The abortion trend after the pronatalist turn of population policies in Iran: a systematic review from 2005 to 2022.

OBJECTIVE: Given Iran's recent shift towards pronatalist population policies, concerns have arisen regarding the potential increase in abortion rates. This review study examines the trends of (medical), intentional (illegal), and spontaneous abortions in Iran over the past two decades, as well as the factors that have contributed to these trends. METHODS: This paper reviewed research articles published between 2005 and 2022 on abortion in Iran. The study employed the PRISMA checklist for systematic reviews. Articles were searched from international (Google Scholar, PubMed, Science Direct, and Web of Science) and national databases (Magiran, Medlib, SID). Once the eligibility criteria were applied, 42 records were included from the initial 349 records. RESULTS: Abortion is influenced by a variety of socioeconomic and cultural factors and the availability of family planning services. Factors that contribute to unintended pregnancy include attitudes toward abortion, knowledge about reproductive health, access to reproductive health services, and fertility desires, among others. In addition to health and medical factors, consanguineous marriage plays an important role in spontaneous and therapeutic abortion. A higher number of illegal abortions were reported by women from more privileged socioeconomic classes. In comparison, a higher number of medical and spontaneous abortions were reported by women from less privileged socioeconomic classes. CONCLUSION: Iranian policymakers are concerned about the declining fertility rate and have turned to pronatalist policies. From a demographic standpoint, this seems to be a reasonable approach. However, the new population policies, particularly, the Family Protection and Young Population Law, along with creating limitations in access to reproductive health services and prenatal screening tests as well as stricter abortion law could potentially lead to an increase in various types of abortions and their associated consequences.

Experiences with family planning and abortion services during the Covid-19 pandemic: a qualitative study in Bangladesh, Iran and Netherlands.

OBJECTIVE: Access to family planning services is a human right that plays an essential role in society's health, particularly women's health. The COVID-19 pandemic has affected all aspects of human life including access to family planning services. Accordingly, the main goal of this study was to explore the experiences of women and service providers from the main challenges and obstacles of access to family planning services and abortion services in Bangladesh, Iran, and the Netherlands during the COVID-19 pandemic. METHODS: In this qualitative study, the data were collected through online, telephone, or in-person semi-structured interviews with key informants. Participants selected by purposive sampling method. The participants included women aged 15 to 49 (n = 63) and service providers (n = 54) in the 3 abovementioned countries. These individuals were included from October 2020 until December 2020. Conventional thematic analysis was employed to analyze the collected data. RESULTS: The main extracted themes were challenges (reduction of referral; disruption of access to services; insufficient knowledge; worries among staff; rising prices; and unavailability of some contraceptives), measures (time extension and visit scheduling; telephone, online, and door to door services; and support of the media) and recommendations (health facility improvements; free, online, and closer services; and ongoing trainings and awareness campaigns). CONCLUSION: The COVID-19 pandemic has affected family planning and reproductive health services in different ways and has uncovered existing inequalities in access to these services. However, in Iran, the reported challenges were also rooted in new population policies that have further limited access to family planning and abortion services.

A pronatalist turn in population policies in Iran and its likely adverse impacts on reproductive rights, health and inequality: a critical narrative review.

Iran has witnessed three major reversals of population policies since their inception in the 1960s. In response to a rapid decline in fertility to very low levels, the latest policy shift has led to the development of legislation that aims to encourage marriage and fertility, particularly the "Youthful Population and Protection of the Family" law approved in 2021. This study reviews the changes in population policy and their interrelations with fertility trends, focusing mainly on the shift towards pronatalist policies since 2005, and accompanying restriction of reproductive health and family planning services. Combining international and national sources, we position the new pronatalist drive in the country within the broader trend of government attempts to reverse fertility decline and promote conservative family values. Our study has three main aims. (1) We provide an overview of fertility trends, policy discourses and policy shifts in the context of the changes in the societal and political structures of Iran during the last half a century. (2) We highlight and discuss the most problematic features of the new Family Law, especially the legislation pertaining to maternal and reproductive health, access to abortion and contraception, and incentives supporting earlier marriage and higher fertility. (3) We discuss the likely consequences of the new legislation for maternal and child health and sexual and reproductive rights, for women in general, and the country's socio-economic disparities. As well as violating reproductive rights, the new policy is unlikely to achieve its aim of initiating a sustained rise in fertility in Iran.

Reasons for early marriage of women in Zahedan, Iran: a qualitative study.

BACKGROUND: Early marriage occurs in some regions of the world. Given that early marriage can have many negative consequences for girls by affecting their physical, mental, and social health, the purpose of this study was to investigate the reasons for early marriage from the perspective of women who had experienced it in Zahedan, Iran. METHODS: This qualitative research was conducted based on the qualitative content analysis method in 2020-2021. The target population included women aged 18-35 living in Zahedan who were married under the age of 18 years. Purposeful sampling was used to select the participants. In order to collect data, in-depth interviews were performed to decipher the reasons for early marriage from these women's perspectives. A total of 36 interviews were conducted from October to December 2020 until reaching theoretical saturation. Conventional content analysis was used to analyze the data and extract the relevant concepts and categories. RESULTS: The analysis of the interviews in this study revealed three main categories:(1) "early marriage as a transcendental coercion" ( early marriage as a cultural heritage and early marriage as a control tool, girls' weaknesses and inability to resist, dominant attitudes toward gender and gender restrictions), (2) "early marriage as a solution or a kind of problem solving" (escape from undesirable family environment, escape from financial poverty, and strategic escape from an unpleasant situation), and (3) "early marriage as a voluntary act" (real agency and imaginary agency). To substantiate these findings, we presented excerpts from the interviews conducted with the participants. CONCLUSION: The results of this study suggest a multidimensional picture of early marriage. It seems that improving cultural conditions and empowering families and girls in various areas, including marriage, can reduce the rate of early marriage and/or at least mitigate its undesirable consequences.