We assessed whether eligible refugee claimants faced barriers to accessing prenatal care in the context of changes to Canadian health care policy that generated multiple categories of refugee health care eligibility. Methods. Prenatal care providers in Toronto were contacted twice using standardized scripts to book appointments for a pregnant non-refugee and refugee claimant, both eligible for prenatal care. Primary outcome: unequivocal offer of appointment. Secondary outcome: reasons for refusal of prenatal care. Results. There was a statistically significantly lower rate of offering prenatal care (34%) to refugee claimants compared with non-refugees (95%) (p <.001). Lack of knowledge, confusion about policies, time-consuming administrative requirements, and slow reimbursement processes were cited as reasons for refusal of care. Conclusions. Our results highlighted barriers to accessing prenatal care for refugee women. There are important future policy implications when considering the numerous changes to refugee health care policy in the last five years. © Meharry Medical College.

Refugee claimant IFHP Pregnancy Women’s health Refugee Health care policy Ontario health policy Prenatal Canada Underserved Toronto OTHP

refugee prenatal care health care policy human Refugees statistics and numerical data reimbursement Medical Audit clinical audit Humans Canada female pregnancy women's health Article Ontario adult outcome assessment Health Services Accessibility health care delivery