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Article(id=1241102814806593724, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102813938380911, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202403221, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1710259200000, receivedDateStr=2024-03-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773831569624, onlineDateStr=2026-03-18, pubDate=1724515200000, pubDateStr=2024-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773831569624, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773831569624, creator=13701087609, updateTime=1773831569624, updator=13701087609, issue=Issue{id=1241102813938380911, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='16', pageStart='2881', pageEnd='3072', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773831569418, creator=13701087609, updateTime=1773831807198, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241103811318706322, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102813938380911, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241103811318706323, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102813938380911, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2982, endPage=2987, ext={EN=ArticleExt(id=1241102815158915262, articleId=1241102814806593724, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The effect of fertility support on the fertility intention of married women of childbearing age under the three-child policy, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the current status of fertility intentions among married women of childbearing age in Hebei Province under the background of the three-child policy, and to analyze the influencing factors of fertility support on married women of childbearing age’s fertility intention.

Methods

A random cluster sampling method was used to select married women of childbearing age in Hebei Province as the respondents in July 2023, and a self-designed questionnaire was used for the survey. Multinomial logistic regression was used to analyze the influencing factors of fertility intentions among married women of childbearing age.

Results

A total of 1 200 questionnaires were distributed and 1104 valid questionnaires were collected, with a valid recovery rate of 92%. Among the survey subjects, 222 people (20.1%) had no intention of fertility/re-fertility, 263 people (23.8%) intended to have 1 child, 545 people (49.4%) intended to have 2 children, and 74 people (6.7%) intended to have 3 children or more. The results of multinomial logistic regression analysis showed that age, ethnicity, occupation, and residence area were influencing factors of fertility intentions. In terms of fertility support, time support, monthly childcare expenses, maternal care, and economic support were influencing factors of fertility intentions among married women of childbearing age.

Conclusion

The fertility intentions of married women of childbearing age are relatively low, and the intention of having three children is still at a low level. Actively providing fertility support and policies that encourage the fertility intentions of married women of childbearing age, and creating a good fertility environment, will help to enhance the fertility intentions of married women of childbearing age.

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目的

调查三孩政策背景下河北省已婚育龄女性生育意愿现状，并分析生育支持对已婚育龄女性生育意愿的影响因素。

方法

采用随机整群抽样方法，于2023年7月抽取河北省内已婚育龄女性作为调查对象，利用自行设计的问卷进行调查，采用无序多分类logistic回归分析已婚育龄女性生育意愿的影响因素。

结果

共发放1 200份问卷，回收有效问卷1 104份，有效回收率92%。调查对象中，222人（20.1%）无生育/再生育意愿，263人（23.8%）意愿生育1个孩子，545人（49.4%）意愿生育2个孩子，74人（6.7%）意愿生育3个及以上孩子。无序多分类logistic回归分析结果显示，年龄、民族、职业、居住地是生育意愿的影响因素；生育支持中，时间支持、托育费用、孕产保健、经济支持是已婚育龄女性生育意愿的影响因素。

结论

已婚育龄女性的生育意愿较低，三孩意愿仍处于较低水平，积极提供促使已婚育龄女性意愿生育的生育支持及政策，营造良好的生育环境，有助于提升已婚育龄女性的生育意愿。

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肖永红，E-mail：
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宋瑾娴（1997—），女，硕士，研究方向：流行病与卫生统计学

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Journal of Huazhong Agricultural University: Social Sciences Edition, 2023, (6): 172-180., articleTitle=The effect of maternity insurance on the reproductive willingness of women with a child analysis based on 2018 CLDS Data, refAbstract=null)], funds=[Fund(id=1241102819806204211, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, awardId=HB22RK002, language=CN, fundingSource=河北省社会科学基金(HB22RK002), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241102815913889987, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, xref=1., ext=[AuthorCompanyExt(id=1241102815922278596, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, companyId=1241102815913889987, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, North China University of Technology, Tangshan, Hebei 063210, China), AuthorCompanyExt(id=1241102815930667205, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, companyId=1241102815913889987, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.华北理工大学公共卫生学院，河北 唐山 063210)]), AuthorCompany(id=1241102816031330503, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, xref=2., ext=[AuthorCompanyExt(id=1241102816039719112, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, companyId=1241102816031330503, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.河北省煤矿卫生与安全重点实验室)])], figs=[ArticleFig(id=1241102818883457279, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=EN, label=Table 1, caption=

