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“Yo No Sabía...”—Immigrant Women’s Use of National Health Systems for Reproductive and Abortion Care

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Abstract

Half of pregnancies worldwide are unintended; half of these end in abortion. Immigrant women encounter more obstacles to reproductive healthcare than non-immigrant women, and access to national healthcare is a particularly important factor in abortion access. Spain’s government recently liberalized abortion laws, including abortion services in the national health system available to immigrants. Evidence suggests that immigrant women in Spain experience difficulties navigating the health system—the impact of the changed abortion laws on immigrant’s women’s access to care is not yet clear. Through a literature review and analysis, this paper examines the experiences of immigrant women with national health systems, and their use of such systems for reproductive and abortion care, in order to explore what could be expected in Spain as the national health system expands to include abortion care, and to illuminate immigrant women’s experiences with using national health systems for reproductive healthcare more broadly.

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Notes

  1. This information comes from personal correspondence received after the completion of the literature search for this review.

References

  1. Henshaw S, Singh S, Haas T. The incidence of abortion worldwide. Int Fam Plan Perspect 1999; 25 issue suppl:30–8.

    Google Scholar 

  2. Freeman R. People flows in globalization. National Bureau of Economic Research, Working Paper 12315. 2006. Retrieved from <http://www.crest.fr/ckfinder/userfiles/files/Pageperso/manondds/mondialisation/freeman-peopleflows.pdf> on 1 Feb 2012.

  3. Stiglitz J. Globalization and its discontents. London: Penguin; 2002.

    Google Scholar 

  4. Borjas G. Welfare reform, labor supply, and health insurance in the immigrant population. University of Michigan: Economic Research Initiative on the Uninsured Working Paper Series, 2003.

  5. Richmond A. Global apartheid, refugees, racism, and the new world order. Toronto: Oxford University Press; 1994.

    Google Scholar 

  6. Deber R, Narine L, Baranek P et al. The public-private mix in health care, striking a balance: health care systems in Canada and elsewhere. Nat Forum Health; 1998 MultiMondes:433.

    Google Scholar 

  7. Guttmacher Institute (AGI). 2010 Spain expands legal access to abortion: Press Release. March 3, 2010. Retrieved from <www.guttmacher.org/media/inthenews/2010/03/03/index.html> on 1 Feb 2012.

  8. Rademakers J, Mouthaan I, de Neef M. Diversity in sexual health: problems and dilemmas. Euro J Contracept Reprod Health. 2005;10(4):207–11.

    Article  CAS  Google Scholar 

  9. Kennedy P, Murphy-Lawless J. The maternity care needs of refugee and asylum seeking women in Ireland. Feminist Rev 2003; 73(Exile and Asylum):39–53.

    Google Scholar 

  10. Guendelman S, Buekens P, Blondel B, et al. Birth outcomes of immigrant women in the United States, France, and Belgium. Maternal Child Health J. 1999;3(4):177–87.

    Article  CAS  Google Scholar 

  11. Toebes B. The right to health and the privatization of National Health Systems: a case study of the Netherlands. Health Human Rights. 2006;9(1):102–27.

    Article  Google Scholar 

  12. Schoevers M, van den Muijsenbergh M, Lagro-Janssen A. Illegal female immigrants in The Netherlands have unmet needs in sexual and reproductive health. J Psychosom Obstet Gynaecol. 2010;31(4):256–64.

    Article  PubMed  Google Scholar 

  13. Helström, Lotti with Odlind V, Zätterström C, Johansson M, Granath F, Correia N, Ekbom A. Abortion rate and contraceptive practices in immigrant and native women in Sweden. Scand J Public Health 2003; 31:405–10.

  14. Rasch V, Gammeltoft T, Knudsen LB, et al. Induced abortion in Denmark: effect of socio-economic situation and country of birth. Euro J Public Health. 2007;18(2):144–9.

    Article  Google Scholar 

  15. Schmid J, Kirchengast S, Vytiska-Binstorfer E, et al. Infertility caused by PCOS—health-related quality of life among Austrian and Moslem immigrant women in Austria. Human Reprod. 2004;19(10):2251–7.

    Article  Google Scholar 

  16. Thierfelder C, Tanner M, Bodiang CK. Female genital mutilation in the context of migration: experience of African women with the Swiss health care system. Euro J Public Health. 2005;15(1):86–90.

    Article  Google Scholar 

  17. Suligoi B, Giuliani M. The migration medicine study group sexually transmitted diseases among foreigners in Italy. Epidemiol Infect. 1997;118(3):235–40.

    Article  PubMed  CAS  Google Scholar 

  18. Donato F, Bollani A, Spiazzi R, et al. Factors associated with non-participation of women in a breast cancer screening programme in a Town in Northern Italy. J Epidemiol Commun Health. 1991;45(1):59–64.

    Article  CAS  Google Scholar 

  19. Medda E, Baglio G, Guasticchi G, et al. Reproductive health of immigrant women in the Lazio region of Italy. Annali dell’Istituto Superiore di Sanita. 2002;38(4):357–65.

