Research on the Factors Influencing the Fertility Intentions of Women of Childbearing Age under the Three-Child Policy: Empirical research based on CGSS 2021 data

doi:10.21203/rs.3.rs-4107103/v1

Download PDF

Research Article

Research on the Factors Influencing the Fertility Intentions of Women of Childbearing Age under the Three-Child Policy: Empirical research based on CGSS 2021 data

https://doi.org/10.21203/rs.3.rs-4107103/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Objective

The fertility intentions of women of childbearing age in China has declined to very low levels, The purpose of this study is to explore the fertility intention for having a third child under the three-child policy and the factors that influence these intentions.

Methods

Based on the 2021 China General Social Survey (CGSS) database, a sample of 864 individuals was selected according to the research objectives. we systematically analyzed the third child fertility intention using descriptive statistical analysis, t-tests or chi-square tests, and binary logistic regression were used for analysis.

Results

Among the 864 women aged 20 to 49, 28.819% expressed a willingness to have a third child. Binary logistic regression analysis revealed that personal education level, family annual income, affordable kindergarten services, and parental support in childcare are factors influencing the fertility intentions of women of childbearing age (P < 0.05). Women with higher education level have a lower willingness to have a third child. Conversely, women with lower education level, higher family income, access to affordable kindergarten services nearby, and support from their parents in childcare have a higher willingness to have a third child.

Conclusions

Implementing the three-child policy necessitates the development of comprehensive support measures, the promotion of various forms of beneficial services, and the strengthening of comprehensive supervision of childcare services to reduce the costs of childbirth, upbringing, and education, hence alleviating family concerns and better unleashing fertility potential, facilitating attainment of a moderate fertility level.

Three-child policy

Women of childbearing age

Fertility intentions

Family support

Binary logistic regression

In recent years, the decline in fertility rates has become a real issue in China and has become a global phenomenon¹. According to the United Nations' "2020 World Fertility and Family Planning Report," the global fertility rate has dropped from 3.2 live births per woman in 1990 to 2.5 in 2019². The United Nations predicts that by 2050, the global fertility rate will reach 2.2 live births per woman, and the fertility rate will continue to decline². According to the data from the seventh national population census, China's overall fertility rate in 2020 was 1.61 live births per woman, and China has fallen into a fertility trough³. The decline in fertility rates will lead to a reduction in the labor force, economic development constraints, a lack of innovation, and population aging, especially in highly industrialized countries⁴. With an aging population, the social burden related to medical insurance management will increase. To raise the fertility rate, the Chinese government issued the "conditional two-child" policy in November 2013, allowing couples where at least one partner is an only child to have two children, gradually phasing out the one-child policy⁵. However, the release of the policy did not fully motivate the potential for fertility. In October 2015, the government introduced the "universal two-child" policy to stimulate fertility, according to which couples are not restricted by the one-child policy and can have two children. The fertility rate increased by 12.95‰ and 12.43‰ in 2016 and 2017³. However, the subsequent impetus of the policy was insufficient, and its promotion of fertility behavior was limited. Compared with the period from 2011 to 2015, the fertility rate decreased by 1.17‰ and 1.63‰ in 2018 and 2019, respectively³. On August 20, 2021, the Standing Committee of the National People's Congress voted to amend the Population and Family Planning Law, and the amended law stipulates that the state advocates appropriate age for marriage and childbirth, and excellent childbirth and upbringing, and a couple can have three children⁶. In 2022, China's birth population was 9.56 million, of which the proportion of three children and above was 15.0%⁷. The introduction of the three-child policy will reverse the current low fertility rate remains to be observed.

