Third birth intention of the childbearing-age population in mainland China and sociodemographic differences: a cross-sectional survey.

Global fertility declines have become an inevitable trend, and many countries are adopting policies to drive fertility increases. Fertility intention plays an important role in predicting fertility behavior. The Chinese government has recently issued the 'three-child' policy, and there is still little research on the third birth intention of the childbearing-age population. Therefore, the aim of this study is to investigate the prevalence and related reasons of third birth intention in the childbearing-age population in mainland China, and analyze the sociodemographic differences. A cross-sectional survey was conducted in mainland China from June to July 2021. A total of 15,332 childbearing-age participants responded and completed the Fertility Intention Questionnaire online through the Wenjuanxing Platform. Data were explored and analyzed by SPSS (version 22.0) software. Descriptive statistics were used to describe the current situation and reasons of third birth intention. Binary logistic regression analysis was applied to assess the influencing factors in the sociodemographic level. The mean age of the participants was 32.9 ± 5.94 years. Only 12.2% of participants reported having third birth intention. The subjective norm of having both son and daughter (22.0%) and busy at work (29.2%) accounted for the largest proportion in the reasons of acceptance and rejection, respectively. Age has negative impact on third birth intention (OR = 0.960). Men were 2.209 times more likely to have three children than women (P < 0.001). With the improvement of education and family monthly income, the birth intention shows a downward trend. Compared with Han nationalities, first marriage and city residents, the ethnic minorities, remarriage and rural residents have stronger birth intention (all P < 0.05). And individuals with two existing children are inclined to have the third child (OR = 1.839). The third birth intention in the childbearing-age population in China is still low after the announcement of the three-child policy. It is necessary to create a favorable fertility context for childbearing-age group with high level of third birth intention, like younger, male, minority, remarriage, with lower education and family monthly income, living in rural and two existing children. Furthermore, removing barriers for those unintended is also prominent to ensure the impetus of policy.

Yan Z ，Hui L ，Wenbin J ，Liuxue L ，Yuemei L ，Bohan L ，Lili W ... -  《BMC PUBLIC HEALTH》

Third-child fertility intention and its socioeconomic factors among women aged 20-34 years in China.

The low birth rates and rapid population aging has drawn considerable attention from scholars and policymakers in China and around the world. In 2021, China launched the policy and supportive measures that allow up to 3 children per couple. This study aims to explore the influencing factors of the third-child fertility intention among women aged 20-34 years in China. We draw data from the National Fertility Survey conducted in 2017. The nationally representative survey adopts a stratified, 3-stage, and probabilities proportional to size sampling method. A total of 61,588 valid samples aged 20-34 years old were obtained. Fertility desire and behavior, childbearing and service use, and potential influencing factors of fertility intention such as the history of pregnancy were assessed. In general, 5.01% of Chinese women of prime childbearing age had fertility intention for a third child, and the proportion varies by region across mainland China. Individual characteristics such as being ethnic minorities, being rural residents, and having more siblings are significantly positively correlated with the third-child fertility intention, while the intention was significantly lower among women with a higher income or education level, migrant women, and those engaged in the non-agricultural labor force. Women who already had a son had lower fertility intention for a third child. Moreover, it was the perceived acceptable costs of childcare services rather than the actual costs that mattered more for the fertility intention. Our study concludes a series of socioeconomic factors, and previous childbearing and childrearing experiences are crucial for women's fertility intention for a third child. These findings highlight the importance of launching supportive measures in addition to the introduction of the 3-child policy in promoting a fertility-friendly society.

Yang H ，Han R ，Wang Z 《BMC PUBLIC HEALTH》

Fertility Intention and Related Factors for Having a Second or Third Child Among Childbearing Couples in Shanghai, China.

