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

BACKGROUND Social integration has been demonstrated to be associated with the health care use among migrants, but few studies have focused on migrant pregnant women. This study aims to explore the association between social integration and childbirth at woman's hometown (childbirth return) of internal migrant pregnant women in China. METHOD Using the data of "Monitoring Data of Chinese Migrants" in 2014, a total of 3412 internal migrant pregnant women were included in this study. Social integration was measured by economic integration, acculturation, and identification. The childbirth locations of internal migrant pregnant women were divided into current residency and the woman's hometown. Univariate logistic regression and two multivariable logistic regression models were employed to assess the association between social integration and childbirth return among internal migrant pregnant women. RESULT Our study finds that 24.56% of migrant pregnant women choose to have a childbirth return. As for social integration, those who have their own house (OR = 0.351 95% CI 0.207-0.595) in current residence, who have been staying in current residence for at least 5 years (OR = 0.449; 95% CI 0.322-0.626), and who are willing to stay in the current residence for a long time (OR = 0.731; 95% CI 0.537-0.995) are less likely to have a childbirth return. Apart from social integration, our results also show that those migrant pregnant women who are older, who have higher education level, who have at least two family members in current residence, with a migration reason of work and business, who have established health record in the current residency, and who were not covered by medical insurances, are less likely to have a childbirth return. CONCLUSION Social integration is negatively associated with childbirth return among internal migrant pregnant women in China. To improve the utilization of maternal care services for migrant pregnant women in current residence, targeted policies should be made to improve social integration status for migrant pregnant women.