Perinatal health care for undocumented women in Montreal: When sub-standard care is almost the rule

Rousseau, Cécile; Ricard-Guay, Alexandra; Laurin‐Lamothe, Audrey; Gagnon, Anita J.; Rousseau, Hélène

doi:10.5430/jnep.v4n3p217

Cited by 12 publications

(8 citation statements)

References 12 publications

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“…Finally, the results of this study are not generalisable to unsuccessful refugee claimants and other migrants without permanent residency. Lack of permanent residency status prohibits access to provincially funded healthcare insurance which has important implications for stress experienced by pregnant women 31. Stress resulting from lack of status may affect PTB differently than that described in this study.…”

Section: Discussionmentioning

confidence: 71%

The influence of refugee status and secondary migration on preterm birth

Wanigaratne

Cole

Bassil

et al. 2016

J Epidemiol Community Health

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Section: Discussionmentioning

confidence: 71%

The influence of refugee status and secondary migration on preterm birth

Wanigaratne

Cole

Bassil

et al. 2016

J Epidemiol Community Health

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“…We did not have data beyond 2005, and pregnancy trends may have changed in recent years. While the number of uninsured women in Canada is not known, undocumented women in Quebec have previously been found to experience sub‐standard perinatal care and increased peripartum morbidity . In the United States, uninsured and state‐insured women had more severe maternal morbidity events than commercially insured women .…”

Section: Discussionmentioning

confidence: 99%

“…While the number of uninsured women in Canada is not known, undocumented women in Quebec have previously been found to experience sub-standard perinatal care and increased peripartum morbidity. 34,35 In the United States, uninsured and state-insured women had more severe maternal morbidity events than commercially insured women. 36 Since we did not have data on uninsured women, the magnitude of adverse postpartum events may have been underestimated.…”

Section: Discussionmentioning

confidence: 99%

Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

Bottega

Malhamé

Guo

et al. 2019

Congenital Heart Disease

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Background The number of women with congenital heart disease (CHD) of reproductive age is increasing, yet a description of trends in pregnancy and delivery outcomes in this population is lacking. Objective To assess secular trends in pregnancy rates, delivery outcomes, and related health care utilization in the adult female CHD population in Quebec, Canada. Methods The Quebec CHD database was used to construct a cohort with all women with CHD aged 18‐45 years between 1992 and 2004. Pregnancy and delivery rates were determined yearly and compared to the general population. Secular trends in pregnancy and delivery rates were assessed with linear regression. The cesarean delivery rate in the CHD population was compared to the general population. Predictors of cesarean section were determined with multivariable logistic regression. Cox regression, adjusted for comorbidities, was used to analyze the impact of cesarean sections on 1‐year health care use following delivery. Results About 14 878 women were included. A total of 10 809 pregnancies were identified in 5641 women, of whom 4551 (80%) and 2528 (45%) experienced at least one delivery and/or abortion, respectively. Absolute yearly numbers and rates of pregnancies and deliveries increased during the study period (P < .05). The increment in cesarean section rates was more pronounced among women with CHD than among the general population. Gestational diabetes (OR 1.50, 95% CI [1.13, 1.99]), gestational hypertension (OR 1.81, 95% CI [1.27, 2.57]), and preeclampsia (OR 1.59, 95% CI [1.11, 2.8]) were independent predictors of cesarean delivery. Cesarean sections were associated with postpartum cardiac‐hospitalization within 1 year following delivery (HR = 2.35, 95% CI [1.05, 5.28]). Conclusions Yearly numbers and rates of pregnancies and deliveries in adult females with CHD rose significantly during the study period. Cesarean sections led to increased health care utilization. Further research is required to determine causes of high cesarean section rates in this patient population.

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“…Because of the cross-sectional design, it is difficult to ascertain whether the health issues declared are consequences of the lack of insurance. However, this association is well known [51] and does not need to be demonstrated. It was not possible to include all variables of interest in our gender-stratified multivariate analysis as their distribution varied according to gender, not enabling us to control for confounding.…”

Section: Strengths and Limitationsmentioning

confidence: 98%

“…In addition, there are many loopholes through which otherwise eligible permanent and temporary migrants may lack access to a public health insurance [9]. A few studies have documented the poor access to perinatal care [50,51] and perinatal outcomes [52] of uninsured pregnant women in Canada. However, there remains a dearth of information about the health impact of the absence of health insurance for migrants with precarious status in Canada, despite the fact that it seems their number is rising [21].…”

Section: Introductionmentioning

confidence: 99%

The negative self-perceived health of migrants with precarious status in Montreal, Canada: A cross-sectional study

et al. 2020

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Background Knowledge about the health impacts of the absence of health insurance for migrants with precarious status (MPS) in Canada is scarce. MPS refer to immigrants with authorized but temporary legal status (i.e. temporary foreign workers, visitors, international students) and/ or unauthorized status (out of legal status, i.e. undocumented). This is the first large empirical study that examines the social determinants of self-perceived health of MPS who are uninsured and residing in Montreal. Methods and findings Between June 2016 and September 2017, we performed a cross-sectional survey of uninsured migrants in Montreal, Quebec. Migrants without health insurance (18+) were sampled through venue-based recruitment, snowball strategy and media announcements. A questionnaire focusing on sociodemographic, socioeconomic and psychosocial characteristics, social determinants, health needs and access to health care, and health self-perception was administered to 806 individuals: 54.1% were recruited in urban spaces and 45.9% in a health clinic. 53.9% were categorized as having temporary legal status in Canada and 46% were without authorized status. Regions of birth were: Asia (5.2%), Caribbean (13.8%), Europe (7.3%), Latin America (35.8%), Middle East (21%), Sub-Saharan Africa (15.8%) and the United States (1.1%). The median age was 37 years (range:18-87). The proportion of respondents reporting negative (bad/fair) self-perception of health was 44.8%: 36.1% among migrants with authorized legal status and 54.4% among those with unauthorized status (statistically significant difference; p<0.001). Factors associated with negative self-perceived health were assessed using logistic regression. Those who were more likely to PLOS ONE |

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Perinatal health care for undocumented women in Montreal: When sub-standard care is almost the rule

Cited by 12 publications

References 12 publications

The influence of refugee status and secondary migration on preterm birth

The influence of refugee status and secondary migration on preterm birth

Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

The negative self-perceived health of migrants with precarious status in Montreal, Canada: A cross-sectional study

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