Nursing Research and Practice Jackie explained the complicated situation surrounding pregnant migrant women. There are no laws regarding pre- gnancy and the H-2A visa program—women are not screen- ed for pregnancy upon entering the country, and there are no consequences if a woman becomes pregnant during her contract. In fact, farmworker women are protected, as are American women, from being laid oﬀ because of their pregnancy. This results in women working under very chal- lenging conditions during pregnancy, and yet as long as they continue to do so, their hours cannot be limited by employers. In addition, under the conditions of the H-2A contract, the woman must work and be paid for at least 75% of the time, and so taking the time oﬀ to obtain prenatal care may be especially diﬃcult. Jackie explained how state-funded programs in Georgia impact pregnant farmworker women. In the state of Geor- gia, pregnant farmworker women, whether documented or authorized to work, do not qualify for publicly funded healthcare in the USA (Medicaid). Emergency Medicaid is available to cover the delivery of pregnant farmworker women; however, their only prenatal care option is to enroll in a state-funded program, “Babies Born Healthy.” This pro- gram is commonly underfunded by the state legislature, leav- ing women without access to prenatal care during the last few months of the ﬁscal year when funds have been expended. While a farmworker’s baby will be an American citizen when born in the United States, and thus entitled to state-spon- sored programs, his/her mother is not entitled to any beneﬁts under federal law. Additionally, there is a limited access to abortion among farmworker women. They would be requir- ed to pay out of pocket and also travel a long way to obtain an abortion. Jackie described a case where a 21-year-old woman had received no prenatal care. The father of the baby left as soon as she became pregnant. For the ﬁrst 4 weeks after the child was delivered, she did not understand what was wrong with her baby and brought the newborn to the clinic. “She came in and sat down in my oﬃce. . .and she said, why is my baby’s head so big?. . .Does my baby have a brain?” Jackie took the young mother and child to the pediatrician, who referred her to a specialist at Children’s Medical in Atlanta. Finding a specialist who would accept this child as a patient was challenging, as the child’s Medicaid coverage was still pending. The child was seen and was determined to have no brainstem. While Jackie discovered that this diagnosis had been made at birth, the young woman did not understand the meaning of the diagnosis or the choices she would have to make as a result. The young woman had received no prenatal care during her pregnancy. This young mother had come to Georgia on an H-2A visa, but overstayed it, making her current status undocumented. She had to move out of the barracks once she gave birth, and was living in a trailer with several other people, sleeping on a mattress on the ﬂoor. In order to qualify, women must have photo identiﬁca- tion. According to Jackie, many undocumented women in Southern Georgia obtain false identiﬁcation using a name that is not their own. This presents a problem at delivery, when the wrong name might go on the birth certiﬁcate of the child. If the woman wants to return to Mexico with her 5 child, unfortunately the only recourse is to obtain a DNA test in order to change the child’s name, which is very expensive. Just as the woman might have had to be smuggled across the border to work in the United States, she may have to smuggle her own child back across the border. Jackie described the way that this can occur—the mother might pay another woman to use her baby’s birth certiﬁcate. In addition to the challenges of providing prenatal care to farmworker women, there is also the challenge of getting women to utilize prenatal care. They still have to pay for a portion of it that is signiﬁcant in their overall income; at the Riverbend Clinic, it is $300 for prenatal care, charged at the ﬁrst visit. Women have often seen their mothers and aunts go without prenatal care, and many wonder if it is a worthwhile expense. Access to health care includes not only physical access, but also whether health care is culturally and linguistically accessible to farmworkers. Another of Jackie’s stories illust- rates the cultural divide between migrant farmworkers and the American social welfare program. A Department of Family and Children’s Services (DFCS) worker made a home visit to a young Guatemalan woman’s home. The DFCS worker was getting very frustrated with the young mother and asked the woman what the baby had eaten that day. Jackie saw the pot of caldo, a traditional broth made from the meat of bones and fed to children, on the stove, and already knew the answer. She opened her cabinet and found that it was full to the brim with baby cereal, which she had never opened because she never understood what to do with it. The DFCS worker also insisted that the young woman obtains a crib for the safety of her child. “Well, when we came the next time, she very excitedly met us at the door and told me to tell her, “I have a crib.” Well, I was excited too. I said, “Oh, she has a crib” and so she’s telling us to come, come with her, come with her, so we’re following her to the back of the trailer and we get back there and what again, it’s about paradigms, what you and I would see as a closet, this young girl saw as her room and she was very excited because she had been able to recall how her mother had created cunas [cradle] by creating this sling- type thing that the baby slept in. Almost like a hammock. . . And so to her, she had done exactly as she was taught. She had got a cuna, and the DFCS worker, before I could do anything, began ripping it out and just screaming at the top of her lungs about the baby being in a closet and the girl had absolutely no connotation of closet. Her home didn’t have closets in Guatemala, you know, just like 100 years ago our houses didn’t have closets and so she was devastated. She was crying. The baby was crying. The DFCS worker was yelling.” While the young mother was proud of herself for fulﬁlling the requirements of the DFAS worker and providing for her child, her concept of the cuna, or cradle, did not align with the American crib envisioned by the DFCS worker. Rather than supporting this mother’s attempts to be a loving