Fertility intentions are related to various factors, such as family income, intergenerational support, and childcare environment. Studies have shown that family income affects fertility rates, and the higher the economic status, the more attention is paid to the quality of childbirth, and the stronger the desire not to have children⁸. Intergenerational support has a positive impact on fertility rates⁹. Couples living with their parents or parents-in-law or living close by can avoid negative impacts on women's careers, compensate for women's disadvantaged position in the labor market, and bring economic benefits to the family^10–11. The difficulty of raising children is exacerbated for families by the dearth of childcare facilities and the high expense of private daycare facilities. Children's education and rearing need a lot of time and effort. Whatever their occupation, women of reproductive age often face exhaustion from their demanding work schedules and raising family loads. This is also the main reason why they do not want to have three children. In China, due to the lack of public subsidies for childcare institutions and the insufficient number of public childcare institutions, private childcare institutions have become mainstream, leading to a significant increase in childcare costs. For the education of school-age children, due to the expenses of both in-school and out-of-school education, the economic burden on families has also increased. Out-of-school costs are generated by parents enrolling their children in various tutoring classes and interest classes. In-school costs include purchasing school district housing and paying school selection fees. According to data from the China Education Panel Survey (CEPS), the average annual expenditure for tutoring classes for families across the country reached 2,268 yuan in 2014¹². Existing literature has proven that these factors are related to fertility intentions, but in real life, we often face a mix of multiple factors, so we should simulate the possible situations in real life and discuss their impact on fertility rates.

Implementing the three-child fertility policy is beneficial in the long term for improving the population age structure, expanding the supply of new labor, reducing the dependency ratio of the elderly population, easing intergenerational conflicts, increasing overall social vitality, and lowering the peak level of aging¹⁴. The policy and its accompanying adjustments mostly affected women of reproductive age, who are defined as 15 to 49 years old and engage in family planning; in reality, family planning monitoring typically begins with marriage, especially women aged 20 to 29, who are in the peak period of fertility¹³. To ensure the overall health level of childbearing women and promote the fertility intentions of the masses, providing a basis for the implementation of the three-child fertility policy, this study uses data from the 2021 "China General Social Survey (CGSS)" to investigate the fertility intentions and influencing factors of women aged 20 to 49.

1.1 Data Sources

The data for this study comes from the 2021 CGSS database. The 2021 CGSS is the 14th annual survey of the China General Social Survey. The project team overcame the difficulties brought by the COVID-19 pandemic and completed the annual survey work in nearly five months, completing a total of 8,148 valid samples nationwide. The study focuses on women aged 20 to 49, so male samples and female samples born after December 31, 2001, were excluded. In addition, considering that women lose their fertility after menopause, and the average age of menopause for women in China is 50 years old, female samples born before January 1, 1972, were also excluded¹³. After screening, a total of 1,854 samples were included, involving 19 provinces/municipalities/autonomous regions. After excluding lost data and erroneous data, a final sample of 864 respondents was included, as shown in Fig. 1.

1.2 Research methods

The CGSS2021 database covers a wide range of content, including 700 variables. According to the research objectives, the following content was extracted: 1. Personal situation: education level, number of properties, housing area, nature of work, medical and pension insurance, household registration, place of residence; 2. Hypothetical questions: family annual income, parental support in raising children, number of sons or daughters, various types of kindergartens; among them, education level was assigned values of 1 for primary school and below, 2 for junior high school, 3 for high school, and 4 for university; the fertility intention for a third child came from the survey questionnaire question "Ms. Li, who is 32 years old, already has two children (boys or girls are not limited). If the policy conditions allow, do you think she should have a third child under the following conditions?" If the answer is ≤ 2, it is considered as having no intention to have a third child and assigned a value of 0; if the answer is > 2, it is considered as not opposing having a third child and assigned a value of 1; the region of residence was divided according to the administrative divisions of China into seven parts, namely East China, North China, Central China, South China, Southwest, Northwest, and Northeast.

1.3 Statistical Analysis

Data analysis was conducted using SPSS 22.0 software. Frequency and proportion were used for general descriptive analysis of the respondents' personal situation and hypothetical conditions, t-tests or chi-square tests were used to compare the fertility intentions of women aged 20 to 49, and logistic regression models were used to explore the influencing factors of the fertility intention for a third child, with a significance level of α = 0.05.

