Unwanted Pregnancy and Abandoned Abortion Decisions among Disadvantaged Women: A Qualitative Study

Document Type : Research Article

Authors

1 Department of Psychology, Hoda College, Qom, Iran

2 Department of Counseling and Psychology, Humanities Faculty, Hazrat-e Masoumeh University, Qom, Iran

Abstract

Background: Unwanted pregnancy among disadvantaged women is often shaped by poverty, family instability, and limited social support. While some proceed with abortion, others initially consider it but ultimately continue the pregnancy. The present study investigated how women’s lived experiences—reflections, evolving meanings of motherhood, and interpretations of social, economic, and familial circumstances—shaped the inner deliberations of those who intended abortion but chose continuation.
Methods: This phenomenological qualitative study, conducted from October 2024 to March 2025, employed Diekelmann’s seven- step hermeneutic method to analyze the lived experiences of 12 low-income women who had considered abortion but ultimately decided not to proceed with it. Data were collected using semi-structured interviews, recorded and transcribed verbatim, and analyzed through iterative coding and thematic synthesis instead of statistical tests.
Results: The findings revealed six main themes: 1) Between bread and life: making sense of economic hardship and maternal choices; 2) The shadow of addiction: perceiving and navigating spousal addiction; 3) Support and assistance: interpreting emotional and practical guidance in decision-making; 4) Navigating physical strain, maternal responsibilities, and marital tensions; 5) Motherhood amid social judgment and stigma: personal meaning and reflection; 6) Negotiating men’s roles: understanding support and pressure in abortion decisions.
Conclusions: Economic hardship, addiction, stigma, and relationship dynamics were interpreted and morally negotiated realities. Women’s decisions to continue pregnancy arose from subjective meaning-making that balanced material constraints with ethical and emotional reflections.These findings call for reproductive health policies that respect women’s agency and lived experiences within disadvantaged contexts.

Highlights

Fateme Malekshahi: (Google Scholar)

Elham Fathi: (Google Scholar)

