Thesis (Ph.D.)--University of Rochester. School of Nursing. Dept. of Health Practice Research, 2012.
Disparities in health outcomes along racial and ethnic divides are a serious
public health issue. As the Latino population continues to grow in the United States,
major differences in health outcomes are evident among Latino subgroups. A
phenomenon known as the epidemiologic paradox has been observed among
unacculturated Mexican women who, despite socioeconomic disadvantages, have
equal or better perinatal outcomes than non-Latina Whites.
The purpose of this retrospective study was to fill gaps in information about
the levels of childbirth risk reflected in the preexisting characteristics of Latina
migrant farmworkers and judge whether the perinatal outcomes among women who
received prenatal care from certified nurse-midwives and family practice physicians
in a federally qualified health care center and gave birth in a community-level
hospital reflect a level of care appropriate to their risk.
The sample included 268 parturient women between the ages of 15 and 44,
of whom 46.1% were Latinas and 53.9% were non-Latina Whites. The outcomes
examined were gestational age, birthweight, 1-minute Apgar, perineal status, and
breastfeeding.
Results supported the epidemiologic paradox. Despite the fact that the Latina
migrant farmworker women in the study lived in a transitory state with multiple
cultural barriers, there was no difference in the outcomes of gestational age, 1-minute
Apgar, or perineal status between Latina migrant farmworker women and local non-
Latina White resident women. Latina women gave birth to infants who weighed an
average of 150 grams less than non-Latino White infants, but the mean birthweight of
Latina babies at 3293.97 grams (sd = 430.04) was within a normal range, and Latina
women were twice as likely to breastfeed as non-Latina Whites. Among the entire
sample, primiparas were more likely to breastfeed than multiparas. Latina women
with adequate prenatal care were more likely to breastfeed than those without
adequate prenatal care.
Research is needed that examines the pattern of migration and living
situations of migrants as well as their identified social supports to better understand
the effects of assimilation and acculturation. Prenatal education regarding the health
benefits of breastfeeding offers the potential to increase breastfeeding rates.
