Understanding the impact of temporary childbirth migration on maternal and child health: study protocol of a community-based prospective cohort study in India.

INTRODUCTION

Temporary childbirth migration (TCM), where women return to their natal homes for pregnancy, delivery or postpartum for a limited duration, is a long-standing sociocultural practice in India. While often motivated by familial support and traditional norms, its implications for maternal and child health and health system engagement remain poorly understood. This study aims to quantify the impact of TCM on maternal and newborn outcomes and to explore how continuity of perinatal care and social support mediate these relationships.

METHODS AND ANALYSIS: We are conducting a three-site, community-based, prospective cohort study across the Health and Demographic Surveillance System sites of Vadu (Maharashtra), Sevagram (Maharashtra) and DEESHA (Delhi). A total of 3000 pregnant women will be enrolled in pregnancy (<24 weeks gestation) and followed through 12 months postpartum. Data collection includes sociodemographic characteristics, pregnancy and delivery histories, maternal morbidity, health service utilisation and quality, social support, empowerment and mental health, complemented by infant anthropometry and morbidity data. Data are captured using electronic case report forms in REDCap to ensure data quality. Analyses will assess the relationship between TCM and adverse perinatal outcomes, including preterm birth, small for gestational age and neonatal mortality, as well as potential mediating and moderating pathways including the continuum of care, quality of healthcare services and types of support (social, instrumental, emotional).

ETHICS AND DISSEMINATION: This study has been approved by the Ethics committees at the KEM Hospital Research Centre Pune (KEMHRC/RVM/EC/1931), Society for Applied Studies (SAS/ERC/TCM Study/2024), Mahatma Gandhi Institute of Medical Sciences (MGIMS/lEC/COMMED/8412023) and University of California San Francisco (22-36484). All research activities are conducted in accordance with Indian Council of Medical Research Guidelines for biomedical research and the Declaration of Helsinki. On study completion, findings will be disseminated to diverse local, national and global stakeholders and published in academic journals.

TRIAL REGISTRATION NUMBER: CTRI/2024/02/062881.