* Corresponding author: Marzieh Akbarzadeh, Lecturer, Maternal –fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Tel: 00989177150234; Email: akbarzadm@sums.ac.ir Causes of Different Types of Abortion in Women Referring To Educational and Medical Centers in Shiraz, Iran Sedighe Alipanahpour (MSc) 1 , Naeimeh Tayebi (MSc) 2 , Mina Taheri (MSc) 3,4 , Marzieh Akbarzadeh (MSc) 3,4* 1 Lecturer, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran 2 Lecturer, Department of Midwifery, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran 3 Lecturer, Maternal–fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 4 Department of Midwifery, School Of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran A R T I C L E I N F O A B S T R A C T Article type: Original article Background & aim: Abortion in Iran, like some countries in the world, has long been a culturally, socially, politically and religiously sensitive issue. So the present study was conducted to investigate the causes of abortions in pregnant women referring to Shiraz educational and medical centers. Methods: : In this cross-sectional study, 437 woman who had an abortion, were selected by examining 5176 pregnant women using sequential sampling method during 4 months from educational and forensic medicine centers in Shiraz, Iran, in 2017. A self-structured questionnaire including demographic characteristics and obstetric data was completed for each mother. Data analysis was carried out using descriptive statistics. Results: Out of 88 abortions with a legal permission from the forensic medicine, 9.1% were due to maternal illness and 90.9% were due to fetal disease, the most common cause of which was fetal cranial and cerebral disorders (17.1%). Out of 105 cases of spontaneous abortion, 8 cases were due to maternal cause (the most common cause of uterine defects (4.8%) and 97 cases were due to fetal cause. Out of 244 induced abortions with obstetric indication, the most common cause was missed abortion (32%). Conclusion: In all three types of abortion, fetal causes were the most common cause of abortion. It seems that education, access to information and awareness raising activities involving the whole community will have a significant effect on preventing the occurrence of abnormalities. Emphasis is placed on the importance of conducting prenatal screening before 20 weeks of gestation. Article History: Received: 26-Jul-2021 Accepted: 03-Oct-2021 Key words: Forensic medicine Abortion Fetal Complications Maternal Complications Please cite this paper as: Alipanahpour S, Tayebi N, Taheri M, Akbarzadeh M. Causes of Different Types of Abortion in Women Referring To Educational and Medical Centers in Shiraz, Iran. Journal of Midwifery and Reproductive Health. 2021; 9(4): 3034- 3042. DOI: 10.22038/jmrh.2021.59249.1716 Introduction About 830 women die each year from pregnancy and childbirth complications in the world, and 99% of such deaths occur in low- and middle-income countries (LMICs) (1,2). Globally, from 2010 to 2014, 25% of pregnancies ended in abortion, and the global abortion rate is estimated at 35 abortions per 1000 women of reproductive age each year. The rate of abortion has decreased significantly in high-income countries, while it has remained unchanged in LMICs (3). In a study in Iran, the overall prevalence of legal abortions performed in public educational and medical centers including both spontaneous and induced abortions was 7.46%, with the highest prevalence being of induced abortion with non- forensic causes (4.17%), induced abortion with forensic permission (1.5%), and spontaneous abortion (1.79%) (4). Abortion is one of the most important causes of maternal death. One of the consequences of unplanned pregnancy is an increase in unsafe abortions, especially in countries where abortion is illegal (5). A recent study of 115