Introduction
Population and its dimensions are the central point of any social system [1, 2]. The world population in 2010 was about 6.9 billion people [3]. In 2015, the population increased to about 7.3 billion people, which represents an annual growth rate of about 1.2% [4]. In 2020, the world population reached 7.8 billion people, and the population growth rate decreased by 1.05% [5]. Also, according to forecasts, the world population is estimated to be more than 8 billion people by the end of 2024 [6], which indicates the continuation of population growth, although at a lower growth rate than in previous years [7-9]. This trend reflects changes in birth and death rates, as well as social and economic impacts on the global population [3, 8].
Demographic changes affect almost all aspects of human life and the world around it, and have different effects on social, economic, political, and environmental sub-systems, causing significant changes in these areas [7, 10]. Numerous developed nations, particularly European countries, have experienced a sharp decrease in fertility in recent decades, leading to fertility rates below the reproductive level. In addition, most of these nations are characterized by maturing populations and will confront a demographic improvement that will challenge their commerce markets, welfare systems, and political education in a few aspects [11]. 
Given the critical role of fertility in shaping demographic trends, it is essential to understand the factors that influence reproductive behavior. Mass media, which includes various platforms, such as television, radio, and the internet, play an effective role in changing social behaviors, including fertility rates [12]. Recent research suggests that the mass media have an impact on changing women’s attitudes toward childbearing. A study published in 2023 found that increased media use leads to positive changes in women’s attitudes toward fertility [10].
The media, especially television, possesses a unique capacity to shape cultural norms and values, making it a powerful tool for influencing fertility-related behaviors. Apart from various cultural, social, and economic reasons affecting the fertility rate in society, many experts emphasize the necessity of “culturalization” in this field. Undoubtedly, the role of the media, especially radio and television, is absolutely key and strategic in this regard. This media, in the position of “the public’s favorite culture production device”, is not comparable to other media in terms of the volume of cultural text production [13]. In general, the media has deeply influenced communities and families with various strategies and techniques and directed public thoughts and opinions about the world around them, and television is no exception to this. Among the many types of television programs, television series try to dominate a certain discourse by naturally showing some actions and attitudes to their audience as an usual practice [14]. 
In addition to traditional media, the emergence of virtual spaces has introduced new dynamics in shaping attitudes toward childbearing [15]. Given the widespread use of social media and virtual spaces, it is important to understand how these digital environments influence couples’ attitudes toward childbearing. Virtual spaces can both positively and negatively influence perceptions of family size and decisions about having children [16, 17]. Furthermore, online television broadcasts have merged with cyberspace; thus, understanding the role of television in shaping attitudes toward parenthood, especially given its ongoing interaction with cyberspace, is crucial [18]. 
This study aimed to address the gap in understanding how media—particularly television—influences reproductive behavior, especially in the context of declining fertility rates observed globally. By exploring the role of television, both as a traditional medium and in its digital evolution, this research provides actionable insights for policymakers and content creators. These insights can inform the design of media interventions that foster informed and positive attitudes toward family formation, ultimately helping to mitigate the challenge of declining fertility rates.
Television’s widespread influence makes it a powerful medium for shaping societal attitudes, particularly those related to family planning and childbearing [19]. Worldwide, people, regardless of nationality, race, social class, gender, or age, watch television [12]. Television is a part of a person’s life since birth [20]. Nowadays, the central position of television, its role in shaping individual and collective identities, and the importance of this cultural form in modern everyday life are not hidden from researchers of communication sciences and cultural studies [21, 22]. 
Exposure to television, radio, and other media was strongly and often significantly linked to reproductive behavior, even with all controls applied [15]. Similar reports were presented from Pakistan, India, and Bangladesh with similar results [23]. Another study concluded that fertility was reduced by the introduction of cable television in India [24, 25]. In this regard, the authors noted that “television may affect fertility by providing information about family planning services or changing the value of women’s time” or “television exposes rural families to urban lifestyles, values, and behaviors that are drastically different from themselves” [24-26]. 
Westoff et al. conducted a study in 48 countries to determine the relationship between reproductive behavior and television and radio exposure, and concluded that television series probably had the greatest effect on changing values and changing behavior. They found that television, even more than radio, exposes viewers to aspects of modern life that compete with traditional attitudes toward marriage and family and lead to attitudes and behavior that lead to fertility control. Television viewing is strongly associated with reproductive behavior: The more television women watch, the more likely they are to use modern contraceptives [27]. 
Another recent study in South Korea concluded that the“perceived prevalence of having fewer children in marriage is significantly influenced by exposure to shows that depict single life and having fewer children in marriage on television” [28]. 
According to the research cited, many studies have focused on specific geographic regions or population groups, which may not provide a comprehensive understanding of how media influences fertility across different populations. Our study addressed this limitation by adopting a global perspective, incorporating a broader range of demographic and cultural contexts from diverse geographic regions. By systematically categorizing television programs and analyzing their impact on fertility-related attitudes and behaviors, we offer a more comprehensive understanding of television’s influence on childbearing. This approach enables us to explore both the positive and negative effects of television, providing valuable insights into how it can address declining fertility rates.
As mentioned, the decline in fertility rates has become one of the serious challenges of today’s societies. Mass media, especially television, can play an important role in shaping attitudes and behaviors related to childbearing. This study was designed to examine the impact of television programs on families’ decisions about childbearing. This study examined the challenges that families face in deciding to have children and the impact of media, such as television, on childbearing decisions. In this study, we tried to take a comprehensive approach that includes examining the impact of television programs on family decision-making. In this study, we adopted a comprehensive approach to examine the influence of television programs on family decision-making, particularly regarding childbearing. By identifying the types of television programs most effective in encouraging families to have children, this research provides actionable recommendations for designing media interventions that support population growth and sustainability.

