Massachusetts

Fertility, Social Services, and Immigration

The fertility rate of 1.7 births per woman is among the lowest in the nation, but similar to other New England states. Age at first birth is high, consistent with other northeastern states as well as high educational attainment. Fertility and births to unmarried women are highest among black and Hispanic women.

Massachusetts does not have provisions for paid family leave. More than 60 percent of Massachusetts mothers with children under 5 are employed. One-fifth of infants and toddlers are in center-based care, more than a quarter are cared for by a relative, and a parent cares for more than one-third.

Low-income families are eligible for state-funded health insurance, Temporary Assistance for Needy Families, the Women, Infants, and Children (WIC) nutrition program, and food stamps. Female heads of household with children under 18 comprise 7.3 percent of families, and more than 20 percent live [Page 693]in poverty. Nearly a third of immigrant households are female headed.

About 23 percent of immigrant families live below the poverty line, three times the rate for native-born families. Immigrant families are the fastest-growing segment of the population, with most coming from Europe, the Caribbean, Latin America, and Asia. As of 2004, one in seven Massachusetts residents was foreign-born, with Portugal the most common birthplace, followed by the Dominican Republic and Canada. Of immigrants who arrived from 200004, 47.3 percent came from Latin America or the Caribbean, and 23.1 percent from Asia. From 2000 to 2003, 19 percent of immigrants were Brazilian. Spanish and Portuguese are the most common world languages spoken at home. Many Hispanics combine use of traditional medicine with modern medical approaches. In Hispanic communities, healers (curaneras and espiristas) practice traditional medicine, and many Hispanic pharmacists are familiar with traditional cures. Hispanic cultural tradition dictates that the husband wait until after the delivery to see the mother and child. Many Hispanic women want their mothers to be with them in labor.

Health Care and Birth Control

Massachusetts had one of the lowest maternal mortality rates in the nation even prior to 2006, when health reform required that all residents obtain health insurance. State subsidies are available to low- and middle-income residents. Eighty-three percent of women receive adequate prenatal care, with public funding a contributing factor. Massachusetts law requires health maintenance organizations and insurance companies providing pregnancy-related benefits to cover medically necessary costs of infertility diagnosis and treatment. The divorce rate is the lowest in the nation at 2.2 percent, possibly due to the large Catholic population. Many observant Catholics, including Hispanics, adhere to the Church's position against any birth control, except the rhythm method. Almost 90 percent of women in union use birth control, which is available to minors without restriction. Unmarried women under age 18, however, must obtain parental or judicial consent to have an abortion.

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