Exploring the role of mass media and virtual social networks on couples’ childbearing decisions: an exploratory qualitative study

Abstract

Introduction

Previous studies have addressed the role of mass media in shaping couples’ fertility attitudes and behaviors. This qualitative study aimed to explain the role of mass media and virtual social networks on couples’ childbearing decisions.

Methods

In this exploratory qualitative study, in-depth interviews were conducted with 34 participants, including couples, key informants, and experts in the fields of population and childbearing, who were purposefully selected. Data were collected through semi-structured face-to-face interviews, continuing until data saturation was achieved. Data analysis was performed using MAXQDA software, employing a conventional content analysis approach that involved the provision of analytical codes and the identification of categories.

Findings

From the data analysis, four main categories emerged: intentional promotion of reproductive behaviors, indirect dissemination of low-fertility-oriented values and transnational cultures, empowering mothers, and completing family leisure and entertainment opportunities. Mass media directly or indirectly influences couples’ reproductive behaviors and may have short-term and long-term effects on their childbearing decisions.

Conclusion

Mass media in the social and cultural context of Iran can influence couples’ fertility decisions. Managing reproductive behaviors in families and society requires attention to couples’ exposure to mass media and virtual networks and the mechanisms of their impact on childbearing. Policymakers in Iran need to pay attention to the role of the media in designing interventions that affect couples’ reproductive behavior.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-026-26581-4.

Introduction

Population is one of the most significant economic, social, and political components globally. Changes in population can significantly influence the economic and social development of any society [1]. In recent years, particularly during the last decade of the 20th century, most countries worldwide have witnessed a decline in the total fertility rate (TFR), which is the number of live children a woman gives birth to during her reproductive years. The global TFR has decreased over the past seven decades and has been on a steady decline since 1950. It fell from 4.97 in 1950 to 2.31 in 2019 [2]. There are notable differences in the decline of the TFR among countries. Developing nations, like the rest of the world, have seen rapid declines in the TFR in recent decades [3]. Consequently, the most significant declines in the TFR have been reported in Asia, North Africa, and Latin America, where relatively swift socioeconomic development is also observed [4].

Iran has also undergone changes in fertility rates over the past decades. According to the Demographic and Health Characteristics Survey, the TFR has dropped from approximately 7.7 children in 1966 to about 2.1 in 2000. By 2010, this rate further declined to 1.6 children per woman. Various studies indicate that this fertility decline in Iran has occurred across all provinces and in both urban and rural areas [5].

Factors such as increasing women’s education, evolving social norms, beliefs and attitudes related to childbearing, improvements in the healthcare system, reductions in infant mortality, economic challenges, rising child-rearing costs, and an increasing age at marriage play a role in individuals’ reproductive decisions [6, 7]. In recent decades, the role of individuals’ social networks and the use of mass media and virtual social networks concerning reproductive behaviors has garnered attention [8, 9]. As the findings of the study by Wildeman et al. (2023) indicated, women who actively engage in social media are likely to encounter new ideas about family planning and reproductive health, leading to shifts in their attitudes towards childbearing [10].

Virtual social networks, including platforms like Facebook and Instagram that enable users to connect, share content, and maintain relationships, provide a unique context in which peer influences can shape reproductive health behaviors. The portrayals of reproductive health and parenting, along with the exchange of personal stories and experiences, can affect women’s perceptions of childbirth and parenting, shaping social norms and individual choices about family planning [8, 11, 12]. Social learning theories suggest that individuals may model behaviors observed in the media [13], which can also extend to fertility decision-making. Therefore, understanding the role of these media sources on reproductive behavior is crucial [14].

Although, previous studies have addressed the role of mass media in shaping couples’ fertility attitudes in various countries [14, 15], based on the researcher’s findings, while previous studies have identified mass media such as radio, television, magazines, and other outlets as sources of information about contraceptive methods in Iran [9, 16], the role of mass media and virtual networks on shifts in fertility trends in Iran has not been thoroughly examined. This includes not only the experiences of couples but also the perspectives of key individuals and experts in the fields of population and childbearing. Therefore, there was a need for a qualitative study to explore this phenomenon within the cultural, religious, and social context of Iran, as a deep understanding of the reasons and mechanisms behind such phenomena can be achieved through qualitative research [17].

