Perinatal care among Hispanic birthing people: Differences by primary language and state policy environment

Overview

The study investigates the utilization and quality of maternal care among Hispanic birthing people, focusing on differences by primary language (Spanish vs. English) and state policy environment. The data encompasses survey responses from 35,779 postpartum individuals with self-reported Hispanic ethnicity who gave birth between 2016 and 2020 across 44 states and two jurisdictions.

Findings

• Language Disparities: Spanish-speaking Hispanic individuals reported lower rates of preconception care attendance, and of timeliness and adequacy of prenatal care compared to English-speaking counterparts.
• State Policy Environment:
  • In states without Medicaid expansion and immigrant Medicaid coverage (compared to Hispanic birthing people in states with these policies):
    • Hispanic birthing people had 2.3 and 3.1 percentage points lower postpartum care attendance.
    • They experienced 4.2 and 9.2 percentage points lower prenatal care quality.
• Language Disparities by State Policy Environment:
  • In states with Medicaid expansion and immigrant Medicaid coverage:
    • Spanish-speaking Hispanic individuals had 3.3 and 3.0 percentage points lower prenatal care adequacy compared to English-speaking counterparts (vs. differences by language of 7.3 and 7.9 percentage points lower in states without these policies).
    • They had 1.3 and 2.7 percentage points higher postpartum care quality compared to English-speaking Hispanic individuals (vs. 9.6 and 5.3 percentage points higher in states without these policies).

Implications for Policy and Practice

• Policy Enhancement: Expanding Medicaid eligibility and waiving the five-year waiting period for pregnant immigrants to access Medicaid can significantly improve the equity of prenatal and postpartum care among Hispanic birthing people.
• Targeted Interventions: Developing targeted healthcare policies to address language barriers and improve care quality and access for Spanish-speaking Hispanic individuals is crucial.
• Ongoing Monitoring: Continuous monitoring and assessment of maternal care utilization and quality in varying state policy environments can help identify gaps and inform future policy decisions to ensure equitable healthcare outcomes.