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The Handmaid's Tale in Iran: Leaked Letter to Hospital Chief Sparks Fears for Pregnant Women

October 5, 2021
Maryam Dehkordi
6 min read
In a recently-leaked letter, the deputy chief justice of Mazandaran province asked for local hospitals to keep track of pregnant women so as to prevent "criminal abortion"
In a recently-leaked letter, the deputy chief justice of Mazandaran province asked for local hospitals to keep track of pregnant women so as to prevent "criminal abortion"
The latest example of the Islamic Republic's attempts to control women's bodies has been compared by some to Margaret Atwood's grim fictional land of Gilead
The latest example of the Islamic Republic's attempts to control women's bodies has been compared by some to Margaret Atwood's grim fictional land of Gilead

In Margaret Atwood’s fictional land of Gilead, the fertile women are marked out by red clothing. Their menstrual cycle is monitored by high-ranking “aunts”, and if a woman falls pregnant, she’s no longer allowed to breathe alone. Those who fail to give birth naturally are brutally punished. In this Canadian novelist’s grim future history, women exist as “handmaids”: reduced to reproductive machines, regardless of their own desires, skills and drives. Many Iranians who read this now-famous novel, which was first published in 1985, have recalled it again of late. It’s like we’re living in Gilead, they say.

Last week a letter was posted (and widely circulated) on Persian-language social media. In it, the deputy justice minister of Mazandaran province addressed the head of Babol University of Medical Sciences – which manages state-run hospitals, and falls under the purview of the Ministry of Health – asking that the fresh bonds be forged between laboratories and health centers so as to prevent "criminal abortion".

To prevent abortion, the former added, all women who had a pregnancy test come back positive should be “followed up” with by the Ministry. IranWire spoke to lawyer Musa Barzin Khalifehlou, a lawyer, and Samaneh Savadi, an Iranian gender equality activist, about the letter and what it represents.


Like in many countries around the world, the disclosure of patient data is considered a crime in Iranian law. Article 648 of the Islamic Penal Code prohibits the unauthorized sharing of people’s confidential health information on pain of up to a year’s imprisonment, and a fine of 150,000 to six million tomans.

This doesn’t appear to mean much to the deputy justice minister of Mazandaran province, who in a confidential letter to hospital bosses, tried to lay the groundwork for medical centers to track patient data with a view to their prosecution. Even the whistleblower who leaked the letter was incredulous, writing: “How can all those whose pregnancy test is positive be followed up on?"

The letter did not explicitly state if the minister was asking the Ministry of Health to keep an internal record of pregnant women, or to pass such a list on to the Ministry of Justice. Article 648 does include an exemption for “legal cases” during which patient information can be safely disclosed, but as IranWire legal consultant Musa Barzin Khalifehlou says, even that wouldn’t be applicable here.

"Abortion is illegal in Iran, except for medical reasons,” he confirmed. “In the event that a crime has occurred, the judiciary, as a non-medical institution, can request information – and if the Ministry of Health or University of Medical Sciences hospital does not cooperate, it can be prosecuted. But to request information on all pregnant women in general is not in the power of the judiciary at all. And it is not possible make it so by issuing a letter of guidance."

A Constant Preoccupation With Women’s Bodies

Despite the fact that it’s perfectly normal in a developed society, the slowing population growth rate in Iran has been a particular obsession of the regime, and especially Supreme Leader Ali Khamenei, for years on end. In February 2021, Khamenei again emphasized "timely marriage and childbearing" as being among "the vital needs of the country’s today and tomorrow".

The next month, MPs approved a seven-year program known as the “Population Youth Plan” that amongst other things would ban the medical sterilization of men and women, prohibit health workers from giving out free contraceptives, and stop doctors them from encouraging expectant mothers to seek screenings for fetal abnormalities. It also stated that patients’ fertility, pregnancy and abortion histories should be recorded by all health centers in the country, and proposed an “abortion council” be formed to control and prevent abortions in Iran, on which three “mujtahid jurists” would hold permanent positions with vetoing rights.

"This letter cannot be examined in a vacuum," Samaneh Savadi, a gender equality and women's rights activist, told IranWire. “It’s one of a series of measures taken by the Islamic Republic to try to increase the population over the past few years. It’s not clear when this letter was issued; it may even have been one of the first steps.

“Frankly, under the laws of the Islamic Republic, women have no ownership of their own bodies. This begins with the imposition of mandatory hijab on girls on entering school, before they’ve even reached puberty, and runs to the ban on sterilization for women who aren’t in a certain age range. I must add that in the latter case, the same applies to men; men who want a vasectomy can only get one at a certain age, with a certain number of children."

More recently, she said, after contraceptives disappeared from the shelves of most Iranian medical centers, “in the field of medical abortion, it was said that the opinion of a specialist doctor alone was not sufficient; jurists should also comment on the case. The scope of jurists' views extends to a woman's hair and body, permission to travel from her husband or father, and the right to have or not have children. It’s like an umbrella covering all aspects of women’s lives – and of course, of society as a whole.”

Iran’s Fraught Abortion Law

For the time being, abortion is legal in Iran only where the mother's life is in danger or in cases of severe fetal abnormalities. These procedures can only take place when signed off by a doctor or specialist, and only in the first 16 weeks of pregnancy. But the voluntary termination of a pregnancy at any stage is a criminal offence.

All this has achieved is that more than 600,000 women in Iran have underground abortions every year, according to the available data. Ali Akbar Mahzoun, director-general of the Statistics Center of Iran, recently said interventions such as "unregulated screening" and "unregulated abortion" were contributing to the lower fertility rate in Iran.

Samaneh Savadi believes that the letter’s publication will help fuel anxiety among those women who seek an abortion for their own reasons. The letter, she said, suggests that “pregnant women may be interrogated in the event of a termination of the pregnancy in order to reveal the identities of the people who helped them. It’s as if the government wants to set up a ‘pregnancy police’."

Savadi, who has experience of voluntary termination herself, explained of the current state of Iranian law: “Unfortunately, some people in society believe that the voluntary ending of a pregnancy is equivalent to murder. This is tied to religious beliefs on the one hand, and state propaganda on the other. We have a long way to go to change this conception.”

Related coverage:

More Than 600,000 Women Have Illegal Abortions in Iran Every Year

Parliament's Cash Incentives for New Babies Don't Add Up

Special Report: Khamenei’s Delusional Population Growth Policy Endangers Iran’s Future

Parliament Drives Through Draconian Plan to Increase Childbearing in Iran

Ayatollah Khamenei: Go Forth and Multiply!



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