Daniel Yirgu¹, Bezza Kedida², Zerihun Assefa³ and Dejene Tolossa Debela¹*

¹Department of Obstetrics and Gyenecology, Resident in Obstetrics and Gynecology, Jimma University, Jimma, Ethiopia
²Department of Obstetrics and Gyenecology, Assistant Professor in Obstetrics and Gynecology, Urogynecology and Pelvic Reconstructive Surgery Fellow, Jimma University, Jimma, Ethiopia
³Department of Monitoring and Evaluation, Jimma University, Jimma, Ethiopia

*Corresponding Author: Dejene Tolossa Debela, Department of Obstetrics and Gyenecology, Resident, Jimma University, Jimma, Ethiopia.

Received: April 28, 2025; Published: May 12, 2025

Abstract

Background: The provision of postpartum family planning counselling which is initiated during antenatal care can significantly reduce the incidence of closely spaced pregnancies. However, there is lack of comprehensive data regarding the effectiveness of family planning counselling during antenatal care in promoting the use of modern postpartum family planning methods, especially in developing countries.

Objective: This study aims to investigate the determinant factors for postpartum family planning contraceptive use.

Methods: A prospective cohort study with purposive sampling technique was conducted from April 15 to December 31, 2024. Mothers with a gestational age of less than 16 weeks were enrolled and interviewed during their initial antenatal care visit. Follow-up interviews were conducted via phone at six weeks postpartum to assess the usage of postpartum family planning methods using Kobo software. Generalized Estimating Equations were employed to identify predictors of postpartum family planning utilization.

Results: The study included 145 mothers, with a mean age of 25.4 years (SD ± 5.3). From total 74.5% of the participants resided in urban areas, and 94.5% were married. The findings indicated that the utilization of modern postpartum family planning methods within six weeks after delivery was 33.1%. The likelihood of postpartum family planning utilization was significantly higher among mothers who received counselling on birth spacing (p-value 0.04), those who attended postnatal care at least once (p-value <0.01), mothers who underwent caesarean delivery (p-value 0.03) and good birth outcome. Inadequate postnatal care, unavailability of preferred family planning methods, absence of menstruation, and indecision regarding family planning choices were contributing factors for low uptake of postpartum family planning.

Conclusion: Counselling on birth spacing and postnatal care follow-up identified as independent risk factors influencing the utilization of postpartum family planning. So, mothers should receive counselling starting from antenatal care that they reach in decision when and which method to use regardless of waiting for menses. Continuous Supply chain should be available, to increase utilization leading to reduction of complication associated with short pregnancy interval.

