Modern women’s appearance management behavior is closely linked to childbirth concerns and influences their willingness to give birth, providing key insights for addressing low birth rates. This study examined appearance management behavior and willingness to give birth among Chinese women in their 20s and 30s, and analyzed the effect of appearance management on childbirth intentions. Data were collected from November 13 to 30, 2024, and analyzed using SPSSWIN 21.0, applying factor analysis (Cronbach’s α), descriptive statistics, correlation, and multiple regression analysis. Participants were mostly women in their 30s, married, with professional occupations, and holding college degrees or higher; many had no children or one child, and annual incomes between 10- 20 million KRW. Measurement reliability was high (appearance management behavior α= .935; willingness to give birth α= .984). Average scores were 3.74 for appearance management and 3.77 for willingness to give birth, both indicating high levels. Correlation analysis revealed a significant positive relationship between appearance management and willingness to give birth, while multiple regression showed that higher appearance concerns—particularly regarding skin, hair, body, and genital changes—were significantly associated with lower childbirth intentions. These findings highlight that stronger appearance management behavior reduces willingness to give birth, reflecting heightened sensitivity to physical changes during pregnancy. This study provides empirical evidence for the impact of appearance management on childbirth intentions and underscores the importance of incorporating these factors into future policy planning.