Interventions facilitating access to perinatal care for migrant women without medical insurance: a scoping review.

Abstract

Poor antenatal monitoring is associated with higher rates of maternal complications at delivery and serious threats to neonatal well-being. This scoping review intended to explore existing interventions and policies addressing access to perinatal care among pregnant migrant women without medical insurance (PMWMI). Additionally, it will highlight the strengths and weaknesses of these interventions, as well as their associated costs. Using the Arksey and O'Malley (2005) framework - selected for its structured and widely used approach to mapping the breadth and nature of available evidence -, an electronic search was conducted across 11 databases for studies published between 2000 and 2025 in English or French. Grey literature was also examined. A total of 14 studies were included: 4 from Canada, 8 from the United States, 1 from Iran, and 1 from Thailand. The gaps created by policy changes, such as the reduction of services, create a misleading perception of economic efficiency. While short-term savings may be evident, they often lead to greater expenses in the medium to long term. In a federal system of government, the financial burden is shifted to the states (or provinces), which are compelled to address the resulting shortfall. The findings indicate that these changes appear to be politically motivated rather than economically beneficial. This scoping review highlighted interventions that facilitate access to perinatal care for migrant women without medical insurance. As the first of its kind, the findings reveal significant policy shifts that jeopardize the health benefits of undocumented immigrants and asylum seekers, contributing to profound health disparities. Further, these individuals may forgo necessary medical treatment, preventive care, and routine check-ups due to fear of detection and deportation.