. 2022 Aug 12;22(1):637.

doi: 10.1186/s12884-022-04873-y.

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

Chenyun Zhang^#^{1

2}, Lingling Wei^#³, Yinyan Zhu^#⁴, Li Teng^#⁵, Wenchang Zhang^{3

6}, Jia Xu⁷, Mengqi Qin⁸, Na Jiang³, Haridah Alias⁹, Li Ping Wong^#^{10

11}

Affiliations

¹ Department of Health Law and Policy, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China. cyzhang@fjmu.edu.cn.
² Fujian Provincial Key Laboratory of Environment and Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China. cyzhang@fjmu.edu.cn.
³ Department of Health Law and Policy, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China.
⁴ Psychological Health Education and Counseling Center, Xiamen City University, Xiamen, 361000, Fujian Province, China.
⁵ School of Management, North Sichuan Medical College, Nanchong, 637000, Sichuan Province, China.
⁶ Fujian Provincial Key Laboratory of Environment and Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China.
⁷ School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning Province, China.
⁸ The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
⁹ Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
¹⁰ Department of Health Law and Policy, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China. wonglp@ummc.edu.my.
¹¹ Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia. wonglp@ummc.edu.my.

^# Contributed equally.

PMID: 35962340
PMCID: PMC9372952
DOI: 10.1186/s12884-022-04873-y

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

Chenyun Zhang et al. BMC Pregnancy Childbirth. 2022.

. 2022 Aug 12;22(1):637.

doi: 10.1186/s12884-022-04873-y.

Authors

Chenyun Zhang^#^{1

2}, Lingling Wei^#³, Yinyan Zhu^#⁴, Li Teng^#⁵, Wenchang Zhang^{3

6}, Jia Xu⁷, Mengqi Qin⁸, Na Jiang³, Haridah Alias⁹, Li Ping Wong^#^{10

11}

Affiliations

¹ Department of Health Law and Policy, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China. cyzhang@fjmu.edu.cn.
² Fujian Provincial Key Laboratory of Environment and Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China. cyzhang@fjmu.edu.cn.
³ Department of Health Law and Policy, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China.
⁴ Psychological Health Education and Counseling Center, Xiamen City University, Xiamen, 361000, Fujian Province, China.
⁵ School of Management, North Sichuan Medical College, Nanchong, 637000, Sichuan Province, China.
⁶ Fujian Provincial Key Laboratory of Environment and Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China.
⁷ School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning Province, China.
⁸ The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
⁹ Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
¹⁰ Department of Health Law and Policy, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China. wonglp@ummc.edu.my.
¹¹ Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia. wonglp@ummc.edu.my.

^# Contributed equally.

PMID: 35962340
PMCID: PMC9372952
DOI: 10.1186/s12884-022-04873-y

Abstract

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.

Keywords: Childbearing; Fertility intentions; Parenthood; Three–child policy; Young adult.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
Distribution of fertility intentions by region

**Fig. 2**
Fertility intentions by gender

**Fig. 3**
Proportion of level of knowledge about reproductive, maternal, newborn, and child health (RMNCH) support and/or services

**Fig. 4**
Distribution of childbearing- and childbirth-related anxiety and parenthood-related anxiety

**Fig. 5**
PLS Path Modelling for Factors Influencing fertility intention by gender

See this image and copyright information in PMC

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References

1. National Bureau of Statistics China . Main Data of the Seventh National Population Census. 2021.
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1. Global Times . China’s fertility rate may become ‘world’s lowest’ without strong intervention policy, India may overtake China by 2023: demographers. 2021.
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Fertility intentions among young people in the era of China's three-child policy: a national survey of university students

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

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