Welfare reform and the perinatal health and health care use of Latino women in California, New York City, and Texas

Objectives. This study analyzed changes in the financing of prenatal care a nd delivery, the use of prenatal care, and birth outcomes among foreign-bor n vs US-born Latino women following enactment of the Personal Responsibilit y and Work Opportunity Reconciliation Act (PRWORA) in August 1996. Methods. We used a pre-post design with a comparison group. The sample cons isted of resident Latinas in California, New York City, and Texas who deliv ered a live infant in 1995 or 1998. Results. The proportion of births to Latinas that initiated prenatal care i n the first 4 months of pregnancy increased for all foreign-born Latinas in California, New York City, and Texas between 1995 and 1998 (P < .05). Exce pt for non-Dominicans in New York City, there was no increase in the propor tion of low- or very-low-birthweight births among foreign-born vs US-born L atinas in the 3 localities between 1995 and 1996. Conclusions. There is little evidence from vital statistics in California, New York City, and Texas that PRWORA had any substantive impact on the peri natal health and health care utilization of foreign-born relative to US-bor n Latinas.