Analysis of the desired number of children for women of childbearing age with different individual characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
个体特征人数意愿生育个数[n(％)]χ2值P值
012≥3
年龄(岁)
20～27371198(53.4)75(20.2)94(25.3)4(1.1)411.487<0.001
28～3520920(9.6)51(24.4)119(56.9)19(9.1)
36～432633(1.1)75(28.5)160(60.8)25(9.5)
44～492611(0.4)62(23.8)172(65.9)26(10.0)
民族
汉族991212(21.4)238(24.0)479(48.3)62(6.3)13.0540.005
其他11310(8.8)25(22.1)66(58.4)12(10.6)
文化程度
本科以上16224(14.8)56(34.6)75(46.3)7(4.3)88.973<0.001
本科519159(30.6)112(21.6)223(43.0)25(4.8)
大专22624(10.6)54(23.9)126(55.8)22(9.7)
高中及以下19715(7.6)41(20.8)121(61.4)20(10.2)
职业
机关单位12812(9.4)43(33.6)64(50.0)9(7.0)344.348<0.001
个体工商户2177(3.2)42(19.4)145(66.8)23(10.6)
企业职工27925(9.0)79(28.3)155(55.6)20(7.2)
技术人员301165(54.8)59(19.6)75(24.9)2(0.7)
无业或其他17913(7.3)40(22.3)106(59.2)20(11.2)
居住地
城区579144(24.9)154(26.6)254(43.9)27(4.7)32.675<0.001
乡镇/村52578(14.9)109(20.8)291(55.4)47(9.0)
月收入(元)
≤2 000351142(40.5)74(21.1)119(33.9)16(4.6)144.484<0.001
2 001～6 00043853(12.1)95(21.7)252(57.5)38(8.7)
6 001～10 00018317(9.3)52(28.4)102(55.7)12(6.6)
≥10 00013210(7.6)42(31.8)72(54.5)8(6.1)
), ArticleFig(id=1241102818971537669, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=CN, label=表1, caption=

不同个体特征已婚育龄女性生育意愿分析[n(％)]

, figureFileSmall=null, figureFileBig=null, tableContent=
个体特征人数意愿生育个数[n(％)]χ2值P值
012≥3
年龄(岁)
20～27371198(53.4)75(20.2)94(25.3)4(1.1)411.487<0.001
28～3520920(9.6)51(24.4)119(56.9)19(9.1)
36～432633(1.1)75(28.5)160(60.8)25(9.5)
44～492611(0.4)62(23.8)172(65.9)26(10.0)
民族
汉族991212(21.4)238(24.0)479(48.3)62(6.3)13.0540.005
其他11310(8.8)25(22.1)66(58.4)12(10.6)
文化程度
本科以上16224(14.8)56(34.6)75(46.3)7(4.3)88.973<0.001
本科519159(30.6)112(21.6)223(43.0)25(4.8)
大专22624(10.6)54(23.9)126(55.8)22(9.7)
高中及以下19715(7.6)41(20.8)121(61.4)20(10.2)
职业
机关单位12812(9.4)43(33.6)64(50.0)9(7.0)344.348<0.001
个体工商户2177(3.2)42(19.4)145(66.8)23(10.6)
企业职工27925(9.0)79(28.3)155(55.6)20(7.2)
技术人员301165(54.8)59(19.6)75(24.9)2(0.7)
无业或其他17913(7.3)40(22.3)106(59.2)20(11.2)
居住地
城区579144(24.9)154(26.6)254(43.9)27(4.7)32.675<0.001
乡镇/村52578(14.9)109(20.8)291(55.4)47(9.0)
月收入(元)
≤2 000351142(40.5)74(21.1)119(33.9)16(4.6)144.484<0.001
2 001～6 00043853(12.1)95(21.7)252(57.5)38(8.7)
6 001～10 00018317(9.3)52(28.4)102(55.7)12(6.6)
≥10 00013210(7.6)42(31.8)72(54.5)8(6.1)
), ArticleFig(id=1241102819059618059, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=EN, label=Table 2, caption=

Univariate analysis of the effect of fertility support on the desired number of children for women of childbearing age