A better understanding of fertility can impact the provision of reproductive health services and inform policymaking aimed at promoting family health in society. By identifying the role of mass media in reproductive decisions and behaviors, it may be possible to adjust the fertility process based on these influences. Consequently, this qualitative study was conducted to explain the role of mass media and virtual social networks on couples’ childbearing decisions.

Methods

The present study is a qualitative investigation with an exploratory approach. The research population comprised all eligible married women of reproductive age (18–49 years) in Mashhad, Iran, as well as men whose spouses met the inclusion criteria, along with key informants and experts in the field of childbearing. Mashhad is the second most populous city in Iran, and like other cities in the country, its TFR has declined and is currently below the replacement rate.

Sampling was conducted purposefully with maximum diversity in environments such as health centers, personal workplaces, offices, and other locations where it was possible to access eligible individuals. The study participants totaled 34, including 14 eligible married women of reproductive age (18–49 years), eight men whose wives were of reproductive age, and 12 key informants and experts in the field of childbearing, which included a psychologist, a sociologist, two reproductive health specialists, two media experts, three gynecologists, a midwife, a family health expert, a religious missionary, and two population and childbearing managers (Tables 1 and 2).

Table 1.

Demographic characteristics of women and men

No	Gender	Job	Number of children
1	Woman	Nurse	Without children
2	Woman	Housewife	4
3	Woman	Housewife	Without children
4	Woman	Housewife	1
5	Woman	Housewife	2
6	Woman	Housewife	2
7	Woman	Hairdresser	2
8	Woman	Freelance job	1
9	Woman	Teacher	2
10	Woman	Teacher	4
11	Woman	Housewife	5
12	Woman	Employee	1
13	Woman	Housewife	1
14	Woman	Teacher	3
15	Man	Freelance job	1
16	Man	Freelance job	1
17	Man	Freelance job	2
18	Man	Freelance job	3
19	Man	Freelance job	2
20	Man	Faculty member	1
21	Man	Employee	3
22	Man	Freelance job	1

Table 2.

Demographic characteristics of key informants

No	Gender	Job	Number of children
23	woman	Psychologist	3
24	Man	Sociologist	2
25	woman	Professor of Quranic Sciences	2
26	woman	Faculty member	Without children
27	woman	Faculty member	2
28	woman	Media expert	2
29	woman	Media expert	4
30	Man	Head of the Youth Committee of the Population	1
31	woman	Midwife	2
32	woman	Gynecologist	2
33	Man	Member of the Youth Committee of the Population	1
34	woman	Gynecologist	2

^a Doctor of Philosophy

^b Medical doctor

At the beginning of the study, all participants received necessary explanations regarding the objectives and methods of the study, and their questions were addressed. It should be noted that sampling continued until data saturation was reached (when no new concepts were reported).

The inclusion criteria for women in the study encompassed those aged 18 to 49 years, with or without children, who were married, Iranian, able to communicate, speak Persian, and willing to participate. Foreign immigrants, individuals prevented from pregnancy due to medical reasons or genetic disorders, postmenopausal women, and men whose wives had undergone menopause were excluded from the study. Men were included if their wives were between 18 and 49 years old. Other participants, referred to as key informants, such as parents of the couple, health workers, and managers, were included regardless of age, provided they had substantial experience and were willing to participate in the interview. For key informants and experts, employment and a minimum of two years of work experience were required as inclusion criteria for the study.

Data collection commenced after obtaining the ethics code and necessary permits from Mashhad University of Medical Sciences. Semi-structured, face-to-face interviews were employed for data collection, each lasting approximately one hour (range: 49–78 min) with participants individually. Sampling continued from June 2024 to April 2025. Interviews were conducted in Persian by one of the researchers (TKH, possessing the requisite skills in conducting interviews and qualitative research), following the analysis of the interviews and the extraction of initial codes and categories, these codes and categories were translated into English. Sampling began in various areas of Mashhad city, among those referred to health centers in the same locality. The selection of these centers for initial sampling was based on their accessibility and extensive coverage in providing health services to women of reproductive age in the city, facilitating access to other participants with the desired characteristics and specifications.

