Fertility intention of young people of childbearing age in China after the implementation of the two-child policy—A systematic review and meta-analysis

In recent years, due to the continuous increase of China's aging population and the decline of birth rate, China 's population base has declined sharply, and the fertility problem of young people has attracted much attention from scholars. Therefore, this study aims to comprehensively analyze the fertility intentions of young people of childbearing age and their influencing factors, explore the reasons for China's low fertility rate, and provide a reasonable theoretical basis for the formulation of subsequent fertility-related policies. A systematic literature search was conducted from January 2012 to September 2023 through the databases PubMed, Web of Science, Embase, CNKI, Wanfang, and VIP using keywords including fertility desire, fertility intention, fertility plan, fertility purpose, fertility motivation, youth, urban youth, school-age youth, childbearing age youth in Chinese; and fertility desire, fertility intention, fertility plan, fertility willingness, youth, young people, child-bearing youth, and school-age youth in English. Two reviewers independently screened studies, extracted data, and appraised the risk of bias. RevMan 5.2 was used for the Meta-analysis of all outcomes. This study systematically evaluated 18 cross-sectional surveys, which included a total of 43,427 participants, with a combined fertility intention of 11.85%. Subgroup analyses revealed that gender, age, education level, economic level, nature of the household, number of existing children, and gender of the first child were related to fertility intentions of young people of childbearing age. In terms of fertility attitudes, the expectations of contemporary young people of childbearing age have shifted from the traditional attitude of "emphasizing sons over daughters" to the attitude of " gender equality ". The low fertility intentions of young people of childbearing age in China are constrained by a combination of economic, age, and level of education. The government may increase the fertility intention of young people by increasing the economic support for fertility, implementing the local education promotion related to "parenting", and actively implementing the early and active fertility of young people of childbearing age.