(368) The impact of immigration status on peripartum care in the United States: a scoping review

This scoping review examines the impact of immigration status on access to and quality of peripartum care in the U.S., with a focus on federal and state policy variations.

Study Design:

A comprehensive literature search was conducted across APA PsycINFO, CINAHL Ultimate, Cochrane Library, PubMed, and Scopus for peer-reviewed articles published in the past 10 years. Eligible studies included empirical and theoretical research examining pregnant or postpartum individuals in the U.S. whose immigration status was explicitly identified (e.g., undocumented, DACA recipients, lawful permanent residents, refugees). Studies were required to assess the impact of one or more immigration- and healthcare-related policies—drawn from a predefined list—on access to or quality of peripartum care. Exclusions included studies lacking legal status details, addressing only racial/ethnic disparities, or focusing solely on pediatric or breastfeeding outcomes. Two independent reviewers and an adjudicator screened 1,602 articles; 32 met inclusion criteria. Thematic analysis was conducted in MAXQDA using deductive and inductive coding.

Results:

Included studies varied in methods and policy focus. Peripartum care access varied widely for undocumented immigrants, with only a subset of states offering continuous coverage from pregnancy through 12 months postpartum. Undocumented and other non-citizen individuals were more likely to receive inadequate prenatal care and face barriers to postpartum care. Anti-immigration sentiments and policies, such as the Public Charge Rule, deterred Medicaid enrollment and were linked to adverse birth outcomes. In contrast, expanded Emergency Medicaid and state programs improved care utilization. Key facilitators included language access, culturally competent care, and extended postpartum coverage.

Conclusion:

In the context of recent Medicaid cuts and rising anti-immigration sentiment, this review highlights how immigration status continues to shape peripartum care access and outcomes. Inclusive policies that reduce barriers and increase coverage are essential for advancing maternal health equity.