At the beginning of sampling, women referring to each health center and their spouses were purposefully selected if they met the sample requirements. Upon agreement, necessary coordination was made regarding the time and place of the interview by first author. To maintain diversity in the sample, factors such as age, employment, education, and number of children were considered. Additionally, individuals with extensive experience, introduced by health center staff and other participants, were invited to participate in the study.

All interviews took place in an environment that ensured participants could maintain their privacy and feel free to express their experiences. Before the interview, participants were asked for permission to record the session, and they were assured of the confidentiality of all information provided, with written informed consent obtained. At the start of each interview session, the discussion began with a general conversation, and participants were encouraged to share their experiences regarding how mass media influenced their reproductive behavior. Subsequent questions were posed based on the participants’ responses.

Semi-structured interviews focused on participants’ perceptions and experiences. The interview guide for couples included the following questions: “What factors have influenced your decisions to have children and become parents?“, “What role do you believe social media and virtual social networks play in the context of childbearing/ reproductive behaviors?“, “What type of content do you engage with in the media or on social networks related to childbearing and parenting?“, “Has specific content on social media and virtual social networks shaped your views and attitudes towards childbearing?“, “Has specific content on social media and virtual social networks affected your decisions about having children and becoming parents?“, “If you could convey a message to the media regarding the issue of reproductive behaviors, what would that message be? Please explain” (Supplementary file 1).

Prompts such as “Can you elaborate on that?” or “Can you provide an example of this?” were used to encourage participants to share more. Participants were invited to speak freely and in detail about their experiences during the interview. At the end of the interview, participants were asked a final question: Is there anything else you would like to discuss? Finally, after thanking the participant, they were informed about the possibility of future in-person or offline interviews, and arrangements were made for the method and timing of subsequent contacts.

The interview guide for key informants included the following questions: “What role do you believe mass media and virtual social networks have on couples’ attitudes and perspectives regarding reproductive behaviors/ childbearing?“, " Do you think there is a specific strategy for the media to modulate couples’ reproductive behaviors?“, “What types of messages in virtual social networks and mass media do you think have the most significant role on couples’ views and decisions about childbearing?” (Supplementary file 1).

During the interview, both behavioral and nonverbal expressions were documented through field notes and maintained in a personal diary. After each interview session, the researcher transcribed the recorded conversations into typed text, word by word (by the first author). Following a thorough examination and initial analysis of each interview text, the next interview was scheduled.

Data analysis was conducted simultaneously with data collection employing the qualitative content analysis method outlined by Granheim and Landman (2004) [18]. Authors (AY and TKH) who are familiar with qualitative data analysis, independently analyzed the data. In this research, interviews served as the primary unit of analysis. After each interview, the researchers repeatedly listened to the audio recording to gain an overall understanding. Subsequently, all interview texts were transcribed verbatim. Relevant sentences or paragraphs connected to the key concept were identified as meaning units. These meaning units were reviewed multiple times before appropriate codes were assigned. Following the processes of reduction and compression, similar codes were combined, resulting in the emergence of subcategories. This data reduction process continued until a final category with both broader and more distinct meanings was identified (Supplementary file 2). Data analysis was performed using MAXQDA software (version 10, VERBI Software GmbH, Berlin).

In this study, four criteria outlined by Lincoln and Guba (1985) were employed to evaluate the quality of data and the accuracy of findings, including credibility, dependability, confirmability, and transferability [19]. This was achieved through methods such as the continuous and long-term involvement of the researcher in the research stages, conducting extensive interviews, and dedicating adequate time to the data collection and analysis process. Additionally, repeated rereading of the interview transcripts and immersion in them, member checking, enabling auditing and evaluation of the study by an external observer, and providing a rich description of the specific conditions of the study and participants were implemented to allow readers to determine whether the results can be generalized to similar situations.