2.1 Univariate Analysis of Factors Influencing the Fertility Intention for a Third Child in the Study Subjects

Among the 864 women aged 20 to 49 who met the research objectives, 249 (28.819%) expressed a willingness to have a third child. The analysis showed significant differences in educational attainment (P < 0.05); the proportion of rural household registration was 59.75%, with a willingness to have a third child at 34.36% (P < 0.05). Hypothetical conditions: For women with an annual family income of 500,000, 150,000, and 50,000, the proportions willing to have a third child were 50.91%, 31.16%, and 14.95%, respectively; women with parental support in childcare had a willingness of 35.8% (P < 0.05); women living near low-cost public kindergartens, low-cost private kindergartens, and high-cost public or private kindergartens had willingness rates of 33.89%, 34.35%, and 28.32%, respectively, as shown in Table 1.

Table 1

Univariate analysis of fertility intentions for a third child among women of childbearing age
	Total	Willing to have a third child n = 249	Not willing to have a third child n = 615	P value
Education Level	3(2, 4)	3(2, 4)	3(2, 4)	0.001
Number of Properties	0.53	0.52	0.54	0.587
Housing Area	120.18	115.41	122.41	0.0543
Work in Government Agencies	11.06%	33.17%	66.83%	0.739
Work in Enterprises	23.62%	28.31%	71.69%	0.049
Work in Social Organizations	2.16%	35%	65%	0.696
No Work	16.24%	30.23%	69.77%	0.437
Urban Basic Medical Insurance / New Rural Cooperative Medical Scheme Insurance / Public Medical Expenses	94.02%	32%	68%	0.722
Urban / Rural Basic Pension Insurance	63.25%	30.6%	69.4%	0.137
Commercial Health Insurance	20.34%	30.9%	69.1%	0.654
Commercial Pension Insurance	9.31%	30.7%	69.3%	0.738
Rural Household Registration	59.75%	34.36%	65.64%	0.016
Urban Household Registration	40.25%	29.01%	70.99%	-
Residence in East China	35.17%	31.44%	68.56%	0.632
North China	16.77%	30.23%	69.78%	0.426
Central China	18.5%	34.4%	65.6%	0.322
South China	4.58%	29.41%	70.59%	0.58
Southwest China	9.65%	36.31%	63.69%	0.209
Northwest China	11.27%	34.45%	65.55%	0.427
Northeast China	4.05%	22.67%	77.33%	0.73
Annual Family Income 50,000	33.55%	14.95%	85.05%	0.000
Annual Family Income 150,000	33.93%	31.16%	68.84%	0.525
Annual Family Income 500,000	32.52%	50.91%	49.09%	0.000
Parental Support in Childcare	48.81%	35.8%	64.2%	0.001
Number of Sons	1(0, 2)	1(0, 2)	1(0, 2)	0.109
Number of Daughters	1(0, 2)	1(0, 2)	1(0, 2)	0.109
Affordable Public Kindergarten	32.47%	33.89%	66.11%	0.266
Affordable Private Kindergarten	33.44%	34.35%	65.65%	0.149
High-Cost Public or Private Kindergarten	34.09%	28.32%	71.68%	0.011

Note:

Education level was assigned values of 1 for primary school and below, 2 for junior high school, 3 for high school, and 4 for university.

The fertility intention for a third child came from the survey questionnaire question "Ms. Li, who is 32 years old, already has two children (boys or girls are not limited). If the policy conditions allow, do you think she should have a third child under the following conditions?" If the answer is ≤ 2, it is considered as having no intention to have a third child and assigned a value of 0; if the answer is > 2, it is considered as not opposing having a third child and assigned a value of 1.

2.2 Multivariate Regression Analysis of Factors Influencing the Fertility Intention for a Third Child in the Study Subjects

Binary logistic regression analysis showed that educational attainment, family annual income, the presence of low-cost childcare facilities nearby, and parental support in childcare significantly influenced the fertility intention for a third child among women of childbearing age (P < 0.05). There was a negative correlation between educational attainment and fertility intention (OR = 0.851), meaning that the higher the education level, the lower the fertility intention. The place of household registration (rural or urban) did not significantly affect the fertility intention of women of childbearing age for a third child (P > 0.05). Family annual income (OR = 2.436), the presence of low-cost childcare facilities nearby (OR = 1.393), and parental support in childcare (OR = 1.426) were positively correlated with fertility intention, indicating that higher income, access to low-cost childcare facilities, and parental assistance all promote the fertility intention for a third child among women of childbearing age, as shown in Fig. 2.

