A study in Shandong Province, China, examined the second birth intentions of reproductive-aged women in light of the Universal Two-Child Policy (UTCP). Conducted through a cross-sectional survey of 2,422 women aged 18-45, the research found that only 48.02% were willing to have a second child. Factors influencing this decision included the timing of fertility, household economic status, awareness of fertility policies, and social expectations. Marital status, personal career development, household size, childcare challenges, self-health status, and perceptions of fertility also played significant roles. The study highlights various social and economic barriers that limit second-birth intentions. To enhance fertility rates, the authors suggest targeted policies that address childcare burdens, support families with only one child, and protect women’s health and work rights.