Introduction

Entering the role of father has long-term positive and protective effects on men’s health. However, evidence also indicates that transitioning to fatherhood can be complex, sometimes leading to distress, anxiety, and an increased risk of depression ¹ . Men have a significant impact on sexual and reproductive health and rights (SRHR). In 1994, the International Conference on Population and Development (ICPD) emphasized the need for greater participation of men and boys in family planning programs2. Similarly, the Cairo and Beijing international conferences emphasized the benefits of active male involvement, which can have a positive impact on the health of men, women, and children. These conferences also stressed the importance of changing men’s attitudes to support the rights and needs of women and girls ^{3 - 4} .

Altshuler et al. (1985–2012) identified four types of male involvement in the abortion process: presence in the medical center, participation in pre-abortion counseling, presence during the abortion procedure or when abortion medications are administered, and involvement in post-abortion care. Their findings indicate that men’s participation is positively associated with women’s well-being, with no evidence of negative outcomes ⁵ . Naziri’s study further highlighted the psychological role of men, showing that two-thirds of participating men disagreed with their wives’ decision to have an abortion. In such situations, supporting both partners to experience the abortion process as a constructive step in personal psychosocial development and relationship dynamics is essential ⁶ .

Involving men in abortion decisions can alter the normative environment surrounding abortion. By engaging men as actors in the abortion process, there is a potential risk of increasing male authority and control. Evidence from the International Men’s Survey shows that men are significantly involved in abortion decisions when a pregnancy is disclosed, and many pregnant women and men cite the partner as an influential factor in the decision to seek care ⁷ . The participation of the wife in care decisions has significant emotional, material, and financial benefits.

Men are not redundant in the abortion process; the roles and responsibilities of fathers begin before conception and continue through pregnancy, birth, and the child’s life. These roles are crucial for the overall development of the child ¹¹ . However, research examining fathers’ contributions to maternal and family health has progressed slowly, highlighting the need to investigate their role in promoting family well-being further. For most men, first-time fatherhood involves substantial changes in identity and relationships with their partners. The pressures of pregnancy and the perceived responsibility for life changes can influence men’s sense of competence ¹² . Jordan (1990) emphasized that when men share in their wives’ pregnancy experiences, it has a profoundly positive impact on the health of the father, mother, infant, and the family as a whole ¹³ .

Studies also show that fathers who witness traumatic births experience long-term effects on mental health and relationship dynamics in the postpartum period ¹⁴ . Pregnancy is a critical stage in a woman’s life that impacts the entire family; it requires active participation from both parents. Despite its importance, the father’s role often receives less attention, even though paternal involvement can improve maternal and paternal mental health and foster better communication within the family.

Therefore, the purpose of this study is to compare the father’s role in abortion decision-making in Western societies and Iran, a predominantly Muslim country.

Methods

Protocol of the Review

This narrative review examined studies published between 1980 and 2023 to conduct a comparative analysis of the father’s role in abortion decision-making in Iran and other countries.

Data Sources

Information for this review was obtained from both domestic and international scientific databases, including Scopus, Cochrane Library, PubMed, ScienceDirect, Medline, Ovid, Google Scholar, Magrin, SID, as well as relevant legal and jurisprudential texts. Searches were conducted using keywords such as attitude, father, rights, abortion, Iran, Europe, civil law, jurisprudence, and Islam.

Eligibility Criteria

Articles were selected based on relevance to the review topic. Studies that closely aligned with the title and objectives of this review were included. Out of 62 articles initially identified, 31 met the inclusion criteria and were analyzed. When multiple reports were available from a single study, the most complete version was considered. Studies were excluded if they lacked sufficient data or if full-text access was unavailable.

Study Selection and Data Collection

Initially, articles containing one or more of the predefined keywords in the title or text were selected. Abstracts of articles published in Persian and English were screened for eligibility according to the inclusion criteria. Following the removal of ineligible studies, the full texts of the remaining articles were reviewed. Data regarding the father’s role in abortion decision-making were extracted and provided to a second researcher for verification and correction (Figure 1).