Methods 
This scoping review, conducted in 2024, investigated the role of television programs in encouraging families to have children. A systematic search strategy was designed using previous studies and authors’ opinions by combining two groups of keywords related to the research topic, including keywords describing television and keywords describing childbearing for each database, and then searching the databases. PubMed, Scopus, and Web of Science were searched until January 28, 2024. The keywords used to search for articles are listed in Table 1.



Study selection
The retrieved studies were selected based on 1) title and abstract screening and 2) full-text review. The titles and abstracts of all studies were evaluated according to the inclusion criteria, and their full texts were read when necessary. Two authors Somayeh Paydar and Zahra Karbasi Dahouji) screened the titles and abstracts of all articles manually to identify articles that were relevant to the research objectives. Disagreements were resolved through discussion or consultation with a third reviewer (Azam Sabahi).

Inclusion criteria
The inclusion criteria were all articles published in English that addressed the role of television programs in encouraging families to have children.

Exclusion criteria
Studies focusing on the role of media (television) in pregnancy prevention were excluded from the analysis. Additionally, non-original articles (such as review articles, editorials, and protocols) were also excluded, although their reference lists were examined. Articles for which the full text could not be obtained for any reason were likewise excluded from the study. 

Data collection stage
One researcher extracted the main data from the studies, while the second researcher checked the data form. Disagreements were resolved through discussion between the two researchers. Data were extracted using a data extraction form based on the following topics: Name of the first author, year of publication, country of study, gender, and age group of the participants, type of television program, and conclusions. Then, the study characteristics were systematically organized.

Results
A total of 830 articles were retrieved from three databases. After removing duplicate articles (212 cases) and reviewing the titles and abstracts of the primary articles identified, 33 articles were selected for the final review. After applying the inclusion and exclusion criteria of the study, 13 articles were considered for data extraction. The details of the articles are presented in Figure 1 and Table 2.  


The oldest and newest studies were published in 1987 and 2023, respectively, with most studies (23%) conducted in 2023 (Table 2). 
Based on the inclusion and exclusion criteria, a total of thirteen studies entered this research, and the characteristics of the selected studies are shown in Table 2. Geographically, most studies were conducted in India (23%) and the United States (15%), respectively. Other studies were conducted in Egypt, Africa, Italy, South Korea, Brazil, Germany, Spain, and Ethiopia, each with 7.7%.
The target group consisted of women in 62% of the studies, men and women in 23% of the studies, and men in 15% of the studies. In 38.4% of the studies, the age group was between 15 and 49 years (Figure 2). The types of television programs designed to encourage families to have children were in five groups: Movies, news, documentaries, expert programs, and advertising programs, respectively (Table 3). 


The results of the current research on the effect of television on increasing childbearing showed that women and men used television as an important source to obtain information on fertility and reproductive health, and television had a positive effect on increasing the fertility rate [30-32, 34-37]. Bessett and Murawsky showed that the role of television in increasing childbearing is greater in people with low education [30]. Guetto et al. also reported that positive economic news has a positive effect on increasing fertility [32]. This is while the results of some studies showed that women and men who are exposed to mass media, including television, are less inclined to have children than women and men who are not exposed to these media [24, 26, 29, 31, 33, 36], with this tendency being more pronounced among individuals with higher university education [30, 31, 33]. Also, unwanted pregnancies have decreased with exposure to television programs [33]. Barranco et al. showed that TV shows had no significant effect on the fertility rate in any of the age groups of women [38].