This qualitative study was conducted by a multidisciplinary research team with complementary expertise in reproductive health, population studies, and education. Throughout the interview data collection and data analysis, the researchers focused on bracketing their own ideas and assumptions. To effectively bracket these assumptions and prevent them from influencing the study’s findings at the outset, the authors articulated their understanding of the role of media on childbearing. The corresponding author is a faculty member and specialist in reproductive health, with extensive experience in teaching population studies and conducting research on fertility and childbearing behaviors. This background contributed to theoretical sensitivity toward fertility-related decision-making and the broader social and media contexts influencing such decisions. The second author is an employee of the education sector and an active researcher in the field of population studies in Iran, whose professional experience provided contextual insight into the social and cultural dimensions of couples’ fertility decisions. The first author is a reproductive health researcher and a faculty member with formal training and practical experience in qualitative research methods and active engagement in fertility-related studies; she played a central role in guiding data analysis.

Findings

The mean age of the women was 32.06 ± 6.7 years and their mean age at the birth of their first child was 23.0 ± 3.7 years. The mean age of the men was 39.25 ± 7.3 years and the mean age of the key informants was 43 ± 7.1 years. 48.3% of the women in the study were employed and 51.7% of them were housewives (Tables 1 and 2).

Most participants in the current study highlighted the perceived importance of information obtained through media and new communication technologies in shaping their own and others’ understandings and considerations regarding reproductive choices. Virtual social networks, the internet, television, radio, newspapers, and magazines were among the primary sources through which participants accessed their information. Analysis of data gathered from participant interviews revealed four main categories: intentional promotion of reproductive behaviors, indirect dissemination of low-fertility-oriented values and transnational cultures, empowering mothers, and completing family leisure and entertainment opportunities (Table 3).

Table 3.

Presents a summary of the emerging main categories and sub-categories

Main Categories	Sub Categories
Intentional promotion of reproductive behaviors	• Past anti-childbearing propaganda • Shifting scientific messages aligned with policy changes • Expert advocacy for childbearing • Models of successful parenting • Legal assurances and limited incentives • Addressing abortion as a societal concern • Social networks amplifying fertility messages • Promoting anti-childbearing narratives centered on non-Iranian culture
Indirect dissemination of low-fertility-oriented values and transnational cultures	• Medicalized childbirth preference • Post-childbirth body anxiety • The disadvantages of large families • Success narratives favoring small families • Incompatibility framing of women’s advancement and motherhood • Luxury-oriented child-rearing norms • Normalization of childfree hedonistic lifestyles • Celebrity-mediated non-Iranian lifestyles
Empowering mothers	• Expert advice via apps and portable devices • Learning from experienced parents on social networks • Enhancing maternal self-efficacy
Completing family leisure and entertainment opportunities	• Parental time displacement by media • Decline in family and social interactions • Media as a substitute for children’s entertainment

Intentional promotion of reproductive behaviors

According to the participants’ perspectives, the media are perceived as playing both short-term and long-term roles in how couples interpret fertility-related messages and reproductive behaviors. Some participants described media content as being explicitly designed, from their perspective, to guide or influence fertility-related decisions. This category was formed from the sub-categories, past anti-childbearing propaganda, shifting scientific messages aligned with policy changes, expert advocacy for childbearing, models of successful parenting, legal assurances and limited incentives, addressing abortion as a societal concern, social networks amplifying fertility messages, and promoting anti-childbearing narratives centered on non-Iranian culture.

Participants considered the impact of media programs in the past, particularly radio and television, as having contributed to a social climate that favored having fewer children. One participant remarked in this regard:

“A large part of the decline in fertility was due to advertisements on radio, television, and other media, which consistently promoted having fewer children for a better life.” (P24).

Most participants recalled that earlier media messages focused on increasing public awareness of contraceptive methods and encouraging their use. They contrasted these messages with more recent media content that reflects changes in national population policies. Participants interpreted these shifts as inconsistent, which, according to some, has generated confusion and skepticism toward official media messages.