According to the heat map (Fig. 3) analysis, the strongest fertility intention for a third child was found among women with a junior high school education level and an annual family income of 500,000, while the lowest fertility intention was among women with a high school education level or above and an annual family income of 50,000. It’s also as shown in Figs. 4 and 5.

3.1 Modern Fertility Concepts

We found that the gender of the existing children did not affect the fertility intention of women of childbearing age for a third child. The reasons for this analysis are as follows. Firstly, with economic development, women gradually become economically independent, and the family's internal power structure becomes more equal or dominant, no longer dependent on their husbands¹⁵. In the age of information, as the level of education of modern people increases, social and ideological views gradually change, moving away from a preference for male children to gender equality^{16, 17}. In China, the marriage cost for daughters is generally lower than for sons, because Chinese grooms are expected to provide a dowry, wedding ceremony, and wedding house¹⁸. Therefore, in families with multiple sons, there is a preference for having daughters.

3.2 Educational Level

Consistent with other studies, educational level is one of the most established socio-economic determinants of fertility intention, with respondents who have received higher education being less likely to have a third child^19–21. Previous research has indicated that compared to high school education, the third-child fertility intention of those with bachelor's and master's degrees decreased by 37.7% and 44.6%, respectively¹⁹. This phenomenon can be explained by the fact that adult children, as their primary caregivers, traditionally provide economic support for their aging parents through Chinese cultural norms. However, in China, the elderly who have received higher education can live on their pensions, thus reducing the motivation to have more children²². More importantly, women with higher education no longer content themselves with being full-time homemakers but focus primarily on pursuing their own career development²³. These women are not inclined to have more children in order to balance work and family life.

3.3 Rural Household Registration

Rural household registration showed a statistically significant difference in the univariate analysis but did not show a significant difference in the binary logistic regression, indicating that rural household registration is not an independent influencing factor. It is influenced by various factors such as education level and family economic status. After these factors are regressed, rural household registration is not found to be an independent influencing factor.

3.4 Economic Level and Women's Career-Family View in the New Era

Some evidence suggests that the conflict between work and family makes it incompatible for women to balance career success and having multiple children^24–26. Yang Qian's research indicates that the decision to have a second child is associated with high economic costs, mainly because it negatively impacts the mother's career without corresponding economic benefits²⁶. Another survey in Xi'an shows that about three-quarters of mothers feel moderate to severe conflict between work and raising two children²⁵. Therefore, women tend to have fewer children to compensate for their disadvantaged position in the labor market²⁷. Additionally, from an economic perspective, the economic benefits women gain from the workplace are much higher than the returns from the family²⁷. The government should strive to reduce the negative impact of having multiple children on women's careers by providing childcare support and enhancing the fertility intention of modern women²⁶.

3.5 Economic Level and Childcare Institutions, Intergenerational Support

The change in family annual income from 50,000 to 500,000, the availability of low-cost kindergartens nearby, and whether parents can help, all indirectly reflect the economic level. To encourage the birth of a third child, social support can be increased, such as adding affordable and high-quality childcare institutions. The government needs to first address these issues²⁸. The main external factors influencing the fertility intention for a third child come from family members' support¹⁰. Studies have found that cohabitation of three generations has a positive impact on increasing fertility rates because the intergenerational transmission of reproductive behavior and family network support can alleviate the burden of child-rearing for couples^29–30. The Singaporean government encourages three-generation cohabitation who live together or live close by³¹, and the Chinese government can also advocate for this family arrangement^32–33. This arrangement will increase the likelihood of women returning to work after childbirth, thereby bringing economic benefits¹¹. However, the government should relax household registration policies and provide convenience in medical care, housing, life, and social aspects for parents from other places to truly achieve three-generation cohabitation, reduce the child-rearing burden on couples, and increase the fertility intention for a third child.

