Empowering Maternal Choice: Exploring Factors Influencing Early Postpartum Contraceptive Adoption Intention Among Pregnant Women in Northeast Ethiopia

Background: Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. According to the Ethiopia Demographic and Health Survey report, early postpartum modern contraceptive method uptake is still unacceptably low in Ethiopia. Objectives: This study aimed to determine the magnitude of intention to adopt early postpartum modern contraceptive methods and its associated factors among pregnant women in Dessie and Kombolcha town zones, northeast Ethiopia. Methods: A community-based cross-sectional study was deployed from 15 January–15 February 2023, in the Dessie and Kombolcha zones, northeast Ethiopia, among pregnant women. The study involved 780 pregnant women using the cluster sampling technique. A census was conducted in 20 randomly selected clusters to identify eligible pregnant women. Actual data were collected home-to-home in the community through face-to-face interviews. Data were collected by Open Data Kit (ODK) and exported to STATA 17 for analysis. A multivariable logistic regression analysis was performed, and the goodness of the model was checked by Hosmer–Lemeshow’s test statistic and rock curve. An adjusted odds ratio with a 95% confidence interval and p -value < 0.05 was considered statistically significant. Result: The study revealed that 49.6% of pregnant women lack autonomy and 50% lack knowledge about early postpartum contraception, with participants’ wealth index status ranging from rich (36.6%) to poor (33.2%). The study found that 75.8% of pregnant women intended to adopt early postpartum modern contraceptive methods early after childbirth. After controlling the potential confounders, mother’s age (AOR = 6.2 [2.6–14.6], birth interval (AOR = 2.5 [1.6–3.7]), have paid work (AOR = 1.9 [1.3–2.8]), health facility from home (AOR = 2.6 [1.5–4.4]), last delivery Place (AOR = 2.4 [1.1–5.7]), knowledge on (AOR = 1.5 [1.1–2.1]), and antenatal care follow-up (AOR = 1.9 [1.2–3.3]) were significant associated factors of intention to uptake early postpartum modern contraceptive methods among pregnant women. Conclusions: The study found that 75% of the participants had the intention to adopt contraceptive methods during the early postpartum period. Identified factors influencing this intention were age, birth interval, women’s employment status, area of residence, distance to health facilities, last delivery place, knowledge of early postpartum modern contraception, gravidity, and antenatal care follow-up. These findings highlight the need for targeted interventions to address these factors, framing the intended users and enabling access to early adoption of postpartum contraceptive methods.