By Jonathan Westerfield

In the same way novelists often employ autobiographical themes in their tomes, researchers may also draw from their own life experiences in their work. And one associate professor of anthropology at the University of Texas at San Antonio easily traces her nascent experiences to her current research.

Jill Fleuriet, Ph.D., grew up in the Rio Grande Valley and as a child would visit Mexico with her family to shop. She recalls “this imaginary line that had very real geopolitical consequences. … By virtue of chance I was raised 10 miles north of that Rio Grande line, and I have a very different life than if I had been born 10 miles south of it.”

There was no chance involved when Fleuriet chose her field of study. With a focus on undocumented immigrants from Mexico and Central America, Fleuriet has set out to explore the factors that affect prenatal health. Research shows that the children of immigrants are as healthy or healthier than the children of citizens. This seems counterintuitive because women who are United States citizens generally have access to better prenatal care. If Fleuriet can discover more about why this phenomenon occurs, she said, she can not only help further the research of the medical community but also help inform the policy that regulates American health care.

Fleuriet began her research into health care needs of Hispanic people when she conducted her doctoral work at Stanford, where she used ethnography to analyze the health care needs of the Kumiai and Paipai people of Northern Mexico for her dissertation. At UTSA, Fleuriet has continued her work as a medical anthropologist, studying how health care systems are shaped by diverse cultural practices.

Most recently, Fleuriet has delved into the phenomenon of the “Latina Paradox.” The Latina Paradox is a phenomenon in which pregnant immigrants from Mexico or Central America have babies of equal or higher birth weight than their non-Hispanic white counterparts, even though Hispanic groups as a whole have disadvantaging factors, such as lower incomes and lack of formal prenatal care. After a few generations, the birth outcomes start to get worse for the offspring of Mexican and Central American immigrants, Fleuriet finds. Low birth weight is linked to a host of health problems such as bleeding in the brain and respiratory distress syndrome and may lead to an increased risk of high blood pressure, Type 2 diabetes and heart disease in adulthood.

When Fleuriet went into the field to research this phenomenon, she conducted a sequence of studies that employed quantitative and qualitative techniques and released a series of papers on her findings. One of the notable aspects of her findings is that there is not a unified cultural response as to how Hispanic women want to cope with their pregnancies. While she found that for some women, there is indeed the desire to be close to the nucleus of the family and to gather support from their familial community, for others, the exact opposite is true. They neither need nor expect their families to be a large part of their pregnancy. In her ongoing research, Fleuriet intends to conduct more interviews and closely investigate the diversity that exists in this cultural group.

Fleuriet wants her research to “be part of a larger work that affects policy.” She points out the women she has studied are undocumented immigrants to the U.S. and receive prenatal care because Texas policy defines the unborn children as U.S. citizens.

Debate on the national level about immigration is a continuous topic and Texas’ position on the issue provides an interesting wrinkle. According to the 14th Amendment of the United States Constitution, anyone born in the United States is automatically a U.S. citizen. Recent debates about immigration policy have prompted some politicians to propose the abolition of the amendment. The issue has attracted national attention again just a couple weeks ago, as California officials closed a house that served as a center for pregnant Chinese tourists who came to the U.S. to give birth so their progeny will have all the rights of U.S. citizens.

The statement Texas makes in granting rights to unborn children is larger in scope than a mere discussion about laws concerning citizenship. Fleuriet said the state allowed prenatal care to undocumented immigrants in 2007 as an extension of the state Children’s Health Insurance Program, “not because the women were considered deserving of publicly funded care, but because their fetuses were unborn citizens.”

“It’s tragic but fascinating. This idea of who’s a citizen, what a citizen means,” Fleuriet said. “Who’s a person? When do they become a person? [It] directly impacts what kind of prenatal care you get and when you get it.”

Prenatal care is a complex issue not easily divided by traditional political lines. David Warner, Ph.D., who is a professor of health and social policy here at UT-Austin’s LBJ School of Public Affairs, said of the legislation, “It is a policy area in which both women’s reproductive rights advocates and right-to-lifers come together for rather different reasons. And it provides insurance coverage to a population that would generally be unable to pay.”

Ultimately, policymakers and political groups are not the only parties involved in the prenatal care discussion. In her recommendations, Fleuriet notes, “an existing model is offered by the promotora, or community health care worker programs. Promotoras are community women who are trained in health and health care education; they meet with individual women in the neighborhood, offer meetings about health and health care issues and serve as point-persons for outreach efforts by clinics.” These observations about the relationship between community and policy are only a small part of the admittedly large and infinitely important research on which Fleuriet continues to labor.

Just as the prenatal period is a formative time that shapes later human life, Fleuriet’s current research interests stem from her formative years growing up near the Texas-Mexico border.

“I’ve always been fascinated by health,” she said. “I’m the kid who also liked to learn about disease. I’m the kid who always wanted to hear about people with illness stories. My family gives me giant microbe stuffed animals for Christmas. It’s a long-standing interest.”