Effects of preconception counseling on maternal health care of migrant women in China: a community-based, cross-sectional survey

Abstract

BackgroundMigrants have long been a disadvantaged group in China’s health care system, especially in terms of maternal health care. Many studies have explored the factors associated with a lack of maternal health care and found many determinants, including social, economic, behavioral, and environmental factors. However, studies focusing on factors associated with maternal health care have rarely examined preconception counseling (PCC). This study explored factors related to PCC uptake among migrant women, and investigated the association between PCC and maternal health care in migrant women.MethodsA community-based cross-sectional study was conducted from July to December 2011, in Nanhai, Guangdong Province, and Pinghu, Zhejiang Province, China. A total of 1,012 migrant women who had their most recent pregnancy within 1 year of the survey answered a standardized interviewer-administered questionnaire about maternal health care. Descriptive statistics and multivariable logistic regression were used to analyze the data.ResultsOnly 208 (20.6%, 95% confidence interval [CI]: 18.1–23.1%) of 1,012 migrant women had received PCC. Younger age, having more than one child, lack of knowledge of maternal health care and inter-province migration were predictors of a lack of PCC. PCC was associated with higher consumption of folic acid supplements during the preconception period (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.66–4.23). Among migrants who were resident in Nanhai or Pinghu for less than 5 years, PCC was related to better quality prenatal care (AOR = 3.07, 95% CI: 1.79–5.24).ConclusionsThe prevalence of PCC among migrant women was low (20.6%, 95% CI: 18.1–23.1%). Positive associations were found between the receipt of PCC and preconception folic acid supplements and quality prenatal care. Future studies focusing on maternal health care should pay attention to PCC and explore the effects of PCC on maternal health care through intervention studies. Continued efforts to increase PCC in migrants should target specific age groups (20–24 years), families with more than one child, and women who have migrated between provinces, as well as provide in-depth knowledge of maternal health care.

Effect of social integration on childbirth return among internal migrant pregnant women: a nationally representative study in China

“…The rapid expanding of migrant population scale promotes economic prosperity, but also brings a number of public health issues, including problems in infectious diseases, childhood immunization, mental health, maternal healthcare etc. [ 2 – 5 ] In the past decades, with the emergence of “family migration style”, more and more fertile women outmigrated with their husbands, and the number of migrant fertile women is on the rapid rise, accounting for over 30% of the total migrant population [ 6 , 7 ]. Consequently, migrant maternal healthcare use is an important issue deserves attention.…”

Antenatal care use and its determinants among migrant women during the first delivery: a nation-wide cross-sectional study in China

“…At the same time, with the gradual emergence of the “family migration style (families migrate together)”, more and more women migrated with their husbands. Migrant childbearing women account for about one-fourth of the national married women [5, 6]. As a consequence, the number of migrant women who use maternal basic public health services in the inflow areas is also on the rapid rise.…”

Mobility patterns and associated factors among pregnant internal migrant women in China: a cross-sectional study from a National Monitoring Survey

“…In 2012, the number of domestic migrants in China was approximately 236 million [ 25 ]. Pregnant migrant women’s health, which relates to the health of two generations, should thus be a focus of attention; however, there is still a gap between health care provision for pregnant migrants and those for local household–registered populations, as well as in health care utilization between them [ 43 , 44 ]. Given this background, the results of this study should remind maternal health service providers to pay more attention to the increasing number of pregnant migrant women spending most of their pregnancy and/or giving birth in receiving areas.…”

“…Given this background, the results of this study should remind maternal health service providers to pay more attention to the increasing number of pregnant migrant women spending most of their pregnancy and/or giving birth in receiving areas. Maternal health resources should be allocated with consideration to the size and shifting trends in this population, especially for those who are inclined to stay in receiving areas during most or all of their pregnancy and those who choose receiving areas as delivery locations (who are in general also those who have their own housing, those migrating on only a small scale, those with longer migration time, and those with a strong will to integrate), since more attention has been paid to the size and demands of the household registered population to date [ 43 , 44 ] . For younger women without their own housing , with a cross-province or cross-city migration range , and who have high mobility during pregnancy (MR and MS), the integrity and continuity of medical records between sending and receiving areas need to be improved (remembering that medical record systems are a general challenge for the efficiency of health care in many developing countries [ 45 , 46 ]).…”