Despite the considerable progress made during the past decade in reducing its burden, child undernutrition, which includes conditions such as stunting, underweight, and wasting, contributes to approximately one-half of all childhood mortalities. It is still a major public health problem, particularly in resource-poor countries [1,2]. Stunting, or a small height for one’s age, describes decelerated or arrested linear growth, and it is an indicator of chronic malnutrition . It mainly develops as a result of prolonged food deprivation, or due to a chronic disease or illness .
Regardless of the importance of early childhood nutrition for survival and long-term development, there is no consensus among the global nutrition communities on how to best combat child undernutrition [4,5]. Tackling the challenge of undernutrition requires cross-sector collaboration, innovative approaches, and optimizing the use of all available interventions . A large number of children under 5 years old die each year from malnutrition-related causes, representing nearly one-half of all the deaths in this age group . Moreover, the survivors also exhibit impaired physical growth and intellectual development, which ultimately reduce their adulthood productivity. On a grander scale, this prevents some nations from achieving their full economic potentials .
Globally, an estimated 165 million children under 5 years old (26%) are stunted, 52 million (8%) exhibit wasting, and 100 million (16%) are underweight . Malnutrition contributes to 11% of the disability-adjusted life years (healthy years of life) lost worldwide . In Ethiopia, malnutrition in general, and malnutrition in children under 5 years old in particular, are significant health challenges. Moreover, 44% of the children are stunted, 10% exhibit wasting, and 29% are underweight in Ethiopia . Stunting was estimated to cause a loss of approximately 44 billion Ethiopian Birr from 2005 to 2015 .
Although stunting often begins in utero, several research studies have identified socio-demographic, socioeconomic [11–16], environmental [17,18], dietary [12,18,19], parasitic infection and other related illness [11,20], and psychological  correlations with stunting. One of the psychological factors that might be associated with children stunting is unintended pregnancy, either unwanted (the parent did not desire any or any more children) or mistimed (the pregnancy occurred earlier than desired) [16,21,22]. Evidence has suggested that family planning (FP), a proxy indicator of one’s pregnancy intention, can have a significant influence on achieving key nutrition outcomes. Previous research has shown that when planned pregnancies occur, the feeding practices (including breastfeeding) are improved, resulting in an improvement in the nutritional outcomes of the children . There is also ample evidence of the link between unwanted pregnancies and adverse neonatal outcomes and behaviors, including a low birth weight, neonatal mortality, the absence of breast-feeding, and poor parental care [23,24]. A study conducted by Marston and Cleland in Peru found a 15% greater risk of stunting among children from unwanted pregnancies when compared to those from wanted pregnancies. However, the findings of a study from Egypt were contrary, in that the likelihood of stunting was lower if a pregnancy was mistimed or unwanted than if it was wanted . Barber and colleagues hypothesized that various pathways linked unwanted childbearing, child health, and mother-child relationships. They suggested that children who were unwanted at the time of conception may face more neglect and abuse than those who were wanted .
Even though there has been a trend toward a drop in the global pregnancy rates, the proportion of unintended pregnancies remains high, particularly in the developing world . During 2012, approximately 40% of the pregnancies worldwide (or 85 million pregnancies) were estimated to be unintended. Moreover, studies conducted in different regions of Ethiopia revealed unintended pregnancy rates ranging between 27.9% and 42.4% [26–28], and nearly one million unintended pregnancies are expected to occur each year in Ethiopia . Unintended pregnancies are of concern from both a human rights perspective and a public health perspective, and the consequences of unintended pregnancies are serious. They impose considerable burdens on children, women, men, and families .
Such high rates of unintended pregnancy justify a study of their negative consequences on child nutrition and growth, especially when considering that adverse nutritional outcomes in a child are more likely to occur if the pregnancy was unintended. Therefore, this study was designed to assess the effects of unintended pregnancies and other family and child characteristics on the nutritional status of children, particularly with regard to stunting among children under 5 years old.