Discussion
Low fertility has become a serious social problem in societies [40]. To our knowledge, few studies have explored the impact of television on childbearing. Additionally, no structured research has examined the relationship between family planning programs on television and the use of educational methods related to childbearing. This review analyzed the existing literature to evaluate how television programs influence families’ decisions to have children and offers recommendations for future research. 
Our study examined the impact of television programming on fertility-related attitudes and behaviors, particularly how different types of content influence reproductive decision-making among diverse populations. Specifically, we aimed to examine how different television genres—such as movies, news, documentaries, special programs, and advertising—influence viewers’ attitudes toward reproductive health. In summary, our study illuminates the multifaceted role of television in shaping reproductive behaviors across diverse populations. We believe that these insights contribute significantly to ongoing debates in media studies and reproductive health research.
The majority of studies (23%) were carried out in 2023. This increase in content produced on television in recent years indicates that topics such as fertility policies, marriage, and fertility values, which were rarely mentioned in traditional media, can be discussed more extensively [41]. 
Based on our research, several studies have pointed to the positive effect of television programs on increasing the fertility rate [30-32, 34-37]. In line with the results of this study, Rahman et al. showed that television viewing was associated with reproductive health behavior in Bangladesh [42]. However, Vitek and Ward [43] showed that reality television shows often depict pregnancy and childbirth in sensationalized, risky, and unrealistic ways. These portrayals can increase women’s fears about childbirth and reduce their self-efficacy, potentially discouraging childbearing. This example underscores the importance of responsible media representation, as sensationalized content may amplify anxieties rather than provide balanced and informative perspectives. 
Women who watched television even occasionally had better reproductive health behaviors than women who did not [42]. Based on the findings, 46.15% of the studies showed that couples who are exposed to social media, including television, have a lower desire to have children than women and men who are not exposed to social media [24, 26, 29, 31, 33, 36]. 
Consistent with the results of our study, Westoff et al. showed that television viewing is strongly associated with reproductive behavior: The more television women watch, the more likely they are to use modern contraceptives, the less likely they are to have children (even among young women who have never married), and they tend to have fewer children [27]. Another study found that groups with a preference for new media had significantly lower fertility intentions than groups with a preference for traditional media, and increased use of new media decreased fertility intentions among women of reproductive age [41]. 
In 61.5% of the studies, movies were used to encourage childbearing [24, 26, 29, 30, 34, 36-38]. A study found that television series are likely the most effective in changing values and behaviors [15]. The basic premise is that television, even more than radio, exposes viewers to aspects of modern life that compete with traditional attitudes toward marriage and family, leading to attitudes and behavior that influence birth control. Ting et al. showed that unwanted pregnancies decreased with exposure to television programs [33]. 
According to Ahmed’s study [44], regularly watching television, particularly family planning programs, is positively associated with the current use of modern contraceptives. The more frequently women view television, the more likely they are to use modern birth control methods. Furthermore, a study conducted in Pakistan found that the content of television programs plays a significant role in shaping fertility outcomes. The television series aired in Pakistan portrays a specific family structure—a smaller number of family members compared to the typical Pakistani family—and a type of woman—successful, wealthy, and emancipated with positions of power in politics—which can have long-term effects on fertility rates. Moreover, television programs and advertisements of any genre have the potential to reach a large number of households at relatively low costs, making them an effective tool for policymakers to deliver messages to the public [45]. 
Based on a study by Taghvayi et al. [10], domestic media, as an important source of information, has an impact on society’s acceptance of childbearing. Based on the study by Abbasi and Esmaeili [46], series appropriate for the family atmosphere can address the positive aspects of childbearing and play an effective role in making decisions about having more children. Unlike our study, which examined the effect of television, Kiyanpour et al. [18], who examined the effect of social networks on childbearing, found that a greater presence in social networks, in order to increase awareness and public health about childbearing, leads to a tendency to marry and have children. 
A study [30] showed that the role of television in increasing childbearing is greater in people with low education. Naturally, with the progress of society, women have access to higher education and gain a higher social status. Women have also gained more social roles and have gradually been freed from the fetters that bind them to fertility. With the change in the role and attitude of women in the modern fertility discourse, women’s fertility intentions deserve more attention [41]. Television viewing has been shown to significantly influence childbearing behaviors and reproductive health outcomes. Research indicates that women who watch television regularly tend to have fewer children and are more likely to use modern contraceptives. For instance, a study found that among women who watched television daily, 52% reported no births in the past five years, compared to 30% of those who did not watch television. This trend suggests a strong association between television exposure and reduced fertility rates across various regions, with greater exposure linked to fewer births and increased contraceptive use [47]. 
The content of television programs also plays a critical role in shaping reproductive attitudes and behaviors. Programs that portray family planning and modern lifestyles can influence women’s preferences regarding family size and their decisions to utilize birth control methods. For example, exposure to family planning content on television has been associated with a shift in women’s reproductive choices, leading to a preference for smaller families and greater acceptance of contraceptive use [48, 49]. Moreover, the portrayal of childbirth in the media can impact women’s perceptions and expectations. Dramatic representations of childbirth often emphasize medical interventions and risks, potentially generating fear and anxiety around the birthing process. This sensationalized depiction may lead women to perceive childbirth as more dangerous than it is in reality, which can affect their approach to pregnancy and delivery [50]. It seems that the influence of the media on encouraging families to have children has become one of the serious concerns of societies.

