Determinants of postpartum long-acting reversible contraceptives in the extended postpartum period in Shashago district, Central Ethiopia: a cross-sectional study conducted in the community.

Abstract

Background: Women who fail to initiate contraceptive use within the first year after childbirth face an increased likelihood of experiencing unintended pregnancies in close succession. In regions with limited resources, the use of postpartum contraceptives, particularly long-acting reversible contraceptives, remains notably low. Consequently, this study sought to assess the prevalence and determinants of postpartum long acting reversible contraceptives in the extended postpartum period in the Shashago district, Central Ethiopia.

Methods: This study employed a community-based cross-sectional design, conducted between March 1, 2021, and April 15, 2021, involving a total of 617 women of reproductive age. The selection of study participants was performed using a multistage stratified sampling technique. Data collection was carried out through the use of a structured interviewer-administered questionnaire. Subsequently, the collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for further analysis. Bivariate and multivariable logistic regression analyses were conducted, and statistical significance was determined using a P value of 0.05, along with adjusted odds ratios (AORs) and their corresponding 95% confidence interval (CI).

Results: A total of 224(36.3%) women used long-acting contraceptives after giving birth. Among these women, 31.1% used Implanon, while 5.2% used an intrauterine device (IUD). Factors significantly associated with the use of long-acting contraceptives after childbirth included age 25-29 years (AOR: 1.8, 95% CI: 1.1-3.0), age ≥ 35 years (AOR = 8.7, 95% CI: 3.6-21.5), primary education (AOR = 3.3, 95% CI: 1.6-6.7), secondary education and above (AOR = 3.5, 95% CI: 1.5-8.3), and history of abortion (AOR = 2.7, 95% CI: 1.3-5.4). Additionally, having good knowledge of long-acting contraceptives after childbirth (AOR: 2.4, 95% CI: 1.5-3.9) was significantly associated with their use.

Conclusion: This study revealed that a small number of women opt for long-acting contraceptives after childbirth, with Implanon being more popular than IUDs. Factors such as age, education level, abortion history, pregnancy counseling, and knowledge about long-acting contraceptives were linked to their usage. Integrating contraceptive counseling into routine antenatal and postnatal care is essential for ensuring access to postpartum contraception. Tailored interventions based on age and education level could also help promote long-acting contraceptive use. More research and targeted interventions are needed to overcome these barriers and improve access to these methods for postpartum women.