Access to Highly Effective Contraception: Are Migrants from Mexico Leaving It Behind?

Joseph E. Potter, University of Texas at Austin
Celia Hubert, University of Texas at Austin

It is a remarkable, but not widely known, fact that access to highly effective contraception is far greater in Mexico than it is in the United States, especially for low-income women. It is also the case that access to contraception for the undocumented varies greatly across states in the US, especially between the two most important destination regions, California and Texas. In both states, migrants account for a significant share of all Medicaid births. In this paper, we note differences in the mix of contraceptives used by Mexicans in Mexico as compared to Mexicans in the United States, and contrast the long history of contraceptive provision in Mexico in the immediate postpartum period with the recent interest in such provision in the US. We also review the recent evidence on the extent of the frustrated demand for effective contraception on the part of the Mexican origin women in Texas, drawing on both qualitative and quantitative information collected in the course of our research. Finally, we comment on the unfortunate political influences that have led to the current situation whereby the undocumented are left out of virtually all of the programs or measures included in the Affordable Care Act (ACA) to extend the coverage of health insurance and increase access to contraception. In the absence of protection via the ACA, the contraceptive needs of undocumented women are left at the mercy of the vicissitudes of state politics and legislatures.