The 2016 Presidential Election and Prenatal Care Utilization Among Foreign-born Hispanic Pregnant People

Background: Few studies have evaluated the relationship between adequate and timely prenatal care among immigrant pregnant people and the recent political climate, including the 2016 election and associated campaigns. Objectives: We examine whether the 2016 presidential election was associated with changes in prenatal care utilization among US foreign-born Hispanic pregnant people. Research Design: Interrupted time series. Subjects: All foreign-born Hispanic and US-born non-Hispanic White people delivering singleton infants from 2008 to 2017 who resided in the 23 states that fully implemented the 2003 version of the birth certificate before January 2008 (n=12,397,503). Measures: We examine the relationship between the presidential election and changes in the odds of inadequate or late/no prenatal care among immigrant Hispanic pregnant people, as well as trends in prenatal care utilization before the election. Results: Our results show no unexpected changes in receipt of inadequate prenatal care, and late/no prenatal care, among the 7 monthly conception cohorts exposed to the election before the third trimester. However, we detected increases in the odds of both inadequate care and late/no prenatal care among foreign-born Hispanic pregnant people in June 2015 and January 2016, respectively. These upward level shifts persisted through the remainder of our time series ending with the cohort conceived around December 2016. Conclusions: The worsening shifts in prenatal care utilization we observe may serve as a bellwether for worsening outcomes among immigrant women and their families. Research is therefore urgently needed to investigate the determinants and consequences of these concerning trends.