    PubMed  Google Scholar 

  20. Baglio G, Saunders C, Spinelli A, et al. Utilisation of hospital services in Italy: a comparative analysis of immigrant and Italian citizens. J Immigr Minor Health. 2010;12(4):598–609.

    Article  PubMed  Google Scholar 

  21. Fedeli U, Alba N, Lisiero M, et al. Obstetric hospitalizations among Italian women, regular and irregular immigrants in North-Eastern Italy. Acta Obstet Gynecol Scand. 2010;89(11):1432–7.

    Article  PubMed  Google Scholar 

  22. Boonstra H. The heart of the matter, public funding of abortion for poor women in the United States. Guttmacher Policy Rev. 2007;10(1):12–3.

    Google Scholar 

  23. Hacker K, Chu J, Leung C, et al. The impact of immigration and customs enforcement on immigrant health: perceptions of immigrants in everett, Massachusetts, USA. Social Sci Med. 2011;73(4):586–94.

    Article  Google Scholar 

  24. LaRoche M. Health status and health services utilization of Canada’s immigrant and non-immigrant populations. Can Public Policy. 2000;26(1):51–75.

    Article  PubMed  CAS  Google Scholar 

  25. Meintel D, Labelle M, Turcotte G, et al. Migration, wage labor, and domestic relationships: immigrant women workers in Montréa. Anthropologica. 1984;26(2):135–69.

    Article  Google Scholar 

  26. Billings D, Moreno C, Ramos C, et al. Constructing access to legal abortion services in Mexico City. Reprod Health Matters. 2002;10(19):86–94.

    Article  PubMed  Google Scholar 

  27. Willen S. Birthing “invisible” children: state power, NGO activism, and reproductive health among “illegal migrant” workers in Tel Aviv, Israel. J Middle East Women’s Stud. 2005;1(2):55–88.

    Article  Google Scholar 

  28. Remmenick L. “I have no time for potential troubles”: Russian immigrant women and breast cancer screening in Israel. J Immigr Minor Health. 2003;5(4):153–63.

    Article  Google Scholar 

  29. Sabatello EF. Soviet immigration in Israel: consequences for family planning and abortion services. Planned Parent Europe. 1991;20(2):9–11.

    CAS  Google Scholar 

  30. DeJong J, Jawad R, Mortagy I, et al. The sexual and reproductive health of young people in the Arab countries and Iran. Reprod Health Matters. 2005;13(25):49–59.

    Article  PubMed  Google Scholar 

  31. Mansour A, Al-Osimy M. A study of satisfaction among primary health care patients in Saudi Arabia. J Commun Health. 1993;18(3):163–73.

    Article  CAS  Google Scholar 

  32. al Ahmed K, Aday LA, Walker G. Patient satisfaction in government Health facilities in the State of Qatar. J Commun Health 1996; 21(5):349–58.

    Google Scholar 

  33. Marquette C. Nicaraguan migrants in Costa Rica. Poblacion y Salud en Mesoamerica. 2006;4(1):1–31.

    Google Scholar 

  34. Chopra M, Lawn J, Sanders D, et al. Achieving the health millennium development goals for South Africa: challenges and priorities. The Lancet. 2009;374(2009):1023–31.

    Article  Google Scholar 

  35. Hajri S. Medical abortion: the Tunisian experience. Afr J Reprod Health/La Revue Africaine Santé Reprod. 2004;8(1):63–9.

    Article  Google Scholar 

  36. Gilson L, McIntyre D. Removing user fees for primary care in Africa: the need for careful action. Br Med J 2005; 331(7519):page numbers not listed.

  37. Varkey P, Balakrishna P, Prasad JH, et al. The reality of unsafe abortion in a rural community in South India. Reprod Health Matters. 2000;8(16):83–91.

    Article  PubMed  CAS  Google Scholar 

  38. Shakya G, Kishore S, Bird C, et al. Abortion law reform in Nepal: women’s right to life and health. Reprod Health Matters. 2004;12(24):75–84.

    Article  PubMed  Google Scholar 

  39. Gallo M, Nghia N. Real life is different: a qualitative study of why women delay abortion until the second trimester in Vietnam. Social Sci Med. 2007;64(2007):1812–22.

    Article  Google Scholar 

  40. Author. The role of social support in overcoming obstacles to abortion access: Oregon women tell their stories. Scholars Archive 2010; Oregon State University. Retrieved from <http://scholarsarchive.library.oregonstate.edu/xmlui/bitstream/handle/1957/16387/Author2010.pdf;jsessionid=3C9F5400C9546F7C9C97DBB320DAF32D?sequence=1> on 1 Feb 2012.

  41. Linders A. Victory and beyond: a historical comparative analysis of the outcomes of the abortion movements in Sweden and the United States. Sociol Forum. 2004;19(3):371–404.

    Article  Google Scholar 

  42. Jones E, Forrest JD, Goldman N, et al. Teenage pregnancy in developed countries. Fam Plann Perspect. 1985;17(2):53–69.

    Article  PubMed  CAS  Google Scholar 

  43. Johnson B, Horga M, Fajans P. A strategic assessment of abortion and contraception in Romania. Reprod Health Matters. 2004;12(24):184–94.

