The 2002 “unborn child ruling” resulted in State Children’s Health Insurance Program (SCHIP) expansion for states to cover prenatal care for low-income women without health insurance. Foreign-born Latinas who do not qualify for Medicaid coverage theoretically should have benefited most from the policy ruling given their documented low rates of prenatal care utilization. This study compares prenatal care utilization and subsequent birth outcomes among foreign-born Latinas in six states that used the unborn child ruling to expand coverage to those in ten states that did not implement the expansion. This policy analysis examines cross-sectional pooled US natality data from the pre-enactment years (2000–2003) versus post-enactment years (2004–2007) to estimate the effect of the UCR on prenatal care utilization and birth outcome measures for foreign-born Latinas. Then using a difference-in-difference estimator, we assessed these differences across time for states that did or did not enact the unborn child ruling. Analyses were then replicated on a high-risk subset of the population (single foreign-born Latinas with lower levels of education). The SCHIP unborn child ruling policy expansion increased PNCU over time in the six enacting states. Foreign-born Latinas in expansion enacting states experienced increases in prenatal care utilization though only the high-risk subset were statistically significant. Birth outcomes did not change. The SCHIP unborn child ruling policy was associated with enhanced PNC for a subset of high-risk foreign-born Latinas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

PRWORA:

Personal Responsibility and Work Opportunity Act

NCHS:

National Center for Health Statistics

DD:

Difference-in-differences

SCHIP:

State Children’s Health Insurance Program

APNCU:

Adequacy of Prenatal Care Utilization

ARS:

Adequacy of Received Services

NAPHSIS:

National Association for Public Health Statistics Information Systems

References

  1. McCormick, M. C., & Siegel, J. C. (1999). Prenatal care: Effectiveness and implementation. Cambridge: Cambridge Press.

    Book  Google Scholar 

  2. Alexander, G. R., & Kotelchuck, M. (2001). Assessing the role and effectiveness of prenatal care: History, challenges, and directions for future research. Public Health Reports, 116, 306–316.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Alexander, G. R., & Korenbrot, C. C. (1995). The role of prenatal care in preventing low birth weight. Future of Children, 5(1), 103–120.

    Article  CAS  PubMed  Google Scholar 

  4. Fiscella, K. (1995). Does prenatal care improve birth outcomes? A critical review. Obstetrics and Gynecology, 85(3), 468–479.

    Article  CAS  PubMed  Google Scholar 

  5. Health and Human Services. (1998). Routine prenatal and postpartum care for undocumented aliens. https://oig.hhs.gov/oei/reports/oei-07-96-00310.pdf. Accessed 11 Oct 2013.

  6. Fuentes-Afflick, E., Hessol, N. A., Bauer, T., et al. (2006). Use of prenatal care by Hispanic women after welfare reform. Obstetrics and Gynecology, 107, 151–160.

    Article  PubMed  Google Scholar 

  7. Hayes-Bautista, D. E., Gamboa, C., Kahramanian, M. I., Hayes-Bautista, M., & Hsu, P. (2012). Timely access to prenatal care: Prime necessity for Latina mothers. Policy brief. Los Angeles: Center for the Study of Latino Health and Culture.

    Google Scholar 

  8. Kalofonos, I., & Palinkas, L. A. (1999). Barriers to prenatal care for Mexican and Mexican American women. Journal of Gender, Culture, and Health, 4, 135–152.

    Article  Google Scholar 

  9. Wasserman, M., Bender, D., & Lee, S. D. (2007). Use of preventive maternal and child health services by Latina women: A review of published intervention studies. Medical Care Research and Review, 64, 4–45.

    Article  PubMed  Google Scholar 

  10. Acevedo-Garcia, D., & Cacari, S. L. (2008). State variation in health insurance coverage for US citizen children of immigrants. Health Affairs, 27(2), 434–446.

    Article  PubMed  Google Scholar 

  11. Glasford, A., & Huang, P. (2008). Immigrant women’s health a casualty in the immigration policy war. Women’s Health Activist, 1–3.

  12. Luecken, L. J., Purdom, C., & Howe, R. (2009). Prenatal care initiation in low-income Hispanic women: Risk and protective factors. American Journal of Health Behavior, 33, 264–275.

