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Tayebeh Mokhtari Sorkhani, Mahshid Bokaie , Farzan Madadizadeh , Manoj Sharma , Seyed Saeed Mazloomy Mahmoodabad,
Volume 22, Issue 3 (9-2025)
Abstract

Background: The total fertility rate (TFR) has dropped to below the replacement levels in numerous countries, which necessitates new educational approaches and behavioral models to encourage a more positive societal view of childbearing. The present research aims to design, implement, and evaluate an intervention based on the multi-theory model (MTM) aiming at boosting childbearing intentions among Iranian single-child women of reproductive age.
Methods: This mixed-methods study, designed in three phases, will first explore childbearing intentions qualitatively through in-depth interviews, with the resulting data analyzed using a directed content analysis based on the MTM. Second, the themes identified from this phase will then be used to develop and psychometrically validate a new measurement tool. Third, a field trial will be conducted to implement and evaluate an MTM-based educational intervention. Data will be collected with the validated tool both pre- and post-intervention, with follow-ups at three, six, and nine months to assess pregnancy outcomes. The effectiveness of the program and participant feedback will be analyzed via descriptive statistics, paired t-tests for within-group comparisons, and repeated measures analysis of variance (ANOVA) for between-group differences over time. All statistical analyses will be performed using SPSS version 22.
Conclusion: This study represents the first known application of the MTM to investigate childbearing intentions among single-child women. Developing and assessing a culturally-adapted intervention has the potential to boost individuals’ childbearing intentions and generate evidence for guiding reproductive health policies in settings experiencing a decline in fertility.

Sakineh Nazari, Zohreh Abbasi, Mohammad Jalal Abbasi- Shavazi, Abbas Ebadi, Seyedeh Mahboobeh Rezaeean, Zohreh Keshavarz,
Volume 23, Issue 1 (5-2026)
Abstract

Background: Assessing fertility levels is considered one of the most critical indicators in population forecasting and reproductive health research. Therefore, this qualitative study was conducted to explore women’s and experts’ perspectives on childbearing, including the views of healthcare professionals, university faculty members, and sociologists, regarding factors influencing childbearing.
Methods: This qualitative study was conducted in 2025 in North Khorasan Province, Iran. Participants were selected through purposive sampling and included three groups: women with two or fewer children (n = 35), women with more than two children (n = 16), and experts in the field of childbearing (n = 13). Data were collected through in-depth individual interviews and analyzed using MAXQDA 10 software according to conventional content analysis procedures.
Results: Analysis of the participants’ narratives identified four main themes influencing the decision to have more than two children: “gaining power, passive social acceptance, inefficiency of educational and health approaches, and a specific lifestyle pattern.” In contrast, rethinking the value of children and reconsidering fertility emerged as key factors influencing the decision to have fewer than two children.
Conclusion: The findings indicate that fertility preferences are shaped by a complex interplay of social and personal factors. While empowerment, passive social acceptance, ineffective educational and health strategies, and lifestyle considerations tend to promote larger family sizes, reassessment of the value of children and fertility considerations support smaller family choices. These results highlight the need for tailored reproductive health policies and context-sensitive educational interventions to support informed decision-making and balanced population strategies.


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