Explanation of unwanted pregnancy from the perspective of family planning service providers: An exploratory study

Document Type : Review Article


1 Associate Professor, Department of Health Education & Promotion, Health Sciences Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

2 M.Sc. student in Health Education & Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

3 Assistant Professor, Department of Health Education & Promotion, Health Sciences Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

4 Assistant professor, Department of Health Education & Promotion, School of Health, Zanjan University of medical sciences, Zanjan, Iran.


Introduction: Pregnancy is one of the best events in a woman's life, but unwanted pregnancy may threats the health of mother, child, family and community. This study was performed with aim to identify the reasons of unwanted pregnancy from the perspective of family planning service providers.
Methods: This study is based on qualitative content analysis approach which was performed in 2015. Participants were 13 health providers who provided family planning services to the referred women to health centers in Mashhad. Purposive sampling was conducted and data gathering continued until saturation. Semi-structured in-depth interview was done to collect data. The interview was recorded and transcribed. Data were analyzed based on content analysis approach in MAXQDA software.
Results: Three main following factors were explored as perceived reason for unwanted pregnancy:" reasons related to problems of health care system ", " reasons related to the characteristics of the services recipients" , and " reasons related to the quality of family planning tools"
Conclusion: Reduced incidence of unwanted pregnancy needs to improve the quality of family planning services, consultation, husband's participation, promoting knowledge and improving attitudes of health providers towards family planning and improving the quality of family planning tools.


