title: Perinatal outcomes of uninsured immigrant, refugee and migrant mothers and newborns living in Toronto, Canada.
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.
authors.affiliation: Midwifery Education Program, Ryerson University, 350 Victoria Street, Toronto,Ontario, Canada. k.wilsonmitchell@ryerson.ca
authors.forename: Karline
authors.initials: K
authors.lastname: Wilson-Mitchell
authors.forename: Joanna Anneke
authors.initials: JA
authors.lastname: Rummens
mesh_terms: D000328:Adult; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007231:Infant, Newborn; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D009035:Mothers; D009313:National Health Programs; D009864:Ontario / Q000453:epidemiology; D018743:Perinatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014171:Transients and Migrants / Q000706:statistics & numerical data*