Keywords

References

  1. Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health. 2020;8(9):e1152-e1162. doi: 10.1016/s2214-109x(20)30315-6. PubMed PMID: 32710833. ##
  2. Bell SO, Oumarou S, Larson EA, Alzouma S, Moreau C. Abortion incidence and safety in Niger in 2021: findings from a nationally representative cross-sectional survey of reproductive-aged women using direct and indirect measurement approaches. PLOS Glob Public Health. 2023;3(10):e0002353. doi: 10.1371/journal.pgph.0002353. PubMed PMID: 37831640; PubMed Central PMCID: PMC10575533. ##
  3. Coast E, Norris AH, Moore AM, Freeman E. Trajectories of women's abortion-related care: A conceptual framework. Soc Sci Med. 2018;200:199-210. doi: 10.1016/j.socscimed.2018.01.035. PubMed PMID: 29421467. ##
  4. Chae S, Desai S, Crowell M, Sedgh G. Reasons why women have induced abortions: a synthesis of findings from 14 countries. Contraception. 2017;96(4):233-241. doi: 10.1016/j.contraception.2017.06.014. PubMed PMID: 28694165; PubMed Central PMCID: PMCPMC5957082. ##
  5. Oberman M. Motherhood, Abortion, and the Medicalization of Poverty. J Law Med Ethics. 2018;46(3):665-671. doi: 10.1177/1073110518804221. PubMed PMID: 30336087. ##
  6. Sánchez-Siancas LE, Rodríguez-Medina A, Piscoya A, Bernabe-Ortiz A. Association between perceived social support and induced abortion: A study in maternal health centers in Lima, Peru. PLoS One. 2018;13(4):e0192764. doi: 10.1371/journal.pone.0192764. PubMed PMID: 29649229; PubMed Central PMCID: PMCPMC5896907. ##
  7. Rehnström Loi U, Lindgren M, Faxelid E, Oguttu M, Klingberg-Allvin M. Decision-making preceding induced abortion: a qualitative study of women's experiences in Kisumu, Kenya. Reprod Health. 2018;15(1):166. doi: 10.1186/s12978-018-0612-6. PubMed PMID: 30285768; PubMed Central PMCID: PMCPMC6171301. ##
  8. Mappaware NA, Irianta T, Avisha M. Ethical dilemmas in voluntary termination of pregnancy with severe congenital anomalies. Ethics, Medicine and Public Health. 2025;33:101084. doi: 10.1016/j.jemep.2025.101084. ##
  9. Mizuno M, Ando F, Ohira M. A phenomenographic study of midwives' perceptions of abortion care in Japan. Sex Reprod Healthc. 2025;43:101066. doi: 10.1016/j.srhc.2025.101066. PubMed PMID: 39904014. ##
  10. Baker J, Lozano N, Shrestha A, Kayser S, Adair L. "It Makes It More Real to You": Abortion Attitudes Following Experience and Contact With Abortion. Perspect Sex Reprod Health. 2025;57(2):198-210. doi: 10.1111/psrh.70019. PubMed PMID: 40534175; PubMed Central PMCID: PMCPMC12204123. ##
  11. Perry SL, Schmidgall DK. How Christian nationalism co-opts Black Americans for republicans: the case of abortion in the 2024 presidential election. Ethnic and Racial Studies. 2025;48(15):3073-3089. doi: 10.1080/01419870.2025.2482717. ##
  12. Kaczor C. The Ethics of Abortion: Women's Rights, Human Life, and the Question of Justice. USA: Routledge; 2023. ##
  13. Creswell JW, Creswell JD. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. USA: Sage publications; 2017. ##
  14. Chadderton H. Hermeneutics and nursing research. In Rapport F. New qualitative methodologies in health and social care research. London: Routledge; 2004. p. 55-78. ##
  15. Diekelmann NL, Allen D, Tanner CA. The NLN Criteria for Appraisal of Baccalaureate Programs: A Critical Hermeneutic Analysis. USA: National League for Nursing; 1989. ##
  16. Silverman D. Instances or Sequences? Improving the State of the Art of Qualitative Research. Forum Qualitative Sozialforschung. 2005;6(3). ##
  17. Beumer WY, Reilingh A, Dalmijn E, Roseboom TJ, van Ditzhuijzen J. Motivations for Abortion or Continuation of an Unwanted Pregnancy: A Scoping Review of the Global Literature. Perspect Sex Reprod Health. 2025;57(1):45-62. doi: 10.1111/psrh.12293. PubMed PMID: 39843393; PubMed Central PMCID: PMCPMC11936852. ##
  18. Okui T. Association of socioeconomic status with unintended pregnancy and induced abortion in married couples: An analysis of the 2021 national survey data in Japan. Clinical Epidemiology and Global Health. 2024;30:101814. doi: 10.1016/j.cegh.2024.101814. ##
  19. Lipari RN, Van Horn SL. In The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2013. PubMed PMID: 29144715. ##
  20. Katz J. Supporting Women Coping With Emotional Distress After Abortion. The Professional Counselor. 2019;9(2):100-108. doi: 10.15241/jk.9.2.100. ##
  21. Reardon DC, Rafferty KA, Longbons T. The Effects of Abortion Decision Rightness and Decision Type on Women's Satisfaction and Mental Health. Cureus. 2023;15(5):e38882. doi: 10.7759/cureus.38882. PubMed PMID: 37303450; PubMed Central PMCID: PMCPMC10257365. ##
  22. Goldenberg I, Stanton M, Goldenberg H. Family therapy: An overview. USA: Cengage; 2016. ##
  23. Goemans SL, Singh A, Yadav AK, McDougal L, Raj A, Averbach SH. The association between intimate partner violence and recent self-managed abortion in India. AJOG Glob Rep. 2021;1(4):100029. doi: 10.1016/j.xagr.2021.100029. PubMed PMID: 35291317; PubMed Central PMCID: PMCPMC8920295. ##
  24. Sorhaindo AM, Lavelanet AF. Why does abortion stigma matter? A scoping review and hybrid analysis of qualitative evidence illustrating the role of stigma in the quality of abortion care. Soc Sci Med. 2022;311:115271. doi: 10.1016/j.socscimed.2022.115271. PubMed PMID: 36152401; PubMed Central PMCID: PMCPMC9577010. ##
  25. Rawicka I. Attitudes of spouses towards abortion and the quality of their mutual relations. Kwartalnik Naukowy Fides Et Rati. 2022;51(3):94-105. doi: 10.34766/fetr.v3i51.1109. Polish. ##

Files

Share

How to cite

Statistics