The relationship between social media use and fertility anxiety: a parallel mediation model

Abstract

Purpose

To investigate the relationship between social media use and fertility anxiety among women of childbearing age as well as the mediating effects of social comparison tendency and gender role attitudes, with the aim of enriching the understanding of the underlying psychological mechanisms of fertility anxiety and providing a theoretical basis for developing evidence-based prevention and intervention strategies.

Methods

A survey of 597 women in China was conducted using the Fertility Anxiety Scale for Women of Childbearing Age, the Social Network Sites Intensity Scale, the Social Comparison Orientation Scale, and the Gender Role Attitude Scale. Afterwards, a multiple mediation model was constructed to explore the relationships between the variables.

Results

(1) Social media use significantly and positively predicted fertility anxiety, and (2) social comparison tendency and gender role attitude played parallel mediating roles in the relationship between social media use and fertility anxiety.

Conclusions

This study revealed associations among social comparison tendency, gender role attitude, social media use, and fertility anxiety. Understanding these factors can offer insights that may be relevant to addressing fertility anxiety among women of childbearing age.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-026-04119-y.

Introduction

Currently, “fertility anxiety” is a widely discussed topic in both academic and societal contexts [1, 2]. Fertility anxiety originates from the psychological concept of anxiety, which is a complex emotional response involving irrational feelings [3]. It inherits the multidimensional emotional characteristics of general anxiety. At the same time, it shows unique manifestations within the context of fertility. Women of childbearing age often experience hesitation and uncertainty when deciding whether and when to have children, leading to a prolonged state of ambivalence and emotional instability [4]. Based on the definition of anxiety and its manifestations in the fertility context, we argue that fertility anxiety is a complex emotional experience, including tension, depression, worry, irritability, and fear, that women of childbearing age encounter when contemplating their reproductive prospects. Research has indicated that fertility anxiety is widespread [5–8]. A study conducted in Southwestern China showed that approximately 50.9% of women of childbearing age experiencing such emotions [9]. Its intensity varies according to demographic factors such as age, marital status, education, and urban–rural residence [10]. For instance, studies have found that fertility anxiety decreases with age [11], with women aged 18–25 exhibiting higher levels of fertility anxiety than those aged 25–30 and 30–35 [12]. They often struggle with the perceived conflict between motherhood and professional advancement, experiencing a persistent sense of dilemma: the desire to have children versus concerns about career interruption and financial burden [4]. If not effectively addressed, fertility anxiety at the individual level may escalate into broader societal challenges, including a decline in the youth population and an accelerated aging process [13]. Although childbearing can yield social and familial benefits, such as mitigating population aging, enhancing family well-being, and fulfilling intergenerational responsibilities [14, 15], the substantial economic and psychological costs associated with childbearing often induce fertility anxiety, prompting concerns and worries regarding individual fertility decisions [4, 14]. For unmarried women, there are various factors affecting individual fertility decision-making and reproductive behavior, such as occupational stress, health concerns, worries about the environment in which children grow up [16], and concomitant fertility fears, such as the fear of pain, appearance change, and personal safety [17]. Exhibited by the married women of childbearing age, fertility anxiety is mainly reflected in the conflict arising between family and career and in the lack of economic and social support [5, 18–20]. When the women of childbearing age are heavily burdened with the internal and external costs of childbearing, they tend to show higher fertility anxiety levels, facing a decision-making dilemma. In addition to daily life, the online social environment is another factor that affects the fertility anxiety level among women of childbearing age. The fertility anxiety in younger women can be easily triggered by the exaggerated negative fertility culture in online information [21]. Through the infinite extension of social communication surrounding fertility information, online media influences the women of childbearing age. Research has found that women of childbearing age are frequently exposed to negative fertility-related information on social media [22].This negative information includes the high-risk pregnancy challenges faced by other women, the heavy financial burdens associated with child-rearing (such as rising education costs), and career risks such as stalled promotion opportunities after maternity leave [23, 24]. Such information not only influences the fertility choices of women of childbearing age but also has a significant impact on their fertility intentions, ultimately contributing to a decline in fertility rates [23, 24].