, figureFileSmall=null, figureFileBig=null, tableContent=
生育支持及分类人数意愿生育个数[n(％)]χ2值P值
012≥3
时间支持(休假及弹性工作)121.755<0.001
弹性工作制或灵活时间24520(8.2)57(23.3)148(60.4)20(8.2)
育儿假/产假<98天41869(16.5)102(24.4)219(52.4)28(6.7)
育儿假/产假≥98天278115(41.4)59(21.2)96(34.5)8(2.9)
不提供/不了解16318(11.0)45(27.6)82(50.3)18(11.0)
照料支持58.654<0.001
托育机构数(个)
016245(27.8)33(20.4)70(43.2)14(8.6)
1～252463(12.0)132(25.2)288(55.0)41(7.8)
≥310416(15.4)24(23.1)59(56.7)5(4.8)
不清楚31498(31.2)74(23.6)128(40.8)14(4.5)
月托育费用(元)46.93<0.001
≤1 00041268(16.5)79(19.2)225(54.6)40(9.7)
1 001～1 50032554(16.6)95(29.2)158(48.6)18(5.5)
1 501～2 00018139(21.5)51(28.2)87(48.1)4(2.2)
≥2 00018661(32.8)38(20.4)75(40.3)12(6.5)
服务支持87.134<0.001
医疗保险
缴纳且享受福利35540(11.3)101(28.5)191(53.8)23(6.5)
缴纳但未享受福利22134(15.4)61(27.6)110(49.8)16(7.2)
未缴纳24942(16.9)49(19.7)133(53.4)25(10.0)
不了解279106(38.0)52(18.6)111(39.8)10(3.6)
孕产保健63.519<0.001
孕前检查49772(14.5)126(25.4)264(53.1)35(7.0)
围产保健14523(15.9)28(19.3)76(52.4)18(12.4)
访视及干预8726(29.9)20(23)35(40.2)6(6.9)
新生儿健康检查13520(14.8)29(21.5)80(59.3)6(4.4)
其他/没享受24081(33.8)60(25.0)90(37.5)9(3.8)
经济支持(补助及福利)
福利住房27740(14.4)64(23.1)163(58.8)10(3.6)27.6130.024
税收减免15033(22.0)40(26.7)66(44.0)11(7.3)
医疗费用减免20438(18.6)51(25.0)98(48.0)17(8.3)
生育保险11128(25.2)32(28.8)41(36.9)10(9.0)
生育津贴16035(21.9)35(21.9)76(47.5)14(8.8)
其他/不清楚20248(23.8)41(20.3)101(50.0)12(5.9)
), ArticleFig(id=1241102819143504141, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=CN, label=表2, caption=

生育支持对已婚育龄女性生育意愿影响的单因素分析[n(％)]

, figureFileSmall=null, figureFileBig=null, tableContent=
生育支持及分类人数意愿生育个数[n(％)]χ2值P值
012≥3
时间支持(休假及弹性工作)121.755<0.001
弹性工作制或灵活时间24520(8.2)57(23.3)148(60.4)20(8.2)
育儿假/产假<98天41869(16.5)102(24.4)219(52.4)28(6.7)
育儿假/产假≥98天278115(41.4)59(21.2)96(34.5)8(2.9)
不提供/不了解16318(11.0)45(27.6)82(50.3)18(11.0)
照料支持58.654<0.001
托育机构数(个)
016245(27.8)33(20.4)70(43.2)14(8.6)
1～252463(12.0)132(25.2)288(55.0)41(7.8)
≥310416(15.4)24(23.1)59(56.7)5(4.8)
不清楚31498(31.2)74(23.6)128(40.8)14(4.5)
月托育费用(元)46.93<0.001
≤1 00041268(16.5)79(19.2)225(54.6)40(9.7)
1 001～1 50032554(16.6)95(29.2)158(48.6)18(5.5)
1 501～2 00018139(21.5)51(28.2)87(48.1)4(2.2)
≥2 00018661(32.8)38(20.4)75(40.3)12(6.5)
服务支持87.134<0.001
医疗保险
缴纳且享受福利35540(11.3)101(28.5)191(53.8)23(6.5)
缴纳但未享受福利22134(15.4)61(27.6)110(49.8)16(7.2)
未缴纳24942(16.9)49(19.7)133(53.4)25(10.0)
不了解279106(38.0)52(18.6)111(39.8)10(3.6)
孕产保健63.519<0.001
孕前检查49772(14.5)126(25.4)264(53.1)35(7.0)
围产保健14523(15.9)28(19.3)76(52.4)18(12.4)
访视及干预8726(29.9)20(23)35(40.2)6(6.9)
新生儿健康检查13520(14.8)29(21.5)80(59.3)6(4.4)
其他/没享受24081(33.8)60(25.0)90(37.5)9(3.8)
经济支持(补助及福利)
福利住房27740(14.4)64(23.1)163(58.8)10(3.6)27.6130.024
税收减免15033(22.0)40(26.7)66(44.0)11(7.3)
医疗费用减免20438(18.6)51(25.0)98(48.0)17(8.3)
生育保险11128(25.2)32(28.8)41(36.9)10(9.0)
生育津贴16035(21.9)35(21.9)76(47.5)14(8.8)
其他/不清楚20248(23.8)41(20.3)101(50.0)12(5.9)
), ArticleFig(id=1241102819219001617, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=EN, label=Table 3, caption=

