Background: Traditional Chinese medicine (TCM) is widely used by pregnant and breastfeeding women in China, yet predictors of its use intention remain understudied in mainland China. This study applied an extended Theory of Planned Behavior (TPB) framework to identify factors influencing TCM use intention in this population.

Methods: A cross-sectional survey was conducted among 264 pregnant and breastfeeding women from diverse regions in mainland China between July and October 2023. Data were collected through an online questionnaire that included demographic information, TPB-based measures (attitudes, subjective norms, perceived behavioral control, intention), and past TCM use experiences. Structural Equation Modeling (SEM) was used to test hypothesized relationships.

Results: The results showed that 37.5% of participants reported using TCM during pregnancy or lactation. The extended TPB model explained 84.5% of variance in intention, with subjective norms having the strongest impact (β = 0.435; p < 0.001), followed by attitudes (β = 0.304; p < 0.001) and perceived behavioral control(β = 0.294; p < 0.001). Past experience with TCM also significantly influenced both attitudes and intentions. The model demonstrated excellent fit (χ²/df = 1.53; CFI = 0.99; RMSEA = 0.04).

Conclusions: This study demonstrates that TCM use during pregnancy and lactation is common in China, and that subjective norms, attitudes, perceived behavioral control, and prior experience are key predictors of intention to use TCM. These findings underscore the importance of integrating cultural and social considerations into healthcare practices. Healthcare providers should be aware of the significant role of family in decision-making and incorporate culturally sensitive counseling into maternal care. Policymakers should strengthen regulatory oversight of TCM to ensure its safe and effective use during pregnancy.

Keywords: Breastfeeding; China; Intentions; Pregnancy; Survey; Theory of planned behavior; Traditional Chinese medicine.

© 2025. The Author(s).

背景: 传统中医（TCM）在中国孕妇和哺乳期妇女中广泛使用，然而，在中国大陆预测其使用意愿的因素仍研究不足。本研究应用扩展的计划行为理论（TPB）框架来识别影响这一人群使用 TCM 的因素。

方法: 2023 年 7 月至 10 月期间，对来自中国大陆不同地区的 264 名孕妇和哺乳期妇女进行了横断面调查。数据通过包含人口统计信息、基于 TPB 的措施（态度、主观规范、感知行为控制、意图）及过去使用 TCM 经历的在线问卷收集。使用结构方程建模（SEM）来测试假设关系。

结果: 结果显示，37.5% 的参与者报告在怀孕或哺乳期间使用过 TCM。扩展后的 TPB 模型解释了 84.5% 的意图变化，其中主观规范影响最强（β = 0.435；p

结论: 本研究显示，在中国，孕妇和哺乳期妇女使用 TCM 的情况很普遍，并且主观规范、态度、感知行为控制以及以往经验是预测使用 TCM 意图的关键因素。这些发现强调了在医疗实践中整合文化和社会考虑的重要性。医疗服务提供者应了解家庭决策中的重要作用，并将文化敏感的咨询融入产妇护理中。政策制定者应加强对 TCM 的监管监督，确保其在怀孕期间的安全和有效使用。

关键词: 哺乳；中国；意图；怀孕；调查；计划行为理论；传统中医