Department of Pediatrics, Emory University, Health Sciences Research Building W417, 1760 Haygood Drive NE, Atlanta, GA, 30322, USA.
Emory Global Health Institute, Emory University, Atlanta, GA, USA.
Matern Child Health J. 2021 Jan;25(1):9-14. doi: 10.1007/s10995-020-03020-3. Epub 2020 Nov 17.
The 14th amendment of the United States (US) Constitution guarantees citizenship to infants born in the US. With documentation of citizenship, typically through a birth certificate, neonates gain official identity and the opportunity to qualify for services like healthcare. Most guidance on caring for immigrant children assumes that access to health care is guaranteed for babies born in the US. In practice, some infants born to non-citizen mothers face barriers in obtaining services fundamental to neonatal health.
We conducted a review of the literature to identify articles on access to care for infants born to non-citizen mothers in the US. Because of the scarcity of relevant peer-reviewed published literature on this topic, the search was broadened to grey literature including news articles, online articles, and legal reviews. Using these aggregated sources, we created a framework for understanding maternal immigration status and barriers to healthcare for neonates born in the US. We discuss risk factors from the public health, historical and ethical perspectives.
Barriers exist for some mother-infant dyads in obtaining services such as healthcare, health insurance and supplemental nutrition programs. At-risk dyads include neonates of undocumented immigrants and birth tourists as well as neonates born to women on visas. The impact of these barriers on health-seeking behaviors, access to care, and health outcomes for these neonates is largely unknown.
The framework for understanding challenges of non-citizen mothers and their infants that we present in this article provides a resource for physicians and public health professionals serving this population. That much of the literature exists outside of healthcare highlights the need for more scholarly work on this problem. Future research will better inform advocacy and public health efforts to protect this vulnerable population of newborn citizens and their mothers.
美国宪法第十四修正案保障在美国出生的婴儿获得公民身份。有了公民身份的证明，通常是通过出生证明，新生儿就获得了正式的身份，并有机会获得医疗保健等服务。关于照顾移民儿童的大多数指导都假设，在美国出生的婴儿可以获得医疗保健。实际上，一些非公民母亲所生的婴儿在获得基本新生儿健康服务方面面临障碍。
我们对文献进行了回顾，以确定关于在美国出生的非公民母亲所生孩子获得医疗保健机会的文章。由于关于这个主题的相关同行评议已发表文献稀缺，因此搜索范围扩大到包括新闻文章、在线文章和法律评论在内的灰色文献。利用这些汇总的来源，我们创建了一个框架，以了解母亲移民身份和美国出生的新生儿获得医疗保健的障碍。我们从公共卫生、历史和伦理的角度讨论了风险因素。
一些母婴对在获得医疗保健、健康保险和补充营养计划等服务方面存在障碍。处于危险中的母婴对包括无证移民和生育旅游的新生儿以及持签证的妇女所生的新生儿。这些障碍对这些新生儿寻求医疗服务、获得医疗服务和健康结果的行为的影响在很大程度上是未知的。
我们在本文中提出的理解非公民母亲及其婴儿所面临挑战的框架为服务于这一人群的医生和公共卫生专业人员提供了资源。大部分文献存在于医疗保健之外，这突出表明需要在这个问题上进行更多的学术研究。未来的研究将更好地为保护这一脆弱的新生儿公民及其母亲群体的宣传和公共卫生工作提供信息。