  1. Fergusson DM, Horwood LJ, Boden JM. Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence. Aust N Z J Psychiatry 2013; 47(9):819-27.
  2. Panova OV, Kulikov AM, Berchtold A, Suris JC. Factors associated with unwanted pregnancy among adolescents in Russia. J Pediatr Adolesc Gynecol 2016; 4:4.
  3. Jrahi L, Zavar A, Neamat Shahi M. Evaluation of the frequency of unwanted pregnancy and its related factors in the pregnant women of Sarakhs city. Iran J Obstet Gynecol Infertil 2014; 17(124):8-14. (Persian).
  4. Moosazadeh M, Nekoei‐moghadam M, Emrani Z, Amiresmaili M. Prevalence of unwanted pregnancy in Iran: a systematic review and meta‐analysis. Int J Health Plann Manage 2014; 29(3):e277-90.
  5. Nisand I, Bettahar K, Investigators of the aMaYa Study. Medical management of unwanted pregnancy in France: modalities and outcomes. The aMaYa study. Eur J Obstet Gynecol Reprod Biol 2015; 184:13-8.
  6. Zaheri F, Ranaie F, Hashemi Nasab L, Karimeh R, Shahoi R. Unwanted pregnancy and associated factors among pregnant women who referred to Sanandaj health centers in 2011. Iran J Obstet Gynecol Infertil 2015; 17(132):10-5. (Persian).
  7. Nojah S, Latifi M. The effects of unwanted pregnancy on lactation in the first three-hours period after delivery. J Sabzevar Univ Med Sci 2001; 7(4):37-42. (Persian).
  8. Bairagi R, Islam MM, Barura MK. Contraceptive failure; levels, trends and determinants in Matlab, Bangladesh. J Biosoc Sci 2000; 32(1):107-23.
  9. Kheiriat M, Aamanialavijeh F, Araban M, Kheiriat F. Reasons deemed for an unwanted pregnancy: a qualitative study (unwanted pregnancy). Health Educ Health Prom 2014; 2(2):153-64. (Persian).
  10. Iranfar S, Shakeri J, Ranjbar M, NazhadJafar P, Razaie M. Is unintended pregnancy a risk factor for depression in Iranian women? East Mediterr Health J 2005; 11(4):618-24.
  11. Hakimi S, Mohammad Ali Zadeh S. Reproductive rights in Iran health system: challenges and outcomes. Iran J Med Law 2009; 2(7):129-43.
  12. Zamani Alaviche F, Eftekhar Ardebili H, Bashardost N, Marashi T, Naghibi A. The behavior of women confronted with unwanted pregnancies. J Sch Public Health Instit Public Health Res 2004; 2(2):55-62. (Persian).
  13. Nourani Saadodin S, Goudarzi M, Peyman N, Esmaily H. Prediction of intrauterine device insertion among women of childbearing age based on the theory of planned behavior. Iran J Obstet Gynecol Infertil 2013; 16(45):13-9. (Persian).
  14. Peyman N, Oakley D. Married Iranian women’s knowledge, attitude and sense of self-efficacy about oral contraceptives: focus group discussion. J Reprod Infertil 2011; 12(4):281-8.
  15. Canning D, Schultz TP. The economic consequences of reproductive health and family planning. Lancet 2012; 380(9837):165-71.
  16. Rahman M, DaVanzo J, Razzaque A. Do better family planning services reduce abortion in Bangladesh? Lancet 2001; 358(9287):1051-6.
  17. Miller E, Tancredi DJ, Decker MR, McCauley HL, Jones KA, Anderson H, et al. A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial. Contraception 2016; 94(1):58-67.
  18. Tehrani H, Majlessi F, Shojaeizadeh D, Sadeghi R, Hasani Kabootarkhani M. Applying socioecological model to improve women’s physical activity: a randomized control trial. Iran Red Crescent Med J 2016; 18(3):e21072.
  19. Schin A. Pregnancy preventing using emergency contraception. Pediatr Atr Adolesc Gynecol 1999; 12(1):3-9.
  20. Adekunle AO, Arowojolu AO, Adedimeji AA, Okunlola MA. Emergency contraception: survey of knowledge, attitudes and practice of health care professionals in Ibadan, Nigeria. J Obstet Gynaecol 2000; 20(3):284-9.
  21. Tehrani H, Rakhshani T, Shojaee Zadeh D, Hosseini SM, Bagheriyan S. Analyzing the relationship between job stress to mental health, personality type and stressful life events of the nurses occupied in Tehran 115 emergency. Iran Red Crescent Med J 2013; 15(3):272-3.
  22. Smit J, McFadyen L, Beksinska M, De Pinho H, Morroni C, Mqhayi M, et al. Emergency contraception in South Africa: knowledge, attitudes, and use among public sector primary healthcare clients. Contraception 2001; 64(6):333-7.
  23. Shahidzade A, Mir Moeeni ES, Aazimian MH, Mani-Kashani K. A qualitative assessment of urban family planning facilities Hamadan, May–September 2003. J Sch Public Health Instit Public Health Res 2003; 2(1):1-10. (Persian).
  24. Abazri F, Arab M, Abbaszade A. Relationship of unwanted pregnancy and fertility behavior in pregnant women who visited maternity wards of Kerman hospitals. J Reprod Fertil 2002; 4(1):39-46. (Persian).
  25. Kreuter MW, McClure SM. The role of culture in health communication. Ann Rev Public Health 2004; 25:439–55.
  26. Champion V, Maraj M, Hui S, Perkins AJ, Tierney W, Menon U, et al. Comparison of tailored interventions to increase mammography screening in nonadherent older women. Prev Med 2003; 36(2):150–8.
  27. Movahed M, Turajian H. Review of relationship between social factors-cultural with male attitudes in family planning programs in Shiraz, Iran. J Iran Demog Soc. 2007; 2(3):92-110. (Persian).
  28. Rakhshani F, Niknami S, Ansari Moghaddam AR. Couples communication role in family planning decision-making in Zahedan, Islamic Republic of Iran. East Mediterr Health J 2005; 11(4):586-93.
  29. Mazloomy Mahmoodabad SS, Tehrani H, Gholian-Aval M, Gholami H, Nematy M. The effect of social class on the amount of salt intake in patients with hypertension. Blood Press 2016; 5:1-4.
  30. White K, Hopkins K, Potter JE, Grossman D. Knowledge and attitudes about long-acting reversible contraception among Latina women who desire sterilization. Womens Health Issues 2013; 23(4):e257-63.
  31. Rostamian A, Heidari G, Zafarmand M, Asadi K, Barghandan R, Dianat M, et al. Investigation of causes of male participation in family planning in Boushehr, Iran. Iran South Med J 2001; 4(2):142-9. (Persian).
  32. Rakhshani F. Razaghi A, Rakhshani M, Different views of classes about marriage and family planning in Zahedan, Iran. J Qazvin Med Sci Health Serv 2002; 21(1):28-35. (Persian).