Social media use and fertility anxiety

According to Maslow’s hierarchy of needs theory, social interaction is desired by human beings because of the support provided by socializing at the psychological and social levels [25]. This theory explains the fundamental motivation for social media use, namely, fulfilling individuals’ needs for belonging and esteem. This need not only acts as the initial driving force motivating individuals to use social media but also forms the psychological foundation for subsequent social comparison behaviors. With the popularization and development of mobile internet, social media has evolved into a major platform where people learn, work, and socialize. As the traditional offline socialization mode has increasingly moved online, individuals are shaping their personal virtual social worlds progressively. By integrating mass media and feminism, social media platforms can disseminate fertility information to netizens in a more intuitive and realistic way during the discussions about fertility, which not only promotes the deconstruction of traditional concepts related to fertility but also exerts influence on the development and exchange of diverse fertility concepts. In addition, the negative effects of fertility tends to be amplified on the Internet by the information on fertility-related costs. In case of more social media use, the feelings of fertility anxiety become stronger [23, 24, 26, 27]. The anxiety about fertility can be exacerbated by the selective exposure to information and social comparison during social media use [28]. Accordingly, we propose the following:

• H1: Social media use positively predicts fertility anxiety in women of childbearing age.

Social comparison tendency

Social Comparison Theory, proposed by Festinger in 1954, posits that individuals are driven by a fundamental need for self-evaluation and are motivated to verify the accuracy of their own viewpoints [29]. When individuals lack objective criteria for self-assessment, they tend to evaluate themselves by comparing with others. Social media has created an environment that continually encourages such social comparison, which represents a key mechanism underlying the development of fertility anxiety. In definition, social comparison is the behavior of individuals comparing their personal circumstance with that of others, such as comparing various aspects including capabilities, perceptions, and physical health. This is a widespread psychosocial activity, and individuals often attempt to understand and assess themselves through social comparisons [29]. The term “social comparison tendency” refers to an individual’s persistent tendency to actively observe and compare themselves to other people [30]. It is specifically manifested in the frequency, initiative, and degree of dependence that an individual exhibits during social comparison processes. Those with a high tendency toward social comparison display greater sensitivity to comparison-related information and frequently rely on such comparisons as a means of achieving self-awareness and evaluation [31]. It is a common phenomenon to make social comparisons on social networks, and people tend to view the information (e.g., updates, pictures, etc.) shared by others for comparison between themselves and others [32]. According to Li [33], female groups publish their views on fertility and share their own fertility experiences on social media, while the recipients of the information update their self-evaluation by actively comparing the performance of others to aspects of their own performance. With a frequent exploration of fertility-related risk issues and fertility fears [34], the online discourse can prompt women of childbearing age into viewing fertility negatively, changing their attitudes toward fertility, or feeling more anxious about fertility. As the social interactions grow more complex, individuals post more negative social behaviors and emotional responses online, and social media use predicts social comparison [35, 36]. When social media use increases, opportunities for engaging in social comparisons become more frequent. Individuals who have a particularly high social comparison tendency tend to produce social comparison behaviors. Moreover, social comparison tendency has been shown to positively predict fertility-related anxiety, indicating that heightened social comparison tendencies significantly exacerbate individuals’ fertility-related anxiety [26]. Therefore, social media use predicts not only fertility anxiety but also social comparison tendency, which in turn predicts fertility anxiety. As such, we propose the following:

• H2: Social comparison tendency tends to mediate the relationship between social media use and women’s fertility anxiety.

Gender role attitude

Social role theory asserts that individual’s gender role attitudes are shaped through their observations of male and female behavioral patterns in everyday life. These observations subsequently inform the development of corresponding gender role attitudes [37]. Exposure to role models who embody a more equitable division of labor between genders within social contexts may evoke profound emotional resonance, thereby catalyzing a shift in individuals’ gender role attitudes toward greater egalitarianism [38]. However, within the context of China’s collectivist culture, traditional gender norms coexist with modern egalitarian ideals. This distinctive cultural environment often exposes individuals to the simultaneous influence of both traditional and contemporary notions when making fertility-related decisions. The formation and transformation of individual gender role attitudes, as explained by social role theory, provide a plausible account for the emergence of such value tensions. Specifically, the gender role attitudes that individuals acquire through observing behaviors and interacting with others can clash with the traditional and modern concepts prevalent in collectivist culture, thereby generating value conflicts in fertility decision-making. In this process, mass media also plays a significant role. By promoting modern concepts of gender roles, the mass media reinforces the idea of gender equality while making individuals more sensitive to gender issues [39]. In the view of Sun and Zhang [40], the mass media exerts a substantial influence on young people’s values, and women, who in particular are deeply influenced by the media, are likely to identify more with the ideas conveyed by the media. When social media use increases, there is a decrease in fertility intention among women of childbearing age [41, 42]. Also, various traditional gender roles are increasingly disproved by women, such as “The man is in charge outside the house. The woman is in charge at home.” [41] Deng et al. [43] found out that social media can positively predict modern women’s gender role attitudes, with a higher frequency of media use leading to a weaker identification of women with traditional gender roles. Additionally, from the perspective of new-age women with modern gender role concepts, there is a necessity to carefully consider the real difficulties associated with choosing to have children, which is an ambivalence contributory to fertility anxiety [13, 44]. Therefore, social media use can influence gender role attitudes, and modernized gender role attitudes induce fertility anxiety. Therefore, we propose:

• H3: Gender role attitude plays a mediating role between social media use and fertility anxiety among women of childbearing age.

