Access to and quality of contraceptive healthcare for undocumented immigrant women in California

Immigrants have lower rates of contraceptive use compared to non-immigrants. Undocumented immigrants face multiple barriers to healthcare and often experience poor-quality healthcare, yet few studies have examined contraceptive healthcare in this population. This study aimed to explore access to and quality of contraceptive healthcare among undocumented immigrants. Twenty-four in-depth interviews were conducted between April and July 2022 with Asian and Latinx undocumented immigrant women of reproductive age living in California within the United States. Interviews were inductively coded and themes were identified through thematic analysis. Most participants were aged 25–29, had college degrees, and were Deferred Action for Childhood Arrivals (DACA) recipients. All participants had ever used some form of contraception including condoms. Access to contraceptive healthcare was primarily impacted by knowledge about contraception, health insurance coverage, and knowledge about using health insurance. Participants who accessed contraceptive healthcare described a range of experiences, including those that were judgmental or dismissive, cursory or impersonal, or person-centered. This study highlights barriers to contraceptive healthcare and aspects of poor-quality contraceptive healthcare among undocumented immigrants, even in a highly-educated sample of mostly DACA recipients living in an inclusive state. Undocumented immigrants with lower socioeconomic status, without the protection of DACA, and living in more exclusive state policy climates may face additional barriers to contraceptive healthcare and worse quality of care. Efforts are needed to improve contraceptive education, consistent health insurance coverage and knowledge, and to ensure person-centered contraceptive healthcare for undocumented immigrants. These efforts will help work towards reproductive justice in this population.