Abstract
Childlessness is an increasingly visible phenomenon. Once predominantly associated with high-income settings, it now spans diverse cultural, economic, and political contexts, including the Global South. Among recent demographic shifts, childlessness has emerged as one of the most ideologically charged and widely debated topics in public discourse, particularly through media narratives. Although media are often overlooked in mainstream public health models, they play critical roles as structural and intermediary determinants of health - shaping issue framing, amplifying voices, and legitimizing solutions. Yet little is known about how childlessness is represented in global media, especially outside the Global North and in the post-pandemic era. This study analysed news media representations of childlessness from a public health perspective, drawing on 131 news articles from 101 outlets across 86 countries (2015-2025). Articles were identified through systematic keyword searches in English and 12 additional languages, screened for relevance, and analysed thematically using Braun and Clarke's inductive method. Our approach was discourse-sensitive, drawing on a social constructionist lens and informed by framing theories and reproductive justice. Five themes were identified: The guinea pig of the state; Crazy rich selfish animal lovers; No baby, no cry; Bringing children into a broken world; and Winter regret and loneliness. These narratives operate across structural, intermediary, and individual levels, fulfilling four discursive functions: politicising, moralising, pathologising, and humanising. By examining how childlessness is problematized or legitimized, this study highlights the media's role in shaping reproductive narratives, stigma, and health equity across diverse contexts.