Parallel mediating effects of social comparison tendency and gender role attitude

In summary, there remain few studies specifically examining how social media use influences fertility anxiety, despite the existing research that has explored the influence of social media on individuals in terms of reproductive psychology. Therefore, this study is purposed to reveal the relationship between social media use and fertility anxiety, along with the influence mechanisms involving social comparison tendency and gender role attitude. Furthermore, both social comparison tendency and gender role attitude belong to the self-cognitive regulation mechanisms formed during the process of individual socialization, sharing a common origin. More importantly, these two elements constitute complementary explanatory pathways within the theoretical framework: social comparison tendency drives individuals to continuously compare their own situations with others on social media, while gender role attitudes emphasize the normative constraints arising from daily observations and the internalization of cultural values. Together, these two mechanisms form an integrated psychological pathway through which social media influences fertility anxiety. Accordingly, the following hypotheses are proposed:

• H4: Social comparison tendency and gender role attitude play a parallel mediating role in the relationship between social media use and fertility anxiety.

Methods

Study design and participants

A questionnaire survey was conducted through convenience sampling across different regions such as Chongqing and Sichuan in China. There are two reasons why convenience sampling was performed. One is to ensure the timeliness of the research, considering that the impact of social media on fertility anxiety among women of reproductive age is a pressing issue of social significance. The other is that convenience sampling facilitates the identification of eligible samples for the studies focusing on specific populations. After being compiled using Questionnaire Star (问卷星), the links and codes for the questionnaires were distributed to the participants. The questionnaire comprised 81 items, including demographic variables and two attention-check questions. All items were set as mandatory to ensure complete responses and prevent skipping. The inclusion criteria were as follows: (1) being women of childbearing age between 20 and 49 years old. This range is set by referencing both the internationally accepted definition (15–49 years) [45] and China’s legal marriage age of 20, and is consistent with prior research [46]; and (2) residing in mainland China with experience in social media use. The exclusion criteria were (1) refusal to consent to participation; (2) failure on the attention-check items; (3) a completion time less than 50% of the average; and (4) evidence of straight-lining (e.g., providing identical responses to a long series of questions).

According to the empirical rule proposed by Krejcie and Morgan [47] for survey sample size calculation, at least ‌384 valid samples are required to comprise an infinite population‌. Meanwhile, G*Power 3.1.9.7 software was used with parameters set to α = 0.05, power = 0.95, and effect size f² = 0.15 [48]. The minimum sample size was calculated to be ‌119 participants‌. For the compliance with both criteria, at least ‌384 valid cases were included in this study‌. Accounting for a ‌20% invalid data rate‌, the final sample size was determined to be 480 participants as a minimum‌. Finally, 670 questionnaires were collected in total. The average time participants took to answer was 12 min and 52 s. After validity screening, 597 valid questionnaires were retained, with a response rate of 89.1%. A total of 73 participants were excluded from the sample. Specifically, 41 were removed for failing the attention-check items, 19 for completing the survey in less than 50% of the average time, and 13 for exhibiting straight-lining behavior. Table 1 lists the basic information about the sample.

Table 1.

Demographic information of the samples (N = 597)

Variables		N	Percentage
Age	20–29 years	172	28.8
	30–39 years	272	45.6
	40–49 years	153	25.6
Marital and dating status	Single	59	9.9
	In a romantic relationship	97	16.2
	Married	441	73.9
Number of children	0	244	40.9
	1	261	43.7
	2 or more	92	15.4
Educational attainment	High school education or below	87	14.6
	Associate degree	112	18.8
	Bachelor’s degrees	295	49.4
	Master’s degrees or above	103	17.2
Residence location	Urban	338	56.6
	Rural	259	43.4

Ethics approval and consent to participate

All the procedures concerned were carried out in strict accordance with the Helsinki Declaration of 1975, as revised in 2008. The research proposal was granted approval by the Ethic Committee for Scientific Research at the School of Educational Sciences, Chongqing Normal University (CNU-PSY-202404-026). Written informed consent was obtained from all the participants, with the content of the consent forms kept confidential. After being informed about the study in terms of purpose, methods, potential risks and benefits, the participants were allowed the opportunity to ask any questions for participation.

