Exploring Exclusionary and Fragmented Healthcare Access for Undocumented Women Immigrant Survivors of Intimate Partner Violence

Background and Purpose: Intimate partner violence (IPV) is a salient public health problem with broad social work practice and policy implications. However, few studies examine how the lack of access to healthcare services for undocumented immigrants creates a burgeoning yet insufficiently addressed health challenge particularly when seeking services to address the IPV health effects. This paper focused on racialized Latinx mixed-status immigrant families in which at least one child is a U.S. citizen and the caretaker parent is living in the U.S. without legal authorization. This study investigated Latina immigrant mothers’ IPV survivorship experiences with an emphasis on the women’s health effects and the healthcare response. The research questions were: 1) What were the physical, reproductive, and mental health effects women experienced from the violence? and 2) How did the women’s immigration status, social class, gender, and ethnicity influence the response they received from healthcare services?

Methods: This qualitative study represented data from a purposive sample of 20 Latina immigrants living in Washington State and recruited from a program that served immigrant IPV survivors. Two in-depth semi-structured interviews were conducted with each participant. Sixteen women migrated from Mexico, two from El Salvador, and two from Guatemala. Participants had experienced a range of violent behavior including physical, sexual, and emotional abuse. Attention was given to their interactions with informal social support networks (e.g. friends, family) and formal help-seeking efforts (e.g. going to the hospital) to illustrate their intersectional process as it pertains to their healthcare accessibility. Thematic analyses were conducted via a collaborative and iterative coding process of the interview transcripts.

Results: The women experienced a series of barriers when accessing healthcare after an altercation with their ex-partners. Their health-related challenges were associated with their undocumented immigrant status as well as living in under-resourced communities. They faced stigma within their own social support networks specific to mental healthcare, insecurity as to how their immigration status will be used by service providers, and economic limitations in affording healthcare. The women reported physical, reproductive, and mental health consequences from IPV such as depression, anxiety, miscarriages, pregnancy complications, physical injuries, and chronic health conditions that persisted years after they left their abusive partners. Nonetheless, women leveraged their faith communities and local community clinics to access healthcare for themselves and their children.  

Conclusions and Implications: This inquiry addressed compelling health and social welfare concerns that arise for undocumented Latinx immigrant IPV survivors who continue to be racialized and to live in economic deprivation within the U.S. Their experiences were situated in a political context inundated with anti-immigrant sentiments. IPV survivors experience life-long health effects; yet, for women with an undocumented status, there were unique barriers to seeking healthcare that social workers need to actively play a role in to reframe and redefine who is deserving of healthcare services. Implications for social work practice and policies require that we take a culturally-responsive look at unintended consequences that exclude undocumented individuals and the bureaucratic screening tools that block access to care for mixed-status immigrant families.