Results of multinominal logistic regression analysis of the factors influencing fertility intentions between desired children number of 1 and no fertility intention (reference group)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(对照)β标准误Wald值P值OR值(95% CI)
年龄(岁，44～49)
20～27-4.8341.16517.225<0.0010.008(0.001～0.078)
28～35-3.2521.1078.6310.0030.039(0.004～0.339)
居住地(乡镇/村)
城区-1.2100.4128.6380.0030.298(0.133～0.668)
时间支持(不提供/不了解)
弹性工作制或灵活时间-0.9750.4444.8330.0280.377(0.158～0.900)
月托育费用(元，≥2 000)
1 001～1 5001.1790.34012.048<0.0013.251(1.671～6.325)
1 501～2 0000.7860.3764.3700.0372.195(1.050～4.589)
孕产保健(其他)
孕前检查1.3020.35813.215<0.0013.675(1.822～7.413)
访视及干预1.0080.4864.3130.0382.741(1.058～7.100)
新生儿健康检查1.4550.4769.3460.0024.287(1.686～10.898)
), ArticleFig(id=1241102819319664921, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=CN, label=表3, caption=

意愿生育个数为1与无生育意愿(参照组)生育意愿影响因素无序多分类logistic回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(对照)β标准误Wald值P值OR值(95% CI)
年龄(岁，44～49)
20～27-4.8341.16517.225<0.0010.008(0.001～0.078)
28～35-3.2521.1078.6310.0030.039(0.004～0.339)
居住地(乡镇/村)
城区-1.2100.4128.6380.0030.298(0.133～0.668)
时间支持(不提供/不了解)
弹性工作制或灵活时间-0.9750.4444.8330.0280.377(0.158～0.900)
月托育费用(元，≥2 000)
1 001～1 5001.1790.34012.048<0.0013.251(1.671～6.325)
1 501～2 0000.7860.3764.3700.0372.195(1.050～4.589)
孕产保健(其他)
孕前检查1.3020.35813.215<0.0013.675(1.822～7.413)
访视及干预1.0080.4864.3130.0382.741(1.058～7.100)
新生儿健康检查1.4550.4769.3460.0024.287(1.686～10.898)
), ArticleFig(id=1241102819416133917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=EN, label=Table 4, caption=

Results of multinominal logistic regression analysis of the factors influencing fertility intentions between desired children number of 2 and no fertility intention (reference group)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(对照)β标准误Wald值P值OR值(95%CI)
年龄(岁，44～49)
20～27-4.4181.17214.218<0.0010.012(0.001～0.120)
28～35-2.9491.1077.0990.0080.052(0.006～0.459)
民族(其他)
汉族-1.4000.4489.7690.0020.247(0.102～0.593)
职业(无业)
机关单位-1.6590.6466.5960.0100.190(0.054～0.675)
企业职工-1.2720.5215.9550.0150.280(0.101～0.778)
技术人员-1.1190.5084.8580.0280.327(0.121～0.883)
居住地(乡镇/村)
城区-3.3760.39473.345<0.0010.034(0.016～0.074)
时间支持(不提供/不了解)
育儿假/产假≥98天1.1280.5234.6570.0313.090(1.109～8.612)
月托育费用(元，≥2 000)
1001～1 5000.9340.3566.8950.0092.544(1.267～5.108)
孕产保健(其他)
孕前检查1.5980.37618.024<0.0014.944(2.364～10.339)
围产保健1.6680.48411.877<0.0015.300(2.053～13.685)
访视及干预1.3840.5177.1710.0073.990(1.449～10.988)
新生儿健康检查2.0850.49018.101<0.0018.041(3.078～21.009)
经济支持(其他)
生育保险-1.2610.5345.5840.0180.283(0.1～0.806)
), ArticleFig(id=1241102819500020000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=CN, label=表4, caption=