Fig. 1. The literature review process for studies examining the father’s role in abortion decision-making

Results

Different Socio-Psychological Experiences of Women in Abortion in Other Countries

Abortion disclosure is a critical component of the abortion care pathway, as it influences how effectively a woman can access abortion services. Women who sought abortion or post-abortion care in clinical settings reported that fear of disclosure—particularly the fear of involving a sexual partner in pregnancy or abortion decisions—was among their main psychological concerns ^{15 - 16} . For younger women, rejection by parents also significantly affected pregnancy disclosure and subsequent decisions about abortion ¹⁷ .

Nonnenmacher et al. reported that women undergoing abortion experienced anxiety, fear, and uncertainty regarding their partner’s reaction to pregnancy, from the time of pregnancy confirmation to the final decision. These complex emotional responses, compounded by individual and social factors, contributed to an increased risk of depression and anxiety disorders following abortion ¹⁶ .

Factors Affecting the Participation and Rights of Men in Abortion Decisions in Other Countries

No Requirement for Spousal Consent

Scholars have argued that the child’s father may also be considered a “victim” of abortion. However, in most European countries and in the United States, the law does not provide the father with any legal rights in the abortion decision-making process. Abortion is treated as a private matter between the woman and her physician, and even within marriage, a husband’s consent is not legally required ¹⁸ .

Choosing to Leave a Sexual Partner

A man’s involvement in abortion decisions is strongly influenced by the nature and quality of his relationship with the woman. When pregnancy results from casual or short-term relationships, the male partner’s participation in decision-making is typically negligible. In contrast, greater intimacy and stability in long-term relationships increase the likelihood of men supporting their partners in the abortion process. Conversely, unstable or strained relationships often heighten women’s anxieties regarding their partner’s reactions. In such cases, abortion may exacerbate feelings of insecurity, abandonment, and neglect. Furthermore, lack of financial support from the father and unstable marital conditions are frequently cited by women as rational justifications for choosing abortion ¹⁶ .

Financial and Supporting Role of Men in Abortion

In many contexts, men’s control over financial resources significantly influences women’s access to safe abortion services. Despite abortion being illegal in Uganda, Singh et al. (2005) estimated that approximately 300,000 induced abortions occur annually, with most women requiring treatment for post-abortion complications. In Uganda’s patriarchal society, husbands’ financial authority often determines whether women can access safer procedures or are forced into unsafe abortions. ¹⁹ .

Leone et al. (2016) reported that in Zambia, nearly half of women needed to involve men to secure the necessary funds for abortion care ²⁰ . Similarly, studies have shown that disclosing an abortion frequently resulted in financial support from male partners. In Nairobi, however, men exerted pressure on women’s decision-making: some provided money specifically for an abortion, while others gave financial support to encourage continuation of the pregnancy ²¹ . In Ghana, men frequently used their role as “breadwinners”—the primary providers and controllers of household finances—to influence or pressure women into abortion decisions ²² .

Effect of Men’s Negative Attitudes and Delaying Abortion

Men’s negative perceptions of abortion can act as significant barriers to timely and safe abortion care. Moore et al. (2003), in a study conducted in Kampala and Mbarara, Uganda, found that many men viewed abortion as morally unacceptable, particularly if the pregnancy was suspected to be fathered by another man. Such attitudes reinforced the belief that women were not entitled to seek abortion under these circumstances.

Moreover, in cases where women experienced post-abortion complications, men frequently expressed unwillingness to provide support. The prevailing belief was that if the pregnancy were truly theirs, the abortion would not have been performed secretly. This lack of emotional and financial support from men not only contributed to delays in seeking abortion services but also increased women’s vulnerability to unsafe abortion practices and inadequate post-abortion care ²³ .

Denial or Rejection of Pregnancy

Denial or rejection of pregnancy by men significantly shapes women’s abortion trajectories. A study of 1,047 high school students in Nigeria found that 48.2% of men whose partners became pregnant denied paternity ²⁴ . Similarly, Schwandt et al. (2013) reported that the stigma associated with single motherhood and abandonment by male partners played a central role in determining women’s decisions regarding abortion.

