Stratified access to care and mental health implications for pregnant and postpartum immigrants in the USMexico border region

This chapter explores how stratified access to healthcare shapes immigrant women's emotional experiences of pregnancy and the postpartum period and how women navigate resulting challenges. We draw from in-depth interviews with 25 pregnant and postpartum immigrant women residing in El Paso, Texas. Most of these women were excluded from Medicaid and private insurance, and thus had minimal access to health services beyond prenatal appointments and the delivery. We use women's narratives to explore the following themes: 1) Access to health and mental health support in relation to immigration status; 2) Immigration concerns as generating an additional mental health burden during pregnancy and the postpartum period; and 3) Strategies for seeking mental health support in the context of limited access to care. We discuss the implications of these patterns for the well-being of women and how programs could be developed to address gaps in services.