Factors Affecting Decision-Making to Have Children in Iran: A Qualitative Study Publisher



Sighaldeh S S ; Taherkhani S ; Bakouei F ; Mirmolaei S T ; Amzajerdi A ; Delpisheh M ; Ahmadabad R F ; Ramezani P ; Sharifi F ; Rastad Z ; Ghafoori F
Source: Health Science Reports Published:2026

Abstract

Background and Aims: Fertility is not only a biological process; it is a multidimensional phenomenon shaped by complex and often contradictory factors, such as cultural norms and economic conditions. Decision-making about childbearing not only affects couples’ lives but also shapes the future of their families and societies. This study examines the components influencing childbearing decisions among women and their spouses across different cities and cultural contexts in Iran, focusing on their personal and shared experiences. Methods: We conducted a conventional content analysis in 2025 using face-to-face interviews with 64 participants of reproductive age from 7 cities across Iran. The sample consisted predominantly of women (60 women and 4 husbands), indicating limited male participation. The textual data were analyzed using MAXQDA version 24, resulting in 678 initial codes that were organized into thematic categories. Results: Six main categories emerged: (1) individual perceptions, attitudes, and experiences, (2) social and cultural factors, (3) modern lifestyle changes, (4) religious and political beliefs, (5) household financial empowerment, and (6) governmental policy support. Conclusion: Childbearing decisions were shaped by a complex interplay of individual, cultural, social, economic, political, and religious factors, highlighting that this decision is not merely personal or private. Moreover, these factors can simultaneously play either a facilitating or inhibiting role, depending on individuals' perceptions, which interpret them as positive or negative. Accordingly, the findings suggest that fertility-related policies may benefit from a comprehensive and multidimensional approach, with particular attention to strengthening positive mindsets. © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC.