{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T12:46:58Z","timestamp":1785847618579,"version":"3.56.0"},"reference-count":39,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","award":["grant ID: 40111151003 (Grant no: 68347)"],"award-info":[{"award-number":["grant ID: 40111151003 (Grant no: 68347)"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,29]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"\n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This study aimed to explore the reasons underlying couples\u2019 decisions to seek induced abortion within the constraints of the current legal framework.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Qualitative interview study, co-designed with couples with a history of induced abortion.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Baharloo, Arash and Imam Khomeini hospitals, as well as private gynaecology and midwifery clinics in Tehran, Iran, between January and November 2024.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n 32 adults participated, including 18\u2009women who had experienced an induced abortion and 14 of their male partners, representing diverse socio-economic backgrounds.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Participants\u2019 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\u2019s futures, along with perceived inadequacy of government support, created conditions in which continuing a pregnancy often seemed unfeasible.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Couples\u2019 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\u2019 decision-making autonomy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113236","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:55:12Z","timestamp":1785844512000},"page":"e113236","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the reasons behind induced abortion among Iranian couples: a qualitative study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3964-8598","authenticated-orcid":false,"given":"Zari","family":"Dolatabadi","sequence":"first","affiliation":[{"name":"Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farnaz","family":"Farnam","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health & Midwifery, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Moridi","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Damghanian","sequence":"additional","affiliation":[{"name":"Nursing and Midwifery Care Research Center, Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"2026080404550865000_16.8.e113236.1","unstructured":"Dashe JS , Bloom SL , Spong CY , et al . Williams obstetrics. 9. McGraw Hill Professional, 2022."},{"key":"2026080404550865000_16.8.e113236.2","unstructured":"Organization, W. H . Abortion care guideline. World Health Organization, 2022."},{"key":"2026080404550865000_16.8.e113236.3","doi-asserted-by":"crossref","DOI":"10.1080\/26410397.2023.2257075","article-title":"A pronatalist turn in population policies in Iran and its likely adverse impacts on reproductive rights, health and inequality: a critical narrative review","volume":"31","author":"Asadisarvestani","year":"2023","journal-title":"Sex Reprod Health Matters"},{"key":"2026080404550865000_16.8.e113236.4","doi-asserted-by":"crossref","DOI":"10.2471\/BLT.14.136333","article-title":"From concept to measurement: operationalizing WHO\u2019s definition of unsafe abortion","volume":"92","author":"Ganatra","year":"2014","journal-title":"Bull World Health Organ"},{"key":"2026080404550865000_16.8.e113236.5","unstructured":"Organization, W. H . 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