    Article  PubMed  Google Scholar 

  44. Akin A, Kocoglu GO, Levent A. Study supports the introduction of early medical abortion in Turkey. Reprod Health Matters. 2005;13(26):101–9.

    Article  PubMed  Google Scholar 

  45. Veeken H. Letter from Cuba: plenty of care, few condoms, no corruption. Br Med J. 1995;311(7010):935–7.

    Article  CAS  Google Scholar 

  46. Calavita K. Immigration, law, and marginalization in a global economy: notes from Spain. Law Soc Rev. 1998;32(3):529–66.

    Article  Google Scholar 

  47. Saurina C, Vall-llosera L, Saez M. A qualitative analysis of immigrant population health practices in the Girona Healthcare Region. BMC Public Health. 2010;10(379):1–11.

    Google Scholar 

  48. de Ramales A, Gilwith L, Morales C, et al. Abortion in immigrant women: the perspective of the social and health professionals who deal with the demand in Madrid. Index de Enfermedad 2006; Retrieved from <http://scielo.isciii.es/scielo.php?pid=S1132-12962006000300003&script=sci_abstract&tlng=en> on 1 Feb 2012.

  49. Terraza-Núñez R, Toledo D, Vargas I, et al. Perception of the Ecuadorian population living in Barcelona regarding access to health services. Int J Public Health. 2010;55(5):381–90.

    Article  PubMed  Google Scholar 

  50. Carrasco-Garrido P, De Miguel A, Barrera VH, et al. Health profiles, lifestyles and use of health resources by the immigrant population resident in Spain. Euro J Public Health. 2007;17(5):503–7.

    Article  CAS  Google Scholar 

  51. Gispert Magarolas R, Clot-Razquin G, Torné MM, et al. Diferencias en el perfil reproductivo de mujeres autoctonas e inmigrantes residentes en Cataluna. Gaceta Sanitaria 2008; 22(6):574–7.

    Google Scholar 

  52. Carta G, Bernal M, Hardoy M, et al. Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1). Clin Practice Epidemiol Mental Health 2005; 1(13):page numbers not listed.

  53. Buron A, Cots F, Garcia O, et al. Hospital emergency department utilisation rates among the immigrant population in Barcelona, Spain. BMC Health Serv Res. 2008;8(51):1–10.

    Google Scholar 

  54. Orjuela M, Regidor E. Contribution of immigration to increase of legal induced abortion. Med Clin Barc. 2009;133(6):213–6.

    Article  PubMed  Google Scholar 

  55. Malmusi D, Pérez G. Induced abortion in immigrant women in a urban setting. Gaceta Sanitaria 2009; Suppl (1):64–6.

  56. APFCiB. Valoración de los datos del Informe 2010 sobre Interrupciones Voluntarias del Embarazo (IVEs). Nota de prensa December 14, 2011; Retrieved from personal correspondence (email listserve) on 1 Feb 2012.

  57. Salut i Familia. Pilot interview with Sr. Rosendo Fernandez, Salut i Familia, Generalitat di Catalunya, Barcelona, Spain; March 2010.

  58. Zurriaga O, Martinez-Beneito M, Truyols A, et al. Recourse to induced abortion in Spain: profiling of users and the influence of migrant populations. Gaceta Sanitaria 2009; 23(S1):57–63.

    Google Scholar 

  59. Barambio, S. Personal correspondence (notes from a Skype meeting) with Dr. Barambio Santiago from Agrupacion Tutor Medica and ACAI, Barcelona, Spain. Retrieved from Skype, 12 April 2012.

  60. Grupo de Interes Espanol en Poblcacion, Desarollo Y Salud Reproductiva. Acceso al Aborto en el Estado Espanol: Una Mapa de Inequidad. Espanya 2009; Asociacion de Clinicas Acreditadas Para La Interrupcion del Embarazo.

  61. APFCiB. Pilot interviews with staff members of the Asociacio de Planificacio Familiar di Catalunya i Balears, March 2010; Barcelona, Spain.

  62. Grimes D, Benson J, Singh S, et al. Unsafe abortion: the preventable pandemic. World Health Organ Sexual Reprod Health. 2006;4:1–4.

    Google Scholar 

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Acknowledgments

The author wishes to thank Drs. Merrill Singer, Pamela Erickson, Samuel Martinez, Kim Price-Glynn (all at the University of Connecticut), and Jocelyn Warren (Oregon State University), for their feedback and suggestions on an early version of this paper. The author is also grateful to Elyse Singer (Washington University), for her editing and proofreading assistance, and to the journal reviewers who provided thorough and thoughtful suggestions for revision on the manuscript originally submitted.

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  1. Department of Anthropology, University of Connecticut, 354 Mansfield Rd., U-2176, Storrs-Mansfield, CT, 06269, USA

    Bayla Ostrach

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Correspondence to Bayla Ostrach.

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Ostrach, B. “Yo No Sabía...”—Immigrant Women’s Use of National Health Systems for Reproductive and Abortion Care. J Immigrant Minority Health 15, 262–272 (2013). https://doi.org/10.1007/s10903-012-9680-9

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