3.6 Regional Relationship

The seven administrative regions were divided, but there were no differences, indicating that the decision to raise a third child is not related to the region but is more influenced by economic and educational levels, and has little to do with traditional culture and the economic level of the region.

4 Limitations

This study has the following limitations. Firstly, this research is based on data from the 2021 survey and does not compare with longitudinal data. Future studies can design longitudinal research to observe changes in fertility intentions over many years to draw more accurate conclusions. Secondly, a literature review indicates that health concerns about fertility risks significantly affect couples' willingness to have more children³⁴, and Kjerulff et al.³⁵ also found that women who have had cesarean sections are less likely to have two or three children than those who have had vaginal deliveries, as most couples consider multiple cesarean sections to be high-risk. The population participating in the fertility intention survey did not distinguish between those who have not given birth and those who have, and the delivery methods and obstetric history of those who have given birth were not included in the study, which requires further exploration.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. All data was from http://www.cnsda.org/index.php?r=projects/view&id=65635422.

Conflict of interest

All the authors declare no conflicts of interest.

Vollset, S.E.; Goren, E.; et al. Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: A forecasting analysis for the Global Burden of Disease Study. Lancet 2020, 396, 1285–1306.
United Nations, Department of Economic and Social Affairs, Population Division. World Fertility and Family Planning Highlights.
Population Census Office of the State Council, population statistics Department of National Bureau of statistics of China, 2021.
Skakkebaek NE, Jørgensen N, Andersson AM, et al. Populations, decreasing fertility, and reproductive health. Lancet. 2019; 393(10180): 1500–1.
Feng W, Gu B, Cai Y. The end of China's one-child policy. Stud Fam Plan. 2016; 47(1): 83–6.
National People's Congress Standing Committee meeting on August 20th voted to pass the decision on amending the Population and Family Planning Law. CCTV. 2021-08-20 [Retrieved 2021-08-20].
Health Development Statistical Bulletin released. National Bureau of Statistics. 2023-10-12 [Retrieved 2023-10-12].
Yan, Z., Hui, L., Wenbin, J., et al. Third birth intention of the childbearing-age population in mainland China and sociodemographic differences: a cross-sectional survey. BMC Public Health 21, 2280 (2021).
Li Y, Jiang Q. Intergenerational Effects and Second-Child Fertility Behavior Among Women of Childbearing Age: Empirical Findings from Shaanxi Province, China. 2015.
Qian Y, Liu XY, Fang B, Zhang F, Gao R. Investigating fertility intentions for a second child in contemporary China based on user-generated content. Int J Environ Res Public Health 2020; 17: 3905.
Shen K, Zhang Y, Yan P. The causal effect of family structure on female labor force participation. Popul Res 2012; 36: 15–27.
Ding ZH. Four basic ways to reduce the cost of childbearing and parenting education. China Population News. 2021-06-24(003).
Xie Xing, Kong Beihua, Duan Tao. Obstetrics and Gynecology [M]. 9th Edition. Beijing: People's Health Publishing House, 2018: 17.
National Health Commission officials answer questions from Xinhua News Agency on the implementation of the three-child policy. Baijiahao. [Retrieved 2021-06-01].
Jiang, Q.; Zhang, C. Recent sex ratio at birth in China. BMJ Glob Health 2021, 6, e005438.
Quanbao, J.; Shuzhuo, L.; Marcus, W.F. Demographic Consequences of Gender Discrimination in China: Simulation Analysis of Policy Options. Popul. Res. Policy Rev. 2011, 30, 619–638.
Guo, J.; Lin, S.; Guo, Y. Sex, Birth Order, and Creativity in the Context of China’s One-Child Policy and Son Preference. Creat. Res. J. 2018, 30, 361–369.
