Temporary childbirth migration and perinatal healthcare in rural Maharashtra, India

Introduction: Maternal health in rural India has improved due to national initiatives, but inadequate healthcare provision persists across most sociodemographic groups. The connection between perinatal care and the widespread practice of Temporary Childbirth Migration (TCM)—returning to one's n...

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Main Authors: Rachel Murro, Alison M. El Ayadi, Rutuja Patil, Dhiraj Agarwal, Sanjay Juvekar, Juliana Kim, Nadia G. Diamond-Smith
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Journal of Migration and Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666623525000212
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author Rachel Murro
Alison M. El Ayadi
Rutuja Patil
Dhiraj Agarwal
Sanjay Juvekar
Juliana Kim
Nadia G. Diamond-Smith
author_facet Rachel Murro
Alison M. El Ayadi
Rutuja Patil
Dhiraj Agarwal
Sanjay Juvekar
Juliana Kim
Nadia G. Diamond-Smith
author_sort Rachel Murro
collection DOAJ
description Introduction: Maternal health in rural India has improved due to national initiatives, but inadequate healthcare provision persists across most sociodemographic groups. The connection between perinatal care and the widespread practice of Temporary Childbirth Migration (TCM)—returning to one's natal home for delivery and the postpartum period—remains unexplored. Methods: Cross-sectional data on migration and health visits were collected from a sample of 1288 women in the Vadu Health and Demographic Surveillance Site (HDSS) (Western Maharashtra) who gave birth in 2018–2022. Childbirth migration (exposure) was analyzed in three ways: binary (any migration), continuous (duration of stay), and multidimensional (duration of stay and change of provider). Outcomes included number of health visits – both facility check-ups and home visits by community health workers – and early antenatal care initiation. Multivariate poisson, negative binomial and logistic regressions were used. Sensitivity analyses checked for recall bias, the influence of migration distance, and model misspecification. Results: Migrators and non-migrators had similar outcomes in early antenatal care initiation, facility visits (before and after pregnancy), and prenatal community health worker visits. Migrators had fewer postnatal community health worker visits (IRR = 0.80; 95 % CI 0.70–0.92). Among migrators, longer natal village stays were associated with fewer community health worker visits in the prenatal period (IRR = 0.92; 95 % CI 0.88–0.96) but not postnatally (IRR = 1.03; 95 % CI 1.00–1.07). Women who switched to a new provider upon arriving in their natal village had fewer facility-based prenatal (IRR = 0.86; 95 % CI 0.78–0.96) but more postnatal visits (IRR = 1.41; 95 % CI 1.06–1.87), regardless of how long they stayed. Conclusion: For women who return to their natal home for childbirth, duration of stay and changing providers upon arrival are linked to differences in receipt of maternal healthcare. Increased attention to the needs of mobile women during the perinatal period is necessary to ensure they can participate in key birth customs while receiving adequate healthcare.
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spelling doaj-art-0b36fd108fe64ee6a3daa8f78a6e7f312025-08-20T03:46:46ZengElsevierJournal of Migration and Health2666-62352025-01-011110032210.1016/j.jmh.2025.100322Temporary childbirth migration and perinatal healthcare in rural Maharashtra, IndiaRachel Murro0Alison M. El Ayadi1Rutuja Patil2Dhiraj Agarwal3Sanjay Juvekar4Juliana Kim5Nadia G. Diamond-Smith6Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th St 2nd Floor, San Francisco CA 94158 USA; Corresponding author.Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, 550 16th Street, #3745, San Francisco CA 94158 USAVadu Rural Health Program, KEM Hospital Research Centre, Sardar Moodliar Road Rasta Peth, Pune 411 Maharashtra IndiaVadu Rural Health Program, KEM Hospital Research Centre, Sardar Moodliar Road Rasta Peth, Pune 411 Maharashtra IndiaVadu Rural Health Program, KEM Hospital Research Centre, Sardar Moodliar Road Rasta Peth, Pune 411 Maharashtra IndiaUniversity of California, Berkeley, 2000 Carleton Street #2284 Berkeley, CA 94720-2284, USADepartment of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th St 2nd Floor, San Francisco CA 94158 USAIntroduction: Maternal health in rural India has improved due to national initiatives, but inadequate healthcare provision persists across most sociodemographic groups. The connection between perinatal care and the widespread practice of Temporary Childbirth Migration (TCM)—returning to one's natal home for delivery and the postpartum period—remains unexplored. Methods: Cross-sectional data on migration and health visits were collected from a sample of 1288 women in the Vadu Health and Demographic Surveillance Site (HDSS) (Western Maharashtra) who gave birth in 2018–2022. Childbirth migration (exposure) was analyzed in three ways: binary (any migration), continuous (duration of stay), and multidimensional (duration of stay and change of provider). Outcomes included number of health visits – both facility check-ups and home visits by community health workers – and early antenatal care initiation. Multivariate poisson, negative binomial and logistic regressions were used. Sensitivity analyses checked for recall bias, the influence of migration distance, and model misspecification. Results: Migrators and non-migrators had similar outcomes in early antenatal care initiation, facility visits (before and after pregnancy), and prenatal community health worker visits. Migrators had fewer postnatal community health worker visits (IRR = 0.80; 95 % CI 0.70–0.92). Among migrators, longer natal village stays were associated with fewer community health worker visits in the prenatal period (IRR = 0.92; 95 % CI 0.88–0.96) but not postnatally (IRR = 1.03; 95 % CI 1.00–1.07). Women who switched to a new provider upon arriving in their natal village had fewer facility-based prenatal (IRR = 0.86; 95 % CI 0.78–0.96) but more postnatal visits (IRR = 1.41; 95 % CI 1.06–1.87), regardless of how long they stayed. Conclusion: For women who return to their natal home for childbirth, duration of stay and changing providers upon arrival are linked to differences in receipt of maternal healthcare. Increased attention to the needs of mobile women during the perinatal period is necessary to ensure they can participate in key birth customs while receiving adequate healthcare.http://www.sciencedirect.com/science/article/pii/S2666623525000212Maternal healthChildbirthTemporary migrationInternal migrationCare continuumAntenatal care
spellingShingle Rachel Murro
Alison M. El Ayadi
Rutuja Patil
Dhiraj Agarwal
Sanjay Juvekar
Juliana Kim
Nadia G. Diamond-Smith
Temporary childbirth migration and perinatal healthcare in rural Maharashtra, India
Journal of Migration and Health
Maternal health
Childbirth
Temporary migration
Internal migration
Care continuum
Antenatal care
title Temporary childbirth migration and perinatal healthcare in rural Maharashtra, India
title_full Temporary childbirth migration and perinatal healthcare in rural Maharashtra, India
title_fullStr Temporary childbirth migration and perinatal healthcare in rural Maharashtra, India
title_full_unstemmed Temporary childbirth migration and perinatal healthcare in rural Maharashtra, India
title_short Temporary childbirth migration and perinatal healthcare in rural Maharashtra, India
title_sort temporary childbirth migration and perinatal healthcare in rural maharashtra india
topic Maternal health
Childbirth
Temporary migration
Internal migration
Care continuum
Antenatal care
url http://www.sciencedirect.com/science/article/pii/S2666623525000212
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