意愿生育个数为2与无生育意愿(参照组)生育意愿影响因素无序多分类logistic回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(对照)β标准误Wald值P值OR值(95%CI)
年龄(岁，44～49)
20～27-4.4181.17214.218<0.0010.012(0.001～0.120)
28～35-2.9491.1077.0990.0080.052(0.006～0.459)
民族(其他)
汉族-1.4000.4489.7690.0020.247(0.102～0.593)
职业(无业)
机关单位-1.6590.6466.5960.0100.190(0.054～0.675)
企业职工-1.2720.5215.9550.0150.280(0.101～0.778)
技术人员-1.1190.5084.8580.0280.327(0.121～0.883)
居住地(乡镇/村)
城区-3.3760.39473.345<0.0010.034(0.016～0.074)
时间支持(不提供/不了解)
育儿假/产假≥98天1.1280.5234.6570.0313.090(1.109～8.612)
月托育费用(元，≥2 000)
1001～1 5000.9340.3566.8950.0092.544(1.267～5.108)
孕产保健(其他)
孕前检查1.5980.37618.024<0.0014.944(2.364～10.339)
围产保健1.6680.48411.877<0.0015.300(2.053～13.685)
访视及干预1.3840.5177.1710.0073.990(1.449～10.988)
新生儿健康检查2.0850.49018.101<0.0018.041(3.078～21.009)
经济支持(其他)
生育保险-1.2610.5345.5840.0180.283(0.1～0.806)
), ArticleFig(id=1241102819588100389, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=EN, label=Table 5, caption=

Results of multinominal logistic regression analysis of the factors influencing fertility intentions between desired children number of 2 and no fertility intention (reference group)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(对照)β标准误Wald值P值OR值(95%CI)
年龄(岁，44～49)
20～27-4.4831.38710.4550.0010.011(0.001～0.171)
28～35-2.4851.1574.6170.0320.083(0.009～0.804)
民族(其他)
汉族-2.4060.57917.243<0.0010.090(0.029～0.281)
职业(无业)
机关单位-1.9380.7636.4490.0110.144(0.032～0.643)
企业职工-1.7860.6198.3410.0040.168(0.050～0.563)
技术人员-2.3581.1154.4730.0340.095(0.011～0.841)
居住地(乡镇/村)
城区-3.2780.48246.231<0.0010.038(0.015～0.097)
时间支持(不提供/不了解)
弹性工作制或灵活时间-1.5230.6365.7360.0170.218(0.063～0.758)
孕产保健(其他)
孕前检查2.0850.55014.374<0.0018.042(2.737~23.627)
围产保健2.8070.65418.447<0.00116.563(4.600~59.631)
访视及干预2.4120.75710.1580.00111.155(2.531~49.161)
新生儿健康检查2.1010.7437.9880.0058.171(1.904~35.068)
补助及福利(其他)
福利住房-1.3340.6514.2030.0400.263(0.074~0.943)
), ArticleFig(id=1241102819676180782, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102814806593724, language=CN, label=表5, caption=

意愿生育个数为3及以上与无生育意愿(参照组)生育意愿影响因素无序多分类logistic回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量(对照)β标准误Wald值P值OR值(95%CI)
年龄(岁，44～49)
20～27-4.4831.38710.4550.0010.011(0.001～0.171)
28～35-2.4851.1574.6170.0320.083(0.009～0.804)
民族(其他)
汉族-2.4060.57917.243<0.0010.090(0.029～0.281)
职业(无业)
机关单位-1.9380.7636.4490.0110.144(0.032～0.643)
企业职工-1.7860.6198.3410.0040.168(0.050～0.563)
技术人员-2.3581.1154.4730.0340.095(0.011～0.841)
居住地(乡镇/村)
城区-3.2780.48246.231<0.0010.038(0.015～0.097)
时间支持(不提供/不了解)
弹性工作制或灵活时间-1.5230.6365.7360.0170.218(0.063～0.758)
孕产保健(其他)
孕前检查2.0850.55014.374<0.0018.042(2.737~23.627)
围产保健2.8070.65418.447<0.00116.563(4.600~59.631)
访视及干预2.4120.75710.1580.00111.155(2.531~49.161)
新生儿健康检查2.1010.7437.9880.0058.171(1.904~35.068)
补助及福利(其他)
福利住房-1.3340.6514.2030.0400.263(0.074~0.943)
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三孩政策下生育支持对已婚育龄女性生育意愿的影响
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宋瑾娴 1, 2 , 肖永红 1, 2
现代预防医学 | 卫生政策与管理 2024,51(16): 2982-2987
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现代预防医学 | 卫生政策与管理 2024, 51(16): 2982-2987
三孩政策下生育支持对已婚育龄女性生育意愿的影响
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宋瑾娴1, 2, 肖永红1, 2
作者信息
  • 1.华北理工大学公共卫生学院，河北 唐山 063210
  • 2.河北省煤矿卫生与安全重点实验室

