Low intention of the childbearing-age population to have three children in mainland China
Approximately one-eighth (12.2%) of respondents stated that they desired to have three children, which was lower than the second birth intention of China’s childbearing-age women (36.2%) and floating population (21.3%) [22, 23]. The perceived ideal number of children was 2, which was in line with the nationally representative cross-sectional Bangladesh Demographic and Health Survey 2014 data . The third birth intention of most couples in this survey were the same (70.0%), which was consistent with the reports of Gibbs (92% perceived concordance with partner fertility desire) . Undoubtedly, there was a certain bias in the reported birth intention of the other partner in the couple, which may be largely attributable to the perceptions of partners’ fertility preferences . Birth intention is an important predictor of future population growth in a country. Reproductive decisions are made based on couples’ intentions, and the lack of consideration of partner intentions is a missed opportunity to better comprehend the couple-based nature of fertility behavior . Recent studies in the United States corroborate this idea, showing that each partner influences the probability of having a child [28, 29]. Moreover, there is a strong link between baseline fertility desires and subsequent reproduction .
Fertility intention is not stable and changes as conditions change. Studies have shown that the decision to have children is multifaceted and determined not only by individual and economic factors but also by social policies [31, 32]. The results imply that policy makers and producers of reproductive support measures need to consider the fluidity of fertility desires when taking measures to encourage fertility. If conditions become favorable, desires to have three children could be stimulated and may lead to short birth intervals or eventually translate into fertility behavior.
Therefore, relying solely on policies to promote an increase in birth intention is not sufficient. We should shift our focus in policy making to understanding and guiding the third birth intention status of the childbearing-age population.
Time and energy limitations and the high cost of education were major reasons for low intention
The upbringing, care and education of children are time and energy consuming. Regardless of the occupation type of the childbearing-age group, a busy work schedule, coupled with the parenting of multiple children, can exhaust parents. This is also the main reason why they do not want to have three children. Otherwise, in the Chinese context, due to the lack of public subsidized childcare services, market-based childcare has become the mainstream, leading to a substantial increase in the cost of childcare.
For school-age children’s education, the financial burden on the family has also increased due to the expenditure on education within and outside of school. The off-campus expenses accrue through parents registering for various supplementary and interest classes for their children. On-campus fees include the purchase of school district housing and the payment of school selection fees. According to data from the China Education Panel Survey (CEPS), the average household expenditure on extracurricular tutoring classes nationwide reached 2268 yuan per year in 2014 .
Therefore, increasing financial investment in public nursery services and reducing the education costs of children of school age will contribute to increasing the desire to bear more children and promote reproductive behavior.
Sociodemographic characteristics differ in third birth intention
We found in this study that participants’ willingness to bear a third child gradually declined as age increased (OR = 0.960, 95% CI = 0.950,0.971), which was not consistent with the findings of a fertility desire investigation in Bangladesh . That study found that older couples desired more children than younger ones. It may be that older parental age is associated with reduced fertility and a perceived higher risk of pregnancy and neonatal complications . This also suggests that if the government routinely provides preconception health promotion for older couples in primary medical institutions to help them feel that the risks of pregnancy are more controlled, their third-child fertility intentions may be improved.
The willingness of men to have three children was more than twice that of women. Odusina et al. examined couples’ fertility intentions and found that the husband’s willingness to have more children was 49.3%, which was higher than the wife’s willingness of 43.9% , similar to the results of this study. This was also consistent with the second birth intention of the floating population, in which women have significantly lower intentions than men . This may be related to the diverse social responsibilities caused by gender differences. Regarding reproductive behavior, women bear the main duty of pregnancy and birth, which represents a larger risk to women’s physical and psychological health than to men’s. Moreover, for professional women, having more children means that job stability and career development face greater challenges and threats. Therefore, women are more cautious and conservative in the expression of third birth intention. Many studies gauging men’s fertility intention have indicated that men almost universally express a desire for parenthood, which could help sustain a genetic link to the child and is central to masculinity [36, 37]. Furthermore, men perceive fewer problems relating to balancing work and family life and are less concerned about combining work and parenthood . Having a permanent position and having advanced in one’s profession are the only preconditions for parenthood among men, and they are less likely to believe that having another child will affect their status in the labor market .
The third birth intention of minority nationality is stronger than that of Han nationality (OR = 1.819, 95%CI = 1.612–2.042), which is consistent with the research of second birth willingness of nurses in 6 tertiary hospitals in Urumqi . It may be related to the long-term influence of the late marriage and 35-year long one-child policy on Han groups .
