Disparities in adequate prenatal care among immigrant women in the United States

Purpose. This meta-analysis examines nativity and racial/ethnic prenatal care inadequacy in California compared to other states, in the context of Medicaid reform. Methods. Studies in PubMed were included if they were published between 1990-2006 and had nativity as independent variable and adequacy of prenatal care as the dependent variable. Results. 41 studies provided 97 nativity comparisons. Foreign-born women were nearly two times more likely (OR = 1.613) to receive inadequate prenatal care compared to native-born women. Latina foreign-born were over twice as likely (OR = 2.443) compared to White native-born. After the 1996 reform, the relative nativity inequities improved for California, but not for other states. Conclusion. Expanding Medicaid to all women can reduce the rate of inadequate prenatal care, but nativity status disparities will persist unless specific measures can be taken to identify and eliminate other causes for disparities.