Patient Citizens, Immigrant Mothers: Mexican Women, Public Prenatal Care, and the Birth Weight Paradox

230 Pages·2011·1.156 MB·English

by  Alyshia Gálvez

Critical Issues in Health and Medicine
Edited by Rima D. Apple, University of Wisconsin–Madison,
and Janet Golden, Rutgers University, Camden
Growing criticism of the U.S. health care system is coming from consumers,
politicians, the media, activists, and health care professionals. Critical Issues in
Health and Medicine is a collection of books that explores these contemporary
dilemmas from a variety of perspectives, among them political, legal, historical,
sociological, and comparative, and with attention to crucial dimensions such as
race, gender, ethnicity, sexuality, and culture.
For a list of titles in the series, see the last page of the book.
Patient Citizens,
Immigrant Mothers
Mexican Women, Public Prenatal
Care, and the Birth-Weight Paradox
Alyshia Gálvez
Rutgers University Press
New Brunswick, New Jersey, and London
Library of Congress Cataloging-in-Publication Data
Gálvez, Alyshia.
Patient citizens, immigrant mothers : Mexican women, public prenatal care, and the
birth-weight paradox / Alyshia Gálvez.
p. cm. — (Critical issues in health and medicine)
Includes bibliographical references and index.
ISBN 978–0–8135–5141–8 (hardcover : alk. paper) — ISBN 978–0–8135–5142–5
(pbk. : alk. paper)
1. Women—Mexico—Social conditions. 2. Women immigrants—United States—Social
conditions. 3. Prenatal care—United States. 4. Childbirth—United States—Cross-cultural
studies. I. Title.
HQ1462.G35 2011
306.874(cid:2)30896872073—dc22
2011001050
A British Cataloging-in-Publication record for this book is available from the British Library.
Copyright © 2011 by Alyshia Gálvez
All rights reserved
No part of this book may be reproduced or utilized in any form or by any means, electronic or
mechanical, or by any information storage and retrieval system, without written permission
from the publisher. Please contact Rutgers University Press, 100 Joyce Kilmer Avenue,
Piscataway, NJ 08854–8099. The only exception to this prohibition is “fair use” as defined by
U.S. copyright law.
Visit our Web site: http://rutgerspress.rutgers.edu
Manufactured in the United States of America
For Lázaro, Elías, and Carlos, always

Contents
Acknowledgments ix
Chapter 1 Paradoxes and Patients: Immigrants and Prenatal Care 1
Chapter 2 Immigrant Aspirations and the Decisions Families Make 21
Chapter 3 Remembering Reproductive Care in Rural Mexico 49
Chapter 4 Becoming Patients: Birth Experiences in New York City 81
Chapter 5 Critical Perspectives on Prenatal Care 121
Chapter 6 Prenatal Care and the Reception of Immigrants:
Reflections and Suggestions for Change 147
Epilogue 166
Notes 171
References 181
Index 197
vii

Acknowledgments
This book has benefited by the generous input and support of a number of
colleagues and institutions. Of course, the errors that inevitably remain in
the text are mine alone. I had the opportunity to present grant proposals, the
research plan, and drafts of the manuscript in various settings. These opportu-
nities steered me away from many errors in direction and approach and also
gave me encouragement along the way.
Funding for the research described here was provided by PSC-CUNY
faculty grants and New York University’s University Research Challenge Fund.
In addition, a teaching fellowship in New York University’s Center for Latin
American and Caribbean Studies from 2005 to 2007 as well as a semester leave
from Lehman College in 2009 gave me the time, space, and resources I needed
to conduct research and write. I am grateful to the institutions that made the
research possible by offering institutional review or access to research sites or
both: Asociación Tepeyac de New York, City University of New York, Lehman
College of the City University of New York, Manhattan Hospital Center (a pseu-
donym), New York University School of Medicine, and New York University
Graduate School of Arts and Sciences.
Working groups and informal groupings of colleagues at the following
institutions read chapters, listened to me talk about my study formally and
informally, and with their comments and suggestions deeply enriched the
project. I extend thanks to the members of Body, Belief, and Bioethics, a work-
ing group chaired in 2005–2006 by Rayna Rapp and Faye Ginsburg of
the Center for Religion and Media, New York University; my cohort at the
2010 CUNY Faculty Fellowship Publication Program; and the faculty of
Sociomedical Sciences at the Mailman School of Public Health at Columbia
University. Talks at Brown, Rutgers, Syracuse, and Fordham universities,
the Graduate Center of CUNY, and the Universidad Iberoamericana de Puebla
brought this and my former research program together.
Many individuals contributed to this work in large and small ways. First
and foremost, I am grateful to the many women who sat with me and shared
their lives even while their children became bored and their babies fussed.
Although I sometimes won a smile from little ones with markers, snacks, and
games, this was poor compensation for stealing their mothers’ attention. The
generosity of the women and their families who participated in this study, even
ix
x Acknowledgments
while I offered them little in return, was moving and humbling. I am thankful
for the kind assistance of the following people who gave me access to field sites,
endured my annoying queries and requests, and offered sound guidance on the
formulation of my research questions: María Zúñiga Barba, Eric Manheimer,
Machelle Allen, the medical and ancillary staff at the hospital, Valeriana and
Patricia Pizarro, Kristen Norget, Teresa García, Megan Martin, Rosa María
Tellez, and Khiara Bridges. Valeriana holds a special place in our family’s
hearts for her healing work with our son while we were in Oaxaca. Manuela
Fuentes, Saúl Pacheco, their children and families in New York and in the state
of Puebla, including Moisés Fuentes, have been exceedingly generous and wel-
coming for years and my family deeply values their friendship: mil gracias por
la amistad y convivencia, los queremos. A special thanks to Monserrat Xilotl,
who gave so generously of her time and was incredibly helpful—having the
Mexican consul’s wife as a research assistant and valuable interlocutor was a
privilege I never expected and for which I am grateful.
Thanks are due to Marlie Wasserman, Peter Guarnaccia, and Pamela
Fischer for their enthusiasm about and commitment to the project at Rutgers
University Press, and to my editor there, Peter Mickulas, for his professional-
ism, humor, and patience.
Although we may presume teaching is for the benefit of students, I have
always found quite the opposite: that I learn far more from my students than
Icould ever offer to them. To the students who helped with this project, primary
thanks are due to Sandra Céspedes, whose expert transcriptions and formatting
assistance were key, and to Elizabeth Capone-Henríquez, who did tremendous
work on the bibliography and statistical sleuthing in the project’s early phases.
Karen Rojas Chávez did important formatting work at the end of this project.
Others who started out as students but have become friends and colleagues
and to whom I am grateful include Catarina Reiland, Eva Blom Raison, Maya
Vaughan-Smith, Miguel Angeles, Melissa Maldonado-Salcedo, and Laura
Rivera. The following Lehman College colleagues made helpful interventions
into my own political economy of scholarly production and also contributed
to an atmosphere of collegiality at key junctures: Laird Bergad, Ricardo
Fernández, Licia Fiol-Matta, Timothy Alborn, Milagros Ricourt, David Badillo,
Luisa Borrell, Victoria Sanford, Marlene Gottlieb, Marie Marianetti, Bertrade
Banoum, and Susan Markens. Colleagues and mentors at other institutions also
offered or participated in key opportunities to share and discuss the research
publicly and privately: Faye Ginsburg, Rayna Rapp, Jennifer Hirsch, Suzanne
Oboler, Anahí Viladrich, Aminata Maraesa, Diana Taylor, Margarita Alegría,
Elise Andaya, Leigh Binford, Nina Siulc, Sherine Hamdy, Marge Lunney,