Modern contraceptive utilization and associated factors among postpartum women in Sude District, Ethiopia

Abstract Background Maternal health remains a major global concern, with pregnancy and childbirth being leading causes of morbidity and mortality among reproductive-age women. Recently postpartum women represent a group with particularly high unmet contraceptive needs. To reduce the risk of adverse maternal, prenatal, and infant outcomes, the recommended interval between childbirth and subsequent pregnancy is at least two years. However, postpartum modern contraceptive utilization had not been previously studied in the Sude district. Objectives This study aimed to assess postpartum modern contraceptive utilization and its associated factors among women who gave birth at health facilities in Sude district, Arsi Zone, Oromia, Ethiopia, in 2023. Methods An institution-based cross-sectional study was conducted from March 1 to April 30, 2023. Study participants were selected using systematic random sampling, and data were collected using an interviewer-administered structured questionnaire. After checking for completeness, data were entered and screened for missing values and outliers using Epi-info Version 7.2, then exported to Statistical Package for Social Sciences (SPSS) version 25 for analysis. Data were analyzed using descriptive statistics to characterize study participants. Binary logistic regression analysis was undertaken to identify factors associated with postpartum modern contraceptive utilization. Variables with p-value < 0.25 in bivariate analysis were considered for multiple logistic regression, with statistical significance set at p-value < 0.05. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to estimate the magnitude of associations. Results Of the 419 planned participants, 417 completed the study (response rate: 99.5%). The study found that 57.6% [95% CI: 52.9–62.4] of postpartum women utilized modern contraceptives. Among those using contraceptives, injectables (50.8%), implants (39.2%), and pills (10%) were the chosen methods. Several factors were significantly associated with postpartum modern contraceptive utilization: having more than 4 children [AOR = 2.02, 95% CI: 1.09–3.77], living within 2 hours of a health facility [AOR = 2.54, 95% CI: 1.49–4.34], being between 6 to 12 months postpartum [AOR = 3.41, 95% CI: 1.89–6.15], having resumed menses [AOR = 8.24, 95% CI: 4.64–14.64], having 2–4 previous births [AOR = 3.10, 95% CI: 1.53–6.29], and discussing postpartum family planning with a partner [AOR = 2.96, 95% CI: 1.72–5.09]. Conclusion Postpartum modern contraceptive utilization was low compared to previous studies. Key factors associated with contraceptive use included number of children, distance to health facilities, postpartum duration, parity, menstrual resumption, and partner discussions about family planning. Healthcare providers should focus on providing timely contraceptive education, strengthening the integration of contraceptive services with maternal and child healthcare, and promoting family planning discussions among couples.