To explore the sexual and reproductive health (SRH) behaviors, health insurance coverage, and use of SRH services of women in the United States (U.S.) by nativity, disaggregated by race and ethnicity.

We analyzed publicly-available and restricted data from the National Survey of Family Growth to assess differences and similarities between foreign-born and U.S.-born women, both overall and within Hispanic, non-Hispanic (NH) white, NH black, and NH Asian groups.

A larger proportion of foreign-born women than U.S.-born women lacked health insurance coverage. Foreign-born women utilized SRH services at lower rates than U.S.-born women; this effect diminished at the multivariate level, although race and ethnicity differences remained. Overall, foreign-born women were less likely to pay for SRH services with private insurance than U.S.-born women. Foreign-born women were less likely to use the most effective contraceptive methods than U.S.-born women, with some variation across race and ethnicity: NH white and NH black foreign-born women were less likely to use highly effective contraceptive methods than their U.S.-born counterparts, but among Hispanic women, the reverse was true.

Our findings demonstrate that the SRH behaviors, needs, and outcomes of foreign-born women differ from those of U.S-born women within the same race/ethnic group.

This paper contributes to the emergent literature on immigrants in the United States by laying the foundation for further research on the SRH of the foreign-born population in the country, which is critical for developing public health policies and programs to understand better and serve this growing and diverse population.