A preliminary study of reproductive outcomes of female maquiladora workers in Tijuana, Mexico.

Maquiladoras are plants on the Mexican side of the United States-Mexico border which are used largely by U.S. manufacturers to assemble premanufactured parts. We examined reproductive outcomes of women employed in electronics (N = 120) and garment (N = 121) maquiladora work compared to women employed in the service sector (N = 119) in Tijuana, Mexico. Women recruited by community health workers were interviewed about their reproductive history, sociodemographic characteristics, health behaviors, and characteristics of their current job. Length of regular menstrual cycle in the past year as well as time of conception and rates of fetal loss in the most recent pregnancy were similar across occupational groups. However, infants of garment maquiladora workers were 653 g lighter (95% confidence interval [CI]: -1,041 g, -265 g) and infants of electronic maquiladora workers were 337 g lighter (95% CI: -682 g, 9 g) than infants of service workers after adjusting for potential confounders. The cause of these differences remains unclear.

[Maquiladoras and women on the US-Mexican border: a benefit or a detriment to occupational health?]. / Maquiladoras y mujeres fronterizas: beneficio o daño a la salud obrera?

This article examines the impact of work conditions on the health of women working in assembly plants known as "maquiladoras". A sample of 480 women residing in Tijuana and with similar low socioeconomic conditions was studied. The sample included 120 electronics workers, 120 textile workers, 120 service workers and 120 women with no history of labor-force participation. These groups were compared on physical and psychosocial health outcomes, including depression, nervousness, functional impediments and sense of control over life. Data were obtained from interviews conducted in the communities where workers reside. Although high levels of depression and a low sense of control over life was observed, maquiladora workers--particularly in the electronics industry--suffered less functional impediments and nervousness than service workers. However, maquiladora workers were at higher risk of delivering infants of low birthweight.

Giving birth across the border: the San Diego-Tijuana connection.

Large immigration flows of young Mexican women to the U.S.-Mexico border are increasing the demand for maternity services in the Southwest. To date no attempt has been made to determine how U.S. births are distributed among stable, permanent residents and transient migrants, such as border residents of Mexico who enter the U.S. temporarily, yet long enough to use health services. This exploratory study examines factors associated with childbirth in California by border residents of Tijuana, Mexico. Data on 184 women, 15-44 years old, who gave birth between 1982-87, were examined using a household survey and focus group discussions. The findings indicate that 10.4% of the sample crossed the border to give birth in the United States. Socio-economic and legal status, spoken English proficiency, history of U.S. residency, annual visits across the border, single parenthood and primiparity were factors significantly associated with childbirth in the United States. These factors, in addition to social class differentials in attitudes towards U.S. obstetrical care and citizenship-by-birth need to be examined in future studies of cross-border utilization of services. The findings also demonstrate that most U.S. deliveries were in the private sector and paid for out of pocket, representing a very low public health burden. Changes in Medicaid legislation, which have extended maternity care coverage to the undocumented, may encourage deliveries in the public sector. These effects, coupled with the bridging effects that newly legalized immigrant networks exert on friends and relatives, familiarizing them with U.S. health care resources, will require monitoring to determine changes in demand for U.S. maternity care by this population.

Measuring Tijuana residents' choice of Mexican or U.S. health care services.

There is growing concern that the indigent health care burden in the southwestern United States may be caused partly by Mexican residents who cross the border to use U.S. health services. This article describes the first attempt to measure the extent of this use by border residents. It also compares factors associated with their use of health care services in both the United States and Mexico. Data were obtained from a household survey conducted in Tijuana, Mexico, near the California border, using a random, stratified analytic sample of 660 households that included a total of 2,954 persons. The dependent variables--extent and volume of contacts with health professionals--were examined according to sociodemographic characteristics, insurance coverage, payment modality, type of visit, and health care setting. The results indicate that 40.3 percent of the Tijuana population used health services exclusively in Mexico during a 6-month period, compared with only 2.5 percent who used services in the United States. Of the Mexican users of U.S. services, the largest proportion appeared to be older people, lawful permanent residents or citizens of the United States who are living in Mexico, and persons from high- or middle-income sectors. In addition to the low level of use of U.S. health services, the findings show that more than 84 percent of the visits were to providers in the private sector and, for 59 percent of the visits, a fee for services was implied. Overall, this border population does not seem to be a drain on the U.S. public health system. The findings must remain tentative, given some methodological constraints of the study; they point to the need for further assessments of the demand for specific services by distinct segments of the border population. Furthermore,since health care financing is a critical issue for Mexico as well, more studies are needed that examine the behavior of U.S. residents who use Mexican health services.