Measures

Fertility anxiety scale for women of childbearing age

An independently developed questionnaire was used to evaluate the level of fertility anxiety among women of childbearing age [49]. Based on the fertility anxiety theory grounded in the rational economic person hypothesis, the marginal child rational choice theory [50], and the work-family conflict theory [40], this scale conceptualizes fertility anxiety as comprising four dimensions: self-sacrifice, financial commitment, resource scarcity, and parenting support. Subsequently, through an open-ended questionnaire survey and literature analysis, 34 preliminary items were identified and proceeded to the initial scale testing phase (which included item analysis and exploratory factor analysis), and a final scale testing phase (which encompassed confirmatory factor analysis, composite reliability analysis, internal consistency reliability analysis, as well as construct validity analysis and convergent validity analysis). The Cronbach’s α coefficient for the scale was 0.938, while the Cronbach’s α coefficient for the four dimensions, namely self-sacrifice, financial commitment, lack of resources, and parenting support, was 0.895, 0.859, 0.830, and 0.781, respectively. Furthermore, confirmatory factor analysis revealed the following statistics: χ²/df = 1.965, RMSEA = 0.049 (less than 0.08), and RMR = 0.035 (also less than 0.08). Additionally, NFI = 0.926, IFI = 0.962, TLI = 0.956, and CFI = 0.962. All of these indices exceeded 0.8. Following aforementioned rigorous statistical analyses, 20 items were retained to constitute the formal Fertility Anxiety Scale for Women of Childbearing Age. Moreover, a 5-point Likert scale was employed, in which participants rated the extent to which each item aligned with their own circumstances, with scores ranging from 1 (strongly disagree) to 5 (strongly agree). The total score of the scale ranges from 20 to 100. A higher score on this scale implies a higher level of fertility anxiety. Scores ≤ 65 indicate mild fertility anxiety, scores > 65 but < 90 suggest moderate fertility anxiety, and scores ≥ 90 denote severe fertility anxiety. The Cronbach’s α coefficient for this study was 0.923. To sum up, these results demonstrate the high reliability and validity of the self-designed scale.

Social network sites intensity scale

Developed by Ellison et al., the Social Network Sites Intensity Scale was applied in this study. The Chinese adaptation of the questionnaire, translated by Niu [51], was useed to evaluate the use of social networking sites by the participants. The first two questions were designed to assess the number of friends and the average daily time spent on these sites. In contrast, the following six questions were designed using a 5-point Likert scale (ranging from 1, indicating strong disapproval, to 5, indicating strong approval) to evaluate the users for their emotional attachment to the social network and the level of incorporating the social network into their daily routines. In this study, the Cronbach’s α coefficient for the scale was 0.745.

Social comparison orientation scale

Translated by Wang et al. [52] for localized use in Chinese, the Chinese version of the Social Comparison Tendency Scale was applied in this study. This scale is composed of two subdimensions, namely ability comparison and conceptual comparison, involving seven and four items, respectively. It adopts a 5-point Likert scale, with 1 representing “very non-compliant” and 5 representing “very compliant.” The scale also assesses the frequency of individuals’ social comparison behavior, where a higher total score indicates a greater tendency toward social comparisons. In this study, the Cronbach’s α coefficient of the questionnaire was 0.759.

Gender role attitude scale

Developed by Shi [53], the Gender Role Attitude Questionnaire was used in this study. It encompasses four factors: social rights and obligations, competence traits and performance, occupational interests and work, and gender interactions and relationships. The Cronbach’s α coefficient used for this questionnaire in the present study was 0.902, complying with the criteria set for a reliable measurement instrument. The participants assessed their own responses on a 7-point scale, with 1 representing complete disagreement and 7 representing complete agreement. A higher score on this scale indicates a more traditional attitude toward gender roles, whereas a lower score indicates a more modern perspective.

Data analyses

During the process of data analysis, an analysis of demographic statistical variables was first conducted for 597 women of reproductive age. Then, the data were examined through Harman’s one-factor test [54]. As revealed by the principal component analysis conducted without rotation, there were 13 factors with eigenvalues exceeding 1, while the first factor accounted for only 28.85% of the total variance, which fell below the commonly accepted threshold of 40%. On this basis, it was assumed that the data collected in this study were not significantly affected by common methodological bias. Afterwards, descriptive statistics and correlation analyses were performed using the software SPSS 24.0 on the independent variable of social media use, the dependent variable of fertility anxiety, as well as the two mediator variables of social comparison tendency and gender role attitude. Finally, Model 4 of the SPSS macro program PROCESS, developed by Hayes [55], was applied to examine the relationship between the independent and dependent variables, as well as to test the parallel mediation effects. Through this model, 5000 bootstrap samples were created using the bias-corrected nonparametric bootstrap percentile method to analyze the mediation effect. Additionally, based on prior research [5, 10], this study incorporated age, as well as marital and dating status as covariates in the analysis.

