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Why Iranian married women use withdrawal instead of oral contraceptives? A qualitative study from Iran

Parvin Rahnama1, Alireza Hidarnia1*, Farkhondeh Amin Shokravi1, Anoushiravan Kazemnejad2, Deborah Oakley3 and Ali Montazeri4

Author Affiliations

1 Department of Health Education, Tarbiat Modares University, Tehran, Iran

2 Department of Biostatistics, Tarbiat Modares University, Tehran, Iran

3 School of Nursing, University of Michigan, Ann Arbor, Michigan, USA

4 Department of Mental Health, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran

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BMC Public Health 2010, 10:289  doi:10.1186/1471-2458-10-289

Published: 28 May 2010



Withdrawal as a method of birth control is still used in Iran. The aim of this study was to explore married women's perspectives and attitudes on withdrawal use instead of oral contraceptive (OC) in Tehran, Iran.


This was a qualitative study. Participants were 50 married women, not currently pregnant, not desiring pregnancy and who had been using withdrawal for contraception. Face-to face interviews were conducted to collect data. Content analysis was performed to analyze the data.


Four major themes were extracted from the interviews: advantages, disadvantages, barriers for OC use, and husband-related factors. Advantages of withdrawal use were identified as: easy to use, convenient, ease of access, natural. Even those participants who had experienced unwanted pregnancy while using withdrawal, relied on withdrawal as their contraceptive method. Disadvantages of OC included concerns about side effects. Barriers related to use of OC included the need for medical advice, vaginal examination and daily use. Husband-related factors included: the husband wanted to be the primary decision maker on the number of children and that he preferred withdrawal.


Health providers should address misunderstandings that exist about OC and highlight the non-contraceptive health benefits of OC to balance the information provided for women. We suggest that not only women but also their spouses be advised in family planning programs.