Latina Immigrants’ Experiences Accessing Contraceptive Services Beyond the Postpartum Period and the Role of Community and Pediatric Settings

Abstract

Many immigrants lose healthcare access postpartum including contraceptive methods and management. Community health centers (CHCs) fill gaps in preventive healthcare access for uninsured, but the transition from hospital to community settings for immigrants is complex and not well described. While parental healthcare access diminishes postpartum, infants have frequent pediatric visits during the first year of life. The pediatric office can offer a family-centered approach to care for immigrant parents with diverse cultural backgrounds and lived experiences. Our primary study goal was to describe family planning navigation experiences among recently postpartum immigrant Latine with contraceptive needs using the Levesque conceptual framework of healthcare access. Our secondary goal was to explore the perception of the pediatrician in family planning navigation. We conducted semi-structured interviews in Spanish with 19 mothers at an urban pediatric practice. Our results centered around five themes: there is no standard process of obtaining information about CHCs postpartum; the pediatrician is a trusted information source, but displacing time for child-focused needs is a concern; structural barriers impede family planning goals; lack of health insurance affects autonomy in contraceptive decision making; and CHC care is satisfactory when accessible. Postpartum Latine immigrants receive inconsistent information about CHC resources for family planning and face barriers to their contraceptive goals. Pediatricians are considered trusted sources for family planning information. Bridging gaps in contraceptive access can include up-to-date CHC resources, resource navigators, interventions in pediatric settings, and broader insurance coverage.