A Study On Fertility Intention And Relationships With Mental Health Of Second-child Pregnant Women Over 30 In Small And Medium-sized Cities Of Anhui Province

Objective To understand the fertility intention and the influencing factors of pregnant women over 30 of small and medium-sized cities in Anhui province,and analyze if fertility intentions can influence the mental health.Thus we can protect women’s mental health,and promote the family planning department of health issued a corresponding policy guarantee for older women’s reproductive rights.Methods From April 2018 to September,we have investigated 648 second-child pregnant women over 30,163 husbands and 16 family members in Tongling,Huainan,and Lu ’an in Anhui province.A face-to-face survey was conducted by using the questionnaire on the second-child fertility intention and its physical and mental health status and interview,which was proved by experts.The survey contents included: demographic characteristics,information related to reproductive rights,related factors affecting reproductive rights and fertility intention,and general well-being scale(GWBS).Data was analyzed by Chi-square,t-test,multiple linear regression and multiple logistic regression.Results A total of 648 second-child pregnant women were surveyed,336 whose first child was a boy and 312 whose first child was a girl.163 husbands and 16 family member of pregnant women were interviewed.The main reasons that pregnant women and their husbands are willing to have a second child are "one child is too lonely","want to have a son and a daughter",and "in good health and with a proper age ",etc.Based on the interviews,it can be found that the gender preference of the second child will affect the pregnant women’s fertility intention.Compared with pregnant women with a boy,the reasons for whose first child is a girl want to have a second child are not only the above reasons,but also the "Just want a boy".Those who were reluctant to have a second child,whether they were pregnant women or husbands,took into account the "family financial burden","lack of energy" and "older or in poor health ".37.68% of husbands whose first child is a girl thought they can decide pregnancy,higher than those whose first child is a boy,who account for 26.6%.The reproductive rights of older women cannot be fully recognized by their husbands,especially the pregnant women whose first child is a boy.98.93% of the husband whose first child is a boy is willing to obey his wife’s fertility desire,and 89.86% of who has a girl.Husbands whose first child is a girl tend to be reluctant to comply with their wives’ reproductive intention.Pregnant women were less likely to receive publicity about their reproductive rights,and only about 50% knew about the law on the protection of women’s rights and interests and women’s reproductive rights.In terms of mental health,physical health status,occupation and gender preferences all have an impact on pregnant women’s mental.Pregnant women whose first child was a boy had a statistically significant difference in preference to girls in the three dimensions of "depressed or cheerful state of mind","emotional and behavioral control",and "relaxation and tension(anxiety)".Among women whose first child was a girl,those who preferred boys scored lower on three dimensions: "satisfaction and interest in life","depressed or cheerful state of mind" and "emotional and behavioral control" than those who were unbiased,with statistically significant differences.Pregnant women with a boy have lower score of GWBS when they have a bad physical health condition.The probability of "depression" and "distress" is higher for them.And compared with worker,pregnant women who are engaged in professional and technology-related work have lower risk of “distress”(OR=0.12,95%CI:0.08~0.54).Among women with a girl,those who have no preference had a lower risk of "distress" than those preferred boys(OR=0.73,95%CI:0.53~0.99).Conclusion In small and medium-sized cities in Anhui province,the fertility intentions of pregnant women are involuntary and influenced by others.Some pregnant women are reluctant to have a second child due to age,physical and economic conditions.Gender preference also had an impact on fertility intentions,and resulted in adverse mental health outcomes on pregnant women with a girl.To protect second-child intention,promote gender equality and reduce pregnant women’s mental health problems,health and family planning authorities should issue relevant policies to protect women’s reproductive rights and interests,especially those whose first child is a girl.