“Not long ago, TV and radio said that getting pregnant after 35 was scientifically risky for both mother and child. Now they’re saying the opposite — that even pregnancy after 40 has no risk. One of these has to be wrong, and the public deserves accurate scientific information.” (P5).

Some participants viewed the explanation of childbearing and parenting issues as an important responsibility of the media and emphasized the need to disseminate messages about what they described as the individual and social implications of childlessness and low fertility. They considered existing media programs insufficient in this regard and suggested that presenting relatable and positive parenting role models could enhance the credibility of such messages.

“Media and social networks should showcase successful mothers in parenting as role models. These role models should embody lifestyles that are appealing to the public and that others can emulate.” (P12).

Some participants felt it was essential to create targeted programs and content designed to foster a sense of social responsibility among individuals, particularly young people, regarding population issues. They referred to media discussions surrounding incentives introduced under the Youth Population Law and questioned their effectiveness when implementation was perceived as inconsistent.

“The media constantly discusses incentives for having children, like land and cars, etc. However, only a small number of eligible individuals have received these incentives, while most have received nothing. It seems this conversation has become somewhat repetitive and ineffective.” (P2).

A number of participants emphasized the necessity of directly and intentionally addressing various aspects of abortion as a significant issue in the country’s reproductive health discourse, particularly on TV, to shift public attitudes and foster a supportive culture in this regard.

“Given the high prevalence of abortion in the country, a widespread cultural shift is essential, and this should be facilitated through mass media that reach a broad audience. The legal, religious, and medical dimensions of this issue must be made public.” (P31).

Participants consistently described virtual social networks as highly influential platforms due to their accessibility, brevity of messages, and extensive reach. However, they emphasized that media messages are actively interpreted and evaluated based on personal experiences and socioeconomic realities.

“They say we should make shows that prove big families are happier and more successful, but those programs have to match real life. We see large families struggling without enough support. When young people see how hard life is for them, they’re less likely to believe or accept ads that promote having more kids.” (P21).

According to some participants, society currently struggles to meet the educational, economic, social, and psychological needs of children. Consequently, negative messages shared on social networks and in the media that align with their views are accepted more readily than positive perspectives on having children.

“People have economic concerns about having more children, so they trust negative messages that validate their worries more.” (P27).

Some participants highlighted the intentional and targeted promotion of anti-child behaviors on social networks and various media, believing that some of this content is biased and reinforces individualism and a lack of responsibility towards society.

“There is a lot of promotion of unrealistic content on social media to discourage people from having children. Some individuals are alien to Iranian culture and deliberately advocate for an individualistic and irresponsible lifestyle towards society.” (P 22).

Empowering mothers

The second category of findings in the present study was formed from the subcategories of expert advice via apps and portable devices, learning from experienced parents on social networks, and enhancing maternal self-efficacy.

Participants described virtual social networks as providing new opportunities for accessing expert advice and peer support related to pregnancy and parenting. These platforms were perceived as facilitating timely, two-way communication between mothers and health professionals.

“I know a few useful sites and apps. I also kept in touch with the midwives I saw during my pregnancy through social media. Whenever I had a question, they tried to respond quickly.” (P14).

Several participants emphasized the importance of media programs that recognize and value the role of parents—particularly mothers—and described such representations as potentially enhancing confidence and readiness for parenthood.

“Television should discuss the importance of the position of mothers and the value that Islam places on mothers and fathers.” (P4).

Participants also highlighted the value of peer-to-peer learning on social networks, where shared experiences of parenting were viewed as more relatable and credible, thereby strengthening maternal self-efficacy.

“Sharing the experiences of successful mothers in childbearing can yield positive effects. Parents are eager to learn how those with multiple children managed their living expenses and balanced their other responsibilities while being mothers. Today, this connection is accessible to mothers through chat rooms on social networks.” (P27).

