Prevalence and Associated Factors of Postpartum Modern Contraceptive Uptake among Mothers Delivered at Mekelle Public Hospitals, Northern Ethiopia

Abstract

Background

Postpartum family planning has the potential to reduce maternal and child morbidity and mortality. A short birth interval of less than two years is associated with adverse health effects for the mother and baby and the society as a whole. Postpartum contraceptive uptake is one of the lowest in Ethiopia.

Objectives

The aim of this study was to determine the magnitude and associated factors of postpartum family planning acceptance in Mekelle public hospitals from 1 April to 31 July 2022.

Methodology           

The cross-sectional study design was employed. Data were collected prospectively using an interviewer-administrated structured questionnaire. In both hospitals (i.e. Mekelle General Hospital and Ayder Comprehensive Specialised Hospital), 399 mothers were interviewed in their immediate postpartum period. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 22. In addition to descriptive statistics, Pearson’s chi-square test was used for bivariate analysis of sociodemographic and reproductive health factors and postpartum family planning. Multiple logistic regression was used to explore factors associated with postpartum contraceptive use.

Results

The prevalence rate of family planning uptake in the immediate postpartum period was 17.8% (n=71). More than a third (n=152, 38.1%) of mothers in this study did not receive appropriate family planning. Slightly more than half (52.8%) intend to use contraceptives at 6 weeks postpartum. Compared to those who did not counseled, those who were counseled were ten times more likely to receive postpartum family planning (AOR=10.1, 95% CI: (3.911-26.375). Women who gave birth by cesarean delivery used family planning twice more than those who gave vaginally (AOR = 1.954, 95% CI: (1.072-2773).

Conclusion

Despite the high-risk obstetric population in teaching hospitals, a small proportion of women used family planning. Furthermore, many women did not receive appropriate counseling on postpartum family planning. Counseling was the most significant factor influencing postpartum modern contraception uptake. Because referral and teaching hospitals host a large number of high-risk mothers, immediate postpartum family planning uptake should be considered a very important element of care. Previous studies have reported that most women who planned to come for contraceptive uptake 6 weeks postpartum do not actually come. Therefore, timely (ie, periconceptional and antepartum) and appropriate counseling should be advocated to increase the immediate adoption of postpartum family planning.

Key words: Postpartum family planning, counseling, contraception,