Second-Child Fertility Intentions among Urban Women in China: A Systematic Review and Meta-Analysis

With the adjustment of China’s fertility policy, the topic of women’s fertility has attracted much attention. In particular, urban women face a difficult choice between family and work. This study analyzed the prevalence and determinants of second-child fertility intention among urban women in China and aimed to provide evidence for improving fertility rate measures. A systematic review and meta-analysis were conducted using quantitative primary studies. We identified 16 cross-sectional studies that investigated a total of 24,979 urban women. The prevalence of second-child fertility intentions was 37%. A subgroup analysis revealed that the highest prevalence was observed between 2016 and 2017, and the lowest was observed in first-tier cities. Meta-analyses indicated that 18 factors were significantly associated with second-child fertility intentions, including demographic factors, fertility attitude, husbands, children, parents, or others. The findings of this study highlight the low second-child fertility intentions among urban women in China. Therefore, policymakers should consider various aspects, gradually optimizing fertility-supporting facilities, while encouraging fertility.