Results

Descriptive statistics and correlation analysis

In order to reveal the relationship between fertility anxiety, social media use, social comparison tendency, and gender role attitude, the variables were analyzed by performing descriptive statistics and correlation analysis. Table 2 lists the correlation coefficients among the variables, along with the standard deviation and mean of each variable. Fertility anxiety was significantly positively correlated with social media use (r = 0.20, p < 0.001) and social comparison tendency (r = 0.27, p < 0.001). Social media use was significantly positively correlated with social comparison tendency (r = 0.23, p < 0.001). In contrast, gender role attitude was significantly negatively correlated with fertility anxiety (r=-0.40, p < 0.001), social media use (r=-0.17, p < 0.001), and social comparison tendency (r=-0.09, p = 0.031). Since gender role attitude and social comparison tendency were hypothesized as two parallel mediators, their correlation was relatively low.

Table 2.

Descriptive statistics and correlation analysis of variables (N = 597)

Variables	M ± SD	1	2	3	4
1 Fertility anxiety	3.90 ± 0.64	1
2 Social media use	3.93 ± 0.51	0.20***	1
3 Social comparison tendency	3.41 ± 0.59	0.27***	0.23***	1
4 Gender role attitude	2.26 ± 1.22	−0.40***	−0.17***	−0.09*	1

***p < 0.001, **‌p < 0.01, *p < 0.05

Parallel mediation effect test

According to the results shown in Table 3, social media use statistically significantly and positively predicted fertility anxiety (β = 0.091, p = 0.014), thereby confirming Hypothesis 1.

Table 3.

Tests of mediating effects of gender role attitudes and social comparison tendency (N=597)

Regression equation		Overall fit index			Significance of regression coefficients
Outcome variable	Predictor variable	𝑅	𝑅2	F	𝛽	𝑡
Social comparison tendency	Social media use age Marital and dating status	0.244	0.059	12.468***	0.228 -0.096 0.145	5.730*** -1.483 2.238*
Gender role attitude	Social media use age Marital and dating status	0.274	0.075	16.084***	-0.163 0.164 0.064	-4.129*** 2.554* 0.996
Fertility anxiety	Social media use Social comparison tendency Gender role attitude	0.496	0.246	38.604***	0.091 0.218 -0.326	2.457* -5.916*** -8.767***
	Age				-0.185	-3.165**
	Marital and dating status				0.019	0.331

***p < 0.001, **‌p < 0.01, *p < 0.05

The significance of the mediating effects was evaluated using the bias-corrected bootstrap method. The bootstrap results revealed a statistically significant mediating effect exerted on the relationship between social media use and fertility anxiety among women of childbearing age. Specifically, the mediating effect of social comparison tendency reached a statistically significant extent, shaping the path of “social media use → social comparison tendency → fertility anxiety”. Regarding the mediating effect, IE = 0.063 and SE = 0.017, with a 95% CI of [0.033, 0.100]. Additionally, gender role attitude demonstrated a significant mediating effect in this relationship as well, indicating the statistically significance of the path “social media use → gender role attitude → fertility anxiety”. As for the mediating effect, IE = 0.068 and SE = 0.022, with a 95% CI of [0.026, 0.113]. Social comparison tendency and gender role attitude collectively acted as parallel mediators between social media use and fertility anxiety. Thus, Hypotheses 2, 3 and 4 were validated. According to the comparison of the mediating effects, the bootstrap 95% confidence interval encompassed 0, indicating that there was no statistically significant difference between the mediating effect of social comparison tendency and that of gender role attitude. Table 4 presents the mediating effect values, and Fig. 1 shows the simulated path coefficients.

Table 4.

Decomposition of mediating effects of social comparison tendency and gender role attitude between social media use and fertility anxiety (N = 597)

	Effect	Bootstrap SE	Bootstrap 95% CI
			LLCI	ULCI
Total effect Direct effect	0.247 0.116	0.050 0.047	0.149 0.023	0.345 0.209
Total indirect effect	0.131	0.030	0.073	0.192
Mediating role of social Comparison tendency	0.063	0.017	0.033	0.100
Mediating role of gender role attitude	0.068	0.022	0.026	0.113
Comparing the mediating effect	−0.004	0.026	−0.054	0.048

Mediation effects were considered statistically significant if the CI did not include zero

LLCI the lower limit in 95% confidence interval, ULCI the upper limit in 95% confidential interval

Fig. 1.

