the present study is a descriptive and cross - sectional one , and aims to clarify the psychological consequences of abortion in the study population . socio - economic and demographic characteristics of women who experienced abortion had been explored and studied . the socio - economic and demographic characteristics of the husbands of the sample were also taken into account in order to have a broader view of men 's roles in family structure , decision making , and performance . general and maternity hospitals , from different sectors ( public and private ) , in tehran were determined as sites of data collection . shariati and valie - asr as university hospitals , mirza koochak khan , rooeentan arash , and hedayat as maternity complexes , baharloo , milad and pasteurno as general hospitals were selected for this purpose . coordination with administrators and managers as well as nursing departments of these hospitals was made , and interviewers started to complete the questionnaire with eligible respondents . on the whole , 261 questionnaires have been completed . because of several , mainly administrative , barriers to access the abortionees , an attempt has been made to select cooperating hospitals . as a bias prevention strategy , different hospitals with different affiliations located in different parts of tehran were selected for the study . women of age 15 - 49 who referred to tehran 's hospitals , ( public and private ) , and had experienced abortion at least once in their reproductive life have been considered as the study population . out of the whole respondents ( 278 ) , there were 17 who did not appropriately respond to the questionnaires . number of respondents in different hospitals data collection was carried out through a questionnaire which consisted of two parts . the first part included 32 questions about socio - economic and demographic characteristics of the respondents and their spouses as well . this part also includes a number of questions which meet some characteristics of original family and abortion related behavior of the respondents . the characteristics of abortion service providers , existing and ideal family size , sex of the aborted fetus , the place of first abortion performed , group or individuals consulted either for abortion or for  post abortion  care , and temporary marriage ( whether or not resulted in pregnancy and child delivery ) , were other questions which were asked from the respondents . the second part of the questionnaire included 21 questions prepared in lickert scale format on physical , psychological , and social consequences of abortion ; of which , 10 belonged to psychological consequences attributed to abortion . the questionnaire was developed based on a vast global literature review , and consulting experts on women 's health , and also on sociology and psychology disciplines . the respondents were asked to mark the most relevant option ( too much , sizeable , few , much less , nothing ) as determined for consequences . the independent variables included in the study were education , occupation , and the age of spouses , fields of study , age at first marriage , age at first abortion , marital status , temporary marriage , family size , and ideal family size , frequency of abortions experienced , reasons for abortion , and psychological consequences of abortion experienced by the respondents . general and maternity hospitals , from different sectors ( public and private ) , in tehran were determined as sites of data collection . shariati and valie - asr as university hospitals , mirza koochak khan , rooeentan arash , and hedayat as maternity complexes , baharloo , milad and pasteurno as general hospitals were selected for this purpose . coordination with administrators and managers as well as nursing departments of these hospitals was made , and interviewers started to complete the questionnaire with eligible respondents . on the whole , 261 questionnaires have been completed . because of several , mainly administrative , barriers to access the abortionees , an attempt has been made to select cooperating hospitals . as a bias prevention strategy , different hospitals with different affiliations located in different parts of tehran were selected for the study . women of age 15 - 49 who referred to tehran 's hospitals , ( public and private ) , and had experienced abortion at least once in their reproductive life have been considered as the study population . out of the whole respondents ( 278 ) , there were 17 who did not appropriately respond to the questionnaires . the first part included 32 questions about socio - economic and demographic characteristics of the respondents and their spouses as well . this part also includes a number of questions which meet some characteristics of original family and abortion related behavior of the respondents . the characteristics of abortion service providers , existing and ideal family size , sex of the aborted fetus , the place of first abortion performed , group or individuals consulted either for abortion or for  post abortion  care , and temporary marriage ( whether or not resulted in pregnancy and child delivery ) , were other questions which were asked from the respondents . the second part of the questionnaire included 21 questions prepared in lickert scale format on physical , psychological , and social consequences of abortion ; of which , 10 belonged to psychological consequences attributed to abortion . the questionnaire was developed based on a vast global literature review , and consulting experts on women 's health , and also on sociology and psychology disciplines . the respondents were asked to mark the most relevant option ( too much , sizeable , few , much less , nothing ) as determined for consequences . the independent variables included in the study were education , occupation , and the age of spouses , fields of study , age at first