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Abstract：
METHODS: Community-engaged qualitative study using inductive thematic analysis of semistructured interviews.
OBJECTIVE: To understand Latine immigrants\' recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization.
BACKGROUND: Decreased health care utilization among immigrants due to punitive immigration policies (ie, the \"chilling effect\") has been well-documented among Latine birthing people both pre and postnatally.
METHODS: Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants\' pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants.
RESULTS: Participants\' recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants\' rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants\' rights to health care. Participants also suggested training non-medical office staff in the use of interpreters.
CONCLUSIONS: Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants\' suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability.
OBJECTIVE: To understand Latine immigrants\' recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization.
BACKGROUND: Decreased health care utilization among immigrants due to punitive immigration policies (ie, the \"chilling effect\") has been well-documented among Latine birthing people both pre and postnatally.
METHODS: Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants\' pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants.
RESULTS: Participants\' recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants\' rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants\' rights to health care. Participants also suggested training non-medical office staff in the use of interpreters.
CONCLUSIONS: Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants\' suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability.
摘要：
方法：使用半结构化访谈的归纳主题分析进行社区参与的定性研究。
目的：了解拉丁移民最近的产前护理经验，并制定社区知情策略，以减轻政策对产前护理利用的寒害影响。
背景：由于惩罚性移民政策，移民中的医疗保健利用率降低（即，在产前和产后的拉丁分娩人群中，“寒害效应”）已得到充分证明。
方法：目前或最近怀孕的大费城移民拉丁人是从产科诊所招募的，2个儿科初级保健诊所，和2个基于社区的组织客户池。24人达到主题饱和。参与者的怀孕叙述以及他们对医疗保健提供者和系统如何使移民的产前护理更安全，更舒适的看法。
结果：参与者为减轻产前期间的寒意效应而提出的建议包括培训产前医疗保健提供者，以敏感地发起有关移民权利的讨论，并重申对移民身份的保密。与会者建议，医疗保健系统应扩大怀孕移民的信息来源，要么通过与社区组织合作传播信息，要么通过增加对了解移民医疗保健权利的受信任个人的访问。与会者还建议培训非医疗办公室工作人员使用口译员。
结论：大费城地区的移民拉丁孕妇和分娩者描述了对利用产前护理的持续恐惧和困惑，以及歧视的经历。参与者关于减轻与移民有关的寒害影响的建议可以转化为潜在的政策和方案干预措施，这些措施可以在当地实施并进行评估，以获得更广泛的适用性。
目的：了解拉丁移民最近的产前护理经验，并制定社区知情策略，以减轻政策对产前护理利用的寒害影响。
背景：由于惩罚性移民政策，移民中的医疗保健利用率降低（即，在产前和产后的拉丁分娩人群中，“寒害效应”）已得到充分证明。
方法：目前或最近怀孕的大费城移民拉丁人是从产科诊所招募的，2个儿科初级保健诊所，和2个基于社区的组织客户池。24人达到主题饱和。参与者的怀孕叙述以及他们对医疗保健提供者和系统如何使移民的产前护理更安全，更舒适的看法。
结果：参与者为减轻产前期间的寒意效应而提出的建议包括培训产前医疗保健提供者，以敏感地发起有关移民权利的讨论，并重申对移民身份的保密。与会者建议，医疗保健系统应扩大怀孕移民的信息来源，要么通过与社区组织合作传播信息，要么通过增加对了解移民医疗保健权利的受信任个人的访问。与会者还建议培训非医疗办公室工作人员使用口译员。
结论：大费城地区的移民拉丁孕妇和分娩者描述了对利用产前护理的持续恐惧和困惑，以及歧视的经历。参与者关于减轻与移民有关的寒害影响的建议可以转化为潜在的政策和方案干预措施，这些措施可以在当地实施并进行评估，以获得更广泛的适用性。
