“Ella anduvo conmigo:” Relying on Social Capital to Navigate Healthcare and Coverage Throughout Pregnancy and Postpartum

• In Event: 40817 - Health Care and Care Delivery: Medical Organizations, Providers and Patients

Abstract

This article draws on longitudinal, in-depth, semi-structured interviews with 32 pregnant or early postpartum low-income women in Central Texas as they describe their experience securing their healthcare and health coverage. Our sample includes primarily Latina women, half of whom were born outside of the United States and all of whom relied on a temporary public healthcare program (i.e., Medicaid for pregnant women or CHIP-Perinatal) to cover their healthcare costs. We ask: 1) How do low-income uninsured women of color navigate the healthcare system throughout their pregnancy, and how do these experiences vary? 2) What strategies, skills, and resources are most useful during the pregnancy experience for marginalized women? First, we find that social capital (in the form of social support) was the most useful resource our participants cited for navigating their healthcare access, coverage, and general interactions with healthcare systems. Second, we detail how social capital shaped our participants' pregnancy trajectories. We find that while social capital is often used, not all social support proved useful, and sometimes, the support our participants received from their networks negatively affected their overall experience. Finally, we argue that one skill that our participants relied consistently on was the ability to draw on specific types of support from the people they felt best offered the knowledge or ability to help them achieve their goals. Our participants were exceptionally skilled at identifying key junctures throughout the pregnancy trajectory in which social capital was valuable and necessary for our participants. Not only were the women in our study able to identify moments when they needed extra support, but they could also differentiate what type of support they needed and who (in their network) to ask based on their needs. This study contributes to theories of how marginalized individuals navigate the healthcare system despite the numerous structural challenges that they face.

Authors

• Dagoberto Cortez, University of Texas-Austin

• Charlotte Bliss Perez, University of Texas at Austin

• Eileen Nehme, Texas Health Institute

• Divya Patel, UTHealth Houston School of Public Health