Factors Associated with Sexual and Reproductive Health Care by Mexican Immigrant Women in New York City: A Mixed Method Study

Abstract

Limited research has examined barriers to sexual and reproductive health (SRH) services for Mexican immigrant women, especially those living in the eastern United States. This mixed-method study describes SRH care utilization and barriers experienced by female Mexican immigrants living in New York City. One hundred and fifty-one women completed surveys, and twenty-three also participated in focus groups. Usage of SRH care was low apart from prenatal services. The highest barriers included cost, language differences, child care, and poor service quality. After adjusting for insurance status, barriers were associated with receipt of gynecological care from a clinic or private doctor. Greater SRH knowledge was associated with current contraceptive use and a recent PAP test. Women reported that promotoras could increase information about SRH and decrease barriers. Results suggest that in a context where services are geographically available, health care utilization is impacted by lack of knowledge and structural barriers such as language, cost, and child care. Implications for community outreach are discussed.

Migrant Workers and Their Occupational Health and Safety

“…Women often face barriers to reproductive health related to the costs of health care, access to health insurance, or child care. Immigrant women tend to underutilize family planning services, delay prenatal care, and have more unplanned pregnancies than do native-born women (8,73,74).…”

The experiences and perceptions of family planning of female Chinese asylum seekers living in the UK

“…Language difficulties have been identified as a common barrier to appropriate access8 9 together with negative attitudes towards certain forms of contraception 10 11. It is recognised that different cultural backgrounds present distinctive issues due to knowledge and attitudes towards contraception 12.…”

A Call to Action: Developing and Strengthening New Strategies to Promote Adolescent Sexual Health

“…Although foreign-born adolescents frequently initiate sexual intercourse later in life, they are less likely to use contraception and more likely to report a pregnancy as intended in comparison to U.S.-born adolescents [123,124]. When navigating relationships, decisions about sex, contraception, and pregnancy, immigrant and refugee youth may find themselves bridging two cultures and value systems [125]. Immigrants and refugees often experience language barriers, cultural discordance in reproductive health services, restricted access to health insurance or health care services, and limited perceptions regarding their ability to engage in decision making [125,126].…”

“…When navigating relationships, decisions about sex, contraception, and pregnancy, immigrant and refugee youth may find themselves bridging two cultures and value systems [125]. Immigrants and refugees often experience language barriers, cultural discordance in reproductive health services, restricted access to health insurance or health care services, and limited perceptions regarding their ability to engage in decision making [125,126]. Evidence-based interventions targeted at foreign-born youth can decrease pregnancy risks by including culturally relevant sex education to address specific cultural and family structure issues [126].…”

“…Health care providers should receive training in the varied cultural norms in their community, have access to professional translation services, and strive to increase the diversity of their workforce [126]. Using promotoras, community-based health educators, is another promising approach to increase outreach and awareness of reproductive health services, though more research is needed on efforts with adolescents [125].…”