This study aimed to investigate the current situation regarding fertility intentions, parenting attitudes, and fear of childbirth among college students in mainland China and the factors related to these variables.A cross-sectional study SETTING: Colleges across China PARTICIPANTS: Five hundred and eighty-three college students attending regular institutions of higher education MAIN OUTCOME MEASURES: Fertility intentions and fear of childbirth were measured using the Swedish Fertility Awareness Questionnaire and the Childbirth Fear Prior to Pregnancy scale.Only 38.8% of participants expressed their willingness to have children, and there was a significant difference between male and female students (P < .02). Males regarded having children as more important (P < .01), and females were more concerned about the negative effects of becoming parents, including difficulties in the labor market, having less freedom, and having less money. When deciding whether to have children, factors such as work, economics, and childcare were more important to females. Students who did not want children had higher levels of fear of childbirth than those who wanted children or were unsure (P < .02).The fertility intentions of college students were not optimistic. In addition to the 2-child Chinese fertility policy, interventions aimed at reducing the cost of raising children, eliminating gender inequality in the workplace, and normalizing childcare institutions might help alleviate conflict between work and childrearing.