Does China's universal two-child policy affect contraceptive use among internal migrant women in China? Evidence...

In 2016, China implemented the universal two-child policy to increase the birth rate. This study aimed to explore the effect of the policy on the contraception use and the type of contraception used by internal migrant women in China.

This study used Guangdong Province data from 4 rounds of the cross-sectional China Migrants Dynamic Survey, that is, 2 rounds before (2014 and 2015) and 2 rounds after (2016 and 2017) the universal two-child policy. Migrant women aged 20 to 49 years were categorized into 3 groups according to the number of their children (0, 1, 2 or more). Multilevel logistic regression models based on inverse probability weighted data were used to examine the effect of the policy on contraceptive use.

We included 16,438 migrant women in this study. Of these, 88.8% and 79.7% used contraception before and after the policy, respectively, while the proportion of participants using short-acting reversible contraception or other traditional contraceptive methods increased from 34.6% to 40.6%. Among migrant women with children, the policy reduced contraception use prevalence (one-child group: AOR = 0.3, 95% CI: 0.3-0.4; two-or-more-children group: AOR = 0.5, 95% CI: 0.4-0.7).

China's 2016 two child policy produced a modest reduction in contraceptive use among migrant women with only one child.

Additional measures, such as child care, education and housing reforms, are needed to meaningfully increase the Chinese birth rate.