The findings indicate that social support

The findings indicate that social support mechanisms may be at play, as opposed to the social norms of sending communities. Given that women in urban areas report higher levels of both family planning use as well as institutional deliveries, it would be hypothesized that if social norms were operating, that higher cross-border social ties would be associated with lower use. Rural areas are typically more conservative, with parents (and older cohorts) significantly more likely to have delivered at home compared to young people, and rural residents more likely to have a home delivery due to lack of available facilities and social norms around delivering at home (Thind, Mohani, Banerjee, & Hagigi, 2008). Therefore, our findings suggest that, as opposed to social norms from hometowns (which may promote greater acceptance of home deliveries), social support mechanisms garnered from the relationships with family and friends in hometowns may be operating to improve institutional delivery outcomes. Ease of visiting home may help maintain the social support and sense of belonging of hometowns, decreasing stress and improving wellbeing among women. Moreover, results suggest that cross-border social ties was only marginally significantly associated with family planning while strongly associated with an increase in institutional deliveries. Future studies should qualitatively explore whether there are specific predictors of social ties, such as ease of visiting home, that may more strongly explain and be more important factors in the association between cross-border social ties and different reproductive health outcomes. Additionally, scheduled caste and tribe populations in India are often the most socially marginalized and discriminated against, live in slums and are poorer, and lack access to health care and have poorer health outcomes and behaviors (Navaneetham & Dharmalingam, 2002). Our study builds upon past work on understanding caste and reproductive health outcomes, which have often grouped together scheduled caste and tribe populations (Thind et al., 2008). Our findings suggest that, as expected, scheduled caste women were less likely to have an institutional delivery and use modern family planning; however, scheduled tribe populations were found to have higher odds of family planning use, controlling for demographic characteristics. These findings related to scheduled tribe are surprising, others have found that this pde-5 inhibitors had the lowest family planning knowledge and use (Narzary, 2009). It is possible that since people with fewer cross-border ties are more marginalized, once factors associated with cross-border ties are taken into account, tribal populations actually do not have lower odds of family planning use than non-tribal populations. Finally, it is also possible that the relatively small sample size of this population (N=67) led to these unexpected results and a larger sample with more respondents from scheduled tribes are needed to fully interpret and validate these findings. Future studies may want to focus on qualitative data across caste categories to understand how cross-border social ties may operate differently on reproductive health outcomes across groups. This study is novel in that it builds upon concepts developed in the international migration literature, specifically cross-border ties, and assesses whether this applies to internal migration streams in India. It demonstrates that cross-border ties occur frequently, both through physical contact/visiting home as well as communication with people at home. This study finds that women aged 20–24 years, who migrated at 20 years or older, are Hindu, identify as OBC, with either no education or 12+ years education, and had no employment are more likely to experience higher cross-border social ties. It is possible that younger women are less likely to migrate because they may have migrated with their parents; similarly, those who migrated at later ages may have higher cross-border social ties because they have lived for a longer period of time in their hometowns and may have left behind family and peers. This study also suggests that women who are not employed have higher cross-border social ties. Time availability and limited social networks in destination communities may explain these findings. Women who are not participating in the work force may have more time to communicate with their hometowns. It is also possible that women may actually require more support from their hometown kin if they feel more socially isolated. Others have found that “weak ties” garnered from interacting with others in the workplace serve an important source of support for integration and information (Hagan, 1998). Hometown ties may therefore be particularly important for women who are unable to, or decide not to, participate in the labor force. On the other hand, women who work may be limited in time and ability to visit hometowns. Employment may restrict the number of person-days missed, and women may face additional financial burden if they forgo income by taking leave. Moreover, only 17% reported remitting money, which may be due to the low socioeconomic status of women in these communities and low employment among participants. In this context, cross-border ties were maintained typically with a parent back home, as opposed to neighbor or peers. Young people typically communicated weekly, if not daily, with their parents, neighbors, and friends back home. Approximately 9.2% of women reported discussing health during a visit; however, the data is limited in the content of these discussions. Future studies using qualitative data should explore the nature and content of this communication.