OBJECTIVE: To determine the prevalence of contraceptive use and unmet need for family planning in Iran and to explore the public-health implications.

METHODS: A nationwide cross-sectional study was conducted by interviewing 2120 married women aged 15-49 years. The sample population was enrolled in 6 large Iranian cities (Tehran, Mashhad, Tabriz, Isfahan, Shiraz, and Ahvaz) and 2 small cities (Zahedan and Kerman) from September 22 to December 20, 2011.

RESULTS: The overall contraceptive prevalence rate was 81.5% and the unmet need for any method of contraception was 2.6% (95% confidence interval, 2.0%-3.3%). Given the frequency of women who used traditional contraceptive methods (22.3%), the unmet need for modern methods was estimated as 17.4%. The main reasons given for unmet need for family planning were low perceived risk of pregnancy (41.8%) and family opposition (21.8%). Unwanted pregnancy was reported by 30.7% of the participants.

CONCLUSION: A high rate of unmet need for modern contraceptive methods might potentially lead to increased rates of unwanted pregnancies and induced abortions. Healthcare policymakers should, therefore, be warned against a sense of complacency that family planning in Iran does not need their support.