The association between childbirth-related fear, childbirth readiness, and fertility intentions, and childbirth readiness as the mediator.

Over the past two decades, fertility rates have been dropping steadily in most countries. Fertility intentions have been proven to be a reliable predictor of actual fertility behaviour. The worldwide sluggish fertility trend has brought about a series of issues, such as accelerated population ageing, shrinking workforce, and economic decline. China has the largest national population in the world, accounting for nearly one-fifth of the world's population, thus having a huge impact on global population trends. Therefore, in the context of significant fertility decline and population policy changes, timely research on fertility intention is of great significance for China and other low-fertility countries. CBRF has been proven to be negatively associated with childbirth readiness and fertility intentions among women, while childbirth readiness was positively related to fertility intentions. This study aimed to investigate the unique association between fertility intentions, CBRF, and childbirth readiness, and whether childbirth readiness would mediate the relationship between CBRF and fertility intentions. In this cross-sectional study, we found that women with high childbirth readiness had higher fertility intentions. However, women with high CBRF were more likely to have lower fertility intentions. Furthermore, CBRF had both direct and indirect effects on the level of fertility intentions. Childbirth readiness mediated the relationship between CBRF and the level of fertility intentions. Higher CBRF was associated with lower scores of childbirth readiness, which was associated with lower levels of fertility intentions. This finding suggested that it is important for health policymakers and health providers to pay more attention to improving women's childbirth readiness, which might reduce the negative influence of CBRF on fertility intentions, thus strengthening their fertility intentions.