Unauthorised pregnancies and use of maternity care in rural China

ABSTRACT

Objectives To describe the use of maternity care in rural China by the legal status of the pregnancy.

Methods Cross-sectional survey wherein information was obtained about 2576 women who gave birth in 2006. Logistic regression was used to compare women having an unauthorised pregnancy with those having an authorised second birth, adjusting for confounding factors.

Results Almost all respondents had antenatal care and most deliveries occurred in hospitals. Women with unauthorised pregnancies were significantly less likely to have had maternity care, particularly prenatal care, postnatal care, to have been hospitalised during pregnancy, and to have been reimbursed for hospital delivery costs than women with an authorised second birth. They were also more likely to have been hospitalised for seven or more days after delivery. Primiparous women used maternity care services and received financial support more often than women with an authorised second birth. Among the women with an unauthorised pregnancy an important reason for not using hospital care during pregnancy or delivery was financial constraint.

Conclusions Women with unauthorised pregnancies use less maternity care, although pregnancy in such circumstances may adversely impact their health. Primiparous women benefit from more financial support than multiparous women.

KEYWORDS:

• Antenatal care
• China
• Hospital delivery
• Unauthorised pregnancy
• One-child policy

ACKNOWLEDGEMENTS

Thanks are due to the many Chinese women who participated in the survey and the provincial university staff who collected the data. This article is an output of the project ‘Structural hinders to and promoters of good maternal care in rural China – CHIMACA (015396)’, funded by the European Commission INCO Programme and coordinated by the National Institute for Health and Welfare, Helsinki.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.