Fertility intentions among young people in the era of China's three-child policy: a national survey of university students.

BACKGROUND

This study aimed to assess the fertility intentions of young people after the announcement of the three-child policy in China and to determine whether knowledge about reproductive, maternal, newborn, and child health (RMNCH) services or support, childbearing- and childbirth-related anxiety, and parenthood-related anxiety influence fertility intentions.

METHODS

A cross-sectional Internet-based survey was conducted on a nationwide sample of young people aged 18 to 28 years old in education institutions. Factors associated with fertility intentions were analysed using partial least squares structural equation modelling (PLS-SEM).

RESULTS

Only 4.2% of males and 1.7% of females intended to have three children or more. On the whole, the majority (40.3%) reported the intention to have two children. The mean and standard deviation (SD) for the total knowledge RMNCH support and/or services knowledge score was 9.5 (SD ± 8.9), out of a possible score of 39. The median and interquartile range (IQR) of childbearing- and childbirth-related anxiety score was 8.0 (IQR = 6.0-9.0), out of a possible score of 10. The median and IQR of parenthood-related anxiety score among the males was 6.0 (IQR = 4.0-9.0) and for females was 7.0 (IQR = 5.0-9.0). Results from PLS-SEM revealed that a higher level of knowledge of RMNCH support and/or services is significantly associated with higher fertility intentions. Both childbearing- and childbirth-related anxiety and parenthood-related anxiety were inversely associated with fertility intentions.

CONCLUSION

Raising awareness about RMNCH supportive measures and easing birth- and parenting anxiety are imperative to enhance birth rates. Future policies should pay more attention to these determinants to achieve their intended goal of boosting population growth.