Jiang, Q.B. Sex Imbalance and Marriage Squeeze. Available online: https://theasiadialogue.com/2019/11/18/gender-imbalance-and-the-marriage-squeeze-in-china/ (accessed on 18 November 2019).
Yan, Z.; Hui, L.; Wenbin, J.; Liuxue, L.; Yuemei, L.; Bohan, L.; Lili, W. Third birth intention of the childbearing-age population in mainland China and sociodemographic differences: A cross-sectional survey. BMC Public Health 2021, 21, 2280.
Zheng, Y.; Yuan, J.; Xu, T.; Chen, M.; Liang, H.; Connor, D.; Gao, Y.; Sun, W.; Shankar, N.; Lu, C., et al. Socioeconomic status and fertility intentions among Chinese women with one child. Hum. Fertil. 2016, 19, 43–47.
Matovu, J.K.; Makumbi, F.; Wanyenze, R.K.; Serwadda, D. Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: A cross-sectional study. Reprod. Health 2017, 14, 2.
Qian, Y.; Liu, X.Y.; Fang, B.; Zhang, F.; Gao, R. Investigating Fertility Intentions for a Second Child in Contemporary China Based on User-Generated Content. Int. J. Environ. Res. Public Health 2020, 17, 3905.
Liu, P.; Cao, J.; Nie, W.; Wang, X.; Tian, Y.; Ma, C. The Influence of Internet Usage Frequency on Women‘s Fertility Intentions—The Mediating Effects of Gender Role Attitudes. Int. J. Environ. Res. Public Health 2021, 18, 4784.
Zhou Y. The dual demands: gender equity and fertility intentions after the one-child policy. J. Contemp China 2018, 28, 367–384.
Liu J, Zhou Z. Mothers’ subjective well-being after having a second child in current China: a case study of Xi’an city. Int J Environ Res Public Health 2019, 16, 3823.
Qian Y, Liu XY, Fang B, Zhang F, Gao R. Investigating fertility intentions for a second child in contemporary China based on user-generated content. Int J Environ Res Public Health 2020, 17: 3905.
Yang SL, Yao J. Gender conception, family-work conflict and fertility intention of reproductive age women. J Shijiazhuang Tiedao Univ 2021, 15, 30–38.
Tatum M. China's three-child policy. Lancet 2021, 397, 2238.
Weinstein M, Sun TH, Chang MC, Freedman R. Household composition, extended kinship, and reproduction in Taiwan: 1965-1985. Popul Stud (Camb) 1990, 44, 217–239.
Sear R, Coall D. How much does family matter? Cooperative breeding and the demographic transition. Popul Dev Rev 2011, 37, 81–112.
Liang Y. China may get enlightenment from Singapore’s model of family support for elderly. Going Forward in the Same Boat 2014, 9: 36–37.
Laidlaw K, Wang D, Coelho C, Power M. Attitudes to ageing and expectations for filial piety across Chinese and British cultures: a pilot exploratory evaluation. Aging Ment Health 2010, 14, 283–292.
Zeng Y, Hesketh T. The effects of China's universal two-child policy. Lancet 2016, 388, 1930–1938.
Hashemzadeh, M.; Shariati, M.; Mohammad Nazari, A.; Keramat, A. Childbearing intention and its associated factors: A systematic review. Nurs. Open 2021, 8, 2354–2368.
Kjerulff, K.H.; Velott, D.L.; Zhu, J.; Chuang, C.H.; Hillemeier, M.M.; Paul, I.M.; Repke, J.T. Mode of first delivery and women‘s intentions for subsequent childbearing: Findings from the First Baby Study. Paediatr. Perinat. Epidemiol. 2013, 27, 62–71.

No competing interests reported.

Download PDF

Version 1

posted

You are reading this latest preprint version

Research on the Factors Influencing the Fertility Intentions of Women of Childbearing Age under the Three-Child Policy: Empirical research based on CGSS 2021 data

Status:

Version 1

Abstract

Objective

Methods

Results

Conclusions

Figures

Introduction

Data and Methods

1.1 Data Sources

1.2 Research methods

1.3 Statistical Analysis

Results

Discussion

3.1 Modern Fertility Concepts

3.2 Educational Level

3.3 Rural Household Registration

3.4 Economic Level and Women's Career-Family View in the New Era

3.5 Economic Level and Childcare Institutions, Intergenerational Support

3.6 Regional Relationship

4 Limitations

Declarations

References

Additional Declarations

Status:

Version 1