Indirect dissemination of low-fertility-oriented values and transnational cultures

Participants described how media content, even when not explicitly addressing fertility, was perceived as conveying values and norms related to childbearing. This category was formed from the subcategories of medicalized childbirth preference, post-childbirth body anxiety, the disadvantages of large families, success narratives favoring small families, incompatibility framing of women’s advancement and motherhood, luxury-oriented child-rearing norms, normalization of childfree hedonistic lifestyles, and celebrity-mediated non-Iranian lifestyles.

Some participants believed that media representations of childbirth contributed to the normalization of elective cesarean sections. They emphasized the need to change mothers’ perceptions of elective cesarean sections and to inform the public about the true indications for cesarean delivery.

“The media has a major role in shaping attitudes. Unless society develops a healthier view of natural childbirth and limits unnecessary C-sections, other efforts to encourage having children won’t work. Unfortunately, many media outlets and social networks still directly or indirectly promote C-sections.” (P32).

Others pointed to social media advertising of cosmetic procedures as reinforcing anxieties about pregnancy-related bodily changes.

“Advertisements for cosmetic surgeries of the abdomen and genitals on social media have created a false sense of necessity among women. Following these surgeries, women are discouraged from becoming pregnant and giving birth to ensure that the results of their surgery remain intact.” (P31).

Participants also described television dramas and films as portraying small families more favorably, while depicting larger families as economically or socially disadvantaged.

“In these films, children from families with one or two children are portrayed as very successful. Conversely, families with many children are depicted as having poor financial conditions, and their children often become delinquents.” (P29).

From the participants’ perspective, another way the media influences childbearing is by showcasing misbehavior and aggression of children, particularly teenagers, towards their parents in films, which diminishes society’s desire to have children.

“In some movies, kids are always shown fighting with their parents, causing stress and trouble, and showing no appreciation, which teaches children that having kids only leads to problems.” (P29).

From the perspective of some participants, television programs promote higher levels of education for women, change women’s gender roles, and increase their social participation. Some participants felt that increasing women’s knowledge and access to information about sexuality and family planning through the Internet and social media could increase fertility control behaviors. Some also stated, increasing education for both women and men delays marriage and childbearing. According to some participants, changing gender roles and increasing women’s social participation are associated with a decrease in acceptance of the motherhood role and a decrease in fertility rates.

“Movies encourage girls to pursue careers and higher education, influencing their attitudes and helping to delay marriage and childbirth. As girls engage with these films, they aspire to attain a college education, secure a job, and then marry.” (P11).

Others noted that media portrayals of luxury-oriented lifestyles increased perceived costs of parenting.

“The media can create an artificial demand for children’s clothes, toys, and luxury items that are frequently showcased on social media. This leads to frustration among parents, as some believe that if they cannot provide these items for their children, they are failing as parents.” (P9).

According to the findings of this study, the promotion of modernity and behaviors related to non-Iranian culture, through virtual networks, has had a significant contribution to determining family size in society. Some people believe that films portray a lifestyle with fewer children, along with fun and pleasure, and reinforce hedonistic values ​​among people.

“When some people observe the happiness and freedom of foreigners on the Internet and social networks, they assume that individuals in these countries are genuinely comfortable and happy, free from problems. These individuals tend to avoid having one or two more children.” (P7).

Some participants pointed to the role of public figures and domestic celebrities in transmitting non-Iranian culture regarding family size.

“Young people witness the luxurious lifestyle of celebrities, their lack of marriage and childlessness, and emulate them.” (P13).

Completing family leisure and entertainment opportunities

This category was formed from subcategories of parental time displacement by media, decline in family and social interactions, and media as a substitute for children’s entertainment. Several participants’ statements indicated that the media plays another indirect role in family size by filling in family leisure and entertainment opportunities. In this way, the media has become part of parents’ daily activities and, by occupying a significant portion of their time, reduces their willingness to devote sufficient time to caring for their children and social participation. They believe that this may affect attitudes towards childbearing. Some of them stated that in the past, children would spend their free time with their siblings, but now children are entertained with cyberspace and no longer need siblings to play with.

