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

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.

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.

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.

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.