Effect of premarital physical examination policy on women health behaviors before marriage, pregnant, and during pregnant

Objective To evaluate the impact of policy change in premarital physical examination on women's use of maternal health services.Methods Subjects were 467 019 women who delivered during the period of 2001～2005 in twenty-two cities or counties in Zhejiang and Jiangsu provinces,China.The timing of registration for maternal health booklet,rates of prenatal care and first-trimester prenatal care,average times of prenatal visits,and mean weeks of first prenatal visits were computed and compared before and after 2003,the year of implementation of the new Marriage Ordinance that changed premarital physical examination from mandatory to voluntary.Results The proportion of registration for maternal health booklet before marriage decreased from 71.3% in 2003 to 14.6% in 2005,whereas the proportion of registration for maternal health booklet after pregnancy increased from 23.6% in 2003 to 75.4% in 2005.The proportion of registration during labor or postpartum also increased since 2003.The rate of first-trimester visit decreased from 64% in 2003 to 50% in 2005.The average number of prenatal visit decreased by 0.4 times per woman.The mean gestational weeks at first prenatal visit delayed by two weeks in 2005 compared with that in 2003.Conclusion The abolishment of mandatory premarital physical examina2 tion had adverse impact on women's use of maternal health services.