Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors

Abstract

Objectives: The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period.

Methods: A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values <0.05 were considered to indicate statistical significance.

Results: Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72).

Conclusions: Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women's educational status are crucial steps for to enhance modern contraceptive use among postpartum women.

Keywords: Contraception; Ethiopia; Postpartum period; Women.

Figure 1.

Schematic presentation of the sampling procedure of this study of postpartum modern contraceptive use and associated factors in town of Aksum, northern Ethiopia, June 2015. Kebele 1, Hawelti; Kebele 2, Kindaya; Kebele 3, Hayelom; Kebele 4, Maebel.

Figure 2.

Number of modern contraceptive users by type and purpose among extended postpartum women in town of Aksum, northern Ethiopia, June 2015 (n = 283). IUD, intrauterine device. ¹Others: women sterilization, men condom.

Figure 3.

Major reasons for not using modern contraceptives during the extended postpartum period in town Aksum, northern Ethiopia, June 2015 (n = 307). ¹Others: medical problem, want to have a child soon.