In previous studies, more attention has been paid to the differences in fertility intention between married and single persons , and less is known to the relationship between first or remarried marital status and third birth intention. We find that remarried participants are 2.34 times more likely to have the third birth intention by contrast of those in first marriage, which is consistent with the research of Wu (OR = 3.041, 95%CI = 1.418–6.521) . The potential causes may be related to the tendency to choose co-fertility of reorganized families, which could help sustain and strengthen the emotional relationship between couples and family members.
The analyses of the cross-sectional data on the relationship between education and fertility desire revealed a diversity of findings [15, 42,43,44,45,46,47]. Education is one of the most established socioeconomic determinants of fertility intentions  and is inversely associated with fertility behavior . Previous studies in other developing countries emphasize that women’s fertility intentions tend to decline with educational attainment , especially for females in the floating population . The results of this study are similar to the above research. Comparing to participants with high school degree, the third birth intention of those with a bachelor’s degree and a master’s degree decreased by 37.7% and 44.6%, respectively, which may be related to the phenomenon that improving education allows women to pursue their own careers and have freed some of them from raising children .
Housing type is associated with third birth intention according to the systematic review . We also found that, even participants who rent a house now, their willingness to give birth the third child are 15.9% stronger than those who own house with loan (OR = 0.841, 95%CI = 0.720–0.982). Compared with renting a house, the economic pressure of buying a house with loan in China is greater. Additionally, couples have to invest a high share of their economic resources into home ownership, which necessarily competes with the high costs of bearing another child . If the loan interest rate can be lowered or more convenient and sustainable rental services could be provided, it will help increase intention of childbearing population to have more children in China context.
Annual household income has a positive effect on the rate of preferred birth: the higher the economic status is, the more attention given to the quality of childbearing and the greater the desire not to have another child. The third birth intention of those with monthly family income less than 20,000 and 30,000 yuan, is 80.5% and 78.2% of those with less than 10,000, respectively. In addition, the analysis of the reasoning for different third birth intentions indicated that the high costs of raising and educating children were the second major reasons for unwillingness to have a third child. With the continuous development of China’s social economy and the catalytic effect of family planning on family transformation, families have begun to follow modern reproductive trends. Meaningfully, in addition to the basic living security of children, families focus on children’s emotional wellbeing and quality education. Thus, parents are willing to pay more money and spend more energy to cultivate their children, with fertility costs becoming higher. This is consistent with Becker’s child quantity and quality substitution theory . The important implication of this theory is a negative correlation between the quantity and quality of children, which means that raising the quality of child care may lead to a decline in the number of children. The relationship between economic income and fertility intention is also applicable to some countries in Africa. Additionally, for economic reasons, people of childbearing age experience the constant dilemma of the high fertility costs of additional children and the desire for a larger family . Previous studies stated that persons may revise their preferences if their financial circumstances improve .
Historically, fertility decreases started earlier and developed faster in cities than in rural regions. In the present study, the third birth intention of the rural population was 1.203 times that of the urban population, which was consistent with the results from the 2012 Niger Demographic and Health Survey (OR = 1.61, 95% CI = 1.20-2.17) . Previous studies have also shown that the realization of fertility intention in rural areas is significantly higher than that in urban areas [52, 53]. The reasons may be related to the different regional contexts and fertility ideologies , such as overall maternal employment, the high cost of living, and enhanced educational and labor market opportunities in the urban context. All of the above factors have become barriers to the increase and realization of birth intentions.
Compared with those who have not yet had living children, the third birth intention of those who already have two children increases 83.9%. However, those who have only one existing child are less willing to have the third child (OR = 0.853, 95% CI = 0.729–0.998). Some disparities with studies conducted in sub-Saharan Africa exist in this regard, as one study found that those who had four or more living children were less likely to desire more children (OR = 0.09, 95%CI = 0.07–0.12) . This may be related to the different populations investigated, differences in cultural context and the variance in the number of existing children. Another study also indicated that among childless women in the US, those who experienced infertility and were identified as infertile reported the highest ideal number of children (M = 2.35) . However, this study did not include the previous experience of infertility as an independent variable. Therefore, whether this conclusion is applicable to the Chinese population needs to be further verified.
Three limitations of this study deserve mention. First, the imbalance in the distribution of the population was mainly manifested in the concentration of the population in certain geographical areas. Participants in East China accounted for the highest proportion, exceeding 50% of the total population. A previous study also pointed out that fertility intentions may vary across regions , which was not considered in this research. In addition to the unbalanced geographical distribution, selection bias cannot be ignored in terms of occupation, with healthcare workers enjoying the highest proportion (71.0%). In addition, this study used WeChat to disseminate the questionnaire. Participants without access to this social media application were probably not included, and the response bias could not be estimated. Finally, the third birth intention of spouse was limited to the perception of partner’s desire, which may lead to a moderate agreement of the intention between spouse .