Population policies are among the multi-facet policies which need a holistic approach supported by the best available evidences. Population policies are quite dependent on the way policy maker think about the future. Those who believe in renewal of the nature and those who believe in limited resources have different population policies. It is clear that ideological back ground rigorously affects these policies. The Malthusian theory was the dominant approach for more than two decades in this field. But in mid-twenties the failure of this theory to forecast population changes was discerned. It was a window for opitamalists who agree on optimal population to fulfill the need of nations to take over. There are many controversies on what is optimal for a nation but it is clear that to define optimal population for any nation the available resources of that country as well as their need in this turbulent world should be considered. It is also known that the situation is dynamic, the way the country plans for its next generation, the development strategies and the international relations may all affect these policies intensely. In a combat for survival of nature, environmentalists calculate the hazards of populations for the earth and define an ecosystem friendly population for any specific country. Although modernization has severe insults on environment including climate changes and threats for life in the nature, but this situation has also changed. With more environmental friendly technologies, the modernization could now occur without these harms, at least theoretically. Among resources it is now renowned that the young population of every nation is its greatest resource which would assure its opulence in future.
Iran witnessed the fastest reduction in population growth rate in the past three decades from 3.9% in 1986 to 1.3% in 2011 (1). One of the major reasons for this success was the fatwa of late Imam Khomeini as the religious leader in early eighties on approval of birth control programs with resultant increase in contraceptive prevalence rate from 37% before Islamic revolution in 1978 to 72% in 2000 (2, 3). This matter along with the other reasons including the impact of war resulted in decrease of total fertility rate from 6.8 in 1984 to 5.4 in 1988 only within four years.
As a result, low replacement fertility rate which started in the capital in early 1990s become apparent in most of 31 provinces of the country (4). In the first glance, economy might be considered as the major cause of this trend, but statistics in Iran show that in recent years the wealthier the family, the less the number of children.
The main problem seems not to be in economy but in attitude toward child bearing marriage, and less supportive environment. Women are now looking for more prolonged educations which they find contradictory with marriage. Both the number and the percentage of women entering universities have dramatically increased since the Islamic revolution and now females form more than 60% of university admissions in Iran. Young women have to select between marriage or higher education in many families, since full time study and lack of supportive environment make them mutually exclusive for most persons. This has resulted in vivid increase in the number of never married women to 980 thousands in 2011. These changes affected the delivery pattern of families with higher rates of cesarean section among families with higher education in Iran which is in contrast to the other countries (5). Meanwhile the life expectancy in Iran rose from 50.1 to 73 years during the same period (1, 6). Currently 54.9% of the Iranian population is less than 30 (1). This is a window of opportunity to revive the nation form the predicted future situation of reduced young population, and increased economically dependent elderly, which with the current trends is predicted only within forty years.
While offenders of these new policies pointed out some of possible health hazards of the new legislation on population policy, they did not mention the consequences of the predicted demographic changes with continuation of the current trends (7). One of the earliest trials to address this issue was increasing maternity leave from three months to nine months. This had a small but rapid effect on willingness for child bearing. On the contrary, direct payment for child bearing did not seem to be an effective policy since the willingness for childbearing is at the lowest level among the high mid socioeconomic groups in Iran. It seems that willingness for child bearing should be considered as a cultural issue for which the solution should be mainly cultural. Recently, a new legislation was passed in the Iranian parliament to address these needs. The new law aimed to support child bearing. The most controversial point in the draft was considering providing permanent contraceptive modes as crime. Later, it was changed in the final draft recognizing these methods to be done under professional control. The permanent sterilization which was previously part of the national family planning is now only available for medical reasons.
Through this new legislation the subsidization of government for contraception methods is restricted to special vulnerable groups. Since most of the modern contraceptive devices are available through domestic production with much less cost than the international market, the affordability is predicted not to change in a vivid manner. One may argue the most effective and less hazardous population policies, but the need for change in these policies in Iran to maintain prosperity of the nation seems mandatory.
