Amir Erfani

The Fertility Transition in Iran: Revolution and Reproduction

The Islamic Republic of Iran has experienced perhaps the most rapid and far-reach-ing fertility decline demographers have ever witnessed. After the 1979 Islamic Revolution, the total fertility rate, which rose slightly to 7.0 children during 1980–84, dropped by more than 5 children to below-replacement-level fertility (1.9 children) in 2006. This is a re-markable fertility transition, as the government policy in Iran never resorted to the types of coercive measures that have been employed elsewhere. This book is the first volume that attempts to explain the rapid fall in fertility after the 1979 revolution.The most striking feature of the book is its use of a wealth of data, taken from three censuses as well as the 2000 Demographic and Health Survey and two fertility surveys conducted by the authors in 2002 and 2005 among four provinces of Iran. Various demo-graphic methods are applied to estimate fertility levels and to interpret the data. The book is easy to read, and each chapter is written concisely with a clear organization, though it is sadly marred by an undue number of typographical, editorial, and technical errors (for example, see pages 36, 46–47, 56, 97, 100, 104, 108, 111, 128, 130, 154, 156, 165, and 182). Although most of the errors are not serious, the cumulative effect may discourage the reader and weaken confidence in the argument.The book has ten chapters, including fascinating estimations of fertility levels, analyses, and discussions, which largely had appeared before in journal articles and working papers. To explain the fertility transition in Iran, the authors start with a review of conventional fertility theories, followed by a solid, concise description of socioeconomic and political contexts of changes in the population policies before and after the 1979 Islamic Revolution. They argue that a series of structural and individual-level changes, including the war-induced economic hardship, a rise in women’s literacy and age at first marriage, socioeconomic developments of deprived rural areas, and a successful nationwide family planning program, all together contributed to the rapid fertility transition in Iran. In subsequent chapters, they analyze the fertility-inhibiting effects of marriage structure and contraceptive use, and investigate the influence of women’s autonomy and changes in family-related behaviours and attitudes across cohorts of women on the fertility decline observed in Iran.

Induced abortion in Tehran, Iran: estimated rates and correlates.

CONTEXT Abortion is severely restricted in Iran, and many women with an unwanted pregnancy resort to clandes-tine, unsafe abortions. Accurate information on abortion incidence is needed to assess the extent to which women ?experience unwanted pregnancies and to allocate resources for contraceptive services. METHODS Data for analysis came from 2,934 married women aged 15-49 who completed the 2009 Tehran Survey of Fertility. Estimated abortion rates and proportions of known pregnancies that end in abortion were calculated for all women and for demographic and socioeconomic subgroups, and descriptive data were used to examine womens contraceptive use and reasons for having an abortion. RESULTS Annually, married women in Tehran have about 11,500 abortions. In the year before the survey, the estimated total abortion rate was 0.16 abortions per woman, and the annual general abortion rate was 5.5 abortions per 1,000 women; the general abortion rate peaked at 11.7 abortions among those aged 30-34. An estimated 8.7 of every 100 known pregnancies ended in abortion. The abortion rate was elevated among women who were employed or had high levels of income or education, as well as among those who reported a low level of religiosity, had two children or wanted no more. Fertility-related and socioeconomic reasons were cited by seven in 10 women who obtained an abortion. More than two-thirds of pregnancies that were terminated resulted from method failures among women who had used withdrawal, the pill or a condom. CONCLUSIONS Estimated abortion rates and their correlates can help policymakers and program planners identify subgroups of women who are in particular need of services and counseling to prevent unwanted pregnancy.

Levels, trends, and determinants of unintended pregnancy in iran: the role of contraceptive failures.

The rate of contraceptive use in Iran is high, but because abortion is illegal, many unintended pregnancies among married women are likely to be terminated by clandestine and often unsafe procedures, resulting in adverse health outcomes. Drawing upon data from the 2009 Tehran Survey of Fertility, this study estimates the levels and trends of unintended pregnancy and examines determinants of pregnancy intentions for the most recent birth, using multinomial logistic regression analysis. The level of unintended pregnancy decreased from 32 percent in 2000 to 21 percent in 2009, while contraceptive use increased. Unintended pregnancies in the five years preceding the 2009 survey resulted from failures of withdrawal (48 percent) and of modern contraceptive use (20 percent), together with contraceptive discontinuation (26 percent) and nonuse (6 percent). Multivariate findings show that, compared with women experiencing withdrawal failures, the risk of unintended pregnancy was higher among women reporting modern contraceptive failure and lower among those reporting contraceptive discontinuation and nonuse. The high risk of unwanted pregnancy among women experiencing failures in practicing withdrawal or using modern contraceptive methods points to an unmet need for family planning counseling and education rather than to a shortage of contraceptive methods.

The Changing Timing of Births in Iran: An Explanation of the Rise and Fall in Fertility After the 1979 Islamic Revolution

Studies exploring the course of period fertility in Iran after the 1979 Islamic Revolution have not examined systematically the role played by changes in the timing of births. Using retrospective data from the 2000 Iran Demographic and Health Survey and frailty hazard models, this study finds that the rise in fertility in the early 1980s was due to faster transitions to the first birth among all social groups of women and to the fourth birth largely among illiterate and less educated women. In contrast, the rapid fertility decline after 1985 is attributed to slower transition to successive births, especially to the second, third, and fourth births. These findings point to the importance of education and contraceptive use (measured by length of previous birth interval) as key determinants of birth timing in Iran. Interaction between age at marriage and education positively influenced the timing of births, with stronger effects among highly educated women, suggesting that the onset of rapid fertility decline was likely driven by these highly educated women. Another interaction between the gender of prior children and education shows that birth timing, even among highly educated women, appears to have been influenced by son preference in Iran.