Implications of the study
The results of the present study have several important implications for policymakers. First, television programs have a positive effect on increasing the fertility rate. Second, the role of television in increasing childbearing is greater in people with low levels of education. Third, by influencing individual behaviors related to fertility and family planning, television plays an important role in influencing population dynamics. Finally, depending on the content and messages broadcast, television can both decrease and increase the rate of population growth. Also, content producers should develop programs that focus on childbearing and its benefits. Collaboration with psychologists, sociologists, and family experts is crucial to ensure that the content is both informative and culturally sensitive. They should create content that introduces new models of family life and fertility, enhancing public awareness and positively influencing attitudes toward childbearing.

Limitations and strengths 
There are a few studies on the effect of television on childbearing, and no structured study has considered the relationship between family planning programs on television and the use of educational methods for childbearing. Despite these limitations, the current study offers initial evidence supporting the potential effectiveness of a mass or social media intervention. Among the strengths of our study are the following: We systematically reviewed 13 selected articles from different geographical regions and provided a global perspective on the topic. By categorizing television programs into five distinct types (films, news, documentaries, special programs, and advertising), we provided detailed insights into how content types influence fertility-related behaviors. The study also had limitations, such as the fact that it focused solely on television and did not consider the increasing influence of digital media platforms. A significant portion of the studies were conducted in India and the US, which may not fully reflect other cultural contexts. Our study highlights the potential of television as a tool for promoting family planning and reproductive health education, and policymakers can use this media tool for population growth policies and planning. 
We suggest that future studies explore the specific types of television and media programs that are most effective and beneficial in encouraging childbearing, and also examine their impact on childbearing in different cultural and social contexts. While the scoping review model was selected for its ability to provide a broad overview of television’s role in encouraging childbearing, incorporating educational theories, such as social learning theory [51, 52], cultivation theory [53], and the health belief model [54], could offer deeper insights into the mechanisms through which television influences fertility behaviors. These theories could be particularly useful in future research to explore the psychological and social processes underlying the relationship between media exposure and reproductive decision-making.

Conclusion 
Television programs, especially series, can effectively shape and change social attitudes and values. They provide new models of family life and fertility, increasing public awareness and influencing attitudes toward childbearing. Television serves as a vital source of information on topics, such as pregnancy and childbirth, helping to decrease social anxiety and guide families through key life transitions. This review surveyed the influence of television on childbearing, revealing that media exposure, particularly through television, impacts reproductive decisions by presenting alternative lifestyles and role models. Cultural and economic factors also play a role, but television remains a key medium for disseminating knowledge and awareness about fertility-related issues. The analysis of studies indicates that appropriate television programs can positively inform and educate families about having children. However, the effect varies depending on the content and the audience’s conditions. For instance, positive economic news and educational programs can encourage childbearing, while exposure to modern lifestyles and family planning information may reduce fertility intentions. Television’s impact is particularly strong among individuals with lower education levels, highlighting the importance of tailored content. In conclusion, television programs have the potential to significantly influence family decisions regarding childbearing. Policymakers and content producers should leverage television to promote informed and positive attitudes toward family formation, addressing the challenge of declining fertility rates. Future research should explore the specific types of television and media programs that are most effective in encouraging childbearing across different cultural and social contexts. 

Ethical Considerations
Compliance with ethical guidelines
There were no ethical considerations to be considered in this research.

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
Study design and supervision: Somayeh Paydar and Azam Sabahi; Data collection: Zarrin Zarrinabadi, Shahrbanoo Pahlevanynejad, and Zahra Karbasi Dahouji; Data analysis and interpretation: Malihe Ram; Writing: Hasan Siamian, Shahrbanoo Pahlevanynejad, and Zahra Karbasi Dahouji; Final approval: All authors.

Conflict of interest
The authors declared no conflict of interest.

 
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