Parallel mediation effects (N = 597)

Discussion

This study aims to reveal the relationship between social media use and fertility anxiety, along with their underlying mechanisms. In the new era, it contributes significantly to the research on fertility anxiety from a psychological perspective, providing a more in-depth understanding of the relationship between social media use and fertility anxiety. This study strictly adheres to the established criteria for mediation analysis [56], with its research model grounded in robust literature review and empirical validation, thereby providing a solid theoretical foundation for the study’s conclusions. Moreover, transcending the traditional framework that solely attributes fertility anxiety to economic or policy factors, this finding contributes theoretical enhancements from a mediated social perspective to the research on fertility decisions in the digital era. It thereby enriches psychological studies on fertility issues and offers theoretical support for government policy-making, media publicity, and educational endeavors.

The relationship between social media use and fertility anxiety

The results of this study show that social media use positively predicts fertility anxiety among women of childbearing age. Thus, the more social media is used, the higher the level of fertility anxiety, which is consistent with the results of a previous study [26]. Meanwhile, as Maslow’s hierarchy of needs posits, individuals’ intrinsic desire for social interaction stems from the psychological and social support it provides [25], which also constitutes the psychological foundation for social media’s widespread adoption. However, although social media meets individuals’ basic needs, exposure to fertility-related content during its use can significantly influence their psychological states [34]. The findings offer preliminary insights that may assist social media platforms in refining their strategies for distributing fertility-related content. This could contribute to a more balanced information environment and help mitigate risks associated with the unintentional amplification of collective anxiety. As a multifunctional platform, social media is attractive to many users, with 42.1% of the surveyed participants classed as social media addicts [57, 58]. Notably, the magnitude of this phenomenon has been increasing constantly [57, 58]. It is evidenced that the use of social media has become increasingly universal as it deeply penetrates daily life. Under this trend, fertility-related topics have attracted widespread attention on social platforms. According to some studies, people’s willingness to have children has been significantly reduced by entertainment-based online activities, and individuals are accepting of many negative fertility concepts while surfing the Internet. Thus, their personal behaviors are unconsciously influenced [59]. In this process, fertility anxiety spreads and becomes intertwined with other factors to cause inescapable social anxiety [60].

As the primary channel for disseminating information in modern society, the Internet al.lows people to recognize and form opinions in new ways. Heated debates are sparked when the issues related to childbirth risks and modern feminist perspectives on childbirth have been increasingly exposed to the public on social media platforms. This open and inclusive discussion environment has contributed to the emergence of various modern fertility concepts, such as “the value of happiness in childbirth” [61]. Over time, they have posed challenge to the traditional fertility beliefs like “passing on the family name to the next generation” and “more children, more happiness.” The progressive erosion of traditional fertility concepts, such as laying emphasis on the importance attached to “passing on the family name” and “having many children,” has made people less willing to have children. Furthermore, the satisfaction that can be derived from childbearing is now replaced to some extent as people are investing more time and money in online shopping, entertainment, and social activities. Consequently, fertility intentions diminish [22]. For the women of childbearing age, their childbearing-related behaviors can be avoided if the costs of childcare are indirectly raised by spreading childcare-related anxiety. According to Balbo and Barban [62], there is an increase in online social interactions, and these interactions are viewed as an important way to exert influence on individual fertility intentions through social influences and social learning mechanisms. As these factors become increasingly significant, a wider range of social groups and levels can be reached. Finally, women are more active on social media, which renders them more susceptible to the influence of popular thinking online. In addition to stimulating the sense of independence among women, social media also makes it more likely for them to develop fertility anxiety, which affects their fertility intentions.

The mediating role of social comparison tendency

As revealed in this study, social media use can affect the level of fertility anxiety among women of childbearing age through social comparison tendency, and social comparison tendency can have a positive effect on fertility anxiety, which aligns with the findings of Zhang and Zhao [26]. According to social comparison theory, an individual’s need for self-evaluation drives an increase in their tendency for social comparison [29]. This intrinsic drive for self-evaluation predisposes individuals toward social comparison [29], a process through which they gauge themselves against perceived benchmarks. During this process, the individual’s self-evaluation may undergo negative changes due to perceived disparities. With the rapid development of the Internet nowadays, “sharing daily life” has become prevalent, which is especially true for women of childbearing age. When browsing information about people they believe to be of a higher social class, regardless of the veracity of the information, women of childbearing age present higher social comparison tendencies, which in turn, increases the likelihood that they will engage in social comparison behaviors. As indicated by Sherf and Venkataramani [63], social comparisons play a pivotal role in an individual’s judgment of fairness and an individual’s emotions are influenced by the sense of fairness. Some women experience a strong activation of their innate social comparison tendency when they come across the images of supposedly “successful individuals” that are promoted by their social circles or social media platforms. This might lead to discontent with their existing standard of living, which would then erode their feeling of wellbeing and cause them to worry and become anxious about having children. This anxiety results not only from the current state of life, but also from expectations and concerns about future possibilities, particularly when the resources and responsibilities involved in having and raising children are considered. Therefore, social comparison tendency functions as a catalyst in this process, which increases the fertility anxiety among women of reproductive age to some extent, exerting influence on their attitudes and decisions towards childbearing.