    • 宋瑾娴（1997—），女，硕士，研究方向：流行病与卫生统计学

通讯作者:

肖永红，E-mail：
The effect of fertility support on the fertility intention of married women of childbearing age under the three-child policy
Jin-xian SONG1, 2, Yong-hong XIAO1, 2
Affiliations
  • School of Public Health, North China University of Technology, Tangshan, Hebei 063210, China
出版时间: 2024-08-25 doi: 10.20043/j.cnki.MPM.202403221
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摘要
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目的

调查三孩政策背景下河北省已婚育龄女性生育意愿现状，并分析生育支持对已婚育龄女性生育意愿的影响因素。

方法

采用随机整群抽样方法，于2023年7月抽取河北省内已婚育龄女性作为调查对象，利用自行设计的问卷进行调查，采用无序多分类logistic回归分析已婚育龄女性生育意愿的影响因素。

结果

共发放1 200份问卷，回收有效问卷1 104份，有效回收率92%。调查对象中，222人（20.1%）无生育/再生育意愿，263人（23.8%）意愿生育1个孩子，545人（49.4%）意愿生育2个孩子，74人（6.7%）意愿生育3个及以上孩子。无序多分类logistic回归分析结果显示，年龄、民族、职业、居住地是生育意愿的影响因素；生育支持中，时间支持、托育费用、孕产保健、经济支持是已婚育龄女性生育意愿的影响因素。

结论

已婚育龄女性的生育意愿较低，三孩意愿仍处于较低水平，积极提供促使已婚育龄女性意愿生育的生育支持及政策，营造良好的生育环境，有助于提升已婚育龄女性的生育意愿。

三孩政策  /  生育支持  /  生育意愿  /  影响因素
Objective

To investigate the current status of fertility intentions among married women of childbearing age in Hebei Province under the background of the three-child policy, and to analyze the influencing factors of fertility support on married women of childbearing age’s fertility intention.

Methods

A random cluster sampling method was used to select married women of childbearing age in Hebei Province as the respondents in July 2023, and a self-designed questionnaire was used for the survey. Multinomial logistic regression was used to analyze the influencing factors of fertility intentions among married women of childbearing age.

Results

A total of 1 200 questionnaires were distributed and 1104 valid questionnaires were collected, with a valid recovery rate of 92%. Among the survey subjects, 222 people (20.1%) had no intention of fertility/re-fertility, 263 people (23.8%) intended to have 1 child, 545 people (49.4%) intended to have 2 children, and 74 people (6.7%) intended to have 3 children or more. The results of multinomial logistic regression analysis showed that age, ethnicity, occupation, and residence area were influencing factors of fertility intentions. In terms of fertility support, time support, monthly childcare expenses, maternal care, and economic support were influencing factors of fertility intentions among married women of childbearing age.

Conclusion

The fertility intentions of married women of childbearing age are relatively low, and the intention of having three children is still at a low level. Actively providing fertility support and policies that encourage the fertility intentions of married women of childbearing age, and creating a good fertility environment, will help to enhance the fertility intentions of married women of childbearing age.

