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Changes in fertility intention among married Chinese couples with two children during COVID-19: a cross-sectional study
  1. Ni Ning1,2,
  2. Xiangmin Tan3,
  3. Ying Li4,
  4. Jingfei Tang2,
  5. Lisa Lommel5,
  6. Mei Sun6
  1. 1 Graduate School of Innovation and Practice for Smart Society, Hiroshima University, Hiroshima, Japan
  2. 2 Xiangya School of Nursing, Central South University, Changsha, China
  3. 3 School of rural health, Monash University, Melbourne, Victoria, Australia
  4. 4 School of Nursing, Sun Yat-Sen University, Guangzhou, China
  5. 5 School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
  6. 6 School of Nursing, Xinjiang Medical University, Urumqi, China
  1. Correspondence to Professor Mei Sun; smnjw2008{at}126.com

Abstract

Background A three-child policy was implemented in China to stimulate a rise in fertility levels and coincided with the COVID-19 pandemic. Data suggested that COVID-19 has a negative impact on fertility intention.

Aim To describe married couples’ changes in intention to have a third child during the COVID-19 pandemic and determine factors associated with altered intentions.

Methods An online survey was conducted in October 2021, including sociodemographic characteristics, change of intention to have a third child after the COVID-19 pandemic outbreak, reasons for increased or decreased intention, and the Fertility Intention Scale (FIS). Bivariate and multivariable logistic regression were used to test the potential factors associated with changes in intention.

Results A total of 1308 participants provided responses. Following the COVID-19 outbreak, 35.8% of participants decreased their third-child intention, while 2.8% of participants increased their third-child intention. Males (aOR 1.90, 95% CI 1.42 to 2.54), youngsters (aOR 1.77, 95% CI 1.08 to 2.93) and those living in Estern China (aOR 2.12, 95% CI 1.13 to 3.98) were more likely to decrease their third-child intention. Perceived risk (aOR 1.07, 95% CI 1.03 to 1.10) and policy support (aOR 1.06, 95% CI 1.03 to 1.09) as measured on the FIS decreased couples’ intention to have a third child. Social support (aOR 0.94, 95% CI 0.91 to 0.98) as measured on the scale protected participants from decreased intention.

Conclusions During severe public health emergencies, strong prevention and control policies, together with enhancing support from partners and healthcare professionals for women, are necessary to improve intentions to give birth.

  • COVID-19
  • family planning policy
  • health education
  • surveys and questionnaires
  • sexual behavior

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors NN and MS designed the study. NN and XMT collected the data. Data were analysed by NN, JFT and YL. NN prepared the first draft of the manuscript. LL, MS and NN contributed to revising the manuscript. All authors have read and agreed to the published version of the manuscript.

  • Funding This research was funded by Central South University (2022YJSKS026) and Education Bureau of Hunan Province (HNJG-2022-0446).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.