Fertility intention and its affecting factors in China: A national cross-sectional survey

INTRODUCTION: Low fertility rate has become an inevitable problem globally. Although current policies have a certain effect on promoting fertility and raising the birth rate, the overall effect is not obvious to meet the need. Therefore, the exploration of fertility intention and its affecting factors is extremely significant. METHODS: This study collected demographic data and the intention of respondents to have a second children, which focused on the factors that could affect fertility issues. 11,031 respondents were divided into non-fertile group (n = 5062) and fertile group (n = 5969) according to whether they had children or not, and the fertility group (n = 5969) were divided into group with 1–2 children (n = 5293) and group with ≥3 children (n = 676) according to the number of children. Non-fertility respondents aged 26–40 (n = 1369) were divided to explore the factors affecting the second-children intention. Binary logistic regression analysis was used to determine the affecting factors. RESULTS: It was revealed that gender [Male: OR: 0.60, 95% CI: 0.54–0.68], age [26–40: OR: 16.0, 95% CI: 13.4–19.1; 41–60: OR: 233.8, 95% CI: 186.7–292.6; >60: OR: 105.6, 95% CI: 77.1–144.6], political status [Partisans: OR: 0.48, 95% CI: 0.42–0.54], highest educational level [Middle school: OR: 0.21, 95% CI: 0.17–0.26; College degree or above: OR: 0.09, 95% CI: 0.08–0.11], whether having chronic disease [Yes: OR: 1.95, 95% CI: 1.60–2.38] and depression [Mild depression: OR: 0.63, 95% CI: 0.56–0.72; Moderate depression: OR: 0.43, 95% CI: 0.36–0.53; Moderate to severe depression: OR: 0.45, 95% CI: 0.35–0.57; Severe depression: OR: 0.50, 95% CI: 0.33–0.74] were important factors affecting fertility intention. We found that age [26–40: OR: 0.11, 95% CI: 0.08–0.15; 41–60: OR: 0.15, 95% CI: 0.12–0.18; >60: 0.81, 95% CI: 0.66–0.99], region [Central China: OR: 1.49, 95% CI: 1.20–1.86; Western China: OR: 1.75, 95% CI: 1.41–2.18], resident place [Urban: OR: 0.59, 95% CI: 0.49–0.72], per capita monthly household income [6001–12000: OR: 0.63, 95% CI:0.46–0.83; ≥12,000: OR: 1.83, 95% CI: 1.20–2.80], political status [Non-partisans: OR: 0.24, 95% CI: 0.09–0.69], highest educational level [Middle school: OR: 0.36, 95%CI: 0.27–0.46; College degree or above: OR: 0.22, 95% CI: 0.17–0.30] and anxiety [Moderate anxiety: OR: 1.39, 95% CI: 1.04–1.88; Severe anxiety: OR: 2.19, 95% CI: 1.26–3.80] were the main affecting factors for choosing the number of children. Furthermore, the second-children intention investigation in respondents aged 26–40 showed that gender [Male: OR: 2.06, 95% CI: 1.67–2.53], resident place [Urban: OR: 0.59, 95% CI: 0.49–0.72], per capita monthly household income [≥12,000: OR: 1.86, 95% CI: 1.23–2.82] and pressure [Severe pressure: OR: 0.54, 95% CI: 0.34–0.85] were the important factors. CONCLUSION: Region, educational level, psychological factors, income, political status and medical insurance were the important factors affecting the intention of fertility and the number of children. The government should take these factors into account when optimizing the existing policy.