Knowledge of the statutory fertility provision and its associated factors among reproductive-aged women: a cross-sectional study conducted in Shandong Province, China.

Long-term balanced population development is the core support for sustainable economic and social progress (). At present, China’s population growth has entered a new stage of negative growth. In 2024, the total number of births nationwide was 9.54 million, with a natural growth rate of −0.99‰ (). From the perspective of population age structure, China has entered a society with sub-replacement fertility and population aging (). Low fertility and population aging have become major strategic issues affecting national development (). To actively respond to this situation, China has successively introduced the two-child policy in 2016 and three-child policy in 2021, as well as their supporting measures (). By providing a series of fertility policies including fertility subsidies, leave protection, and childcare services, China is building a fertility-friendly society to facilitate the translation of fertility intention into actual fertility behavior (, ). Although a series of measures have been enacted, their effects are evident only in the short term, while long-term outcomes remain inadequate (). Therefore, further analysis is required to examine the reasons why fertility policies have failed to achieve sustained effectiveness in stimulating childbirth. When examining the reasons why the effects of fertility policies have failed to persist, apart from macro-level factors such as economic pressure and childcare costs, a fundamental and critical antecedent cannot be overlooked: the level of fertility policy awareness among the reproductive-aged population (). Fertility policy awareness serves as the “first gateway” connecting policy supply to fertility behavior (). In essence, it represents individuals’ subjective understanding of policy content, eligibility criteria, and potential benefits (). Insufficient awareness directly hinders the realization of policy dividends and prevents support measures from being effectively translated into fertility incentives (). Currently, fertility policy awareness in China suffers from three prominent issues: low levels of public knowledge, incomplete understanding, and inconvenient access to information (). These problems are particularly pronounced among rural populations, individuals with lower educational attainment, and migrant groups (). These issues have become salient weaknesses constraining the effectiveness of fertility policies. Notably, although scholarly attention to fertility support policies has increased, most research remains focused on analyzing the determinants of fertility intentions, while systematic, large-sample investigations specifically targeting fertility policy awareness relatively limited (). Consequently, fundamental questions regarding the current level of awareness about fertility policy and its influencing factors remain to be fully elucidated. To address this research gap, it is particularly necessary to conduct regional, large-sample, and multi-factor empirical research. In China, Shandong Province has a large population and significant urban–rural disparities (). Therefore, the research findings on awareness of fertility policies among reproductive-aged women in Shandong Province may hold significant referential value for the nation as a whole (). On this basis, this study took reproductive-aged women in Shandong Province as the research subjects to investigate the current level of knowledge of the statutory fertility provision and explore factors associated with it. The results may provide a reliable basis for optimizing fertility policy dissemination and improving the precision of policy communication, offering considerable practical significance and application value.