by Jenna Raleigh
In the past few decades Iran has progressed immensely in the area of family planning. It has been said that Iran has, perhaps, the best family planning program world-wide. The program’s merits include making contraceptives free and readily available, requiring pre-marital counseling in order to be granted a marriage license, and has greatly improved maternal and child health and outcomes nationwide. With no more than a quick search on the internet you can see plenty of articles and interviews that feature comments of praise for the program, and it is fair to give it praise since it has accomplished so much and succeeds in many ways. However, there are serious problems that have fallen through the cracks and do not get the attention they need. One in particular is the program’s lack of ability to accommodate women who wish to induce abortion. This is due to the Islamic government’s ruling that abortion, when not medically advised, is illegal.
According to the Qur’an, which Islamic law follows, life is a sacred gift and to abort a fetus after “ensoulment” is sinful and unacceptable. The idea of ensoulment is constructed around the belief that, after 120 days from the moment of conception, a fetus becomes ‘ensouled’ by angels sent from Allah. Through this action it is believed that the fetus becomes a person. Therefore, they believe that from that moment the fetus has rights and the choice of abortion is no longer up to the parents. Despite this, the Islamic government has taken into consideration the life-threatening complications that can arise from pregnancy. Many efforts were made to address this problem but for several years the legal system and the medical community have struggled to create an understandable list of diseases, factors, and requirements that can fall under the category of medically advised legal abortion, which has led to a lot of confusion and many overlooked possible factors. An additional hurdle to overcome is that the law requires a diagnosis from three experts and confirmation by the Legal Medicine Organization, which greatly increases the difficulty of obtaining an abortion. Furthermore, since only 1% of induced abortion is for medical reasons, the majority of women who induce abortion are not being accommodated.
Increasing numbers of Iranian women wishing to pursue higher education, struggling with financial issues, and desiring to have smaller families means that more and more of these women are choosing to have abortions. In addition to that, the trend of Iranian couples using the withdrawal method during intercourse, despite access to contraceptives, makes unwanted pregnancies a frequent occurrence. Worryingly, about a third of these women opt for dangerous methods through which to induce abortion; methods which range from puncturing the fetal sac with sharp objects via the cervix to using strong herbal medicines. If abortions are performed by individuals, not specifically trained to perform abortions, risk for serious complications are very high. Even if these abortions are carried out in safe and clean environments and through use of methods routinely used by obstetricians, such as injection of prostaglandins.
A study conducted by Anzar Ranji, MS, in which 2,705 Iranian women were interviewed and surveyed, revealed that of those 2,705 women, 495 (17%) had experienced illegal induced abortion and most of these women (84%) experienced complications that required hospitalization. Bleeding, infection, menstrual disorders, chronic pelvic pain, necessity of blood transfusions, infertility, and resulting in hysterectomy are among these complications. Obviously this study could not account for the women who actually died from complications, but death is also associated with these unsafe abortions. One of the big reasons for complications is due to the fact that many of these abortions are incomplete, which can lead to infection and painful delivery of the partially aborted fetus. This study alone reveals that induced abortion being illegal is a big problem. These women should not have to feel as though they need to seek risky methods, especially since it means that they will not receive post-abortion care which is offered even when the abortion was illegal.
Ideally, the solution to this problem would involve removing Islamic law from the government and the legal system, which would most likely lead to the legality of all induced abortion. This, however, is not a viable option presently and will not, most likely, be in the near future. Alternatively, I think it is important for Iran’s family planning program to make it a priority to teach Iranian couples about the importance of contraceptive use, the probability of contraceptives failing, particularly with the withdrawal method. I also think the program should encourage the women who have abortions to make sure they seek post-abortion care even, and maybe especially, when the abortion was performed illegally.
Probably the most detrimental force acting against these women is the lack of attention to this problem. Some people may say that the numbers are small or that it is a minimal problem in Iran’s flourishing family planning program, but it definitely is not a minimal problem for any woman facing serious medical and familial consequences. The physical, emotional, and psychological suffering these women endured will undoubtedly have had a huge impact on their quality of life and this should be unacceptable. This is what happens when the strong beliefs of certain individuals and groups, which can be potentially harmful, infiltrate institutions which govern and protect a population.
Jenna Raleigh is a double major in Anthropology and French at East Carolina University