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Background China has experienced changes in family planning policies and a continuous population decline. Previous research on intentions to have a second child has focused more on analysing the costs and benefits of fertility decisions. However, childbearing decision-making is a complex process involving many social, economic, political, and individual factors.Methods This study investigated not only whether mothers of young children intend to have a second birth but also their perceptions and experiences through in-depth interviews. This qualitative study was fully based on 40 in-depth semi-structured interviews, and the sample comprised 40 parous (or currently pregnant) women with at least one iving biological child aged under six in Guizhou and Shanghai in China.Results This study concluded that the legacie of three decades of implementation of the one-child policy have caused ideational changes in fertility among mothers, leading them to invest scarce resources in one child instead of having more children. In addition, Chinese mothers prioritise self-achievement and self-realisation nowadays, while also adhering to traditional values such as gender-role division and son preference.Discussion This study suggested that public health policymakers should consider the unique cultural and political environment in China to influence second-child fertility intentions. While policy changes, such as the two- or three-child policy, may not directly influence fertility intentions, addressing internalised values and creating a supportive social environment could have a positive impact. Combining these efforts with family planning policies may help to enhance second-child fertility intentions in China.