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

Background 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. Method 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. Results 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). Conclusion 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.

Can Pets Replace Children? The Interaction Effect of Pet Attachment and Subjective Socioeconomic Status on Fertility Intention

A growing number of young people tend to regard their pets as their surrogate children, yet research examining the relationship between pet attachment and fertility intention remains scarce. Moreover, individuals’ fertility intention is affected by economic resources. Therefore, we conducted two studies to examine the interaction effect of pet attachment and subjective socioeconomic status (SES) on childbearing-aged individuals’ fertility intention. In Study 1, we utilized questionnaires to measure Chinese pet owners’ pet attachment, subjective SES, and fertility intention. In Study 2, participants’ pet attachment was experimentally manipulated by reading articles about the benefits of petkeeping. The results of the two studies consistently demonstrated that the effect of pet attachment on fertility intention was moderated by subjective SES. Specifically, pet attachment was negatively associated with fertility intention when individuals had a high level of subjective SES, whereas this effect disappeared when individuals had low subjective SES. These findings suggest an explanation for why individuals with high subjective SES delay or even opt out of childbearing. The limitations and implications of the current study are discussed.

Factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa: evidence from cross-sectional surveys of 29 countries

Background In sub-Saharan Africa, the majority of women of reproductive age who want to avoid pregnancy do not use any method of contraception. This study sought to determine the factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa. Methods This study used data from the Demographic and Health Surveys of 29 countries in sub-Saharan Africa. A total of 87,554 women aged 15–49 with no fertility intention and who had completed information on all the variables of interest were considered in this study. Using a multilevel logistic regression analysis, four models were used to examine the individual and contextual factors associated with modern contraceptive use. The results were presented as adjusted odds ratios (aOR), with their respective confidence intervals (CIs). Statistical significance was set at p< 0.05. Results The prevalence of modern contraceptive use was 29.6%. With the individual-level factors, women aged 45–49 had lower odds of using modern contraceptives (aOR = 0.33, 95% CI = 0.28, 0.39). Women who had their first sex at age 15–19 (aOR = 1.12, 95% CI = 1.07, 1.17), those with higher education (aOR = 1.93, 95% CI = 1.75, 2.13), and women who were exposed to newspaper (aOR = 1.15, 95% CI = 1.10, 1.20) and radio (aOR = 1.21, 95% CI = 1.17, 1.26) had higher odds of modern contraceptive use. In terms of the contextual factors, women living in urban areas (aOR = 1.06, 95% CI = 1.02, 1.11), women in the richest wealth quintile (aOR = 1.55, 95% CI = 1.43, 1.67), and those in communities with medium literacy level (aOR = 1.11, 95% CI = 1.06, 1.16) and medium community socio-economic status (aOR = 1.17, 95% CI = 1.10, 1.23) had higher odds of modern contraceptive use. Across the geographic regions in sub-Saharan Africa, women in Southern Africa had higher odds of modern contraceptive use (aOR = 5.29, 95% CI = 4.86, 5.76). Conclusion There is a relatively low prevalence of modern contraceptive use among women with no fertility intention in sub-Saharan Africa, with cross-country variations. Women’s age, age at first sex, level of education, mass media exposure, place of residence, community literacy level and community socio-economic status were found to be associated with modern contraceptive use. It is, therefore, important for policy makers to consider these factors when designing and implementing programmes or policies to increase contraceptive use among women who have no intention to give birth. Also, policymakers and other key stakeholders should intensify mass education programmes to address disparities in modern contraceptive use among women.

The effect of the universal two-child policy on medical insurance funds with a rapidly ageing population: evidence from China’s urban and rural residents’ medical insurance

Background With the rapid growth of the ageing population, the operating burden of China’s basic medical insurance fund is becoming increasingly heavy. To counter rapid population ageing and ameliorate a series of problems, China has adjusted its fertility policies several times. On January 1, 2016, the universal two-child policy was implemented. This study analysed the impacts of the adjustment to the fertility policy and potential improvements in fertility intention on the insured population and medical insurance fund sustainability. Methods We used an actuarial science method and took the urban and rural residents’ basic medical insurance (URRBMI) of China, which covers most urban and rural residents, as an example to build a dynamic forecast model of population growth and a dynamic actuarial model of medical insurance funds. Results Compared with the original policy, under the current fertility intention (40%) with the universal two-child policy, the ageing of the population structure of URRBMI participants will decline significantly after 2026, and individuals aged 65 and over will account for only 19.01% of the total participants in 2050. The occurrence of the current deficit and accumulated deficit of the URRBMI fund will be postponed for one year to 2022 and 2028, respectively. If fertility intentions continue to rise, the ageing degree of the population structure will decrease, and the deficit would be further delayed. Conclusions The universal two-child policy is conducive to improving the degree of overall population ageing, delaying the occurrence of a URRBMI fund deficit, and improving the sustainability of URRBMI funds. If fertility intention increases, the effects would be stronger. However, since the adjustment of the universal two-child policy has a certain time lag, it will take time to demonstrate this impact. Therefore, while actively promoting the universal two-child policy, other measures should be taken, such as improving the fertility desire among couples of childbearing age and reforming medical insurance payment methods.

