Maternal health problems remain a major global concern since pregnancy and childbirth are the leading causes of morbidity and mortality among reproductive age women. Family Planning (FP) is recognized as a key life-saving intervention for mothers and their children(1). Family planning prevents unintended or unwanted pregnancies and enables women not to have pregnancies too early, too late, or too frequently, thereby avoiding exposure to risks of death from complications of pregnancy(2).
The extended post-partum period is the twelve months after delivery which is a very critical time for mothers to ensure a safe birth interval. The benefit of postpartum family planning (PPFP) for maternal and child survival has long been recognized and the concept of implementing special family planning programs for postpartum women has been recognized as the standard of care since 1966(3).
The success of postpartum family planning programs in low income countries has been limited by poor access to prenatal care, skilled delivery and postnatal care, Therefore, access to maternal and child health services is a crucial factor in the early adoption of a family planning method after a birth(4).
More than one-third of the 205 million pregnancies that occur worldwide annually are unintended. The majority of these unintended pregnancies occur in developing countries, where more than one third of 182 million pregnancies are unintended. Two-thirds of these unintended pregnancies occur among women who are not using a method of family planning. Family planning use during the first year postpartum has the potential to significantly reduce the number of unintended pregnancies(5).
Globally, more than 9 out of 10 women want to avoid pregnancy for two years after having a baby(6). According to an analysis of Demographic and Health Surveys data from 27 countries, 95% of women who are 0–12 months postpartum want to avoid a pregnancy in the next 24 months; but70% of them are not using contraception. Family planning can avert more than 30% of maternal deaths and 10% of child mortality if couples space their pregnancies more than 2 years apart (7).
In sub-Saharan Africa, the proportion of postpartum women who are exposed to the risk of pregnancy by having sex while using no contraceptive method within 2 years after childbirth is nearly one third. For these women, addressing unmet need for family planning in the postpartum period is crucial for child survival as well as maternal health (8).
Post-Partum family planning utilization varies in sub-Saharan countries, which is 40 % in Zambia, 25 % in Kenya, 20 % in Tanzania, 15 % in Nigeria and less than 10 % in Ethiopia. In a recent study, women of postpartum period were less likely to use family planning by the end of the extended postpartum period when compared with married women in the general population. Those using contraception made up only a small proportion of those needing it(5).
Demographic characteristics, socioeconomic characteristics, fertility preferences and use of maternal health services are some of determinants of utilization of post-partum family planning (9). Antenatal care (ANC) visits, skilled birth, wealth and education were associated with family planning in the postpartum period(10).
Even though giving birth at a health institution increases the opportunity of uptake of post-partum family planning, institutional delivery in Ethiopia is 26% which is very low(11). According to a study conducted in low and middle income countries the percentage of postpartum women with short inter-pregnancy interval in Ethiopia was 47 %(12). However, studies regarding contraceptive utilization in the extended post-partum period are limited at the study area. Hence, we conducted the study at Wukro town to estimate utilization of contraceptive and associated factors among women in the extended post-partum period.