270 - Experiences of undocumented Latina mothers in North Carolina navigating healthcare and public benefits for themselves and their infants

Poster Number: 270
Publication Number: 270.1650

Background: Undocumented mothers and their US born children face disparities in healthcare and public benefits access due to unique barriers.

Objective: To understand undocumented Latina mothers’ experiences accessing healthcare and public benefits for themselves and their infants during the perinatal period in NC, with a focus on the role of anti-immigrant policy on services use.

Design/Methods: To identify participants (n=20), we contacted Latina mothers who received emergency Medicaid coverage at delivery (≥37 weeks gestation) and gave birth between January 1-September 29, 2022 at an academic medical center in NC. This is a proxy for documentation status as over 99% of the population covered by emergency Medicaid in NC are undocumented. A bilingual, bicultural team member conducted semi-structured interviews in Spanish. Rapid qualitative content analysis was used for timely, action-oriented analysis. A summary template using pre-specified domains from the interview guide was iteratively modified. Summary templates were combined into a matrix for display of each domain across participants, to connect and analyze findings and identify overarching themes.

Results: The first theme was participants’ perceptions of public benefits, with varying levels of trust in benefit types and fears around using too many benefits. Despite varying levels of trust, participants utilized benefits to meet their children’s needs. The second theme was confusion about Medicaid eligibility and complicated enrollment processes for Medicaid and SNAP. The third theme was costs when uninsured as a barrier to care. Financial assistance was a valuable resource, but often not enough to support care for women in the postpartum period or uninsured children. The fourth theme was positive experiences based on language support and respectfulness. The final theme was “making it work,” by prioritizing children’s health despite barriers. Throughout these discussions, women described social support systems as important in navigating healthcare and public benefits.

Conclusion(s): Complicated public benefit enrollment processes and healthcare costs for uninsured family members are significant obstacles to decreasing health inequities. Investing in bilingual, bicultural healthcare workers to support families in navigating complicated enrollment processes and policy-level initiatives, like multi-year benefit enrollment and increased financial support to FQHCs and health department clinics, are critical to improving the health and wellbeing of Latino children.