Intent to have a second child among Chinese women of childbearing age following China’s new universal two-child policy: a cross-sectional study

INTRODUCTION: China's one-child policy was replaced by a new universal two-child policy in 2015; however, few studies have addressed the intent to have a second child and resulting related issues. METHODS: We performed a cross-sectional study on 11 991 Chinese women, 18-49 years of age, from 11 provinces in 2016-2017, in order to assess the intent for a second child among Chinese women of childbearing age and other related factors after the introduction of China's new universal two-child policy. RESULTS: We found that the overall prevalence of the intent to have a second child was 39.4% and that economic, childrearing, and health barriers affected fertility intent. Multivariate logistic regression models showed that the age range of 25-39 years (aOR 1.28-1.30), living in Eastern (aOR 1.28, 95% CI 1.10 to 1.50) or Central China (aOR 1.52, 95% CI 1.27 to 1.78), living in a rural area (aOR 1.62, 95% CI 1.47 to 1.78), being a farmer (aOR 1.43, 95% CI 1.09 to 1.88), having a higher household income (aOR 1.13, 95% CI 1.00 to 1.28), having a history of abortion (aOR 1.18, 95% CI 1.05 to 1.31), and already having one child (aOR 3.65 for girls, aOR 2.70 for boys) were associated with a greater intent to have a second child (all p<0.05). Conversely, economic, health, childrearing, and educational barriers were associated with a lower intent to have a second child (aOR 0.65-0.75). CONCLUSION: Four in ten women of childbearing age demonstrated an intent for a second child. We maintain that fertility-related factors be given full consideration when promoting the two-child policy.