BMJ Open · Published 2026-08-01 · DOI 10.1136/bmjopen-2025-113236
Zari Dolatabadi, Farnaz Farnam, Maryam Moridi, Maryam Damghanian
Background Induced abortion remains a significant reproductive health issue in Iran, shaped by complex socio-economic, cultural and legal factors. Despite its importance, limited evidence exists on the underlying motivations for seeking abortion in a context of restrictive laws and pronatalist policies.Objectives This study aimed to explore the reasons underlying couples’ decisions to seek induced abortion within the constraints of the current legal framework.Design Qualitative interview study, co-designed with couples with a history of induced abortion.Methods We conducted semi-structured interviews with a purposively selected sample of couples. Data analysis followed a content analysis approach and was iterative, occurring concurrently with data collection until thematic saturation was reached.Setting Baharloo, Arash and Imam Khomeini hospitals, as well as private gynaecology and midwifery clinics in Tehran, Iran, between January and November 2024.Participants 32 adults participated, including 18 women who had experienced an induced abortion and 14 of their male partners, representing diverse socio-economic backgrounds.Results Participants’ decisions about abortion were shaped by multiple, interconnected factors. Economic pressures, including job instability and high costs of childbearing, intersected with relationship concerns, such as lack of partner support and unstable marital life. Social norms influenced choices through expectations of parenting, emphasis on individual autonomy and attitudes toward fertility. Pregnancy-related fears, including past traumatic experiences, health concerns and worries about fetal well-being, further contributed to decision-making. Finally, social uncertainty and anxieties about children’s futures, along with perceived inadequacy of government support, created conditions in which continuing a pregnancy often seemed unfeasible.Conclusion Couples’ decisions to seek induced abortion in Iran emerge from complex interactions between economic pressures, relational dynamics, cultural shifts, embodied experiences and structural constraints. Pro-natalist policies that fail to address these underlying factors are unlikely to reduce abortion rates. Findings underscore the need for comprehensive interventions addressing socioeconomic insecurities, relationship support and reproductive health services, while respecting couples’ decision-making autonomy.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Dolatabadi, Z., Farnam, F., Moridi, M., et al. (2026). Exploring the reasons behind induced abortion among Iranian couples: a qualitative study. BMJ Open. https://doi.org/10.1136/bmjopen-2025-113236