Three-child policy  /  Fertility support  /  Fertility intention  /  Influencing factors
宋瑾娴, 肖永红. 三孩政策下生育支持对已婚育龄女性生育意愿的影响. 现代预防医学, 2024 , 51 (16) : 2982 -2987 . DOI: 10.20043/j.cnki.MPM.202403221
Jin-xian SONG, Yong-hong XIAO. The effect of fertility support on the fertility intention of married women of childbearing age under the three-child policy[J]. Modern Preventive Medicine, 2024 , 51 (16) : 2982 -2987 . DOI: 10.20043/j.cnki.MPM.202403221
正文
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随着我国人口出生率的不断降低以及人口老龄化的加剧，我国的生育问题受到了国内外学者的广泛关注[1-2]，为了增加出生率，我国在2021年完全放开了“三孩政策”。育龄女性作为生育行为的重要驱动因子，在促进人口出生率的提升中发挥重要作用[3]。近几年来，我国女性生育意愿不断降低[4]，2023年一胎平均生育率降至0.5，平均每位女性仅有0.5名子女。
在我国逐步推广的生育政策尚未成功激励国民生育的情况下，“生育支持”的概念逐渐为人所知。生育支持主要指不同主体例如社会、企业、政府，为有生育或再生育需求的家庭提供的包括时间、经济、服务等各方面的支持或服务[5]。以社会支持理论为基础，生育支持有两个内涵：首先，政府和单位等分担生育的经济成本，以降低女性承担的生育成本。二是照顾责任与事业发生冲突时，提供保育帮助或带薪休假等支持。不同学者通过不同角度，其对生育支持的分类也不尽相同，本研究将生育支持分为四个方面：一是时间支持，为母亲享受的围产期育儿假、产假等以及“弹性工作制”的工作安排；二是照料支持，社会儿童保育是减轻养育压力的重要措施,通过托育机构对养育孩子的家庭提供正规的照顾等服务；三是服务支持，包括孕产保健服务、医疗保险等便民服务，为生养提供便携的育儿服务帮助；四是经济支持，主要为资金补贴形式，包括育儿津贴、家庭税收减免、福利住房等[6-7]。
我国于2022年7月发布的《关于进一步完善和落实积极生育支持措施的指导意见》为营造生育友好型工作环境等方面提供了指导，鼓励民众通过选择生育和再生育来响应生育政策[8]。生育意愿为人们在生育方面上的愿望，其包含了数目、时间，性别三个方面[9]，本研究聚焦现行的 "三孩政策"，分析了现行政策下已婚育龄女性的生育意愿，即意愿生育个数（理想子女数）。同时，根据当前的人口发展趋势，从社会、政治、经济等多个层面对生育支持政策提供参考，进而为我国生育水平的提升、人口结构的改善提供理论支撑。
1　对象与方法
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1.1　调查对象
本研究采用随机整群抽样方法，于2023年7月在河北省范围内随机选取4个地级市，每个市内随机选取1个县，每个县内随机选取1个乡镇、1个城区，从中随机各选取1个村、1个小区，选取居住于本村和小区内的已婚育龄女性作为本课题研究对象。根据我国女性的法定结婚年龄标准，本文研究将调查的已婚育龄女性年龄限定在20~49岁[10]。排除精神障碍、认知障碍及语言表达障碍等不能合作者，所有调查者均知情同意参加。此研究已通过华北理工大学医学伦理委员会审查（编号：2024169）。
1.2　方法与内容
1.2.1　调查方法
采用网络问卷及现场发放回收问卷，网络问卷通过“问卷星”实施线上编写、发放、回收及统计分析等工作。本次调查为匿名调查，对符合要求者发放线上问卷。共发放1 200份问卷，回收有效问卷1 104 份，其中现场发放633份，回收有效问卷601份，网络问卷发放567份，有效问卷503份。总有效回收率92%。线上问卷设置必填题及匿名填写保证问卷填写的完整性、真实性。对收集的问卷进行整理，筛除重复IP和存在明显逻辑错误的问卷。线下调查的问卷回收后，对问卷进行核查，剔除无效问卷，并将余下有效问卷统一编号并进行双录入。
1.2.2　研究内容
使用自行设计的调查表，包括（1）已婚育龄女性意愿生育数量；（2）已婚育龄女性个体特征：年龄、民族（汉族、其他少数民族）、文化程度、职业、居住地（城区、乡镇/村）、月收入等个人基本情况；（3）生育支持：时间支持（休假及弹性工作制）、服务支持（孕产保健服务及医疗保险）、照料支持（托育机构数及月托育费用）、经济支持（补助及福利）。
1.3　统计学方法
使用SPSS 26.0软件进行统计分析，生育意愿的计数资料用百分比表示，组间比较用χ2检验；采用无序多分类logistic回归分析已婚育龄女性生育意愿个数的影响因素，计算比值比（OR）及95%可信区间（95%CI）。检验水准α为0.05。
2　结果
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2.1　资料概况
调查的1 104名已婚育龄女性中，平均年龄（32.4±9.6）岁；222名无生育/再生育意愿，占20.1%，263名意愿生育1个孩子，占23.8%，545名意愿生育2个孩子，占49.4%，74名意愿生育3个及以上孩子，占6.7%。
2.2　不同个体特征已婚育龄女性生育意愿分析
不同年龄、民族、文化程度、职业、居住地、月收入的已婚育龄女性生育意愿（即意愿生育个数）差异均有统计学意义（P<0.05），详见表1。
2.3　生育支持对已婚育龄女性生育意愿影响的单因素分析
