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Nebraska Decision on Prenatal Care Bittersweet Victory for Women

Posted: Apr 27, 2012

Ed Note: Nebraska’s legislature last week overrode Gov. Dave Heineman’s veto of a bill seeking to provide free prenatal care to undocumented immigrant women. While welcome news for immigrant women in the state, commentator Jessica González-Rojas says it is a bittersweet victory as the arguments used effectively acknowledge rights to the fetus that are denied to the mother.

In the latest example of the hostile political climate that is emerging for Latinas and their families, Nebraska Governor Dave Heineman recently attempted to block immigrant women from accessing prenatal and labor/delivery care.

Thankfully, Nebraska legislators intervened and restored maternity care for all women.

Two years ago the federal government determined that the structure of Nebraska’s programs serving needy women violated federal rules. Federal health policy dictates that undocumented immigrants cannot receive federal Medicaid-funded health care; however it is possible, through the Children’s Health Insurance Program (CHIP), for women to receive prenatal care designated for the fetus.

Instead of fixing their program to align with federal rules, however, Nebraska politicians cut undocumented immigrant women off from pregnancy care, creating a health crisis for many Latinas. Nebraska women began traveling 155 miles to get prenatal care, and at least five babies died in the first year after women were cut off from healthcare.

Restoring access to prenatal care for all immigrant women in need was a lifesaving victory for many Nebraskans. All pregnant women, regardless of status, have the right to access care that will allow them to have healthier pregnancies and children.

Unfortunately this policy is crafted on the troubling premise that, while the fetus she carries can be enrolled in public health insurance, the pregnant woman herself is ineligible for benefits. A New York Times editorial said Nebraska legislators simply “took the woman out of the equation.”

Prenatal, labor and delivery care are critical for the health of women. Studies show that women who have access to prenatal care have healthier pregnancies and healthier babies. Regular prenatal care can prevent birth defects, delivery complications, low birth rate and life-long health issues for children, while allowing doctors to identify potential problems, like high-blood pressure or gestational diabetes, early to improve treatment for mothers.

The nonsensical medical separation of a woman from her fetus is dehumanizing and contrary to good healthcare practices.

Latinas under fire by the Governor advocated for their own health and dignity. For practical reasons, proponents of access to healthcare used the false premise of a woman as a vessel to restore critical access to care.

Sarah Roe, a pregnant Nebraskan with undocumented immigration status, filed a lawsuit on behalf of all pregnant immigrant women challenging the state for denying her prenatal care. Using the “CHIP” model, adopted in a number of states and which defines a child as anyone under 19 “from conception to birth,” Roe argued successfully that her fetus was eligible for healthcare coverage, even if she was not.

State legislators mirrored the arguments in her legal case in their recent reinstatement of care.

Treating immigrant women as invisible is a troubling reality in the nation’s debates about access to health care. For example, Texas slashed funding from its CHIP program, which provides prenatal and pregnancy care to many immigrant women. Nebraska’s six neighboring states do not offer prenatal care for undocumented immigrant women. And federal healthcare reform includes provisions that specifically exclude immigrant women without proof of legal residency from services.

The Nebraska legislation also continues a false and disturbing trend of demonizing immigrant families as hostile to the economy and the well being of communities.

Governor Heineman repeatedly set up a false dichotomy between allowing undocumented women to have healthy pregnancies and supporting the middle class.
In fact, providing pregnancy care will do both. For every $1 invested in prenatal care, states save between $1.70 and $3.38, according to the National Conference of State Legislatures.

All women deserve access to health care, including prenatal care, as a matter of basic human rights and dignity. The false demonization of immigrant communities is harmful to our communities, which are best served by policies that treat everyone with dignity, justice and compassion.

Jessica González-Rojas is Executive Director for the National Latina Institute for Reproductive Health. New America Media’s “Immigration Matters” column features the views of immigration experts and advocates.

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