Dataset Information

Fertility intentions among young people in the era of China's three-child policy: a national survey of university students.

ABSTRACT:

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.

SUBMITTER: Zhang C

PROVIDER: S-EPMC9372952 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Fertility intentions among young people in the era of China's three-child policy: a national survey of university students.

Zhang Chenyun C Wei Lingling L Zhu Yinyan Y Teng Li L Zhang Wenchang W Xu Jia J Qin Mengqi M Jiang Na N Alias Haridah H Wong Li Ping LP

BMC pregnancy and childbirth 20220812 1

<h4>Background</h4>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.<h4>Methods</h4>A cross-sectional Internet-based survey was conducted on a nationwide sample of young people aged 18 to 28 year ...[more]

PMID: 35962340

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Project description:BackgroundOn May 31, 2021, the Chinese authorities announced that couples can have up to three children, aiming to stimulate a rise in fertility levels. However, there is limited research on second and third birth intentions of the childbearing-age population under China's three-child policy, and the existing results are inconsistent.MethodsA cross-sectional survey was performed in Central China from June to August 2022. A total of 13 479 respondents aged 20-49 were enrolled in the study through a multi-stage sampling method. Data on the intentions to have a second or third child were collected using anonymized questionnaires. Descriptive statistics were performed to assess fertility intentions. Multivariate logistic regression analyses were used to assess the associations between fertility intentions and the related factors.ResultsAmong families with a single child, 29.7% (1444 / 4859) of the respondents intended to have a second child, while among two-child families, 10.6% (750 / 7056) respondents intended to have a third child. Overall, participants indicated that the ideal number of children was 1.85 ± 0.52. The age-specific fertility intentions of the one-child families were always higher than those of two-child families; however, based on couples' age groups, the number of ideal children reported by two-child families was always higher than that of one-child families. Fertility intentions were influenced by the respondents' gender, age, residence, marital status, educational level, average working time, childcare support, marital satisfaction, accessibility of educational resources, health condition of both spouses, loan situation, size of living house and the gender of the first child or second child.ConclusionsThe general prevalence of the second and third birth intention of the childbearing-age population in Central China is not high. To increase the birth rate, it is necessary to create a favourable fertility context and offer supportive measures.

Project description:Aging populations, along with low fertility rates, have become a pervasive world-wide problem. To address this challenge, China issued a universal 3-child policy on May 31, 2021. However, little is known regarding the intentions of childbearing-aged Chinese for a third child. The purpose of this study was to assess the fertility intentions of the Chinese as related to this third-child policy and identify risk factors for third-child refusal. In this cross-sectional study, a total of 2129 Chinese childbearing-aged participants were recruited nationwide from June 15 to July 22, 2021. Each participant was interviewed using questionnaires to establish their sociodemographic variables, psychosocial factors as related to third-child intentions, and reasons for third-child refusal. Finally, 2115 responses (866 men and 1249 women) were analyzed. IBM SPSS Statistical Software (version 19) was used for the statistical analyses. Multivariate logistic regression analyses were used to assess independent influences for third-child refusal. Approximately 30% of these participants reported an intention for having a third child. In those expressing a refusal for a third child, women showed a higher prevalence rate (74.1 vs 63.2%, P < .001). Results from multivariate logistic regression analyses revealed that age (P = .033), unemployment (P = .045), and currently raising 2 children (P = .017) were risk factors for third-child refusal among men, while age (P < .001), >15 years of education (P = .017), current smokers (P = .005) and residing in Northern China (P = .035) were risk factors for women. Overall, increased demands upon time and energy (41.5%), as well as economic burdens (41.4%), were the most prevalent reasons for the refusal of a third child, while achieving mutual care among siblings (52.5%) and reducing child educational costs (33.3%) were the most effective persuasions. In response to the 3-child policy, Chinese childbearing-aged adults showed low rates of intention for a third child, with women showing a higher prevalence of third-child refusal. The identification of risk factors and the reasons for third-child refusal as revealed from the results of this study provide a foundation for the development of programs needed to aid in the implementation of this 3-child policy.