“Television and social media have reduced social activities and the time that should be devoted to one’s spouse and children. These have filled people’s time so much that no one at home is bored with the children anymore”. (P 22)

“Now all children are entertained by the Internet and no longer need siblings.” (P18).

Discussion

The findings of the present study suggest that couples and experts perceive mass media and virtual social networks as influential in childbearing decisions through four interconnected pathways: intentional promotion of reproductive behaviors, indirect dissemination of low-fertility-oriented values and transnational cultures, empowering mothers, and completing family leisure and entertainment opportunities.

Findings from Jensen & Oster’s (2009) reported that access to television in rural India was associated with changes in birth spacing and gender attitudes. These findings suggest that exposure to new messages and lifestyles may shape reproductive intentions [20]. A study in Brazil revealed that portrayals of small families in popular TV series were associated with a decline in fertility in the regions covered by the TV programs, particularly among women of lower socioeconomic status [21]. Findings from a study by Ghosh et al. (2021) demonstrated that enhancing women’s representation in mass media can significantly boost the use of modern and reversible contraception methods in a cost-effective yet impactful manner among women seeking family planning services [22]. These findings align with the results of the present study concerning targeted promotion of birth control, which refers to intentional media campaigns aimed at influencing reproductive and family planning behaviors.

However, findings from a study in Africa indicated that exposure to mass media positively influences knowledge, attitudes, and the choice of family planning methods, although its impact is less significant than that of other socio-cultural factors such as education, household wealth, and marital status [23]. Another study in Ethiopia also found no significant association between women in rural areas exposed to mass media family planning messages and the use of modern contraceptive methods. This study also highlighted the role of inequalities in the adoption of modern contraceptive methods, shaped by structural and mediating factors including religion, location, household wealth, education, and number of children [24]. A study in China revealed that the relationship between media use and reproductive intention is significantly moderated by social/institutional trust [11], consistent with these findings, participants in the present study emphasized that media messages are interpreted through personal experiences and broader social conditions, which can limit or amplify their perceived relevance.

Participants in this study also described how media content indirectly conveys norms related to family size and lifestyle. Previous studies corroborate these findings. Findings from a study in South Korea revealed that the prevalence of low childbearing among married individuals was influenced by television narratives that portrayed single life and fewer children among married couples. They explored how Korean television programs shape social perceptions of single life and attitudes toward smaller families in marriage [25]. Research by Westoff & Koffman (2011) across 48 developing countries indicated that television exposes viewers to modern lifestyles, challenges traditional attitudes toward marriage and family planning, and encourages the adoption of birth control methods [26]. A study also indicated that access to television may lower fertility rates due to gradual lifestyle changes and the introduction of new patterns for women [20].

While some participants in this study interpreted women’s education, employment, and social participation as factors primarily associated with delayed marriage and reduced fertility, it is essential to analyze these findings within the broader framework of women’s agency and reproductive autonomy. Evidence suggests that women’s empowerment—including access to education, employment, and reproductive health information—does not necessarily lead to reduced fertility, but rather facilitates more informed and purposeful decisions regarding the timing, spacing, and number of children [27]. Research has shown that reproductive autonomy, defined as women’s ability to make independent decisions about contraceptive use, pregnancy, and childbearing timing, is a key dimension of reproductive health and is associated with positive individual and family outcomes [28]. Comparative studies also indicate that in contexts where women have structural support to combine work and family roles, empowerment not only does not prevent childbearing but can also help achieve desired and planned fertility [29]. These findings highlight the importance of distinguishing between participants’ interpretations and broader empirical evidence.

Based on participants’ accounts, the occupation of leisure and entertainment opportunities by media and new communication technologies is perceived as potentially influencing couples’ considerations regarding childbearing. This perceived shift represents a relatively underexplored dimension of fertility decision-making and warrants further investigation. Historically, children played a central role in family leisure; however, participants described the availability of diverse entertainment options, including media, as partially replacing children in this role.