In Ghana, despite the legality of abortion, induced abortion complications remain the second leading cause of maternal mortality. Men’s involvement in these decisions occurs both directly—by pressuring women to undergo abortion—and indirectly, by denying responsibility for the pregnancy ²⁵ . Other studies also indicate that abandonment by male partners or denial of marital responsibility exerts considerable influence over women’s decision-making processes ²⁶ .

Importantly, the presence of a supportive partner who is aware of the abortion has been associated with safer abortion practices. Conversely, denial of paternity is more prevalent among younger men than older counterparts, further exacerbating risks for younger women.

Other Human Factors Affecting Abortion

A range of individuals beyond the expectant mother shapes the final decision to terminate a pregnancy. Male partners, friends, and even employers may exert direct or indirect influence over the outcome. Unwanted or unplanned pregnancies often heighten these external pressures.

Psychological factors related to the husband—such as disliking the man responsible for the pregnancy or uncertainty about his commitment—also play an important role. Additional concerns include fear of fetal abnormalities, anxiety about possible complications in future pregnancies following unsafe procedures, and broader economic considerations ²² .

Living with parents

Each year in low- and middle-income countries (LMICs), an estimated 16 million girls aged 15–19 give birth, with 2.5 million of them under the age of 16.

Men’s participation in these situations often manifests as “orders” to terminate a pregnancy or as a refusal to accept responsibility for the pregnant teenager. This dynamic, compounded by parental control, increases the likelihood of unsafe abortions by limiting young women’s autonomy in decision-making ²⁸ .

For young women and girls, limited knowledge, financial constraints, and social pressures often mean that decisions are often dominated by husbands and parents ^{29 , 17} . In some cases, unmarried pregnant mothers, students, and unemployed women have also reported being pressured by their brothers to undergo abortion ³⁰ .

Instability of Marital Relationship

Women whose partners were unwilling to maintain a stable relationship, refused marriage, or denied paternity were more likely to undergo abortion.

Influence of National Factors on Men’s Participation in Abortion Decisions

In the study of Steven et al. (2019), it was reported that women who sought abortions in Congo were subjected to negative beliefs, stigmatization, and isolation, and were sometimes forced to leave their communities. Abusers, alcoholics, or unemployed people with financial problems, as well as community leaders, supported abortion as sexual and reproductive health (SRH) advocates and considered themselves responsible for ensuring access to post-abortion care (PAC) services for mothers.

Using Socio-Cultural Norms for Men's Participation in Abortion Decision-Making

In national discourses about masculinity and abortion in South Africa, men are referred to as the "new man". They are described as family-loving and committed, who try to dissuade their wives from abortion ³⁴ . They generally do not support women's abortions and provide financial support if the pregnancy continues ²³ . Other studies have shown that men do not support abortion because it is considered sinful and unacceptable according to societal norms ^{35 , 30} .

Father's Rights in Abortion and Pregnancy Without Marriage in Other Countries

In many Western industrialized countries, there is an agreement that men who have children out of wedlock share the obligation to support their children financially. Some men's groups argue that it would be unfair to hold genetic fathers financially responsible for child support if women are the decision-makers regarding whether to continue or terminate the pregnancy. However, this arrangement is often supported and enforced by law ³⁶ .

Sexual relations leading to pregnancy outside of marriage can create different situations for a woman: if she has the necessary maturity to assume the responsibilities of motherhood, the financial ability to support a child, or the opportunity to spend time with the child, given her employment conditions. The possible outcomes include: the mother accepting custody of the child after birth, continuing the pregnancy and relinquishing her rights after birth, giving the child up for adoption, or terminating the pregnancy through abortion.

