hispanic-paradox-500pxImmigrants come to America for many reasons, but a decrease in their children’s birth weight certainly isn’t one of them. As a Texas A&M Health Science Center (TAMHSC) College of Nursing (CON) researcher points out, the adoption of American culture can have detrimental effects for Mexican immigrant mothers.

Low birth weight and premature birth are identified as major public health concerns for American mothers. The United States has seen infant mortality rates decrease over the past several decades – but the rate of low birth weight infants has remained steady.

Several factors have been identified as putting American women at risk of delivering low-birth-weight and premature babies: low socio-economic status, lack of access to professional health care, low education levels and high stress are all considered risk factors for low birth weight.

Many Mexican immigrants are often affected by these risk factors, but unlike American mothers (regardless of race) first-generation Mexican immigrant mothers boast higher birth weights.

Robin Page, Ph.D., RN, CNM, director of education at the TAMHSC College of Nursing, found this “Hispanic Paradox” in her research on Mexican immigrant mothers. Page has a Master of Science in Nurse-Midwifery and a doctoral portfolio in Mexican-American studies.

She found that differences in birth weight were the result of differences in prenatal health behaviors, not race, and that these differences were the result of cultural standards and values. 

Within the Mexican immigrant population, an increased desirability of pregnancy, better nutritional support, lack of substance abuse and an increase in the role of religion within the mother’s life were identified as positive cultural factors.

Additionally, Page found that as these immigrants grew accustomed to living in America and adopted American cultural norms, their birth weights decreased.

“These differences in prenatal health behaviors encompass the structural social support experienced by immigrants through a concept called ‘familialism,’” said Page. “Essentially, these immigrant populations place family and community relationships at the center of identity. This seems to diminish with acculturation.”

But what does this teach us about prenatal care in a global, humanistic perspective? What can this mean for the public health concerns of America? The answer offers a unique reflection for all mothers and medical professionals and suggests that one of the most important components of prenatal health care is the caring relationships formed for and around the mother. 

“This has implications beyond these results,” said Page. “It helps us, as nurses, understand cultural influences and assist patients of all cultural backgrounds. Clearly factors other than ethnicity and socioeconomic status contribute to health disparities.”

She hopes that these differences can be translated through holistic health care to reduce low birth weight within the United States.

“By enhancing our understanding of the concept of acculturation, nurses can provide holistic care that is culturally competent,” said Page. “We need a focus on care that acknowledges more than just the body, but encompasses an intricate web of factors.”

As these immigrant mothers became more acculturated, their risk of delivering a low-birth-weight infant increased. This is also true across generations. Page explained that one study found the risk for low birth weight was approximately 4 times higher for second than first generation Mexican American women.

“It is possible that Mexican culture fosters positive feelings toward childbearing that influence health-related behaviors, thus affecting pregnancy outcomes,” said Page. “First-generation immigrants were found to consume more protein, calcium, folic acid, and vitamins A and C than did second generation Mexican-Americans and non-Hispanic women despite often low socioeconomic statuses.”

Page also notes that religion, specifically, was identified as a positive psychological factor among Mexican immigrants. By fostering positive attitudes toward pregnancy and subsequent prenatal care, religion was found to provide a source of social support – a factor Page identified as increasingly important for healthy prenatal behavior. 

Prenatal care providers should assess pregnant clients’ resources for social support and help facilitate the mobilization of that support. Page suggests that the most important component of prenatal care may not be the provider, but the caring relationships that are formed for the mother.  

— Katherine Hancock

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