    Article  PubMed  Google Scholar 

  13. Devine, S. (2010). Rethinking the Hispanic Paradox: Favorable low birth weight outcomes obscure a hidden epidemic of Large-For-Gestational-Age births, in 2010. American Public Health Association Conference. Denver, CO.

  14. Kelaher, M., & Jessop, D. J. (2002). Differences in low-birthweight among documented and undocumented foreign-born and US-born Latinas. Social Science and Medicine, 55, 2171–2175.

    Article  PubMed  Google Scholar 

  15. McDonald, J. A., Suellentrop, K., Paulozzi, L. J., & Morrow, B. (2008). Reproductive health of the rapidly growing Hispanic population: Data from the pregnancy risk assessment monitoring system. Maternal and Child Health Journal, 2008(12), 342–356.

    Article  Google Scholar 

  16. McGlade, M. S., Saha, S., & Dahlstrom, M. E. (2004). The Latina paradox: An opportunity for restructuring prenatal care delivery. American Journal of Public Health, 94, 2062–2065.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Shiono, P. H., & Klebanoff, M. A. (1986). Ethnic differences in preterm and very preterm delivery. American Journal of Public Health, 76(11), 1317–1321.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. James, C. V., Salganicoff, A., Thomas, M., & Lillie-Blanton, M. (2009). Putting women’s health care disparities on the map. Henry J. Kaiser Foundation Report.

  19. Park, L. S., Sarnoff, R., Bender, C., & Korenbrot, C. (2000). Impact of recent welfare and immigration reforms on use of Medicaid for prenatal care by immigrants in California. Journal of Immigrant Health, 2(1), 5–22.

    Article  CAS  PubMed  Google Scholar 

  20. McCullough, L. B., & Chervenak, F. A. (2008). A critical analysis of the concept and discourse of ‘unborn child. American Journal of Bioethics, 8(7), 34–39.

    Article  PubMed  Google Scholar 

  21. Kaiser Commission on Medicaid and the Uninsured. (2004). Covering new americans: A review of federal and state policies related to immigrant’s eligibility and access to publicly funded health insurance. Center on Budget and Policy Priorities.

  22. National Immigration Law Center. (2003). Prenatal coverage for immigrants through SCHIP. http://www.nilc.org/. Accessed 12 Jan 2014.

  23. National Health Policy Forum. (2003). Sailing SCHIP through troubled waters, Washington D.C.

  24. Centers for Disease Control and Prevention. (2011). Vital statistics birth data files. National Center for Health Statistics.

  25. Migration Policy Institute. (2010). Mexican foreign-born residing in the United States. http://www.migrationpolicy.org/article/mexican-immigrants-united-states-0 Accessed 15 Oct 2013.

  26. US Department of Health and Human Services. (2012). Overview of immigrant eligibility for SNAP, TANF, Medicaid, and CHIP. http://aspe.hhs.gov/hsp/11/ImmigrantAccess/Eligibility/ib.shtml Accessed 30 Jul 2014.

  27. Medicaid. (2014). CHIP state program information. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Childrens-Health-Insurance-Program-CHIP/CHIP-State-Program-Information.html Accessed 30 Jul 2014.

  28. Baumrucker, E. P. (2008). Congressional Research Service Report for Congress: SCHIP coverage for pregnant women and unborn children.

  29. Brick, K., Challinor A. E., & Rosenblum M. R. (2011). Mexican and Central American immigrants in the United States. Report from Migration Policy Institute.

  30. Albrecht, S. L., & Miller, M. K. (1996). Hispanic subgroup differences in prenatal care. Social Biology, 43(1–2), 38–57.

    CAS  PubMed  Google Scholar 

  31. Wooldridge, J. (2001). Chapter 13 Pooling cross sections across time: Simple panel data methods in Introductory econometrics: A modern approach. Mason, Ohio.

  32. Kotelchuck, M. (1994). An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. American Journal of Public Health, 84(9), 1414–1420.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. Bengiamin, M., Capitman, J. A., & Mathilda, R. (2007). Prenatal care and birth outcomes: Challenges to growing a more nurturing San Joaquin Valley. Fresno, CA: Central Valley Health Policy Institute.

    Google Scholar 

  34. Coonrod, D. V., Lopopolo, C. M., Bay, R. C, Balcazar, H., Brady, J, et al. (2000). A natural experiment with materninity care: The defunding of prenatal care for undocumented immigrants. In 128th meeting of American Public Health Association, Boston, MD.