For the man, however, choices are limited. In the case of adoption, the unmarried father's consent may be required or not, depending on the law. In cases where the woman decides to have an abortion or place the child for adoption, the unmarried father has no legal authority to intervene. He cannot force the woman to place the child for adoption, and in the case of abortion, the unmarried father has no rights. According to current United States law, no father can interfere with a woman's decision; the decision to have an abortion is made solely by the woman, and the court's role is to legalize her right to abortion. The father cannot give orders, prevent the abortion, or otherwise influence the decision ³⁷ .

Abortion in Islam

Non-Therapeutic Abortion

All major world religions regard life as sacred, from conception to the end of life. Islam is no exception in this regard. Since ancient times, abortion has been either strictly forbidden or permitted only under certain conditions ³⁸ . All Sunni and Shia scholars agree that abortion should not be performed after the fourth month of pregnancy unless it is necessary to save the life of the mother. From the perspective of Shiite jurisprudence, the fetus is considered a respectable being, and its abortion before four months of age (before ensoulment) is allowed only in special cases, based on the principle of rejecting hardship (“Osr-o-Haraj”) and the principle of rationality of Shari'a rulings ³⁹ . Contemporary Shia jurists define the beginning of pregnancy as the implantation of a fertilized embryo in the uterus ²¹ .

Ayatollah Khomeini (RA) stated: "Termination of pregnancy even at the earliest possible stages is not permissible under normal conditions without reason." ²² . Ayatollah Khamenei wrote: "Shari'a does not allow abortion." According to Shariah Sharif, there is no distinction between pregnancies of less than four months and those of more than four months regarding this matter. This position is consistent among other contemporary Shiite scholars ^{38 , 40 - 41}

Punishment for Abortion without Legal Permission

Voluntary abortion should be divided into two categories: legal and criminal. In criminal abortion, termination of pregnancy without legal permission is punishable (Articles 715, 718, 622, 623, and 624 of the Punishment Section of the Islamic Penal Code, Book Five, approved in 1375, and Articles 56 and 61 of the Family and Youth Protection Law). For example, if someone causes the abortion of a fetus by beating the mother (Articles 715 and 622 of the Civil Code), if someone causes an abortion by giving or administering medicine (Articles 623 and 624 of the Civil Code), or if the mother aborts her fetus without legal permission (Article 718 of the Civil Code), it constitutes a crime.

By contrast, in legal abortion, there are legitimate motives and legal authorization, such as avoiding danger to the mother’s life, preventing the birth of a defective child, or removing severe hardship.

Legal Medical Abortion and the Role of the Father

In 1997, Ayatollah Khamenei announced that abortion for fetuses suffering from thalassemia major is legally permissible, and in 1384, the legislator addressed this issue by approving the Abortion Therapy Law ⁴² . One of the objections concerns the independence of allowing abortion by the mother without considering the rights and will of the father toward the child. In forensic medicine, permission is also obtained from the father; however, in the absence of the father or in cases of conflict between the couple, the mother can perform an abortion alone.

According to the Law on Therapeutic Abortion, approved by the Islamic Council in 2005, the issuance of a license for therapeutic abortion was based on the mother’s request and consent; therefore, the father’s permission did not affect the issuance of this license. Ultimately, however, the Law on the Protection of the Family and Youth of the Population was approved by the Islamic Council on October 16, 2021, and was agreed to be implemented on a trial basis for seven years. According to Article 73 of this law, the article on therapeutic abortion approved in 2005 was repealed ⁴³ .

In the new law, therapeutic abortion is subject to the following conditions: 1. The mother's request and consent, 2. The mother's embarrassment, 3. The lack of possibility of compensation and replacement for the mother's embarrassment, 4. The absence of spiritual release. 5- The intervention of the guardian of the fetus in the process of abortion. The last clause is newly added, and compared to the previous law, which practically did not provide any role for the opinion and decision of the father/guardian of the fetus, it represents a significant change. Currently, in one of the three cases of legal abortion—namely paragraph (c) of Article 56 of the mentioned law—the father’s permission is necessary. According to this section, in situations where all the unbearable conditions of the mother mentioned above exist, the legal abortion of the fetus depends on obtaining the guardian’s opinion and permission. 6. The generalization of therapeutic abortion cases: in the previous law, abortion was only permitted due to the retardation or malformation of the fetus. In the new law, this has been expanded to include the absolute embarrassment of the mother, with fetal disease being only one of its types. The cause of emergency abortion may also include cases such as rape ⁴³ .

