Explaining the reasons for induced abortion in Fasa County, Iran: a qualitative content analysis study

Background Intentional abortion is a complex reproductive health issue influenced by individual, family, economic, cultural, and legal factors. Despite national policies aimed at increasing fertility rates, there is a significant lack of in-depth, local qualitative data that explains the reasons for intentional abortion in smaller cities and rural areas such as Fasa County, Iran. This study protocol aimed to explain the reasons for intentional abortion in Fasa County, Iran, from the perspectives of women who have experienced it and healthcare providers. Methods This study employed a qualitative approach using conventional content analysis, guided by the Graneheim and Lundman method. The study was conducted in Fasa County, Iran, from Mach 2024 to March 2026. Participants included two groups: (a) married women aged 15–45 years with a history of intentional abortion and (b) healthcare providers (midwives, obstetricians and gynecologists) involved in women's reproductive health. Participants were selected using purposive sampling with maximum diversity. Data were collected through semi-structured in-depth interviews conducted in a private setting. Interviews continued until data saturation was reached. Data analysis included verbatim transcription, semantic unit identification, open coding, categorization, and theme development. Data validity was ensured using Lincoln and Guba criteria. Results Five main themes emerged from the data: (1) Inexorability of Non-Existence (encompassing economic hardship, lack of support, and family instability), (2) Secret Paths, Dangerous Destinations (including reliance on the internet, informal advice, underground clinics, and fear of stigma), (3) Enduring Harms (covering physical complications, psychological distress, and deep regret), (4) Missed Opportunities (highlighting lack of education and weakened religious beliefs), and (5) The Art of Preserving Dignity (emphasizing non-judgmental environments and respect for personhood). Conclusion Intentional abortion in Fasa County is driven by a confluence of economic despair, social isolation, inadequate education, and limited access to safe services. The hidden and illegal nature of these procedures exposes women to severe physical and psychological harms. Addressing this issue requires comprehensive reproductive health education, non-judgmental counseling, enhanced family support systems, and policy reforms aimed at reducing the socioeconomic vulnerabilities that drive women toward unsafe abortions.