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To protect the well-being the mother and child, pregnant women are advised to reduce or stop strenuous and dangerous work; others can continue to the last trimester. There are almost no studies on working patterns during pregnancy from lowand middle-income countries. This study describes the pattern and determinants of working during pregnancy in rural China and change over time. METHODS: A cross-sectional interview survey was carried out in rural areas among 3966 mothers who had recently given birth in 2009 in three provinces (Anhui, Chongqing and Shaanxi) and among 1479 women in Anhui in 2001–03. RESULTS: Overall in 2009, 39% of the women stopped working during early pregnancy, 32% worked the same throughout pregnancy and the rest decreased their work or stopped later in pregnancy. Women from Anhui (53%) and Chongqing (54%) provinces were more likely to stop work in early pregnancy than women from Shaanxi province (20%). Older women (OR 0.74, 95% CI 0.56–0.99), those having two or more children (OR 0.55, 0.43–0.69) and non-farmers (OR 0.50, 0.65–0.99) were less likely to stop working on the first trimester, but those with higher education (high school OR 1.43, 1.05–1.94) were more likely to stop working. Stopping work early was not related to household income and adequacy of prenatal care. In 2001–03 in Anhui stopping working during early pregnancy was much less common than in 2009 (6% vs 53%). Working the same throughout pregnancy was 30% in 2001–03 and 23% in 2009. CONCLUSIONS: Women’s working patterns during pregnancy in rural China in 2009 were polarized: many women stopped working already in early pregnancy, but others continued to work as before until the end of pregnancy. The common practice of stopping working at early pregnancy seems to be a new practice. i262 International Journal of Epidemiology, 2015, Vol. 44, Supplement 1

Work Behavior during Pregnancy in Rural China in 2009 and 2001.