Abstract
BackgroundThere is a very large population of internal migrants in China, and the majority of migrant women are of childbearing age. Little is known about their utilization of prenatal care and factors that influence this. We examined this using data from a large national survey of migrants.Methods5372 married rural to urban migrant women aged 20–34 who were included in the 2014 National Dynamic Monitoring Survey on Migrants and who delivered a baby within the previous two years were studied. We examined demographic and migration experience predictors of prenatal care in the first trimester and of adequate prenatal visits.Results12.6% of migrant women reported no examination in the first trimester and 27.6% had less than 5 prenatal visits during their latest pregnancy. Multivariate analysis indicated that demographic predictors of delayed and inadequate care included lower educational level, lower income and not having childbearing insurance. Migrating before pregnancy, longer time since migration, having migrated a greater distance, and not returning to their home town for delivery were correlated with better prenatal care.ConclusionsMany internal migrant women in China do not receive adequate prenatal care. While internal migration before pregnancy seems to promote adequate prenatal care, it also creates barriers to receiving care. Strategies to improve prenatal care utilization include expanding access to childbearing insurance and timely education for women before and after they migrate.
Highlights
There is a very large population of internal migrants in China, and the majority of migrant women are of childbearing age
Women who had not yet migrated at the time of their pregnancy were excluded from analyses that included variables that did not apply to them at the time they were pregnant: geographic spread of migration, whether they stayed at their home town during pregnancy, and time since migration
Sample composition The sample consisted of 5372 married rural-to-urban migrant women, 48.6% of whom were aged 25–29 years, 92.6% had at least a middle school education, 75.8% migrated from central or west China, 72.7% had only rural medical insurance, 78.8% had migrated before this latest pregnancy, and 50.2% had monthly household per capita income of 1000–2000 CNY (Table 1)
Summary
Setting China has a longstanding household registration system under which official place of residence is based on place of birth and can only be permanently changed under certain limited circumstances with official permission. Rural health insurance does not directly cover services outside their home towns In some circumstances, they can pay out-of-pocket for health care in their receiving communities and submit bills for reimbursement, but the process is cumbersome and reimbursement rates are incomplete and variable. Data source This study examined a subsample of the 2014 National Dynamic Monitoring Survey on Migrants This large national survey has been conducted every year since 2009 by the China Population and Development Research Center of the National Health and Family Planning Commission (CPDRC). Women who had not yet migrated at the time of their pregnancy were excluded from analyses that included variables that did not apply to them at the time they were pregnant: geographic spread of migration, whether they stayed at their home town during pregnancy, and time since migration
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