The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in China

BackgroundChina's persistent fertility decline poses serious long-term demographic and socioeconomic challenges. The COVID-19 pandemic has introduced additional uncertainty, raising questions about how external shocks affect fertility intentions in real time.ObjectiveThis study examines the cau...

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Main Authors: Yiting Guo, Yuqi Mou, Yan Peng, Chen Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1631821/full
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author Yiting Guo
Yuqi Mou
Yan Peng
Chen Zhang
author_facet Yiting Guo
Yuqi Mou
Yan Peng
Chen Zhang
author_sort Yiting Guo
collection DOAJ
description BackgroundChina's persistent fertility decline poses serious long-term demographic and socioeconomic challenges. The COVID-19 pandemic has introduced additional uncertainty, raising questions about how external shocks affect fertility intentions in real time.ObjectiveThis study examines the causal impact of localized COVID-19 shocks on fertility intentions in China, as measured by high-frequency digital search data that capture real-time behavioral shifts.MethodsWe construct a monthly city-level fertility index based on Baidu search volumes for pregnancy-related keywords across 222 cities (2019–2022). COVID-19 exposure is measured using sustained “high-risk” status over 14 consecutive days. A staggered difference-in-differences design is employed, with robustness checks including imputation-based estimators, event-study analysis, and heterogeneity analysis by city characteristics.ResultsCOVID-19 shocks led to a significant 5.4% decline (p < 0.01) in fertility-related search activity across Chinese prefecture-level cities. Event study confirmed persistent post-shock suppression, while placebo simulations confirmed the robustness of the identification strategy. Heterogeneity analysis revealed stronger declines in cities with higher GDP per capita (p < 0.01), greater urbanization (p < 0.01), and larger female population shares (p < 0.01), highlighting the amplifying role of local socioeconomic conditions.ConclusionFertility intentions respond sharply to pandemic-related uncertainty, especially under pressure from economic and institutional constraints. The findings underscore the fragility of reproductive intentions under uncertainty and highlight the importance of tailoring fertility policy to local socioeconomic environments.
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spelling doaj-art-65f41ae47f1e49e598fe55a5da820a672025-08-20T04:02:50ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-08-011310.3389/fpubh.2025.16318211631821The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in ChinaYiting Guo0Yuqi Mou1Yan Peng2Chen Zhang3Economics and Management School, Wuhan University, Wuhan, ChinaEconomics and Management School, Wuhan University, Wuhan, ChinaThe Wang Yanan Institute for Studies in Economics, Xiamen University, Xiamen, ChinaSchool of Economics and Management, Huangshan University, Huangshan, ChinaBackgroundChina's persistent fertility decline poses serious long-term demographic and socioeconomic challenges. The COVID-19 pandemic has introduced additional uncertainty, raising questions about how external shocks affect fertility intentions in real time.ObjectiveThis study examines the causal impact of localized COVID-19 shocks on fertility intentions in China, as measured by high-frequency digital search data that capture real-time behavioral shifts.MethodsWe construct a monthly city-level fertility index based on Baidu search volumes for pregnancy-related keywords across 222 cities (2019–2022). COVID-19 exposure is measured using sustained “high-risk” status over 14 consecutive days. A staggered difference-in-differences design is employed, with robustness checks including imputation-based estimators, event-study analysis, and heterogeneity analysis by city characteristics.ResultsCOVID-19 shocks led to a significant 5.4% decline (p < 0.01) in fertility-related search activity across Chinese prefecture-level cities. Event study confirmed persistent post-shock suppression, while placebo simulations confirmed the robustness of the identification strategy. Heterogeneity analysis revealed stronger declines in cities with higher GDP per capita (p < 0.01), greater urbanization (p < 0.01), and larger female population shares (p < 0.01), highlighting the amplifying role of local socioeconomic conditions.ConclusionFertility intentions respond sharply to pandemic-related uncertainty, especially under pressure from economic and institutional constraints. The findings underscore the fragility of reproductive intentions under uncertainty and highlight the importance of tailoring fertility policy to local socioeconomic environments.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1631821/fullfertility intentionsCOVID-19public health shocksdifference-in-differencesinternet search index data
spellingShingle Yiting Guo
Yuqi Mou
Yan Peng
Chen Zhang
The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in China
Frontiers in Public Health
fertility intentions
COVID-19
public health shocks
difference-in-differences
internet search index data
title The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in China
title_full The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in China
title_fullStr The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in China
title_full_unstemmed The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in China
title_short The impact of public health shocks on fertility intentions: evidence from the COVID-19 pandemic in China
title_sort impact of public health shocks on fertility intentions evidence from the covid 19 pandemic in china
topic fertility intentions
COVID-19
public health shocks
difference-in-differences
internet search index data
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1631821/full
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