  35. Hessol, N. A., Vittinghoff, E., & Fuentes-Afflick, E. (2004). Reduced risk of inadequate prenatal care in the era after Medicaid expansions in California. Medical Care, 42(5), 416–422.

    Article  PubMed  Google Scholar 

  36. Ku, L., & Blaney, S. (2000). Health coverage for legal immigrant children: New census data highlight importance of restoring Medicaid and SCHIP coverage. Washington D.C.: Center on Budget and Policy Priorities.

    Google Scholar 

  37. Seils, D. M., Castel, L. D., Curtis, L. H., & Weinfurt, K. P. (2002). Welfare reform and Latinas’ use of perinatal health care. American Journal of Public Health, 92(5), 699.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Spetz, J., Baker, L., Phibbs, C., Pedersen, R., & Tafoya, S. (2000). The effect of passing an “anti-immigrant” ballot proposition on the use of prenatal care by foreign-born mothers in California. Journal of Immigrant Health, 2, 203–212.

    Article  CAS  PubMed  Google Scholar 

  39. Gortmaker, S. L. (1979). The effects of prenatal care upon the health of the newborn. American Journal of Public Health, 69(7), 653–660.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  40. Lu, M. C., Tache, V., Alexander, G. R., Kotelchuck, M., & Halfon, N. (2003). Preventing low birth weight: Is prenatal care the answer? Journal Maternal Fetal Neonatal Medicine, 13, 362–380.

    Article  CAS  Google Scholar 

  41. Misra, D. P., & Guyer, B. (1998). Benefits and limitations of prenatal care from counting visits to measuring content. Journal of the American Medical Association, 279(20), 1661–1662.

    Article  CAS  PubMed  Google Scholar 

  42. Stevens-Simon, C., & Orleans, M. (1999). Low-birthweight prevention programs: The enigma of failure. Birth, 26(3), 184–191.

    Article  CAS  PubMed  Google Scholar 

  43. Clark, K., Chun-Mei, F., & Burnett, C. (1997). Accuracy of birth certificate data regarding the amount, timing, and adequacy of prenatal care using prenatal clinic medical records as referents. American Journal of Epidemiology, 145(1), 68–71.

    Article  CAS  PubMed  Google Scholar 

  44. Gutman, V. (2003). Prenatal care: Revisions to SCHIP extended health care to “unborn children”. Journal of Law, Medicine, and Ethics, 31(1), 155–157.

    Article  Google Scholar 

  45. National Latina Institute for Reproductive Health. (2005). Prenatal care access among immigrant Latinas. http://latinainstitute.org/es/node/106. Accessed 15 Sept. 2013.

  46. National Women’s Law Center. (2003). Implementation of “unborn child” SCHIP regulations covers no new women and leads to loss in benefits. www.nwlc.org/pdf/SCHIPRegsUpdateMay03.pdf. Accessed 14 Dec. 2013.

  47. Sperow, E. (2004). Redefining child under the state children’s health insurance program: Capabale of repetition, yet evading results. Journal of Gender, Social Policy, and the Law, 12(1), 137–160.

    Google Scholar 

  48. Berk, M. L., Schur, C. L., Chavez, L. R., & Frankel, M. (2000). Health care use among undocumented Latino immigrants. Health Affairs, 19, 51–64.

    Article  CAS  PubMed  Google Scholar 

  49. Kochar, R., Suro, R., & Tafoya, S. (2005). The new Latino South: The context and consequences of rapid population growth. Washington, D.C.: Pew Hispanic Center.

    Google Scholar 

  50. Reed, W. J., Bublitz, C., Battaglia, C., & Fickenscher, A. (2005). Birth outcomes in Colorado’s undocumented immigrant population. BMC Public Health, 5, 100.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Passel, J. (2005). Estimates of the size and characteristics of the undocumented population. Washington, D.C.: Pew Hispanic Center.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathan Drewry.

Additional information

E. Michael Foster: deceased.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Drewry, J., Sen, B., Wingate, M. et al. The Impact of the State Children’s Health Insurance Program’s Unborn Child Ruling Expansions on Foreign-Born Latina Prenatal Care and Birth Outcomes, 2000–2007. Matern Child Health J 19, 1464–1471 (2015). https://doi.org/10.1007/s10995-014-1650-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-014-1650-5

Keywords

Navigation