Abstract
AIMS: This study investigated second birth intentions and its influencing factors among reproductive-aged women in Shandong Province, China, within the context of the Universal Two-Child Policy (UTCP). BACKGROUND: Refining fertility policies and enhancing fertility rates constitute pivotal strategies for China to mitigate the challenges posed by population aging. Understanding fertility intention and its influencing factors is the foundation for refining fertility policies and enhancing fertility rates. As a traditional populous province of China, it has some representativeness to explore the second-birth intentions and their influencing factors of reproductive-aged women in Shandong Province within the context of the UTCP. METHODS: A cross-sectional questionnaire survey was conducted among 2,422 reproductive-aged women (18-45 years) randomly recruited from Shandong Province. Univariate analysis and binary logistic regression analyses were used to identify factors associated with second-birth intentions. RESULTS: Only 48.02% of respondents expressed willingness to have a second child. The results showed that influencing factors of second birth intentions (p < 0.05) included actual fertility timing, impact of household economic status on actual fertility intention, awareness of fertility policy, place of household registration, impact of social and familial expectations on actual fertility intention, marital status, impact of personal career development on actual fertility intention, household size, impact of challenges of childcare on actual fertility intention, self-health status, impact of perceptions of fertility on actual fertility intention and only-child status (ranked by the importance of influencing factors). CONCLUSION: Various social, economic and personal factors limit second-birth intentions among reproductive-aged women in Shandong. Targeted policies to reduce childcare burdens, support only-child families and protect women's health and work rights can foster sustainable fertility intentions.