Background: Although induced abortion is legally restricted in Iran, unintended pregnancies pose complex reproductive dilemmas. Research has focused mainly on central urban centers, leaving decision-making dynamics in disadvantaged border regions under-researched, particularly among women who consider abortion but ultimately decide against it. This study explored factors influencing abortion intentions and subsequent withdrawal among women attending NAFAS counseling centers in Iranshahr, southeastern Iran.
Materials and methods: This qualitative study utilized conventional content analysis. Thirty-one women who experienced an unintended pregnancy, seriously considered abortion, but withdrew to continue the pregnancy were purposively recruited from NAFAS centers affiliated with Iranshahr University of Medical Sciences. Data were collected via in-depth, semi-structured interviews until data saturation was achieved, and analyzed following Graneheim and Lundman’s approach. Trustworthiness was ensured via peer debriefing and member checking.
Results: Participants’ mean age was 31.2 years (77.4% had ≥ 3 pregnancies). Five themes drove initial abortion considerations: (1) reproductive burden and physical exhaustion, (2) severe economic vulnerability, (3) fear from prior adverse obstetric experiences, (4) life-stage inappropriateness, and (5) perceived inability to provide adequate care. Conversely, withdrawal from abortion was facilitated by four themes: (a) emerging maternal–fetal attachment, (b) perceived support from NAFAS counseling, spousal and family encouragement, and (d) religious beliefs framed around divine will (Razā) and blessing (Barakah).
Conclusion: In southeastern Iran, abortion ambivalence reflects a dynamic tension between acute socioeconomic constraints and protective psychosocial and faith-based buffers. Context-tailored reproductive healthcare integrating poverty alleviation, accessible family planning, and culturally anchored, non-judgmental counseling is essential.