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Iran doubles down on abortion and contraception restrictions

A woman with her baby walks through a park in Tehran on Nov. 25. (Abedin Taherkenareh/EPA-EFE/REX/Shutterstock)

Iranians long had degrees of access to free contraception at public health facilities, part of family-planning policies aimed at limiting population growth.

In recent years, policy shifts have whittled away such programs. The changes have culminated under a new law — meant to address an emergent demographic shift — that critics have decried as a major setback for women’s and reproductive rights.

The law, enacted by Iranian President Ebrahim Raisi last month, adds more red tape to existing abortion restrictions, bars public health-care providers from offering free contraception, prohibits voluntary sterilization and offers more benefits to childbearing families, among other measures. It also expands the role of security agencies in surveilling who accesses what services — adding to the ways the Iranian state can control the private lives of citizens.

Advocates for reproductive rights in Iran criticized the tightened restrictions. “Legislation about population control and abortion is ultimately about control over women and families,” said Firoozeh Kashani-Sabet, a historian at the University of Pennsylvania. The law is a “troubling example” of a global trend of some states trying to increase control and surveillance, she said.

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The new legislation, called the “Rejuvenation of the Population and Support of the Family” bill, comes amid warnings by Iranian officials that birth and population rates are in decline. Iran, a country of nearly 85 million, has the lowest fertility rate in the Middle East, Saleh Ghasemi, the head of Iran’s Center for Strategic Research on Population, told Iranian state media in October.

Seyed Hamed Barakati, deputy health minister for family and school population, told Iranian state media in May that the country’s birthrate had decreased 25 percent over the past four years to a fertility rate of around 1.7 children per mother. On average, a couple had their first child after four years of marriage and a second one five years later. He said around 12,000 requests for abortion had been submitted in recent years, fewer than 8,000 to 9,000 of which had been approved.

The full extent of the law’s repercussions remains to be seen. Iran’s government has provided no data connecting abortions with demographic change, a linkage human rights advocates reject.

The change, which runs contrary to a global trend toward increased access to abortion, comes as the U.S. Supreme Court mulls the constitutionality of a Mississippi abortion restriction, in a case that could scale back protections under Roe v. Wade.

United Nations experts, including the special rapporteur on the situation of human rights in Iran, described Iran’s law as a “direct violation of women’s human rights under international law,” in a statement issued in November.

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Previously, Iranians could legally access abortions only during the first four months of pregnancy if three doctors agreed that the pregnancy was life-threatening or if the fetus was shown to have severe disabilities that the family could not handle.

Under the new law, a pregnant person must go before a panel made up of a judge, doctor and forensic specialist. It remains to be seen how this panel will rule, but it is expected to be even more restrictive in granting exemptions, said Tara Sepehri Far, a Human Rights Watch researcher focused on Iran.

The law calls on Iran’s judiciary and Health Ministry to draft a plan for curtailing doctors who provide abortions illegally and people who distribute abortion pills. Another article makes engaging in illegal abortions on a wide scale punishable under penal codes that include capital punishment. The measure appears intended to target any underground abortion networks, said Sepehri Far.

Anywhere between 300,000 and 600,000 illegal abortions are conducted yearly in Iran, according to a U.N. estimate based on government data. Unsafe abortions can cause long-term physical and psychological damage, including infertility, and in some cases can be deadly.

The U.N. statement warned that “the criminalization of abortion can constitute cruel, degrading, and inhumane treatment, and may amount to torture.”

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The legislation requires state broadcasters to produce content encouraging more childbearing, offers loans and job support for newly married and pregnant people, and restricts access to prenatal screening tests, which can detect genetic disorders.

It also requires that the Health Ministry work with security agencies to establish a database for information on anyone visiting a health center for fertility treatment, a pregnancy, labor or an abortion.

Other provisions are intended to keep mothers in the workforce. The law prohibits firing someone because they are pregnant or breastfeeding, and offers nine months of fully covered maternity leave, among other benefits.

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Reproductive rights in Iran have historically grown and shrunk “depending on the perceived political needs at the time,” said Kashani-Sabet.

“In this regime in particular,” she said, referring to Iran’s post-1979-revolution political system, “when there are challenging social and economic issues facing the government, the focus has once again shifted to women.”

But homing in on abortion, Kashani-Sabet said, does not address the other reasons known to affect childbearing rates, such as economic and social welfare.

The bill was fast-tracked through a parliament committee and approved by the country’s powerful legal watchdog, the Guardian Council, before Raisi signed it into law.

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Iran’s supreme leader, Ayatollah Ali Khamenei, has called on Iranians to increase the country’s population.

Raisi, who faced little competition when he was elected in June, presides over a conservative-stacked parliament. Iran’s parliament has been largely marginalized in many decision-making areas, such as foreign policy and the nuclear talks. That has led some conservative parliamentarians to focus on social issues such as reproductive rights and Internet access, spheres where they can have more sway, said Sepehri Far.

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After the conclusion of the 1980-1988 Iran-Iraq war — during which families were encouraged to have more children — Iran’s leadership worried that the country’s population growth could outstrip resources. So it began to implement nationwide family-planning programs, which many internationally viewed as a success.

Under the direction of former supreme leader Ruhollah Khomeini, the government encouraged families to have only one or two children, discouraged underage pregnancies, provided free condoms and subsidized vasectomies, among other initiatives. Even in rural areas, women and pregnant people generally had reliable access to health screenings at clinics and other family-planning services.

In an era of population decline, the calculus appears to have shifted.

Sepehri Far said that cutting off free contraception could be particularly punitive for middle- and lower-class Iranians, who, amid the country’s severe economic crisis, have seen their purchasing power decline. Contraception sold at private clinics is unaffordable for many Iranians. When facing economic hardship, “the first thing they let go of is their health to help the family,” she said.