OBJECTIVE: The reproductive goals of married couples living in impoverished areas of China affect survival rates and quality of life of female children in those areas. The goal of this study was to collect information on parents' attitudes toward reproduction, gender preferences/prejudices, and to collect relevant socioeconomic and demographic data. METHODS: Random sample families were enrolled from 3 poverty counties. Sample size included parents of 1800 children from birth to 6 years old. The children were divided into 6 age groups at one-year interval. Baseline data were collected and a questionnaire (endorsed by UNICEF) was used to evaluate reproductive expectations and gender preferences of parents. RESULTS: (1) The success of the One Child Family program has lead to a decreased overall birthrate. (2) The gender ratio (boys:girls) of the 3 counties studied was 100:87-100:95-100:97. No gender imbalance was found in this study. (3) The "Boy Preference" was still expressed by both fathers (69.0%) and mothers (65.7%). Approximately 40% of fathers and 37% of mothers interviewed expressed that only a male child would be acceptable. (4) Approximately 65% of both fathers and mothers recognize that girls are more likely to care for aging parents. CONCLUSION: Government initiatives have encouraged small families, yet in this region gender ratio of newborns is still normal. More educational and social programs are needed to influence perceptions regarding gender and to eliminate the suboptimal status/poorly perceived value of girls in many societies.