marriage , age at first abortion , marital status , temporary marriage , family size , and ideal family size , frequency of abortions experienced , reasons for abortion , and psychological consequences of abortion experienced by the respondents . socio - economic and demographic characteristics : according to the respondents , a large proportion of them ( 68.3% ) were aged 20- 35 years . in other words , they were in their healthy reproductive years of life . approximately , one- third of the respondents had experienced abortion out of well - known healthy years of pregnancy ( 20 - 35 years ) , ( 6.5% under 20 and 25.3% above 35 years ) . respondents in the age group of 26 - 30 were the largest group of the study population ( 28.4% ) , while the group under 20 remained the smallest ( 6.5% ) . a gap of age was observed between the respondents and their husbands . unlike the respondents , none of their husbands were placed in the age group of under 20 , while most of them ( 44.1% ) were included in the upper limit age group ( 36 and more ) . age distribution of the respondents and their husbands as expected , the majority of the respondents were married and living with their husbands ( 98.1% ) , and only 1.9% were widow or single . the respondents and their husbands were mainly tehran born citizens ( 55.2% and 49.8% respectively ) ; and close to 70% of the participants had high school and tertiary level education . there was not a large gap between spouses in terms of their tertiary educational attainments . slightly more than 50% of the participants ( 50.6% ) married when they were under 20 years of age . the findings revealed that 36.4% and 11.5% of the respondents married in the age 21 - 25 and 26 - 30 respectively ; and only 5% had experienced multiple marriages ( twice ) , and 5.7% temporary marriage . among the latter , more than 80% of the respondents belonged to a small family ( 2 or less children ) . respondents with no children constitute the largest proportion of the study population ( 36.8% ) . about 75% of the respondents experienced abortion just once . 79% of the respondents have experienced their first abortion when they were 20 to 35 year old , and only 21% went through with abortion during inappropriate ages for pregnancy ( < 20 and > 35 ) . the respondents considered two children with opposite sex as an ideal sex composition for a family . on average , 63% of the respondents supported one child of each sex as a preferred family structure . the findings revealed that 50% of the abortions belonged to those respondents who married at their 20s ' or those under 20 years of age ( early marriages ) . the number of abortions has been increased parallel to the decrease of age at first marriage among the respondents ( table 3 ) . hospitals were the main sites for abortion related services , and 64.8% of the respondents practiced abortion in hospitals . however , close to one - forth of the study population ( 24.5% ) aborted their children at home , and 9.2% at physicians ' offices . only 1.5% of the respondents reported  other options  as the place they employed to conduct the abortion . although " hospitals  and  clinics  have been indicated as the most referred institutions for abortion , and abortion related service providers ( 64.7% and 9.1% ) respectively by all age groups of the respondents ( ( 74% ) , still nearly one - quarter of the respondents conducted abortion at home . this could be an alarming indication of unsafe abortion with frequent undesirable consequences ( table 4 ) . age at first marriage and place of abortion practiced respondents in all age groups indicated  spontaneous  abortion as the main reason for abortion they practiced ( 45.2% ) . fetus and mother 's health with 22.2% and 16.4% ( respectively ) were known as the second and third most important reasons for abortion . sex preference stayed on the forth step as a reason for abortion ( 7.3% ) . poverty , family size , and incompatibility of the spouses , were not considered as important as sex preference alone . smoking , drug abuse , eating disorder , depression , attempted suicide , guilt , regret , nightmare , decreased self - esteem , and worry about not being able to conceive again were the questions asked from the respondents as the psychological consequences of abortion . at least one - third of the respondents have experienced one of the above mentioned psychological side effects ( except suicide , drug abuse and smoking ) . depression  and  worry about not being able to conceive  and  eating disorder  were reported as dominant psychological consequences of abortion among the respondents with 60.5% and 53.6% and 48.7% , respectively . ( 39.5% ) ,  guilt  ( 37.5% ) , and  regret  ( 33.3% ) have been placed in the lower steps respectively ( table 5 ) . the findings revealed that 50% of the abortions belonged to those respondents who married at their 20s ' or those under 20 years of age ( early marriages ) . the number of abortions has been increased parallel to the decrease of age at first marriage among the respondents ( table 3 ) . hospitals were the main sites for abortion related services , and 64.8% of the respondents practiced abortion in hospitals . however , close to one - forth of the study population ( 24.5% ) aborted their children at home , and 9.2% at physicians ' offices . only 1.5% of the respondents reported  other options  as the place they employed to conduct the abortion . although " hospitals  and  clinics  have been indicated as the most referred institutions for abortion , and abortion related service providers ( 64.7% and 9.1% ) respectively by all age groups of the respondents ( ( 74% ) , still nearly one - quarter of the respondents conducted abortion at home . this could be an alarming indication of unsafe abortion with frequent undesirable consequences ( table 4 ) . age at first marriage and place of abortion practiced respondents