Birth experiences of urban women of advanced age having their second child after introduction of the universal two-child policy in China: A qualitative study.

Objective: to investigate the birth experiences of women of advanced age having a second child in urban China after introduction of the universal two-child policy in 2016.

Design: data were collected using semi-structured in-depth interviews, and were processed and analysed using a qualitative phenomenological method.

Setting: obstetric department of a class 1, level 3 hospital in Henan Province, China.

Participants: purposive sampling was undertaken, and 11 hospitalized women from urban backgrounds were selected as the participants. They were all aged >35 years and were having their second child. The interviews were conducted 2-4 days post partum.

Findings: the findings were divided into four themes: motives for the birth of a second child; anticipations for the child's gender; difficulty in conceiving; and conflicts after birth. The main reason for having a second child was no longer in accordance with the traditional Chinese mindset to 'raise sons to secure a happy life when one gets old'; instead, it was to secure family balance and harmony to respond to the new policy. Educated women from urban backgrounds were able to accept the gender of the second child 'as it came', without the old mindset that 'men are superior to women' and 'only boys can carry on family lines'. Advanced maternal age and gestational complications were the major difficulties facing these women. Chinese medicine and regimens were recognised as effective and conducive. Following the birth of their second child, the women experienced both positive feelings (joy due to the arrival of the new baby) and negative feelings (pressures and challenges on family finances, demands for more living space, and balancing their affections between two children).

Conclusions And Implications For Practice: women of advanced age who choose to have a second child have sensible motives and, for the most part, their experience is positive. That said, the participants faced and overcame many difficulties before, during and after the birth of their second child. They were in need of help from the government and their employers in terms of policy, and proper education on care-taking and recuperation from medical professionals. Families who have a second child should treat the second child calmly and with common sense, make quick adjustments to family structural changes, and strike a proper balance in an effort to divide love and care equally between the two children.