Keywords: Postpartum Family Planning; Contraceptive; Ethiopia; Counselling

References

1. Mruts KB., et al. “Does family planning counselling during health service contact improve postpartum modern contraceptive uptake in Ethiopia? A nationwide cross-sectional study”. BMJ Open5 (2022).
2. Indicators K. “Mini demographic and health survey”. EPHI and ICF (2019).
3. Organization WH. “Programming strategies for postpartum family planning”. (2013).
4. Organization WH. “Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: executive summary”. World Health Organization (2019).
5. Campbell OM and Graham WJ. “Strategies for reducing maternal mortality: getting on with what works”. The Lancet9543 (2006): 1284-1299.
6. Yee L and Simon M. “Urban minority women's perceptions of and preferences for postpartum contraceptive counselling”. Journal of Midwifery and Women's Health1 (2011): 54-60.
7. Demissie DB and Dadi HW. “Immediate postpartum modern family planning utilization and associated factors among women gave birth public health facilities, Addis Ababa, Ethiopia”. Res Sq. (2021).
8. Agha S and Williams E. “Does the antenatal care visit represent a missed opportunity for increasing contraceptive use in Pakistan? An analysis of household survey data from Sindh province”. Health Policy and Planning 3 (2016): 325-331.
9. Planning F. “A global handbook for providers”. Baltimore and Geneva: CCP and WHO (2007).
10. Rahayuwati L., et al. “Determinant Factors of Post-Partum Contraception among Women during COVID-19 in West Java Province, Indonesia”. International Journal of Environmental Research and Public Health3 (2023): 2303.
11. Joshi AK., et al. “Utilization of family planning methods among postpartum mothers in Kailali district, Nepal”. International Journal of Women's Health (2020): 487-494.
12. Idowu A., et al. “Determinants of intention to use post partum family planning among women attending immunization clinic of a tertiary hospital in Nigeria”. American Journal of Public Health Research 4 (2015): 122-127.
13. Wakuma B., et al. “Postpartum modern contraception utilization and its determinants in Ethiopia: A systematic review and meta-analysis”. Plos One12 (2020): e0243776.
14. Jima G and Garbaba W. “Postpartum family planning utilization and associated factors among women who gave birth in the last 12 months prior to the study in Lode Hetosa District, South East Ethiopia”. Journal of Women’s Health Care3 (2020).
15. Mengesha A and Kebede E. “Postpartum modern contraceptive utilization in addis ababa: antepartum decidedness for postpartum uptake”. Ethiopian Journal of Reproductive Health4 (2022): 10.
16. Tafere TE., et al. “Counseling on family planning during ANC service increases the likelihood of postpartum family planning use in Bahir Dar City Administration, Northwest Ethiopia: a prospective follow up study”. Contraception and Reproductive Medicine 3 (2018): 1-9.
17. Wassihun B., et al. “Prevalence of postpartum family planning utilization and associated factors among postpartum mothers in Arba Minch town, South Ethiopia”. Contraception and Reproductive Medicine 6 (2021): 1-8.
18. Mickler AK., et al. “Individual and facility-level factors associated with women’s receipt of immediate postpartum family planning counseling in Ethiopia: results from national surveys of women and health facilities”. BMC Pregnancy and Childbirth 21 (2021): 1-14.
19. Cahn N. “Contraception Matters: Rights, Class and Context”. Washington and Lee Journal of Civil Rights and Social 24 (2017): 529.
20. Mogeni R., et al. “Predictors of contraceptive implant uptake in the immediate postpartum period: a cross-sectional study”. The European Journal of Contraception and Reproductive Health Care6 (2019): 438-443.
21. Shabiby MM., et al. “Factors influencing uptake of contraceptive implants in the immediate postpartum period among HIV infected and uninfected women at two Kenyan District Hospitals”. BMC Women's Health 15 (2015): 1-8.
22. Andualem G., et al. “Factors associated with utilization of modern postpartum family planing methods during the extended postpartum period among mothers who gave birth in the last 12 months at Injibara town, Northwest, Ethiopia: a cross-sectional study”. Contraception and Reproductive Medicine1 (2022): 25.
23. Abate ZG and Obsie GW. “Early postpartum modern family planning utilization and associated factors in Dilla town, southern Ethiopia; 2019”. Journal of Gynecology and Women's Health 8 (2021): 1-9.
24. Baynes C., et al. “Use of implementation science to advance family planning programs in low-and middle-income countries: A systematic review”. Frontiers in Global Women's Health 3 (2022): 1038297.
25. Moore Z., et al. “Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low-and middle-income countries”. Contraception1 (2015): 31-39.
26. Harrison MS and Goldenberg RL. “Immediate postpartum use of long-acting reversible contraceptives in low-and middle-income countries”. Maternal Health, Neonatology and Perinatology 3 (2017): 1-9.
27. Gebre MN and Edossa ZK. “Modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia: evidence from 2016 Ethiopia demographic and health survey”. BMC Women's Health 20 (2020): 1-14.
28. Matos C. “NGOs and advocacy communications for gender equality and reproductive health in international development”.
29. Thurman AR and Janecek T. “One-year follow-up of women with unfulfilled postpartum sterilization requests”. Obstetrics and Gynecology5 (2010): 1071-1077.
30. Arero WD., et al. “Prevalence and pattern of long acting reversible contraception (LARC) methods use in immediate postpartum period at Jimma University Medical Center, Ethiopia”. (2019).
31. Bruker R and Harrison M. “Contraceptive Counseling at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia”. Journal of Women's Health and Development3 (2022).
32. Mruts KB., et al. “Achieving reductions in the unmet need for contraception with postpartum family planning counselling in Ethiopia, 2019–2020: a national longitudinal study”. Archives of Public Health1 (2023): 79.

Citation

Citation: Dejene Tolossa Debela., et al. “Determinants of Contraceptive Utilization Among Pregnant Mothers Started Antenatal Care Early at Jimma Medical Centre, 2024". Acta Scientific Women's Health 7.6 (2025): 07-17.

Copyright

Copyright: © 2025 Dejene Tolossa Debela., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.