Obviously, in situations where the mother’s life is in danger as a result of carrying the fetus, and where not having an abortion would cause the death of both the mother and the fetus, the father’s permission is not required due to the lack of clarification by the legislator.

Discussion

Although some women may prefer to involve their partners in abortion care, in practice, male partners are rarely engaged in the abortion process ⁴⁴ . Conversely, in recent years, “fathers’ rights” have increasingly been invoked as a legal and political strategy to oppose abortion in several Latin American countries. In Uruguay, Colombia, and Argentina, this approach has influenced the adoption of preliminary rulings that restrict or challenge pregnant individuals’ right to access abortion services.

For decades, some fathers have asserted a right to decide the fate of their fetuses, grounding their claims in three main arguments: (1) the presumption of paternity within marriage, (2) the joint life project of the spouses, and (3) a misrepresentation of the father’s financial support obligations. The legal presumption of paternity in marriage—invoked, for example, in Argentina—has been used by married men to oppose their wives’ decision to terminate a pregnancy. However, this presumption should not be construed as granting “authority” or “power” over a pregnant person’s body. Similarly, the notion of a joint life project between spouses has been cited to justify preventing abortion, effectively instrumentalizing the bodies of pregnant individuals to fulfill a family project. Yet pregnancy entails profound hormonal, physical, psychological, and emotional transformations that are borne exclusively by the pregnant person. The law must therefore recognize the fundamentally unequal conditions between pregnant and non-pregnant individuals, acknowledging that the burdens and risks of pregnancy fall solely on the mother.

Thirdly, fathers often justify their interference in abortion decisions by citing their legal obligations after the birth of the child. However, courts have not consistently upheld these claims. For example, in 2006, a man in Dubai argued that he had equal rights with his wife to prevent an abortion, but the court rejected this argument. The right to abortion is fundamentally grounded in a pregnant person’s right to personal integrity and privacy, which cannot be equated with the rights of a non-pregnant person. ⁴⁵

Another concern arises from the conditional nature of male support. Studies in Mexico among young women aged 13 to 17 show that while men may offer emotional support, such support is often contingent on outcomes aligned with men’s preferences rather than the desires of the pregnant individual ²⁰ . In some cases, husbands have even been identified as agents pressuring women into abortion without their consent. Consequently, many women, fearing violence or separation, conceal their pregnancies and seek abortion independently unless financial dependency forces disclosure. ⁴⁶

Conversely, some women base their abortion decisions primarily on their own beliefs, including religious convictions, with partner or peer opinions exerting comparatively little influence ⁴⁷ . Evidence also indicates that while male participation is associated with improved maternal health outcomes in certain developing contexts, its positive effects in relation to abortion and delivery remain limited. For instance, contrary to findings in developed countries, there is little evidence in developing countries that the presence of husbands in delivery rooms leads to better outcomes ⁴⁸ .

Chikovore’s study further underscores how men often fail to perceive abortion as a women’s reproductive health issue. Instead, abortion was framed as evidence of illicit sexual activity, while contraceptive use was viewed as a strategy by married women to conceal extramarital relations. This perception generated feelings of anxiety and vulnerability among men due to their perceived lack of control over women’s reproductive choices. ⁴⁹

In Islamic legal frameworks, including that of the Islamic Republic of Iran, the father occupies a central position in matters of lineage and financial responsibility toward children. This raises the critical question of whether paternal consent should also be a prerequisite for abortion under Islamic jurisprudence. The legal and religious factors that establish the importance of paternal authority in family matters are frequently invoked to support arguments for paternal involvement in abortion decisions. ⁵⁰

One central factor is the legal attachment of parentage to the father. Article 1158 of the Civil Code stipulates: “Any child born during marriage is attributed to the husband, provided that no less than six months and no more than ten months have elapsed since the time of intercourse.” Parentage, therefore, establishes that from the moment of fertilization, the child is legally attached to the father. Jurists, however, differ in their interpretation of the maximum duration: some accept nine months, others ten, and still others up to twelve months after the last instance of marital intercourse as sufficient to confirm paternal affiliation. ⁵¹

Another relevant consideration is the Qur’anic principle that “Men are in charge of women” (Surah An-Nisaa, verse 34).

Men are the managers of women because of the advantage Allah has granted some of them over others, and by virtue of their spending out of their wealth. Righteous women are obedient and watchful in the absence in guarding what Allah has enjoined to guard. As for those whose misconduct you fear, advise them, and keep away from them in bed, and beat them. Then if they obey you, do not seek any course against them. Indeed, Allah is all-exalted, all-great.

The general scope of the proofs affirming a man’s guardianship over the family institution has also been interpreted to encompass the issue of abortion, suggesting that such authority would not be complete without his consent. From this perspective, the critical decision regarding the continuation of a pregnancy—and thereby the preservation of the child’s life—would ultimately be tied to the father’s opinion ⁵⁰ .

In addition, the legal obligation of child alimony is cited as further evidence supporting the necessity of the husband’s consent in abortion matters. Verse 233 of Surah Al-Baqarah is often referenced as a Qur’anic basis for this obligation, affirming that the father bears responsibility for the financial maintenance of the child.

Mothers shall suckle their children for two full years—that for such as desire to complete the suckling—and on the father shall be their maintenance and clothing, in accordance with Honorable norms....

The father’s obligation to provide alimony is often cited as one of the grounds for his guardianship over his wife and children. Alimony is presented in Islamic law as a divine obligation imposed on men, intended to ensure the care and maintenance of the family. From this perspective, the duty of financial support reinforces paternal guardianship and, consequently, the view that abortion cannot take place without the father’s consent. ⁵

The father’s legal guardianship further strengthens this argument. Article 1168 of the Iranian Civil Code specifies that “child care is both the right and duty of the parents (father and grandfather).” Similarly, Article 1181 affirms that “each of the father and paternal grandfather has guardianship over his children.” Notably, this guardianship does not extend to the mother or maternal grandfather and, even in the event of the father’s death, is not transferred to other relatives ⁵² .

Building on this, Akbari argues that the father’s consent is necessary in cases of abortion that are not explicitly prohibited. He further suggests that the legislator should clarify existing provisions to stipulate that if the father wishes to have the child born—even in cases where the child is expected to be born with disabilities—his decision should not be obstructed ⁵⁰ .

Conclusion

In most European countries, abortion is regarded as a private matter between the woman and her physician, and spousal consent is not required, even in the context of marriage. From the perspective of many women, however, male participation in decisions surrounding pregnancy and abortion increases male power and control, thereby undermining women’s rights. Such involvement can restrict the autonomy of pregnant women and girls, creating significant barriers to their health, sexual and reproductive rights, and freedom of choice. Nevertheless, some women view spousal involvement as beneficial, particularly in terms of emotional and material support.

In contrast, within Islamic jurisprudence and the legal framework of the Islamic Republic of Iran, paternal authority occupies a central role. The child’s legal lineage is connected to the father (Article 1158 of the Civil Code), and the father’s obligation to provide maintenance is considered further evidence of his authority. Together with the broader legal and religious positioning of men in relation to women, these factors are invoked to justify the necessity of paternal consent in abortion decisions.

Acknowledgement:

This article is based on a review of previous studies. We thank all authors whose published work informed this comparative review. We also extend our gratitude to Saman Soleimanzadeh for his assistance in editing the English manuscript.

Authors' Contributions

FG: drafting and original writing. FG and ZY: review drafting, editing, critical revisions, and responses to reviewers.

Funding

No funding was received for this study.

Conflict of Interest

The authors declare no competing interests.

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