Fertility intention and its influencing factors among young people of reproductive age in China: A cross-sectional survey study

BACKGROUND: China's fertility rate has declined sharply despite two- and three-child policies. While most young adults remain generally willing to have a first child, intentions for a second or third child have decreased significantly, contributing to the current fertility crisis. The fertility intentions of individuals of reproductive age directly influence regional and even national fertility levels by shaping their reproductive behaviors. OBJECTIVE: Guided by the Theory of Planned Behavior in variable selection, this study examines the factors influencing the fertility intentions of individuals of reproductive age. This research aims to inform policy development and implementation, enhance fertility rates, mitigate population aging, and address the challenges associated with an unbalanced population structure. METHODS: This study evaluated fertility intentions and related factors among reproductive-age youth in Hubei Province through a cross-sectional survey conducted from August 2023 to March 2024, yielding 3684 valid samples via convenience sampling. Univariate and multivariate linear regression analyses were used. RESULTS: Results indicate low fertility intentions for a second or third child among Chinese youth, influenced by overlapping factors. Positive predictors include having existing children and strong social support. Conversely, negative predictors include aging concerns, unstable employment, higher education, work-family conflicts, and robust family support. CONCLUSIONS: Fertility decisions are shaped by a complex interplay of socioeconomic and personal factors. Beyond policy reforms such as the three-child policy, enhancing social support, employment stability, and work-life balance is essential for creating a fertility-friendly environment. China's experience may also offer insights for other countries facing similar demographic and socioeconomic transitions, emphasizing the importance of addressing both structural and psychosocial barriers to higher-order childbearing.