Sexual and Reproductive Health Education Needs of Engaged Couples in North of Iran: A Qualitative Study
This qualitative study of engaged couples in northern Iran reveals that their sexual and reproductive health education needs extend beyond basic biological information to include relationship skills and communication, highlighting a critical mismatch with current practices and calling for interactive, multi-channel, and culturally sensitive educational approaches.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Marriage is often viewed as a union of two lives, but for health professionals, it is also a critical moment for a couple's long-term physical and emotional well-being. Before a couple says "I do," they face a complex set of decisions regarding their future family, including how to plan for children, how to prevent unintended pregnancies, and how to navigate the intimate aspects of their new relationship. In many parts of the world, including Iran, the government offers premarital counseling to help couples prepare for these realities. These sessions are designed to provide essential information about sexual health, which encompasses not just the mechanics of reproduction, but also the prevention of infections, the management of fertility, and the emotional dynamics of a shared life. However, a gap often exists between what a standardized curriculum offers and what a specific couple actually needs to know. When education feels too rigid or too shy to address real concerns, couples may turn to unreliable sources for answers, leaving them unprepared for the challenges of married life.
A team of researchers from Guilan University of Medical Sciences in northern Iran set out to understand exactly what engaged couples in this region were looking for. They wanted to move beyond checking boxes on a standard checklist and instead listen to the people themselves. The study took place in the premarital counseling centers of Rasht, a city in the north of the country. The researchers did not hand out surveys with fixed answers; instead, they sat down with people and asked them to speak freely about their hopes, fears, and questions. They interviewed 23 engaged individuals, including 15 women and 8 men, and held a small group discussion with two couples. They also spoke with five health professionals who work in the field. The goal was to uncover the specific topics these couples felt were missing from their preparation, the barriers that stopped them from getting good information, and the ways they would prefer to learn.
The conversations revealed that the couples viewed their educational needs as much broader than just biological facts. While they certainly wanted to understand how to prevent pregnancy and how to have a healthy sexual relationship, they placed a heavy emphasis on the human side of marriage. Many participants described a deep need to learn how to communicate with their future spouse about sensitive topics without fear or shame. They spoke about the importance of understanding the differences between men and women, not just in a biological sense, but in how those differences play out in daily life. They wanted to learn practical skills for solving problems when disagreements arose and how to build a foundation of trust and mutual responsibility. One participant noted that commitment is not just a promise made on a wedding day, but a daily choice to care for one another. The study found that for these couples, education was not just about memorizing facts; it was about acquiring the relationship tools necessary to navigate a life together.
Despite the clear desire for this kind of preparation, the couples identified significant hurdles in the current system. A major theme was the cultural silence surrounding sex. Many described these topics as taboo, noting that in their families and communities, such subjects were rarely discussed openly. This silence often forced young people to turn to the internet or social media for answers, where they found information that was often inaccurate or misleading. The couples also pointed out that the government-provided education felt disconnected from their reality. They felt that the classes were too short, lacked continuity, and sometimes failed to address the speed at which culture and technology are changing. Some participants felt that the educators themselves were not fully equipped to handle these sensitive conversations, either due to a lack of training or because they were bound by traditional norms that made them hesitant to speak frankly.
When asked how they would prefer to learn, the engaged couples offered a clear vision for the future. They expressed a strong interest in using technology, such as videos and mobile applications, to access information privately and at their own pace. They wanted education that was interactive, allowing them to ask questions and practice communication skills rather than just listening to a lecture. Perhaps most importantly, they felt that learning should not stop after the wedding. They described a need for ongoing support and education that continues into their married life, rather than a single session before the ceremony. The researchers noted that while most participants valued this education, there were exceptions; a few individuals felt they already had enough information from their families or the internet, and one person even expressed a religious objection to learning about contraception. These differing views highlighted that there is no single experience that fits every couple.
The study concludes that the path to healthier marriages involves more than just delivering a standard set of facts. It suggests that premarital education needs to evolve into a flexible, multi-channel approach that respects the cultural context while embracing modern ways of learning. By listening to the voices of the couples themselves, the researchers found that the most effective education would be one that combines accurate scientific information with the practical skills needed for communication and problem-solving. It would be an education that acknowledges the tension between tradition and modern life, offering a safe space for couples to ask difficult questions and find reliable answers. The findings do not prove that a specific new program will work, but they strongly suggest that the current model needs to expand to include the full range of human needs that these couples are expressing.
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