Occupational health risks for Mexican women: the case of the maquiladora along the Mexican-United States border.

International reports of morbidity among female workers in Mexico's border zone have raised concern about the occupational health of female workers in maquiladora plants (foreign-owned border industries with special tariff benefits). Commentators have suggested that U.S. industries may be exploiting workers by transferring work to nations with less stringent health and safety regulation through the maquiladora program. Using data from a larger evaluation of the effectiveness of Project Concern and a specially developed questionnaire, this study investigated the extent to which female workers reported higher morbidity rates than women with other employment and women not employed outside the home in seven colonias (communities) in Tijuana, Baja California, Mexico. Results showed essentially no difference in many short-term self-reported symptoms of illness among maquiladora workers and two other groups. Women who worked exclusively in the home reported the greatest number of symptoms. These results suggest that additional primary care services may be needed for women who have primarily domestic responsibilities. Additional research is needed to assess the risks for long-latency morbidity.

[Opinion profile and use of maternal-child health services in Tijuana]. / Perfil de opinión y uso de servicios de salud materno-infantil en Tijuana.

PIP: A nonrepresentative sample of 207 women aged 15-35 living in the city of Tijuana were surveyed in 1985 to determine attitudes toward maternal and child health in a Mexican border city. The women were stratified by neighborhood of residence and housing type. 65 were classified in the upper, 80 in the middle, and 62 in the lower socioeconomic strata. 60% of the women surveyed had migrated to Tijuana. They represented 22 Mexican states of origin, not counting other parts of Baja California. 80% lived in extended families and the average household size was 5 persons. 56.5% were married. 51 were economically active, with proportionately more upper status women employed. The average educational level was 8.8 years. 21.5% were students at the time of the survey. 6.3% of the births to upper stratum women, 8.2% to middle stratum women, and none to lower stratum women occurred in the US. 72.3% of upper stratum women, 82.5% of middle stratum women, and 88.7% of lower stratum women stated they preferred birth to occur in Mexico. 27.7% of upper stratum, 17.5% of middle stratum, and 9.7% of lower stratum women would prefer to give birth in the US. The reason most commonly given for preferring birth in the US was superior medical attention. 80% of the births in Mexico were in private hospitals and the rest in public. The upper stratum women had the most prenatal visits and the smallest families. 20% of the middle and lower strata women who had ever been pregnant received no prenatal care. Middle and lower strata women were less informed about the importance of prenatal care. Traditional beliefs about pregnancy and the perinatal period were strongest among middle stratum women. Upper status women were the most likely to enter the US for short visits. 1/3 of middle status women and 70% of lower status women reported they never entered the US, primarily because they lacked documents. Lower stratum women tended to seek medical care late in pregnancy. Home remedies and the advice of relatives and neighbors constitute an option for prenatal care for these impoverished women. The tradition of breast feeding on demand is apparently being lost among women in Tijuana. 34% of the mothers declared they had never breast fed a child, and most of the rest discontinued breast feeding after a very short time. 53% of the 187 women who reported they were sexually active did not use contraception. 19% used oral contraceptives, 14% used IUDs, and 5% were sterilized. Although study results showed that socioeconomic status was related to the use of prenatal and obstetric services, there were no significant differences among socioeconomic groups in infant feeding or family planning practices.^ieng