Project description:ObjectivesThe primary objective of this study was to examine the association between fertility awareness knowledge, and contraceptive use among sexually active female university students (FUS) in Cameroon.MethodsThis study was designed as a secondary data analysis of a cross-sectional survey that was conducted between July and August 2018. We extracted and analyzed relevant data (i.e., socio-demographic characteristics, sexual behavior, fertility-related characteristics, and contraceptive use) using a modified Poisson regression with a robust variance estimator. Prevalence Ratios (PR) and 95% confidence intervals were estimated, and statistical significance was set at P≤0.05.ResultsThe median age of the sexually active FUS was 23 years (IQR = 21-25) and 99.3% indicated that they wanted to have children. Only 49.3% knew their fertile period and 62.5% of the sexually active FUS were current contraceptive users. We found a statistically significant association between fertility awareness knowledge and period abstinence (PR = 1.57;95%CI: 1.02-2.44, p = 0.049). In multivariate adjusted models, there was a statistically significant association between fertility awareness knowledge and male condom use (APR = 1.29; 95% CI:1.02-1.64, p-value = 0.032) and the withdrawal method (APR = 1.40;95% CI:1.02-1.93, p = 0.038). We found a statistically significant effect modification of "preferred timing to have children" on the association between fertility awareness knowledge and withdrawal method use. There was no association between fertility awareness knowledge and the use of oral contraceptive pills.ConclusionMost of the female students intend to have children in the future, but their fertility awareness knowledge was suboptimal. There was a statistically significant relationship between fertility awareness knowledge, and the use of male condoms and the withdrawal method. The study underscores the need for FUS to be targeted with interventions to help them gain knowledge of their menstrual cycle to better plan or avoid unwanted pregnancy.

Project description:ObjectiveTo measure the association of China's universal two child policy, announced in October 2015, with changes in births and health related birth characteristics.DesignNational, descriptive before-and-after comparative study.SettingEvery county in 28 of 31 provinces of mainland China.ParticipantsBirths included in two national databases: 67 786 749 births from county level monthly aggregated data between January 2014 and December 2017; and 31 786 279 deliveries from individual level delivery information records between January 2015 and December 2017.Main outcome measuresMonthly mean number of births and mean proportion of multiparous mothers and mothers aged 35 and over, preterm deliveries, and caesarean deliveries.ResultsThe study had two phases: the baseline period (up to and including June 2016, nine months after the policy announcement) and the effective period (from July 2016 to December 2017). The estimated number of additional births attributable to the new policy between July 2016 and December 2017 was 5.40 million (95% confidence interval 4.34 to 6.46). The monthly mean percentage of multiparous mothers and mothers aged 35 and over increased by 9.1 percentage points (95% confidence interval 6.4 to 11.7) and 5.8 percentage points (5.2 to 6.4), respectively. This increase in older mothers, however, was not associated with a concurrent increase in the overall rate of preterm birth. The monthly mean caesarean delivery rate among multiparous mothers increased by 1.2 percentage points (0.8 to 1.6) from 39.7% to 40.9%, and decreased by 3.0 percentage points (-3.5 to -2.5) among nulliparous mothers from 39.6% to 36.6%.ConclusionsSince its announcement in October 2015, the universal two child policy has been associated with a rise in births in China and with changes in health related birth characteristics: women giving birth have been more likely to be multiparous, and more likely to be aged 35 and over. No evidence of concurrent worsening outcomes (that is, premature births) was seen.

Project description:BackgroundAs women increasingly delay childbearing for educational and career pursuits, understanding the age-related decline in ovarian reserve becomes crucial to avoid infertility. Egg freezing offers a solution, extending the window for achieving pregnancy with a biological child. However, awareness and acceptance of age-related fertility decline and elective egg freezing vary across countries and social groups.MethodsThis descriptive cross-sectional study investigates fertility awareness, childbearing intentions, and attitudes toward elective egg freezing among 138 undergraduate female students at a private university in Kumasi, Ghana. Data were collected via a Google App-based questionnaire.ResultsThe majority of respondents were below 28 years old (76.3%), Christians (79.26%), and single (57. 78%). Many respondents overestimated their knowledge of age-related fertility decline, with almost half (48.89%) incorrectly believing it occurs after age 40. Primary sources of fertility education included health professionals, the Internet, and television. While most (62.96%) considered childbearing necessary, they would not have a child without a partner. Acceptance of donor egg in vitro fertilisation (IVF) varied based on circumstances, and a significant portion was open to donating their eggs (41.48%). Awareness of elective egg freezing was low, but nearly half (48.89%) expressed interest in it, primarily to retain the option for a biological child. The cost of elective egg freezing was a significant deterrent.ConclusionsThe study revealed a significant lack of awareness regarding age-related fertility decline and elective egg freezing among female university students in Kumasi. Most prefer having a biological child only with a partner. While few were open to donating their eggs or accepting the same to achieve a pregnancy, interest in elective egg freezing was notable, albeit hindered by cost. The study recommends enhanced education by health professionals using social media and television to address these gaps.

Dataset Information

Fertility intentions among young people in the era of China's three-child policy: a national survey of university students.

Background

Methods

Results

Conclusion

Publications

Fertility intentions among young people in the era of China's three-child policy: a national survey of university students.

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