A woman we'll call Patricia is making an early dinner for her boyfriend and son on a cold afternoon in Minneapolis. We agreed not to use her real name because she came to this country illegally from Mexico. Patricia is four months pregnant and she's not even showing. Her doctor says she's under-weight. Her diet includes dishes she grew up with.
"Nobody told me that the Mexican cheese I eat could be bad. I didn't know," says Patricia. "I had heard eating spicy peppers was bad because it affects the baby. It's just that my stomach won't take any food that doesn't have at least a little bit of spice in it."
This is her second pregnancy in the United States. She miscarried her first pregnancy earlier in the year and she doesn't want that to happen again. During her first pregnancy, she didn't seek prenatal care at all. She was afraid she would be reported if her doctor knew she was in the country illegally. But now Patricia is seeing a doctor and she's learning how to take care of her baby and herself. She recently got health insurance through a state program, even after her first attempt to register didn't work out.
"Even my husband said, 'How are you going to be eligible for health insurance?' We didn't know I could be, since we don't have family here and we didn't know how anything works." Patricia's story is common among immigrant Latinas who get pregnant in this country. Language can get in the way of finding out what resources are available, and when women do learn about services, they're afraid to seek them out. Immigrants who are in the state illegally are not eligible for most public assistance health care and welfare services, but emergency and pregnancy services are available to all regardless of immigration status.
Officials at the Minnesota Department of Health have met with the Catholic ministry to teach them how to connect women like Patricia to prenatal and social services.
That relationship began when Father Jose Santiago, a pastor at Holy Rosary Parish in southeast Minneapolis, noticed something was going on among the mothers at his church.
"Since I arrived here in January of 2005, I started realizing that I was doing a lot of services for babies who had died prematurely, a lot more than I had experienced in my seven years in Denver," says Santiago. "I would say almost weekly I see either fetal mortality or infant death."
Santiago is just one of several in the Catholic community who alerted the health department about the fetal and infant deaths they were seeing.
Cheryl Fogarty, the infant mortality consultant at the health department, met with Santiago and other church members. She says priests were mostly talking about fetal deaths they had seen in late 2004 and early 2005. Fogarty says the department won't have more recent data until January. But the numbers the health department has through 2002 shows fetal death rates have increased, while infant mortality rates are stable.
No one has figured out exactly why Latina women are experiencing these fetal deaths. Fogarty says it's possible many factors are at play, including diabetes, poor diet, harsh working conditions and problems at home, like domestic violence.
"The population has grown dramatically in the recent years," says Fogarty. "So the priests are seeing more deaths because they are seeing more families in their Latino populations. And these are younger, child-bearing age families."
Fogarty says the department sees higher rates of late or no prenatal care among Latinas. She says in some respects, their outcomes are pretty good considering the barriers they face.
More than 20 medical, community, and religious organizations are collaborating in the effort to connect Latinas to health care access. Father Jose Santiago says churches are even applying for grants to educate all of their church members on health issues.
"We're trying a program where we have a health coordinator within different churches, because that's where a big number of undocumented do come without fear, without any sense of being penalized and discriminated against, and where they understand their language," says Santiago.
The health department and Santiago agree that churches are among the best avenues to connect women, like Patricia, with health care access and services. They hope doing so will improve fetal and infant mortality rates among Latinas, just as they've improved for African-Americans and Native Americans.