To answer the original posters question: in the TV series of Christy, Margaret had faked her own death, leaving Dr MacNeil devastated by her death, only to return years later. When she returned, it was discovered that she had Tuberculosis I believe. She was sent away for treatment, got better, and then returned in the final episode of the series to win back her husband. We are never told what happens from that point. One can speculate that perhaps she was not as well as believed, had a relapse and died later. It could also be that had the series been given another season then she may have remained as Neil's wife only to die in the outbreak that kills Fairlight, leaving the door open for Christy and Neil. Also, divorce was an option in those days, Extremely rare but one can argue that her abandonment of the marriage easily gave Neil grounds to pursue this option should they decide to go this way.
In the movies I believe that they follow more closely to the book and therefore Margaret had indeed died, in childbirth I believe.
As for who Christy chose, in the TV series, no clue. In the movies, Neil obviously. In the book, the interpretation is that she chose Neil. There is no actual sentence stating, "And then Christy and Neil hooked up. The End", however the way the last paragraph is written certainly gives the reader the impression that Christy and Neil will pursue a courtship that will most likely result in their marriage.
In real life, yes, the woman that Christy is based on married the preacher. Why Catherine decided to have her fictional version hook up with the doctor I do not know but one can surmise that she simply liked the character. It could be that fictional preacher and fictional Christy were actually nothing like their real life counterparts in terms of personality and therefore fictional Christy and fictional Neil made more sense. It is simply the events in the book that are based on real life experiences.
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