From intention to withdrawal: reasons Iranian women discontinued seeking illegal abortion—a qualitative study

Every year, millions of women around the world face an unexpected pregnancy. For many, the path forward is not a straight line but a winding road of difficult choices, shaped by money, family, health, and deeply held beliefs. In some places, the law makes these choices even harder, forcing women to weigh their options against strict rules and the fear of punishment. When a woman decides she cannot continue a pregnancy, she may look for a way to end it. But the story does not always end there. Sometimes, a woman who has already decided to seek an abortion changes her mind. She stops looking for a way to end the pregnancy and chooses to continue it instead. Understanding why this happens is crucial. It reveals that the decision to keep a baby is rarely just about one thing; it is a complex mix of support, fear, hope, and the sudden realization that life might be different than expected.

In Iran, where laws regarding abortion are strict and access to safe medical care for ending a pregnancy is limited, this shift in decision-making is particularly significant. A new study set out to understand exactly why Iranian women, who had initially planned to seek an illegal abortion, ultimately decided to carry their pregnancies to term. The researchers did not ask women why they wanted an abortion; instead, they listened to the stories of fifteen women who had changed their minds. These women were interviewed in private, in a safe space, and they spoke openly about the moments that turned their thoughts around. The study, conducted in the city of Karaj, found that the decision to withdraw from seeking an abortion was not caused by a single event, but by a combination of three powerful forces: the people who supported them, the internal changes in how they saw themselves and their future, and the scary realities of what an illegal abortion could do to them.

The first force the researchers identified was the support network. This was the web of people and systems that made continuing the pregnancy feel possible rather than impossible. For many of the women, their husbands played the most critical role. It was not just about a husband saying "yes" to the baby; it was about him showing up. Women described partners who listened to their fears, shared the burden of household chores, and promised to help care for their other children. One woman recalled how her husband told her that having another child would be a gift for their firstborn, a playmate for life. Another noted that her husband respected her right to decide, refusing to force her into a choice she didn't want. When a woman felt that she would not be alone in raising a child, the weight of the decision became lighter.

This support extended beyond the husband to the wider family and friends. Sisters, mothers, and close friends offered emotional reassurance and practical help, such as watching the children or providing money. In some cases, friends who had previously had abortions shared their own stories of regret, warning the women that the guilt might never go away. Beyond the personal circle, the women also looked to the government and their workplaces. While the women felt that financial help from the state, like loans or extended maternity leave, was not enough to solve all their money problems, it did help. For students, support from their universities was a game-changer. When a pregnant student worried that her education would be ruined, a supportive professor who allowed her to attend classes online or adjust her schedule gave her the confidence to stay in school and keep the baby.

The second force was what the researchers called "transformative levers." These were the internal shifts in a woman's mind and heart that changed her perspective. One of the most powerful moments for several women was hearing the fetal heartbeat for the first time. That sound turned a medical concept into a living person, sparking a sudden, deep connection that made the idea of ending the pregnancy feel wrong. For others, looking at their existing children and seeing their laughter made the hardships of pregnancy seem worth it. They began to see the new baby not as a burden, but as a future companion for their older child, a way to prevent loneliness in the years to come.

Religious and moral beliefs also acted as a strong anchor. In a society where abortion is often viewed as a serious sin, the fear of divine punishment and the weight of moral guilt stopped many women in their tracks. They felt that the fetus was a gift from God and that ending its life was a violation of a sacred trust. For some, growing up in a large, happy family made them want to recreate that sense of closeness for their own children. They remembered the joy of having siblings and decided that their first child deserved that same support. Finally, medical reassurance played a key role. When doctors confirmed that the baby was healthy and that the mother's body could handle the pregnancy, the fear of medical complications faded, and the desire to continue grew stronger.

The third force was the perception of threat. Paradoxically, the very dangers of seeking an illegal abortion became a reason to stop. The women were acutely aware that because abortion was illegal, they would have to seek it out in the shadows, often from unqualified providers. They feared the high cost of these illegal services, which many could not afford. More terrifying was the fear of physical harm. Doctors and health workers warned them about the risks of bleeding, infection, and even death. One woman recalled a doctor telling her that an illegal procedure could kill her. Another remembered being warned about the risk of permanent damage to her uterus. These fears were not abstract; they were concrete dangers that loomed large. When the risk of losing their health or their lives seemed greater than the challenges of raising an unplanned child, the decision to continue the pregnancy became the safer, more logical choice.

The study suggests that the decision to keep a pregnancy is rarely a simple calculation of pros and cons. It is a dynamic process where external support, internal beliefs, and fear of danger all interact. The researchers found that while women often start with a plan to end a pregnancy due to financial stress or relationship issues, that plan can unravel when they receive genuine support from their partners, when they feel a new connection to the life growing inside them, or when they realize the extreme risks of the alternative. The findings highlight that simply making abortion illegal does not stop women from considering it, but it does create a landscape of fear and uncertainty that can inadvertently push them toward continuing the pregnancy.

For healthcare providers and policymakers, the message is clear. To support women facing unintended pregnancies, the focus should not be solely on legal restrictions. Instead, there is a need for strong, non-judgmental counseling that addresses the real fears and needs of women. Providing confidential medical advice, ensuring that students can continue their education, and fostering a culture where partners and families support rather than pressure women can make a profound difference. The study concludes that when women feel supported, safe, and heard, they are more likely to make choices that protect their health and their future, whether that means seeking safe medical care or choosing to continue a pregnancy. The path from intention to withdrawal is paved with human connection and the quiet, powerful realization that life, in all its complexity, is worth protecting.