LOW FERTILITY INTENTION IN TEHRAN, IRAN: THE ROLE OF ATTITUDES, NORMS AND PERCEIVED BEHAVIOURAL CONTROL.

Persistent low fertility rates are an increasing concern for countries with low fertility like Iran. Informed by the Theory of Planned Behaviour, this study examined the immediate factors influencing fertility intentions, using data from the 2012 Tehran Survey of Fertility Intentions. The findings show that more than half of young married adults in Tehran intend to have no more children. The multivariate analysis results indicate that individuals who view childbearing as being detrimental to their personal life, feel less normative pressure to have a/another child, and believe their childbearing decision is not contingent on the presence of economic resources required for childbearing, are more likely to want no (more) children or to be unsure rather than to want a/another child. Attitudes and normative pressure are dominant factors influencing the intention to have a first child, while the intention to have a second child is mainly affected by attitudes and perceived constraints. The policy implications of the results are discussed.

Family planning and women's educational advancement in Tehran, Iran

This study examines the impact of contraceptive use on women’s educational advancement as an indicator of female empowerment, using retrospective data from the 2009 Tehran Fertility Survey. The results show that 15 per cent of married women continued their education after marriage. Also, women using modern contraceptives before a first birth were more likely to experience a 1–2-year increase in education level after marriage, controlling for other factors. Recent cohorts were more likely to continue their education after marriage, especially those who used modern vs. traditional contraceptives. The findings clearly indicate that family planning use after marriage enables women to advance their education by freeing them from reproductive activities.

Curbing publicly-funded family planning services in Iran: who is affected?

Objective In response to a persistent low fertility rate in the country, the Supreme Leader of Iran in 2012 called for the shift to pronatalist population policies. Consequently, Irans Parliament proposed a bill to curb the provision of contraceptive knowledge and services as a solution to raising the countrys low fertility rate. This study aimed to investigate which groups of women will be adversely affected if the provision of subsidised contraceptive methods [i.e. sterilisation, intrauterine device (IUD) and injections] is curbed. Methods This study used recent data from the 2014 Tehran Survey of Fertility (n=3012) conducted among a representative sample of 3012 married women of reproductive age, and used multinomial logistic regression analysis to identify women with a higher likelihood of using government-funded contraceptive methods. Results Currently 82% of married women living in Tehran use a contraceptive method. The use of long-acting contraception, namely sterilisation and IUDs, declined from 34% in 2000 to 20% in 2014, and the prevalence of male methods (withdrawal and condoms) increased from 33% to 55% in the same period. Multivariate results showed that women who have a large number of children, want no more children, live in poor districts, and have low education are more likely to use long-acting contraceptive methods than withdrawal and condoms. Conclusions Women of low socioeconomic status who want to stop childbearing are the most vulnerable subgroups of the population if the publicly-funded family planning services are curbed.

Unintended pregnancies in Hamedan, Iran: Levels and determinants

ABSTRACT The recent limitation in the provision of publicly funded family planning services in Iran has concerned stakeholders in reproductive health about the incidence of unintended pregnancies. This study used data from Hamedan Survey of Fertility (HSF), conducted in April–June 2015 among a representative sample of 3,000 married women aged 15–49 years living in the city of Hamedan (Iran), to estimate levels of unintended pregnancies and examine factors related to pregnancy intentions for the most recent birth, using multinomial logistic regression analyses. Results showed that 23 percent of pregnant women reported their pregnancy as unintended (17 percent mistimed and 6 percent unwanted). Moreover, unintended pregnancies in the five years preceding the survey were the result of failures of withdrawal (35 percent) and of modern contraceptive use (33 percent), along with contraceptive discontinuation (23 percent) and non-use (9 percent). Multivariate results indicated that the risk of unintended pregnancy was lower among women reporting modern contraceptive failures and lower among those reporting contraceptive discontinuation and non-use, compared with women experiencing withdrawal failures. The high incidence of unintended pregnancies among women experiencing contraceptive failures and discontinuation imply their high unmet need for contraceptive knowledge and counseling rather than for access to contraceptive methods.

Earnings differences among second-generation South Asians

Despite the fact that South Asians now form the largest visible minority population group in Canada, an important indicator of their integration that is the labour market outcome for second-generation South Asians has been paid less attention. The existing literature treats South Asians a homogeneous group at the neglect of sub-group differences. The present study aims to fill this gap by analysing the earnings of second-generation Indians, Pakistanis and Sri Lankans in relation to British–French counterparts. The analysis of the 2006 Census shows significant earnings differentials among second-generation South Asian sub-groups. Multivariate regression results indicate that Pakistanis and Indians are not statistically different from their British–French counterparts, while the earnings gap remains significant for second-generation Sri Lankans. The findings of the study have implications for policy formulation and future research.

Localization of Determinants of Fertility Through Measurement Adaptations in Developing-Country Settings: The Case of Iran Comment on 'Analysis of Economic Determinants of Fertility in Iran: A Multilevel Approach'

Studies investigating fertility decline in developing countries often adopt measures of determinants of fertility behavior developed based on observations from developed countries, without adapting them to the realities of the study setting. As a result, their findings are usually invalid, anomalous or statistically non-significant. This commentary draws on the research article by Moeeni and colleagues, as an exemplary work which has not adapted measures of two key economic determinants of fertility behavior, namely gender inequality and opportunity costs of childbearing, to the realities of Irans economy. Measurement adaptations that can improve the study are discussed.