Poster Session 3
Jecca R. Steinberg, MD, MSc (she/her/hers)
Maternal Fetal Medicine Fellow
Northwestern University Feinberg School of Medicine
Chicago, IL, United States
Hebron Kelecha, MD, MPH
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Madeline F. Perry, MD
University of Pennsylvania
Chicago, IL, United States
Nivedita Potapragada, MBA, MD
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Allie Valenzuela, MD, MPH
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Erica O'Neill, MD
Stroger Hospital Cook County
Chicago, Illinois, United States
Ashish Premkumar, MD, PhD (he/him/his)
Assistant Professor
Biological Sciences Division, University of Chicago
Chicago, Illinois, United States
Lynn M. Yee, MD, MPH (she/her/hers)
Associate Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Health-harming legal needs (HHLN) comprise social barriers to health best addressed through medical-legal collaboration. The objective of this analysis was to understand patient perspectives and experiences with HHLN in pregnancy and postpartum.
Study Design:
Forty-eight obstetric patients (94% pregnant, 6% postpartum), aged 19-39 years, participated. Twenty participants (42%) identified as Black, 26 as Latine (54%), and 2 as white (4%). All but two participants had public insurance (67%) or were uninsured (27%). In interviews, when asked generally, 92% of participants denied having HHLN. However, 70% of all participants screened positive in the HHLN survey, and when queried about HHLN domains, 95% described obstetric-specific HHLN (Figure). The majority of participants (77%) experienced two or more HHLN, while few faced only an isolated HHLN or none (Figure). The most prevalent obstetric HHLN related to employment (e.g. pregnancy-related workplace discrimination), poor access to public benefits, or substandard housing (Table). Participants described limited options for recourse when HHLN negatively affected their pregnancies (Table).
Conclusion:
HHLN burdened nearly all low-income obstetric patients in this study, but most did not realize they had unmet legal needs. Evidence-based interventions are needed to increase awareness of obstetric HHLN and protect pregnant people from the obstetric consequences of HHLN.