Determinants of induced abortion in Tehran, Iran: the role of contraceptive failure

Abstract

Objectives

Induced abortion is highly restricted in Iran and many married women with unintended pregnancies resort to clandestine procedures, resulting in adverse health outcomes. As there is a lack of reliable data on abortion in Iran, this study aimed to examine factors predisposing women to practise abortion, factors facilitating the use of abortion and factors determining women’s ‘need’ to use abortion to control their number of children.

Methods

The study used data from the 2014 Tehran Survey of Fertility, conducted among 3012 married women aged 15–49 years. Bivariate and multivariate binary logistic regression analyses were used.

Results

About 6% of women reported that they had had an abortion. The proportion was higher among women who were in their later reproductive years, women who were employed, women who intended to continue their education, women who reported a low level of religiosity, women who had two children and women who wanted no/no more children. Multivariate analysis showed that abortion was twice as high among women who had conceived their most recent birth because of the failure of a modern contraceptive method, compared with women who had discontinued or did not use a contraceptive method.

Conclusion

The high risk of abortion among women experiencing failure of a modern contraceptive method indicates an unmet need for family planning counselling and education rather than a shortage of contraceptive methods.

摘要

目的：人工流产在伊朗受到高度限制, 许多意外怀孕的已婚女性寻求隐秘的堕胎程序, 从而导致了不利的健康后果。由于伊朗缺乏关于堕胎的可靠数据, 这项研究旨在调查导致女性倾向于堕胎的因素、促进使用堕胎的因素以及决定女性“需要”使用堕胎来控制子女数量的因素。方法：这项研究使用了2014年德黑兰生育力调查的数据, 该调查对3012名年龄在15-49岁的已婚女性进行了调查。采用二元和多变量二元Logistic回归分析。结果：约6%的女性报告她们曾堕胎。这一比例在晚期育龄女性、有工作的女性、打算继续接受教育的女性、宗教信仰水平较低的女性、有两个孩子的女性以及不想/不想再要孩子的女性中较高。多变量分析显示, 与停止或不使用避孕方法的女性相比, 因现代避孕方法失败而怀上最近一胎的女性的堕胎率是后者的两倍。结论：现代避孕方法失败的女性堕胎的风险很高, 这表明女性对计划生育咨询和教育的需求没有得到满足, 而不是避孕方法的缺乏。

Keywords:

• Contraceptive failure
• abortion
• reproductive health services

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by funding from an Insight Grant [435-2019-1265] of the Social Sciences and Humanities Research Council of Canada. The 2014 Tehran Survey of Fertility was supported by the National Population Studies and Comprehensive Management Institute of Iran Ministry of Science, Research and Technology, and Nipissing University.