时间支持、服务支持、照料支持、经济支持等因素对已婚育龄女性生育意愿的影响均有统计学意义（P<0.05），见表2。
2.4　育龄女性生育意愿的多因素分析
以意愿生育个数为因变量，将单因素分析有显著性的13个变量作为自变量纳入logistic回归模型：以无生育意愿作为参照组，拟合意愿生育数为1、2、3及以上相对于此参数类别的无序多分类logistic回归模型，结果见表3、4、5。表3可见，年龄、居住地、时间支持、照料支持（月托育费用）、服务支持（孕产保健）影响均有统计学意义（P<0.05）。表4分析发现，年龄、民族、职业、居住地、时间支持、照料支持、服务支持、经济支持影响均有统计学意义（P<0.05）。表5结果显示，年龄、民族、职业、居住地、时间支持、服务支持、经济支持影响均有统计学意义（P<0.05）。
3　讨论
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调查发现，20.1%的已婚育龄女性无生育/再生育意愿，且仅有6.7%调查对象意愿生育3个及以上子女。提示目前我国女性生育意愿较低，需要通过生育支持等相关政策，鼓励有生育意愿的女性转化为生育行为。
本研究表明，生育意愿随着年龄的增长而逐渐增强，这与其他研究的结果相矛盾[11]。可能由于随着年龄增长，个体生活状况日益稳定成熟，能够承担生育子女所需成本和时间。而20～35岁女性可能会因为追求工作和社会地位的稳定，更倾向于发展自己；居住在城区的已婚育龄女性生育意愿低于农村，这可能与城区消费水平高、节奏快有关，育龄女性在抚养子女方面没有太多的时间和财力，再加以城区更大的工作压力，生育意愿也就下降了[12]；其次，农村女性倾向于多子多福的传统生育观，会促使更强的生育意愿。汉族生育二孩及以上的意愿低于少数民族，少数民族多遵循民族内部的生育习俗，渴望通过孩子实现自身价值，为家庭传宗接代；不同的职业会影响到育龄女性的生育意愿[13]，机关单位、企业职工、技术人员生育二孩及以上的意愿较低，可能由于养育一孩压力相对较小，在能够承担的范围内。而在抚养多个子女方面，无业的育龄女性花在抚养子女上的时间更多，没有职业压力和竞争，可以在子女上投入更多的精力，从而使她们的生育意愿更高[14-15]。本研究将生育支持分为时间支持、服务支持、照料支持及经济支持四个方面，在时间支持中，员工享受的休假时间越长，其生育意愿越高。享受弹性工作制的已婚育龄女性生育意愿降低，可能由于整体工作时长并未改变，女性在哺乳期仍需要对孩子进行哺育照护，产假的时长不足使得女性需要兼顾工作和家庭两方面，更倾向于不再生育；在照料支持上，托育机构的收费越低，已婚育龄女性的一、二孩生育意愿则越高。养育支出可能会改变家庭的消费结构，降低整个家庭的消费水平，造成的生活压力越大，进而越可能影响生育意愿。意愿生育三孩的家庭其经济基础较高，费用对其抚养的影响也就小了。服务支持方面，在孕产保健服务中，孕前检查、围产保健、访视及干预、新生儿健康的保健服务，均对女性生育意愿有提升。育龄女性对其生育期间自身、胎儿身心健康越来越加以重视，孕产保健服务则会减轻女性生育的医疗负担和心理压力，故更倾向于生育子女；经济支持中，生育保险使育龄女性生育2个及以上孩子的意愿降低，与其他研究结果相反[16]。可能由于生育数、花费增加，使用生育保险的比例较低，较少的报销费用不足以补足花费，也无法减轻家庭的经济压力。居住在福利住房的育龄女性生育3个孩子的意愿降低，可能由于福利住房其住房面积较为有限，而生育子女数越多，越需要更大的居住空间。
由分析可知，已婚育龄女性的生育意愿较低，三孩意愿仍处于较低水平，我们国家的生育扶持政策还需要进一步的完善。在此基础上，适当增加女性养育期间工作的灵活性、优化婴幼儿托育服务、扩大生育相关补贴范围、降低生育成本、建立完整的孕产保健服务体系、提供完善生育医疗保障、积极提供促使育龄女性意愿生育的生育支持及政策，有利于提升育龄女性的生育意愿。
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  • 河北省社会科学基金(HB22RK002)
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参考文献 引证文献
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2024年第51卷第16期
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doi: 10.20043/j.cnki.MPM.202403221
  • 接收时间：2024-03-13
  • 首发时间：2026-03-18
  • 出版时间：2024-08-25
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  • 收稿日期：2024-03-13
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河北省社会科学基金(HB22RK002)
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    1.华北理工大学公共卫生学院，河北 唐山 063210
    2.河北省煤矿卫生与安全重点实验室

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2种不同金属材料的力学参数
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Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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