Abstract:
Background: Worldwide, 9 out of 10 women want to avoid pregnancy for 2 years after
having a baby. However, the absence of priority for birth spacing and lower uptake of
postpartum modern contraceptive results in poor maternal and newborn health
outcomes. Hence, this study aimed to determine the magnitude of timely initiation of
postpartum contraceptive and associated factors among extended postpartum women
in Pawe district, Northwest Ethiopia.
Methods: Community based cross sectional study design was employed from February
to March, 2019 in Pawe district. Multistage stratified sampling technique was used to
select a total of 820 extended postpartum women. Data were collected using a pretested
interviewer administered questionnaire. Bivariable and multivariable logistic regression
model was fitted to identify determinants of timely initiation of postpartum contraceptive
among extended postpartum women. Adjusted Odds ratio(AOR) with was 95%CI
computed to assess the strength of association. Variable with less than p-value 0.05
considered as a significant determinant of contraceptive initiation.
Results: The magnitude of timely initiation of postpartum contraceptive was found to be
37.2 [ 95% CI (34.0,40.5)]. Time return of menses [AOR=18.32, 95%CI(11.66,28.80)],
postnatal care [AOR=7.8, 95%CI(3.98,15.44)], Knowledge level regarding benefit of
modern contraceptive methods [AOR=3.0, 95%CI(1.40,6.59)], time of resumption of
sexual intercourse [AOR=2.1, 95%CI(1.327,3.21), husband approval to use
contraceptive [AOR=2.45, 95%CI(1.42,4.22), antenatal care [AOR=2.1,95%
CI(1.13,3.76), place of delivery [AOR=2.0, 95%CI(1.22,3.39)], and got family planing
counseling at delivery [AOR=2.34, 95%CI(1.22,4.49)] were factors associated with
timely initiation of postpartum contraceptive.
Conclusion and recommendation: The magnitude of timely initiation of postpartum
contraceptive was low. This suggests strengthening integration of postpartum
contraceptive use with other basic maternal health services and improving knowledge of
women in practicing timely initiation of postpartum contraceptive before engagement to
risk activities of unintended pregnancy is important.
Key words: Postpartum, timely initiation,contraceptive, factors, Pawe district, Ethiopia
