PM3027: Exploring Prenatal Care Quality and Access During the COVID-19 Pandemic Among Pregnant Immigrant People in Philadelphia

Background: The ongoing COVID-19 pandemic has led to decreased maternal and child health care access and engagement, especially among vulnerable populations. Existing disparities in prenatal care access and quality faced by pregnant immigrant people are likely to be amplified by the pandemic.

Methods: We conducted semi-structured qualitative interviews with a convenience sample of direct service providers at community-based organizations serving pregnant immigrant families in the Philadelphia region. Interviews addressed barriers and facilitators to prenatal healthcare access and engagement among immigrant families before and during the pandemic. Additional questions elicited context about the demographics of service populations, organizational connectedness to healthcare providers, and pandemic-related operational changes.

Results: Between June and November 2021, ten interviews were conducted in English and Spanish with direct service providers at 5 community-based organizations. With respect to healthcare, primary themes include diminished access and quality of care received due to decreased language accessibility, increased restrictions on bringing support persons to appointments, shifts to telemedicine, and significant changes to appointment scheduling mechanisms. Additional themes include heightened hesitancy engaging with services due to documentation status, lack of understanding of legal rights, financial strain, and health insurance status. Interviewees provided suggestions for improving service access during and post-pandemic for immigrant pregnant people, including implementation of culturally responsive group prenatal care, institutional policies for language access, appointment scheduling assistance, and allowance of support persons at appointments.

Conclusion: Understanding emergent and exacerbated barriers to prenatal care access and quality during the COVID-19 pandemic provides context for how to improve health equity for immigrant pregnant people through public health and healthcare policies both during and after the pandemic.