Undocumented Immigrants Have Healthy Babies, but Need Prenatal Care

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Pregnancy and Prenatal Care

Undocumented immigrant women in Colorado are less likely to have low birth weight or preterm babies than other mothers, but tend to experience higher rates of excessive bleeding, fetal distress and other complications because they don't get adequate prenatal care, according to a newly published study by the University of Colorado at Denver and Health Sciences Center.

CU School of Medicine researchers reported that birth outcomes for undocumented immigrant women compared favorably to those of the general population between 1998 and 1999, but concluded that immigrants and their babies would fare better if they received adequate prenatal care. Researchers believe such care could reduce the need for lengthy and costly hospital stays.

"With some well-intentioned prenatal care that addresses their medical risks they could have even better outcomes," said Mary Shelley Reed, a research assistant in the UCDHSC neuromuscular lab and lead author of the study.

Over the two-year study period, about 5.3 percent of undocumented women gave birth to low-weight babies compared to 6.3 percent for all other mothers. Meanwhile, about 12.9 percent of undocumented mothers had preterm babies, compared to 14.5 percent of the rest of the population.

However, undocumented immigrant women were more likely to have higher rates of medical complications due to a lack of prenatal care. Researchers found that 2.3 percent of them experienced excessive bleeding during labor compared to 0.8 percent for other women, and about 8.7 percent experienced fetal distress, compared to 3.6 percent for the general population.

The study, published this week in the medical journal BioMed Public Health, looked at birth information for nearly 6,000 undocumented immigrant women in Colorado, most of them from Mexico. To gather data for the study, researchers culled anonymous information from birth certificates and emergency Medicaid payments.

According to their findings, undocumented mothers were younger, less educated, more likely to be single, and much less likely to receive prenatal care. They had higher rates of anemia and were less likely to gain enough weight during pregnancy. Conversely, they were less likely to use alcohol or tobacco products, which contributed to their healthy birth outcomes.

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"Their tobacco rate was 10 times lower than the rest of Colorado," said Jack Westfall, MD, an associate professor of family medicine in the CU School of Medicine and the corresponding author of the study. "Most come from poorer regions in Mexico and never had the money or access to tobacco."

Westfall noted that researchers could find no other data that had examined such a large group of undocumented immigrant women before in Colorado, though a few hospitals and county health departments have attempted analyses on a smaller scale.

State health records indicate that Colorado recorded 68,475 live births in 2004, but statistics for non-citizen births are difficult to determine due to stringent patient privacy laws and the transient nature of undocumented immigrant groups.

Colorado researchers were able to determine which women were undocumented immigrants by comparing the state's public birth records against emergency Medicaid billing data. Under the provisions of emergency Medicaid, hospitals can be reimbursed for labor and delivery costs associated with births by undocumented immigrants and foreign students. The coverage, based on specific income requirements, does not include prenatal care, however.

In the end, providing prenatal health care to all women who give birth in Colorado, regardless of their citizenship, could help the state save money in the long run, Westfall said.

"There is some evidence that for every dollar you spend in prenatal care, you save a dollar and a half on extended hospitalization and you have better outcomes for babies," he said.

Statistics vary, but by most accounts there are some 7 million undocumented immigrants in the United States. According to the Center for Immigration, an independent, non-partisan, non-profit research organization based in Washington, D.C., one in four U.S. births in 2002 was by an immigrant mother, either in the country legally or illegally.

The University of Colorado at Denver and Health Sciences Center is one of three campuses in the University of Colorado system.

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