The mediating role of gender role attitude

This study has demonstrated that gender role attitude plays a mediating role in the relationship between social media use and fertility anxiety, and that social media use negatively predicts gender role attitude, which in turn negatively predicts fertility anxiety. It is implied that the more intensive the use of social media, the more modernized the gender role attitude of women become, and the higher the level of fertility anxiety they experience. This finding further supports the perspective of social role theory, suggesting that the media, by presenting a diverse range of gender role models, encourages individuals to re-evaluate and adjust their ingrained perceptions of gender roles [37]. When individuals are exposed to diverse role models on social media, this exposure constitutes an observational learning pathway, thereby providing new cognitive references for their existing gender roles and potentially driving the reshaping of internal attitude structures. In recent years, online communication has been dominated by various modern ideas such as “gender equality,” “feminist ideology,” and “individualism.” Due to its convenience, interactivity, virtuality, and public nature, the Internet provides a broad platform for the public. Pan [64] highlighted how the Internet has significantly reduced the perceived physical differences between genders through its flat working structure, with an equal space created for men and women to communicate. Presenting a challenge to the traditional notion of “male superiority,” it has also promoted gender equality. As feminism continues to challenge gender inequality and the diversity in portrayal of women by the media increases, it has become more feasible to adjust traditional gender concepts.

As revealed by prior studies, gender role consciousness is not only a critical factor in accounting for low fertility levels [65] but also an important source of fertility anxiety. The gender role awareness of women is reinforced by the information spread on online social networks [39], while the increased sense of autonomy and modernized gender role attitude among contemporary women play a pivotal role under the context of low fertility [65]. In addition, those women browsing social media regularly are likely to encounter the discussions about feminism and gender equality, which leads to a shift in gender role perceptions from traditional to modern. In this social environment, people do not simply stick to the outdated concepts of procreation and lifelong marriage any more. Instead, they explore other possibilities for personal growth [66]. As revealed by Deng et al. [43], gender role attitude influences the fertility intentions of women, and a more equal gender role attitude tends to reduce women’s fertility intentions. The women with modern gender role perspectives are active in pursuing equal status with men whether in society or family life. They invest more effort and time in areas outside the home, such as education and careers. Because of this desire, they strive for equal status with men in social and professional development, which subjects them to a higher competitive pressure. However, these women are unwilling to relinquish their roles in the family, which renders the internal conflicts encountered by them in social life more pronounced. Ultimately, the higher levels of fertility anxiety may be caused by this combination of this psychological state and social pressure.

Practical implications

This study yields several actionable insights for mental health practitioners and media regulators. First, mental health practitioners may conduct early screening protocols to identify individuals at risk of fertility anxiety, allowing for the timely deployment of preventive interventions. These interventions may include individual psychological counseling, public educational lectures to raise awareness of social media’s psychological impacts on fertility-related issues, the dissemination of coping strategies for managing social comparison stress, and the promotion of more egalitarian gender role perspectives. Second, media regulators can encourage the production and dissemination of content that alleviates fertility-related anxiety and promotes fertility health, guiding women of childbearing age toward more rational and evidence-based understanding of fertility.

Furthermore, different cultural contexts are characterized by unique fertility values and traditions. In collectivist cultures where family lineage and intergenerational continuity are prioritized [67], fertility anxiety predominantly arises from intense familial and societal pressure to procreate. Such cultural expectation intensifies individuals’ perception of societal obligations regarding childbirth, reinforcing tendencies toward social comparison and conformity. Simultaneously, traditional gender role ideologies, which place the burden of reproduction primarily on women, intersect with the social media–driven portrayal of the “ideal mother”, thereby compounding the psychological stress women face. For such cultures, it is crucial to promote open cand inclusive discourse surrounding fertility choices, empowering individuals to regard fertility as a personal decision. Creating a nonjudgmental environment for expressing concerns and aspirations can help mitigate the adverse psychological impact of fertility-related anxiety. Conversely, in cultures that place greater emphasis on individual autonomy and career development, idealized representations on social media tend to provoke excessive social comparison, intensifying the conflict between traditional gender expectations and modern professional aspirations. In such societies, greater emphasis should be placed on building robust support mechanisms—including the reform of workplace policies and the establishment of community-based mutual aid networks, to help individuals alleviate the anxiety arising from the perceived incompatibility between childbearing and career development.