in all age groups indicated  spontaneous  abortion as the main reason for abortion they practiced ( 45.2% ) . fetus and mother 's health with 22.2% and 16.4% ( respectively ) were known as the second and third most important reasons for abortion . sex preference stayed on the forth step as a reason for abortion ( 7.3% ) . poverty , family size , and incompatibility of the spouses , were not considered as important as sex preference alone . smoking , drug abuse , eating disorder , depression , attempted suicide , guilt , regret , nightmare , decreased self - esteem , and worry about not being able to conceive again were the questions asked from the respondents as the psychological consequences of abortion . at least one - third of the respondents have experienced one of the above mentioned psychological side effects ( except suicide , drug abuse and smoking ) . depression  and  worry about not being able to conceive  and  eating disorder  were reported as dominant psychological consequences of abortion among the respondents with 60.5% and 53.6% and 48.7% , respectively . ( 43.7% ) ,  nightmare  ( 39.5% ) ,  guilt  ( 37.5% ) , and  regret  ( 33.3% ) have been placed in the lower steps respectively ( table 5 ) . age at marriage is known as a strong demographic variable with significant implications on health of mothers and their children . findings of the present study demonstrated that abortions were mostly practiced among the youngest age groups . although there is a legal permission for abortion for specific reasons , the distribution of consultants for abortion and post abortion care indicate that abortion seems to be still a hidden phenomenon practiced out of family and the family of origin supervision . nearly one - quarter of the respondents conducted abortion at home ( table 3 ) . fetus and mother health with 22.2% and 16.4% frequency rates ( respectively ) were known as the second and third most important reasons for abortion . the sex preference stayed on the forth step as a reason for abortion ( 7.3%).whatever the reason and frequency of abortion , the findings have indicated that there was no sizeable knowledge about the consequences of abortion among all age groups of respondents . findings revealed that at least one - third of the respondents have experienced one of the psychological consequences of abortion ( except suicide , drug abuse and smoking ) , and they are demonstrated in table 4 . the commonest psychological consequences of  depression , 60.5%  and  worry about not being able to conceive , 53.6%  , which were experienced by the respondents indicate two more points . the first is that the respondents were unhappy and unsatisfied with abortion , though they did not seek intended and somehow criminal abortion . the second point is that loosing the capability to conceive a child seems to be a major concern for women , perhaps because of stigmas attached to infertility , and infecund women as reproduction of children in a hierarchical male dominated community may help to stabilize newly formed families , and to promote the social status of new mothers . on the whole , the respondents suffered more psychological side effects than physical or social . it seems plausible that due to advances in medical technology and education , physical consequences of abortion decrease . nevertheless , psychological consequences of abortion which refer mainly to very personal understanding and feelings of abortion practiced by individuals may be rooted in depths of the individuals ' mind and conscience . the major barriers for abortion studies in general and for the present study in particular , were lack of national data and literature as well as illegal and sinful characteristics of abortion itself , which force abortionist to avoid collaboration and project their very deep fillings about their own behavior in this respect . intensive attention because of chronic characteristic of psychological disorders , and women 's psychological consequences of abortion have considerably been neglected in a community which has sinful and illegal look to abortion . lack of data and relevant literature together with other several barriers such as limited access to available sources of information , or cultural barriers which attach stigmas on psychological disorders and abortion , made findings limited . different types of psychological side effects , however , experienced by the study population require more health impact on family and population health
objectiveabortion either medical or criminal has distinctive physical , social , and psychological side effects . detecting types and frequent psychological side effects of abortion among post abortion care seeking women in tehran was the main objective of the present study.method278 women of reproductive age ( 15 - 49 ) interviewed as study population . 
 response rate was 93/8 . 
 data collected through a questionnaire with 2 parts meeting broad socio - economic characteristics of the respondents and health- related abortion consequences . 
 tehran hospitals were the site of study.resultsthe results revealed that at least one - third of the respondents have experienced psychological side effects . 
 depression , worrying about not being able to conceive again and abnormal eating behaviors were reported as dominant psychological consequences of abortion among the respondents . 
 decreased self - esteem , nightmare , guilt , and regret with 43.7% , 39.5% , 37.5% , and 33.3% prevalence rates have been placed in the lower status , respectively.conclusionpsychological consequences of abortion have considerably been neglected . 
 several barriers made findings limited . 
 different types of psychological side effects , however , experienced by the study population require more intensive attention because of chronic characteristic of psychological disorders , and women 's health impact on family and population health .