P–480 Adding fuel to the flame of low fertility: Fertility intention and perceived socio-political stability of young adults in Hong Kong

Study question How does perceived socio-political stability impact on the fertility intention of Hong Kong adults? Summary answer Political and economic uncertainties play an especially significant role in reproductive decision-making among young adults in Hong Kong, where traditional family beliefs diminish in importance. What is known already Hong Kong has one of the lowest fertility rates in the world, despite the importance placed on values like family lineage and childbearing as a filial obligation. Previous investigation of Hong Kong students’ perception of reproduction showed that proximal factors such as having a stable relationship and personal maturity as the most important conditions for parenthood. It is yet to be explored whether more distal factors such as the economy and political stability also play a role in reproductive decision-making among Hong Kong adults, especially under the influence of the Anti-Extradition Bill Movement from onwards. Study design, size, duration This study uses cross-sectional data from an online survey that explores the fertility attitudes, intentions, and behaviours and perceived socio-political stability of Hong Kong Chinese adults. Data were collected between July and August 2020. Participants/materials, setting, methods Participants were 629 childless Hong Kong Chinese women (mean age = 30±6.68) recruited through community network and social media. Participants answered questions on fertility intention, and rated the extent to which ‘political environment’, ‘economic stability’ and ‘education system’ are important social-political factors in considering family formation, and to which they agree with traditional family beliefs. We conducted binary logistic regression with fertility intention as the criterion variable and social-political factors of family formation as predictors. Main results and the role of chance Participants considered the ‘political environment’ and ‘education system’ very important factors when considering family formation, especially among those aged 25 or below. More than 70% of respondents said they would like to have children, yet only 44% said they plan on actualizing their parenthood goals in the near future. Regression analyses showed significant main effects of age and gender on fertility intention, such that younger (P&lt;.001) and male (P&lt;.01) participants were less likely to intend on becoming parents. The more participants valued ‘political environment’ (B = 0.48, P&lt;.001) and ‘economic stability’ (B = 0.39, P&lt;.05), the less likely it is for them to intend on becoming parents, controlling for age and gender. There was also significant interaction between age and importance of ‘political environment’ (P&lt;.01), indicating that for whom ‘political environment’ is an important condition for parenthood, younger participants had lower intention of having children than older participants. There was no significant effect of gender. Overall, participants did not subscribe to traditional beliefs such as that childbearing is ‘a necessary part of married life’ or that it is ‘a filial obligation as sons or daughters’ (ratings = 1.95 – 3.05, out of 5). Limitations, reasons for caution Participants were recruited by self-selection through community network and social media, potentially favouring individuals who were more concerned with fertility issues to begin with. Additionally, men were largely under-represented in this sample (15%), potentially obscuring any significant gender differences relating to traditional family beliefs and determinants of reproductive decisions. Wider implications of the findings: With economic and political uncertainties expected to persist, these findings call for increased psychosocial and fertility education for young adults in navigating long-term parenthood goals and reproductive options, and policies that assist young adults in overcoming personal and structural barriers to parenthood amid diminishing confidence in governmental support. Trial registration number Not applicable

Fertility intention-based birth forecasting in the context of China’s universal two-child policy: an algorithm and empirical study in Xi’an City

After a universal two-child policy was introduced in China in 2016, studies have been published using women’s fertility intentions to forecast future births; however, the recommended algorithms need to be improved. In this study, an algorithm based on the method of limiting factors is developed to retrospectively forecast annual births in Xi’an City in the first three years of policy implementation, i.e. 2016–2018. The 2015 Xi’an Fertility Survey (sample: 560 one-child mothers) showed that 17% of mothers intended to have a second child, 30% were undecided and 53% did not intend to do so at the end of 2015. The low forecast variant based on the updated algorithm indicates that there would be a baby boom in 2016–2018, but the annual births would increase by 13% at most. The forecasting results are basically consistent with the official reports on annual births. This study emphasizes the importance of appropriately adjusting all fertility intentions in birth forecasting, helps to understand women’s fertility behaviour and evaluate the effects of implementing the universal two-child policy, and has important implications for China’s population and family planning work.

Factors Influencing Fertility Intentions of Newlyweds in South Korea: Focus on Demographics, Socioeconomics, Housing Situation, Residential Satisfaction, and Housing Expectation

Since 2001, South Korea has experienced sustained lowest-low fertility. This phenomenon has persisted despite the implementation of several social policies aimed at increasing fertility rates. The purpose of this study was to quantitatively analyze the demographics, socioeconomics, housing situation, residential environment, and housing expectation of newlyweds in terms of their fertility intentions in South Korea (within 5 years of marriage) in order to help the development of more effective housing policies. We extracted the factors on the basis of fertility theories and previous related studies and identified differential characteristics of the impact on fertility intentions for the first and for additional child(ren). The results show that fertility intention was higher in non-metropolitan and rental households. There was also a significant relationship between the anticipated period of a home purchase and fertility intention. In particular, for one-child families, the second child fertility intention was significantly affected. In conclusion, we quantitatively confirmed various factors that significantly impact the fertility plans of newlyweds. We suggest that the government implements housing policies on the basis of economic stability, the number of children, and the residential environment of newlywed couples.