Pregnant young women have increased risk of poor maternal health outcomes and frequently have low rates of skilled maternal healthcare utilization. Migrant youth may suffer even poorer use of maternal health services given the disruption of migration, changes in social support, and potential difficulties in obtaining care in a new community. Using a sample of 46,905 women aged 15–24 from 27 Demographic and Health Surveys collected across sub-Saharan Africa from 2003 to 2009, I examine variation in use of skilled maternal healthcare, looking at three aspects of migration: place, disruption, and adaptation. I find evidence of a significant advantage in migrating to urban versus rural areas, suggesting that there is an urban advantage in maternal healthcare regardless of migrant stream. I find no evidence of positive adaptation on maternal healthcare use, but show that rural-rural migrants experience negative adaptation after longer duration of residence. There are lingering positive effects of this urban advantage for urban-rural migrants, who, despite a dearth of healthcare facilities in rural areas, maintain high use of maternal healthcare well after migration. © 2018 Elsevier Ltd

Sub-Saharan Africa Internal migration maternal health Skilled delivery assistance young women Antenatal care

maternal care rural area Africa south of the Sahara Sub-Saharan Africa prenatal care maternal health human social support migrant Adolescent female young population juvenile pregnancy Article health care utilization rural-urban migration major clinical study adult human experiment internal migration outcome assessment health care facility maternal health service health survey