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Perinatal Outcomes of Uninsured Immigrant, Refugee and Migrant Mothers and Newborns Living in Toronto, Canada
Midwifery Education Program, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
Community Health Systems Resource Group, The Hospital for Sick Children & Department of Psychiatry, University of Toronto; 555 University Avenue, Toronto, ON M5G 1X8, Canada
* Author to whom correspondence should be addressed.
Received: 23 April 2013; in revised form: 22 May 2013 / Accepted: 24 May 2013 / Published: 31 May 2013
Abstract: Canadian healthcare insurance is not universal for all newcomer populations. New immigrant, refugee claimant, and migrant women face various barriers to healthcare due to the lack of public health insurance coverage. This retrospective study explored the relationships between insurance status and various perinatal outcomes. Researchers examined and compared perinatal outcomes for 453 uninsured and provincially insured women who delivered at two general hospitals in the Greater Toronto Area between 2007 and 2010. Data on key perinatal health indicators were collected via chart review of hospital medical records. Comparisons were made with regional statistics and professional guidelines where available. Four-in-five uninsured pregnant women received less-than-adequate prenatal care. More than half of them received clearly inadequate prenatal care, and 6.5% received no prenatal care at all. Insurance status was also related to the type of health care provider, reason for caesarean section, neonatal resuscitation rates, and maternal length of hospital stay. Uninsured mothers experienced a higher percentage of caesarian sections due to abnormal fetal heart rates and required more neonatal resuscitations. No significant difference was found for low birth weight, preterm birth, NCIU admissions, postpartum hemorrhage, breast feeding, or intrapartum care provided.
Keywords: perinatal outcomes; uninsured; immigrant; refugee; migrant; women; newborns
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Wilson-Mitchell, K.; Rummens, J.A. Perinatal Outcomes of Uninsured Immigrant, Refugee and Migrant Mothers and Newborns Living in Toronto, Canada. Int. J. Environ. Res. Public Health 2013, 10, 2198-2213.
Wilson-Mitchell K, Rummens JA. Perinatal Outcomes of Uninsured Immigrant, Refugee and Migrant Mothers and Newborns Living in Toronto, Canada. International Journal of Environmental Research and Public Health. 2013; 10(6):2198-2213.
Wilson-Mitchell, Karline; Rummens, Joanna A. 2013. "Perinatal Outcomes of Uninsured Immigrant, Refugee and Migrant Mothers and Newborns Living in Toronto, Canada." Int. J. Environ. Res. Public Health 10, no. 6: 2198-2213.