Factors Influencing Childbearing Intentions in Young Couples Attending Premarital Counseling in Southeast Iran: A Conventional Content Analysis

Abstract

Background: Iran has experienced a sustained decline in fertility. Understanding how newly married couples navigate childbearing decisions is critical for policy and counseling. Objectives: To explore factors shaping childbearing intentions among couples attending premarital counseling in Zahedan, Iran. Methods: We conducted a qualitative study using conventional content analysis (CCA) in 2024. Maximum-variation purposive sampling recruited 18 couples (36 individuals) from a university-affiliated premarital counseling center. Data were generated through in-depth, semi-structured individual interviews until information saturation. Verbatim transcripts were anonymized. Analysis proceeded inductively: Familiarization, line-by-line open coding, grouping codes into sub-categories, abstraction into main categories, and identification of an overarching (central) category. Trustworthiness was ensured via member checking, independent co-coding, an audit trail, reflexivity, and peer debriefing. This report was developed in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: One central category — “Deliberate childbearing: Decision-making contingent on readiness and capability” — organized five main categories: Economic-livelihood, bio-psychological, work-education, cultural-family, and personal preferences. Conclusions: Multilevel strategies that improve economic security, support education-work-family balance, and enhance premarital counseling content may better align couples’ goals with fertility policies.