Navigating Healthcare and Public Benefits in NC: Perspectives of Undocumented Latina Women with U.S.-Born Infants.

Abstract

Mixed-documentation status Latino families face unique barriers to accessing healthcare and public benefits. We examined the experiences of undocumented Latina mothers in North Carolina and the role of anti-immigrant policies and rhetoric in their decisions to access care and public benefits for themselves and their U.S.-born infants. We conducted a qualitative descriptive study to explore Latina mothers' experiences seeking care for themselves and their infants during the perinatal period. We used Emergency Medicaid at delivery as a proxy to identify undocumented mothers with U.S.-born infants. Twenty semi-structured audio interviews were conducted in Spanish via Zoom. We used rapid qualitative content analysis for timely, action-oriented analysis. Rapid qualitative analysis uses visual displays, such as matrices, to connect and analyze findings. Five themes emerged: confusion around public benefit eligibility and complicated enrollment processes; concerns and fears around immigration policy and rhetoric; cost as the most influential barrier to healthcare; positive experiences with language support and respectfulness of providers; "making it work" with the help of social support systems. While mothers narrated their experiences in the setting of prohibitive costs of accessing healthcare and fears and confusion about public benefits, they viewed meeting their child's health needs as a necessity, with social support systems important in navigating complex systems. Postpartum undocumented mothers with U.S.-born infants experience several barriers to NC Medicaid and public benefit enrollment for their infants, including complicated application processes, costs, and immigration-related fear. Advocacy is needed to prevent the dismantling of existing policies and create inclusive policies for immigrants.