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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04873-y.