Infant's sex, birth control policy and postpartum well-being: a prospective cohort study in Shanghai, China

BMJ Open. 2016 Oct 6;6(10):e012207. doi: 10.1136/bmjopen-2016-012207.

Abstract

Objectives: The majority of Chinese families were under either one-child or two-child birth control policy status from 2001 to 2015. We explore the association between an infant's sex and the mother's postpartum well-being, which may be moderated by birth control policy status in China.

Setting and participants: We conducted a prospective cohort study in Shanghai City, one of the largest cities in China. A total number of 1730 childbearing women from eight obstetric hospitals across Shanghai were included in the study at baseline, with 1503 women completing the survey 7 days postpartum in 2013.

Measures: The General Well-Being Schedule (GWBS) was used to assess maternal well-being at baseline and follow-up investigation in the study. The women's demographic, clinical characteristics, and well-being were measured at baseline. Maternal satisfaction and postpartum well-being were assessed in the follow-up survey.

Results: Multivariable linear regression analyses showed that women who gave birth to male infants were positively associated with the total score of maternal well-being, when the participating hospitals, maternal well-being at baseline, sociodemographic characteristics, and maternal and infant health outcomes were added to the adjustments (β=1.462, p<0.05). The association disappeared when the two-child policy status was added to the adjustments (p>0.05). The results of a multiple logistic regression model showed that having a male infant was a risk factor of 'severe distress' (OR=1.607, p<0.05), which was moderated by the two-child policy status (p>0.05).

Conclusions: Our results emphasise the importance of conducting interventions to increase maternal general well-being, especially for those with a female infant in a society such as China where preference is for a son, and enhance the necessity of sustainability of a newly relaxed two-child policy which allows more couples to have a second child in China.

Keywords: Birth control policy; China; Infant’s sex; Postpartum well-being.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China / epidemiology
  • Contraception Behavior / psychology*
  • Cultural Characteristics
  • Depression, Postpartum / psychology
  • Family Characteristics
  • Family Planning Policy* / legislation & jurisprudence
  • Family Planning Services
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Mothers / psychology*
  • Postpartum Period / psychology*
  • Prospective Studies
  • Sex Ratio
  • Young Adult