The Gendered Mediation Effects of Social Support on Fertility Intentions Among Childless Adults of Reproductive Age in China: National Cross-Sectional Study.

BACKGROUND

China is currently facing a low fertility rate, making it crucial to explore the influence of psychosocial factors on fertility intentions to address demographic structural challenges. Social support, as a potentially significant influencing factor, is not yet fully understood in terms of its specific pathways and gender differences.

OBJECTIVE

This study aimed to explore how social support impacts fertility intentions among Chinese adults aged 20-49 years, with an emphasis on gender-specific differences and the mediating roles of self-efficacy and conscientiousness.

METHODS

Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR). This study included 2653 childless adults of reproductive age. A decision tree model was used to identify key factors influencing fertility intentions. A mediation analysis was conducted to explore the mediating effects of self-efficacy and conscientiousness while controlling for demographic confounders.

RESULTS

Among all 2653 participants, 71.3% (1892/2653) had fertility intentions. The proportion was significantly higher in men (weighted 79%, 95% CI 76.5%-81.3%) than in women (weighted 64.5%, 95% CI 61.8-67.1; P<.001). Participants with fertility intentions had a higher total social support score (mean 61.25, SD 14.02 vs mean 58.23, SD 13.01; P=.001). For women, family support significantly influenced fertility intentions, whereas support from friends was more relevant for men. Mediation analysis revealed that for men, self-efficacy significantly mediated the relationship between social support and fertility intention, with an indirect effect of 0.06 (95% CI 0.04-0.09; P=.001) and a mediation proportion of 52.54%. For women, conscientiousness played a significant mediating role, with an indirect effect of 0.011 (95% CI 0.002-0.018; P=.001) and a mediation proportion of 10.25%.

CONCLUSIONS

Enhancing targeted social support can increase fertility intentions, with implications for addressing demographic challenges. Tailored policies should prioritize providing family support and fostering conscientiousness for women, while boosting self-efficacy and friend-based social support for men.