As the global fertility rate declines, China has issued two and three-child policies in the past 10 years. Therefore, this study serves to evaluate fertility intention rates and related factors in couples intending to have a second child and third child. A cross-sectional survey was conducted in mainland China from July to August 2021. Couples with one or two children were invited to participate in our study in order to collect information about more than one child fertility intention and the possibly related factors. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors. Data was collected from a total of 1,026 couples. Among couples with one child, 130 (16.2%) couples had the intention to have a second child. Additionally, only 9.4% of couples with two children desired to have third child. The study revealed large differences in socioeconomic and personal factors between the two groups. For couples with intentions for a second-child, a female age >35 years (adjusted odds ratio, aOR 1.92), a first child's age range from 3 to 6 (aOR 3.12), annual child spending as a percentage of household income >30% (aOR 2.62), and children's educational barriers (aOR 1.55) were associated with lack of intent to have a second child. Similarly, among couples with two children, parents with family financial constraints (aOR 6.18) and children's educational barriers (aOR 4.93) are more likely to have lack of intent to have a third child. Here, we report that government policies encouraging fertility (aOR 0.04) can effectly promote couples to pursue a second or third child. Overall, couples with one or two children in Shanghai had a low intention to give birth to a second or third child. In order to increase the birth rates, it is necessary to implement policies to reduce the burden of raising children and provide relief to parent's pressure of rearing a child with increased free time.

Zhu C ，Yan L ，Wang Y ，Ji S ，Zhang Y ，Zhang J ... -  《Frontiers in Public Health》

Fertility intentions to have a second or third child under China's three-child policy: a national cross-sectional study.

What proportion of people want to have a second or third child after the enactment of the three-child policy in China? Under the three-child policy, fertility intention to have a second child was ∼60% (56% of women vs 65% of men), and fertility intention to have a third child was 13% (10% of women vs 17% of men) among the Chinese population. The Chinese government announced the three-child policy on 31 May 2021, allowing all couples to have up to three children. At present, there is a lack of national surveys on the fertility intentions of women and men to have a second or third child under the three-child policy in China. In June 2021, a national cross-sectional survey including 9243 respondents aged 18-49 years was conducted online from 31 provinces in China's mainland using a random sampling method. Data on the intention to have a second or third child were collected by anonymous questionnaire. Descriptive statistics were performed to assess fertility intentions. Multivariate and multinomial logistic regression analyses were used to assess the association between fertility intentions and the investigated factors. Approximately 60% (5493/9243) of the investigated people (55.6% women vs 64.7% men) intended to have a second child, and 13.0% (1203/9243) of them (10.0% women vs 17.1% men) intended to have a third child under China's three-child policy. For non-child respondents, 46.8% of women and 60.4% of men intended to have a second child. For one-child respondents, 47.8% of women and 53.8% of men intended to have a second child. For two-child respondents, 14.4% of women and 25.9% of men intended to have a third child. The mean desired family size was 1.58 children per woman, which was lower than the 1.76 children per man. Notably, the age-specified fertility intentions of men were always higher than those of women. Women with a college or higher degree (adjusted odds ratio [aOR] 0.60, 95% CI 0.42-0.88) and a high-middle (aOR 0.71, 95% CI 0.53-0.95) or high (aOR 0.64, 95% CI 0.48-0.85) household income, as well as men living in urban areas (aOR 0.71, 95% CI 0.58-0.87) and having a high-middle household income (aOR 0.68, 95% CI 0.52-0.90), were associated with a lower intention to have a third child (all P < 0.05). In contrast, men of public service personnel had a higher intention to have a third child than factory workers (aOR 1.44, 95% CI 1.02-2.04, P < 0.05). Meanwhile, approximately one out of five two-child respondents intended to have a third child, while one out of four two-girl respondents (aOR 2.09, 95% CI 1.44-3.04) were willing to have a third child with a strong preference for boys (12.7% for boys vs 2.7% for girls). Economic and childrearing barriers were the leading barriers to having one more child. The online survey might limit the representativeness of the present study's sample. A large sample size was enrolled and a random sampling method was used to increase the sample diversity and representativeness. This study will assist in estimating the impact on population demographic of the three-child policy in China. Multiple efforts are needed to create a fertility-friendly environment for couples, thereby increasing fertility intentions to have one more child and increasing fertility rates. No funding. The authors declare no conflict of interest. N/A.

Jing W ，Liu J ，Ma Q ，Zhang S ，Li Y ，Liu M ... -  《-》

Intention to have a third child among millennial parents with two children in eastern China: A cross-sectional survey.

Xu F ，Jiang SJ ，Ge PP ，Yang J ，Lu S ... -  《Nursing Open》