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Ted Joyce, PhD, Tamar Bauer, JD, Howard Minkoff, MD and Robert Kaestner, PhD

At the time of the study, Ted Joyce and Robert Kaestner were with Baruch College, City University of New York, and the National Bureau of Economic Research, New York, NY. Tamar Bauer is with the New York Academy of Medicine, New York, NY. Howard Minkoff is with Maimonides Medical Center, Brooklyn, NY, and the State University of New York Health Science Center at Brooklyn.

Correspondence: Requests for reprints should be sent to Ted Joyce, PhD, National Bureau of Economic Research, 365 Fifth Ave, 5th Floor, New York, NY 10016–4309 (e-mail: ted_joyce{at}baruch.cuny.edu).

Objectives. This study analyzed changes in the financing of prenatal care and delivery, the use of prenatal care, and birth outcomes among foreign-born vs US-born Latino women following enactment of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in August 1996.

Methods. We used a pre–post design with a comparison group. The sample consisted of resident Latinas in California, New York City, and Texas who delivered a live infant in 1995 or 1998.

Results. The proportion of births to Latinas that initiated prenatal care in the first 4 months of pregnancy increased for all foreign-born Latinas in California, New York City, and Texas between 1995 and 1998 (P < .05). Except for non-Dominicans in New York City, there was no increase in the proportion of low- or very-low-birthweight births among foreign-born vs US-born Latinas in the 3 localities between 1995 and 1996.

Conclusions. There is little evidence from vital statistics in California, New York City, and Texas that PRWORA had any substantive impact on the perinatal health and health care utilization of foreign-born relative to US-born Latinas.

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