A study in Shandong Province, China, found that only 10.3% of female workers aged 20-49 expressed intentions to have a third child. Researchers surveyed 1,358 participants using a self-administered questionnaire, examining factors like demographic characteristics, attitudes toward childbearing, and perceived control over family decisions. Significant associations were found between third-child fertility intentions and various factors, such as age, education level, and career prospects, as well as caregiver availability and knowledge of the three-child policy. However, subjective norms did not show statistically significant associations. The findings indicate that career-family conflicts contribute to low third-child fertility intentions among women. To encourage higher birth rates, the study suggests that China should enhance its three-child policy, provide clearer benefits, and address barriers to childbearing. Recommendations include expanding affordable childcare options, increasing childcare subsidies, and promoting family-friendly workplace practices. The insights may be relevant for other low-fertility regions, particularly in East Asia.