Prevalence of Spontaneous and Induced Abortion and Its Associated Factors in Iran: A Narrative Review

Background: The primary goal of this study was to determine the prevalence of various abortion types and to identify the most significant associated factors within Iran by aggregating findings from nationwide studies. Methods: This study was conducted as a narrative review, entailing a systematic search of both national and international databases (2010-2025) to analyze quantitative epidemiological findings regarding abortion and its related determinants in the Iranian context. Results: The data indicated that approximately 73,000 to 80,000 illegal and unsafe abortions are performed annually in Iran, with a lifetime prevalence of 12 14% among women of reproductive age. The most significant underlying causes were identified as financial problems, social pressures, and legal restrictions. Spontaneous abortion was found to affect 19 26% of the female population. Severe reproductive health inequities were observed; female sex workers experienced induced abortion at rates 2.5 3 times higher than the general population (35 37% vs. 12 14%). Reported complications included depressive symptoms in over 50% of cases and chronic reproductive issues in 7 11% of women. Conclusion: This review demonstrates that abortion in Iran, despite legal restrictions, remains a troubling issue, resulting in tens of thousands of unsafe abortions annually with severe health complications for women. Restrictive laws have not effectively reduced the incidence rates but have driven the practice underground. Given certain methodological limitations, these findings should be utilized to inform policy-making with appropriate caution. A harm-reduction approach emphasizing contraceptive access, sexual health education, and targeted counseling for vulnerable groups is urgently needed.