Maryam ended her pregnancy two years ago using abortion pills.
Her husband supported her. The couple already have a boy and a girl, and they decided they did not want a third child.
Abortion pills are not easily accessible in Iran due to government restrictions. Maryam obtained misoprostol through a pharmacist who was recommended by a friend.
“I was lucky as I knew the pill was not fake,” she told RFE/RL.
Women who seek an abortion in Iran often rely on the black market to obtain abortion pills that are often counterfeit or expired and ineffective. They also use underground abortion services by doctors and midwives that sometimes operate in unhygienic conditions.
Among them is Neda, who failed to end her pregnancy with an abortion pill. She then went to a gynecologist who she was told performed abortions.
“The doctor treated me like a criminal and didn’t offer any help,” she told the moderate Sharq daily in April.
Finally, she said, she found a midwife who helped end her unwanted pregnancy.
“The surgery was supposed to be with anesthesia, but it lasts only for 20 minutes regardless of how long [the procedure] takes. The [suction] device was in my body for 45 minutes and I can’t even describe the excruciating pain I endured,” she said, describing the mental and physical suffering she went through.
The government is now tightening abortion restrictions, making it even harder for women to terminate unwanted pregnancies.
The steps are being taken in line with a law aimed at boosting the country’s population that was adopted in November 2021 despite widespread criticism by medical professionals, women’s rights advocates, and UN human rights experts.
The "rejuvenation of the population and support of the family" imposed further restrictions on abortions and banned the free distribution of contraceptives by the public health-care system. Under the law,therapeutic abortions are decided by a panel made up of a judge, a doctor, and a forensic expert that could result in fewer exemptions.
Last week, the Health Ministry’s head of the Youth Population Department, Saber Jabbari, announced that “aiding and abetting” abortion is a crime and that medical staff involved will face heavy fines and a ban on practicing medicine.
“If a [doctor] is involved in an abortion, his medical license will be revoked even due to a single intentional abortion,“ Sabberi was quoted as saying by the semiofficial ISNA news agency.
Following the announcement, Tehran Governor Mohsen Mansuri called for the intensification of coercive measures against centers that help women terminate their unwanted pregnancies. Mansuri said earlier this week that such centers can be easily found with a simple search on the Internet, adding “serious work is needed to deal with them” so as to “raise the cost” for those who perform abortions.
He said every year 380,000 abortions are conducted in the country, saying the majority are “illegal and criminal.”
The UN, citing Iranian government estimates, has said that each year between 300,000 to 600,000 abortions are performed in the country.
Health workers and others have warned that the new restrictions are likely to create health complications for women by further limiting their access to safe abortions.
The UN said last week that restricting abortion access does not stop people from seeking the procedure, "it only makes it more deadly." The warning came after the U.S. Supreme Court overturned a 1973 decision legalizing abortion.
“Data clearly shows that criminalizing the termination of a pregnancy does not reduce the number of women who resort to abortion,” a group of UN rights experts, including the special rapporteur on the situation of human rights in Iran, warned in November, calling on Iran to repeal the population law.
“Instead, it forces women to risk their lives by undergoing clandestine and unsafe procedures,” they said.
A woman who had an abortion in the Iranian capital about a decade ago told RFE/RL that her gynecologist performed it in his office. “I knew that he was a professional, but I was still worried that something bad could happen and that he would not be able to save me on his own. Now when I think what women will have to go through because of the [tightening] of restrictions, my whole body shakes,” she said.
A Tehran-based journalist who did not want to be named said women from the lower class are likely to be most affected by the restrictions.
“They can’t afford to buy contraception or reliable abortion pills,” he said.
Nahid Khodakarami, the head of Iran’s Association of Midwives, warned that the population law is dangerous and counterproductive due to the health risks it creates for women.
“It only takes a few percent of women [seeking abortions] to get counterfeit medicine. Under such circumstances, the possibility of losing their uterus, fertility, and all kinds of physical complications is no longer far from conceivable. In fact, a law that seeks to increase fertility will not only not succeed with this approach, but it may also have the opposite effect,” she wrote.
She said Iranians cannot be forced to have more children amid a severe economic crisis that has left many struggling to make ends meet.
“How can a woman who cannot pay her rent think about having children,” she asked.