Limitations and future research

Notably, this study is subject to some limitations. This study is cross-sectional in nature. Although statistical analysis techniques make it possible to discern the mechanism of interaction between the variables, it is still unlikely to conclusively establish the exact causal relationship between them. Therefore, future research should be conducted to further explore the impact of social media usage on fertility anxiety among women of childbearing age, potentially through experimentation or longitudinal tracking study. Secondly, this study adopts self-report scales to measure core variables, which may introduce social desirability bias, such as an underreporting tendency for social media usage frequency. To enhance the comprehensiveness and accuracy of measurements, future research should be carried out through a combination of multiple measurement methods, such as integrating self-report data with behavioral observations and diary entries, for the assess to core variables from multiple perspectives and at different levels. Thirdly, convenient sampling is performed in this study, which allows for the rapid collection of a certain amount of data within limited resources. In spite of this, there are certain limitations on the representativeness of the sample. Therefore, future research could be conducted by adopting more rigorous sampling methods, such as random sampling or stratified sampling. Thus, it can be ensured that the sample is more representative of the target population and the potential impact of sample bias is reduced. Fourthly, the present model was validated within a specific cultural context in which gender roles carry distinct social significance, and the manifestations and drivers of fertility anxiety may differ across societies. Accordingly, future cross-national comparative research is warranted to explore potential differences in the tested relationships. Lastly, in addition to considering educational and social factors, psychological interventions are also required to reduce fertility anxiety, as emphasized by Maeda et al. [68]. Therefore, it is necessary to conduct future research by exploring related interventions, such as group counseling and case studies, for a lower level of fertility anxiety among women of childbearing age. Alternatively, anxiety levels can be lowered by adopting cognitive-behavioral therapy, which enables women of childbearing age to deal with fertility issues more rationally and improves their self-adjustment capabilities [69]. Additionally, digital literacy programs can be leveraged to improve the information literacy of women of childbearing age, which allows them to effectively sift through and utilize online fertility and health information. Meanwhile, they can be protected from being misled by false or misleading information [70].

Conclusions

This study developed a parallel mediation model to investigate the relationship between social media use and fertility anxiety. The findings revealed a positive association between social media use and fertility anxiety. Furthermore, social comparison tendency and gender role attitude played parallel mediating roles in this relationship. These findings indicate that addressing fertility anxiety necessitates a comprehensive approach that considers both social media use and individual psychological factors, highlighting the importance of external media environments and internal psychological mechanisms. This further advances our understanding of the relationship between digital media and fertility psychology, suggesting that systematic interventions should integrate the content ecosystem of social media with individual psychological processes. These findings provide practical insights for designing support programs targeting fertility anxiety among social media users.

Abbreviations

M

Mean

SD

Standard deviation

r

Pearson correlation coefficient

𝑅²

Coefficient of determination

F

F-statistic

𝛽

Standardized regression coefficient

𝑡

𝑡-statistic

χ²

Chi-square

df

Degrees of freedom

RMSEA

Root Mean Square Error of Approximation

RMR

Root mean square residual

NFI

Normed fit index

IFI

Incremental fit index

TLI

Tucker-Lewis Index

CFI

Comparative fit index

IE

Indirect effect

SE

Standard error

95% CI

95% confidence interval

LLCI

Lower limit of the confidence interval

ULCI

Upper limit of the confidence interval

Authors’ contributions

All authors contributed to the conception and design of the study. BZ was responsible for writing the original draft and methodology, SW conducted the investigation, YQ took charge of data curation, and ZL worked on writing review and editing.

Funding

The authors declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by The National Social Science Fund of China in 2022: No.22BSH096.

Data availability

The data will be made available upon the request from the corresponding author.

Declarations

Ethics approval and consent to participate

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The studies involving humans were granted approval by The Ethic Committee for Scientific Research, School of Educational Sciences at Chongqing Normal University on April 26, 2024 (CNU-PSY-202404-026). The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their informed consent in writing to participate in this study.

Consent for publication

Not applicable. All data presented in the manuscript have been anonymized.

Competing interests

The authors declare no competing interests.