Moreover, participants highlighted the growing role of social media as a platform for sharing experiences and peer support related to reproductive health and parenting. These interactions were described as empowering women by providing information, social support, and the opportunity to critically evaluate expert advice, which in turn may influence their fertility-related decisions. A review indicated that women today are increasingly attracted to online environments, particularly social media groups, to connect with other pregnant women and learn from their experiences. Their online interactions influence their childbearing decisions and empower them to challenge expert narratives [8]. A study in China also found that social media has increasingly supported expectant mothers, as they share their pregnancy, birth, and parenting experiences with one another and learn from these interactions [30], which aligns with the findings of the present study.

The findings of the current study indicate that virtual media emphasize low-child/childless lifestyles and individualistic values as desirable norms, which contrasts with the cultural norms of Iran. This portrayal of non-Iranian cultures can influence couples’ fertility decisions. The research conducted by Behjati-Ardakani et al. (2017) revealed that the methods of rationalizing and legitimizing decisions related to fertility and childbearing are defined within the societal context, and the rationale behind these decisions is intertwined with cultural developments in society and family. Cultural developments can significantly impact couples’ fertility choices [31]. Another study in Iran also showed that cultural factors play an important role in the reproductive behaviors of married women [32].

This study, by identifying and examining the role of mass media and virtual social networks on couples’ fertility decisions within the social and cultural context of Iran, and by interviewing women, men, and experts in this field, has yielded important insights, which are among the strengths of this research. The women participating in the present study were of childbearing age; therefore the findings of this study are not generalizable to women who have surpassed reproductive age, those who have not yet reached reproductive age, or couples residing in rural areas. Given that couples interpret messages related to reproductive behavior based on social and cultural conditions, the results of the present study may be less generalizable to different cultures.

Conclusion and suggestions

The findings of the current study indicate how participants perceive and interpret the role of mass media in relation to childbearing decisions through four main pathways: intentional promotion of reproductive behaviors, indirect dissemination of low-fertility-oriented values and transnational cultures, empowering mothers, and completing family leisure and entertainment opportunities.

Participants described media as having both short-term and long-term perceived effects on considerations related to fertility. Television, virtual social networks, the Internet, radio, and magazines were described as widely used sources that participants perceive as influencing attitudes toward childbearing. Participants emphasized that media, because of its accessibility and appeal, occupies a substantial portion of leisure time, which may alter the role of children as sources of family entertainment and social interaction. They also highlighted the importance of delivering fertility-related information through reliable channels, such as health specialists, demographers, sociologists, and psychologists, to provide guidance and correct misconceptions. In this context, conducting interviews, roundtable discussions, and utilizing engaging and informative films aimed at raising awareness about fertility in Iran, boosting motivation, correcting misconceptions about fertility, and assisting couples in making informed decisions can be highly effective. Additionally, educational content should focus on reinforcing the status and dignity of parents among children and teaching children to express conscious and voluntary gratitude towards their parents.

Additionally, creating virtual social networks and numerous educational sites for various target groups, including homemakers, students, and academics, appears advantageous. The extensive dissemination of short messages deemed appropriate from the perspectives of health, psychology, and social sciences, as well as by competent authorities, through mobile phones can effectively promote accurate ideas in the field of fertility. The use of social media also offers health professionals opportunities to engage directly with users, dispel misinformation, and provide reliable information. This collaboration can help address common misconceptions about reproductive health. Future research should consider longitudinal designs to examine the long-term effects of media exposure on reproductive behaviors and to provide deeper insights into the dynamic relationship between media and fertility-related decision-making.

Authors’ contributions

TKH, AY and, EKH contributed to the study conception and design, data analysis and interpretation, and Critical revision of the manuscript. AY, EKH and TKH conducted the interviews and collect the data. AY and TKH wrote and revised the first draft. All authors read and approved the final manuscript.

Funding

This study was funded by Mashhad University of Medical Sciences [grant number 4010186].

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.REC.1403.225). The present study adhered to the Declaration of Helsinki. In accordance with the Declaration of Helsinki, all participants were given oral information about the goal of study, and written informed consent was obtained from all of the participants. Anonymity were secured, and participants were informed that they could withdraw from the study at any time.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.