Childbearing attitudes and associated factors among married couples in Mazandaran Province, Iran: a cross-sectional study

Background Childbearing attitudes are influenced by various demographic, socioeconomic, and psychosocial factors. This study aimed to examine factors associated with childbearing attitudes among married couples in Mazandaran Province, Iran. Methods A cross-sectional analytical study was conducted among 1,600 individuals (800 women and 800 men) attending healthcare centers from March 2024 to February 2025. Participants were selected using multistage sampling. Data were collected using a demographic characteristics checklist, the Attitude Toward Childbearing Questionnaire, the Spiritual Health Questionnaire, and the Socioeconomic Status Questionnaire. Data were analyzed using independent t-tests, Pearson correlation, and univariate and multivariate linear regression analyses in SPSS version 23.0. Results The mean age of women was 31.56 ± 7.08 years and men 36.40 ± 7.17 years, with a mean number of children per couple of 1.23 ± 0.89. The mean attitude toward childbearing score was 71.77 ± 14.88 for women and 73.85 ± 13.50 for men, with a mean difference (95% CI) of -2.08 (-3.47 to -0.68), p = 0.003. The multivariate regression model revealed that among the variables studied, age, duration of marriage, number of children, spirituality, and economic status were identified as strong independent predictors of childbearing attitudes in women, while education level, number of children, and spirituality served as independent predictors in men. Conclusion The findings suggest that demographic, socioeconomic, and psychosocial characteristics are associated with childbearing attitudes among married couples. These results may provide insights for future research and interventions aimed at understanding childbearing attitudes. Further longitudinal studies are recommended to clarify potential causal relationships.