Perceived vulnerability to immigration policies among postpartum Hispanic/Latina women in the MADRES pregnancy cohort before and during the COVID-19 pandemic.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic. METHODS: The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1 month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as "pre-pandemic" (N = 128), between March 2020 and July 2020 as "early pandemic" (N = 38), and between August 2020 and November 2021 as "later pandemic" (N = 21). Average PIPES subscale scores were dichotomized into "higher" and "lower" groups (⩽median, >median) and logistic regression models were performed. RESULTS: Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods. CONCLUSION: Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period.