Prenatal Care for Undocumented Immigrants: Professional Norms, Ethical Tensions, and Practical Workarounds

Rachel E. Fabi, Holly A. Taylor

Research output: Contribution to journalArticlepeer-review


This paper examines the practice implications of various state policies that provide publicly funded prenatal care to undocumented immigrants for health care workers who see undocumented patients. Data were collected through in-depth interviews with purposively sampled health care workers at safety net clinics in California, Maryland, Nebraska, and New York. Health care workers were asked about the process through which undocumented patients receive prenatal care in their health center and the ethical tensions and frustrations they encounter when providing or facilitating this care under policy restrictions. Respondents discussed several professional practice norms as well as the ethical tensions they encountered when policy or institutional constraints prevented them from living up to professional norms. Using Nancy Berlinger's “workarounds” framework, this paper examines health care workers' responses to the misalignment of their professional norms and the policy restrictions in their state. These findings suggest that the prenatal policies in each state raise ethical and professional challenges for the health care workers who implement them.

Original languageEnglish (US)
Pages (from-to)398-408
Number of pages11
JournalJournal of Law, Medicine and Ethics
Issue number3
StatePublished - Sep 1 2019
Externally publishedYes

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health Policy


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