Fertility intentions and associated factors among female hospital employees with children: a cross-sectional study.

OBJECTIVE: To investigate the fertility intentions of female hospital employees with children and to analyze associated factors, providing evidence for the development of targeted support policies and human-centered hospital management strategies. METHODS: From July to September 2025, female hospital employees with children from hospitals in Mianyang, Sichuan Province, China, were recruited. Data were collected using a demographic questionnaire, the Fertility Motivation Scale, and the Perceived Organizational Support Scale. Statistical analyses were conducted using SPSS 25.0. RESULTS: A total of 1,133 questionnaires were distributed, and 1,092 valid responses were returned, yielding an effective response rate of 96.38%. Among respondents, 978 (89.6%) reported no intention of having additional children, while 114 (10.4%) expressed fertility intentions. Of those with fertility intentions, 104 intended to have one more child, and 10 intended to have two. The main reasons for not intending to have additional children were: having already given birth to three children (0.41%), age-related factors (62.99%), health-related factors (55.11%), financial considerations (78.32%), work-related factors (72.70%), time constraints (63.60%), insufficient family support (46.11%), religious beliefs (1.12%), and other reasons (8.79%). Multivariable logistic regression analysis indicated that age group, number of existing children, and fertility motivation were independent predictors of fertility intention among female hospital employees with children. Compared with the younger age group, older participants were significantly less likely to have additional fertility intentions (OR = 0.307, 95% CI: 0.215-0.437, p < 0.001). Similarly, an increase in the number of children was associated with a significantly lower likelihood of additional fertility intention (OR = 0.158, 95% CI: 0.075-0.332, p < 0.001). Regarding fertility motivation, negative fertility motivation was negatively associated with fertility intention (OR = 0.952, 95% CI: 0.926-0.978, p < 0.001), whereas positive fertility motivation was positively associated with fertility intention (OR = 1.038, 95% CI: 1.014-1.062, p = 0.002). Model fit was acceptable (Hosmer-Lemeshow test p > 0.05) and the model explained 9.8-20.1% of variance (Nagelkerke R 2 = 0.201). CONCLUSION: Overall, female hospital employees with children in Mianyang demonstrated a relatively low intention for additional childbearing. Fertility intention was significantly influenced by age, number of existing children, and fertility motivation, all of which were independent predictors. Future research should further explore multidimensional factors influencing fertility intentions among female healthcare workers. In addition, policy-level, organizational, and family-level interventions are needed to create a more fertility-friendly environment. Tailored strategies considering individual and family characteristics may help promote rational fertility decision-making and improve work-family balance among female healthcare professionals.