Postpartum health care receipt among immigrant women in the United States

项目总结 产后期，定义为分娩后三个月，是一个关键的，往往被忽视的时期 产妇健康。常规产后保健，包括检查常见的产后健康状况 关于母乳喂养和避孕的咨询，是由美国产科医师学会推荐的 以及所有产后妇女的妇科医生。怀孕期间的医疗补助覆盖范围，用于支付健康费用 在美国，43%的分娩相关的护理费用覆盖了至少60天的妇女 在分娩后。虽然大多数低收入女性有资格在怀孕期间获得医疗补助，但大多数州 将资格限制为合法居住五年以上的公民或合法居住的移民。州政府 提供其他公共保险选项的拼凑，如紧急医疗补助，以支付 为因以下原因而没有资格享受传统医疗补助的妇女提供分娩和分娩服务 移民身份。与传统的医疗补助不同，这些覆盖范围替代方案通常不包括医疗保健 在产后期间。目前对哪些具体服务涵盖的情况知之甚少 在每个州为分娩提供可选择的公共保险，以及这可能如何影响产后结局 在移民妇女中。这项研究有四个目的： 在目标1中，我们将创建第一个数据库，将怀孕风险评估监测系统的数据链接起来 (PRMS)提供出生证明记录中关于母亲出生地的信息。 在目标2中，我们将记录国家对#年怀孕期间移民妇女的公共保险政策的变化 PRMS州(包括无证妇女和合法居住的非公民) 目标3将使用目标1中汇编的数据来比较产后保健使用情况(包括避孕药 在美国境内和境外出生的女性之间的健康结果和健康行为。 Aim 4将使用在Aim 1中创建的数据集和在Aim 2中编译的策略信息来检查 国家在怀孕期间和怀孕后为移民妇女提供公共保险的政策与 产后妇女在产后保健利用、健康结局和健康行为方面的差异 在美国境内和境外出生 这个项目将是第一个研究母亲出生地点和产后之间关系的研究。 护理收据，并首次研究了国家对移民妇女的公共保险之间的关系 在这一人群中孕期和产后护理。这项研究的结果将为 公共卫生从业者和政策制定者关于医疗保健使用是否存在差异的问题 移民妇女和在美国出生的妇女之间的怀孕。此外，这项研究将有助于 根据我们对国家怀孕保险政策和 产后移民妇女和产后保健使用情况。

PROJECT SUMMARY The postpartum period, defined as the three months after childbirth, is a critical and often neglected period for maternal health. Routine postpartum health care, including testing for common postpartum health conditions and counseling on breastfeeding and contraception, is recommended by the American College of Obstetricians and Gynecologists for all postpartum women. Medicaid coverage during pregnancy, which pays for the health care costs associated with forty three percent of births in the United States, covers women for at least 60 days after childbirth. While the majority of low-income women qualify for Medicaid during pregnancy, most states limit eligibility to citizens or lawfully residing immigrants with greater than five years of legal residence. States offer a patchwork of alternative public coverage options, such as Emergency Medicaid, to cover the cost of labor and delivery for women who are not eligible for traditional Medicaid coverage because of their immigration status. Unlike traditional Medicaid, these coverage alternatives often do not cover health care during the postpartum period. Little is currently known about what specific services are covered under alterative public coverage options for childbirth in each state, and how this may affect postpartum outcomes among immigrant women. This research has four aims: In Aim 1, we will create the first database linking data from the Pregnancy Risk Assessment Monitoring System (PRAMS) with information on maternal place of birth from birth certificate records. In Aim 2, we will document state variation in public coverage policies for immigrant women during pregnancy in PRAMS states (including undocumented women and legally residing non-citizens) Aim 3 will use the data compiled in Aim 1 to compare postpartum health care use (including contraceptive use), health outcomes and health behaviors between women born within and outside the U.S. Aim 4 will use the dataset created in Aim 1, and the policy information compiled in Aim 2, to examine the association between state policies for public coverage of immigrant women during and after pregnancy and disparities in postpartum care utilization, health outcomes and health behaviors between postpartum women born within and outside of the US This project will be the first study to examine the association between maternal place of birth and postpartum care receipt, and the first to examine the relationship between state public coverage for immigrant women during pregnancy and postpartum care in this population. The results of this study will provide information to public health practitioners and policy makers about whether there are disparities in health care use after pregnancy between immigrant women and women born in the United States. Further, this study will contribute to our understanding of the relationship between state insurance coverage policies for pregnant and postpartum immigrant women and postpartum health care use.