The findings of the study showed that 248 (60.5%) pregnancies were unintended pregnancies, of which 78 (19.0) were unplanned and 170 (41.5%) were ambivalent in total. The remaining 162 (39.5%) pregnancies were considered intended. This finding is consistent with the estimated national prevalence of unintended pregnancy by NDHS 2016 . A hospital-based cross-sectional survey conducted in Pakistan in 2015 adopting the LMUP tool revealed 38.3% unintended pregnancies, of which 13.9 percent were ambivalent and 24.3 percent were unplanned . Similarly, a study carried out on the basis of the NDHS 2011 dataset in 2015 showed that the unintended pregnancy rate was 24.59% . In 2012, 40 percent of pregnancies were unintended globally . A community-based cross-sectional study carried out in Ethiopia in 2013 showed 36.5 percent unintended pregnancy . The estimate of this study is higher than that of previously reported data, which might be because previous studies used a dichotomous scale, whereas this study employed six-item LMUP. The prevalence of unintended pregnancy in this study is higher than that of the studies from Ethiopia (36.5%) , Pakistan (38.3%) , Bangladesh (40%)  and Brazil (55.4%) .
In our study, age was significantly associated with unintended pregnancy. Young women below the age of 20 years were more likely to report unintended pregnancy in comparison to women from the above age group, with a similar pattern from other studies of Nepal , Ethiopia , Pakistan , Malawi , Nairobi, Kenya , and Congo . These effects of age on unintended pregnancy can be explained by the fact that young women may have sexual relations for reasons other than childbearing, and they may have inadequate knowledge and skills regarding birth control, therefore increasing the likelihood of pregnancies being unintended .
Likewise, the number of family members was not found to be associated with unintended pregnancy in this study, which is consistent with the findings of Ethiopia . This study revealed a higher percentage of unintended pregnancies among women with less than or equal to six family members than among women with more than six family members. The reason might be that women with a small number of family members may perceive their pregnancy as unintended due to the lack of care takers in house and being unable to allocate time for rearing and caring of children.
Regarding the educational status of respondents’ husbands, it has been found that couples with higher education have better knowledge of the uses and benefits of family planning, making every pregnancy planned. In contrast, it was found not to be associated with pregnancy intentions. This is consistent with the findings made from another study conducted in Nepal  but contrasts with the findings of a study by Malawi  and Congo , where there was an association between partner’s education and pregnancy intention. This study has shown a higher percentage of unintended pregnancies among women whose husbands had taken formal education. The reason might be simply because they might have more confidence regarding the ability to control the timing of their pregnancies  and could also be because of negligence.
In the current study, the occupation of women was not found to be associated with unintended pregnancy, which is similar to the finding of a study in Egypt . However, this finding is contrasting with the findings of a study of Nepal , Iran , and Brazil , which could be because of differences in circumstances and varying natures in the measurement of study variables. This study has resulted higher percentage of unintended pregnancies among women who were engaged in non-agricultural paid work. This could be due to being more career oriented and due to lack of leave as per their requirements, making them perceive their pregnancy unintended.
A significant association was seen between pregnancy intentions and socioeconomic status after adjusting for other factors, which is similar to the findings of Ethiopia  and Nigeria . This finding contradicts the findings made in Nepal  and Pakistan . Women from the lower wealth quintile that means the low-income group (the second (AOR = 0.048, CI = 0.007–0.329) and third (AOR = 0.134, CI = 0.026–0.702) wealth quintiles) had a lower chance of having an unintended pregnancy in comparison to the women of affluent ones (fifth wealth quintile). This could be because this study has not included educational status in the construction of the wealth index . Therefore, education may play a vital role in decision making.
Gravidity was not found to be associated with pregnancy intention in this study, which is similar to the finding of a study by Ethiopia , but it contradicts the finding of a study by Tanzania  and Canada , where there was a significant association between the number of pregnancies and unintended pregnancies. In this study, there was a higher percentage of unintended pregnancies among women who had been pregnant for the first time. The reason behind this finding might be that first pregnancy might not necessarily be planned, making that unintended.
The frequency of abortion was not found to be associated with unintended pregnancy in this study, which is consistent with the findings of a study in Egypt . This study revealed a higher percentage of unintended pregnancies among women who had terminated their pregnancies at least once compared to those who had terminated their pregnancies more than or equal to twice. This result might be because women who had terminated their pregnancy more than once may become more cautious toward pregnancy planning due to the experience of complications and consequences of abortion.
The age of the youngest child was not found to be statistically significant with pregnancy intentions in this study, which contradicts the findings of a study of Malawi in which time since last birth was associated with pregnancy intentions . There was a lower percentage of unintended pregnancies among women whose young child was less than and equal to twelve months of age. This could be because couples might feel comfortable raising both children with a short gap between them so that they grow together.
Communication between husbands and wives regarding contraception might help to involve husbands in contraception decisions, leading to increased acceptance of contraception utilization and decreased failures. In contrast to this concept, it was not found to be associated with pregnancy intentions in this study, which is similar to the findings of Congo  and Ethiopia . This finding is inconsistent with the findings of Tanzania , Ethiopia , and Egypt . In this study, there was a 2.8 percent higher prevalence of unintended pregnancy among women who had communication with their husband. The reason might be that although they have communication between partners, women might not have autonomy to decide on fertility .
Husbands play a major role in family planning utilization. Husband opposition in using contraception was found to be significantly associated with pregnancy intention in the bivariate analysis of this study. This finding is inconsistent with the results of the study of Ethiopia . There were 69.5 percent of unintended pregnancies among women whose husband opposed using contraception, which is higher than that of Ethiopia, where there was 18.5 percent unintended pregnancy due to husband refusal to use contraception . The reason might be due to the lack of autonomy regarding household decision making and deciding their health needs, including lack of knowledge regarding consequences of unintended pregnancy .
A significant association was seen between pregnancy intentions and method of family planning used before pregnancy to control pregnancy in bivariate and multivariate analyses in this study. This finding is similar to the outcome of a study by Congo  and Bangladesh . Similarly, behind the higher probability of unintended pregnancy among women who had used modern contraception before pregnancy, there might be a possibility of problems with contraceptive use effectiveness, including contraceptive discontinuation and failure . Another view might be that the users of modern methods might have high expectations towards limiting and spacing their pregnancies and misconceptions regarding lower fertility while using contraception. Therefore, they may consider their pregnancy as unintended .
The intention of women to use contraception in the future was found to be significantly associated with pregnancy intentions in the bivariate analysis in this study. There was a lower risk of having unintended pregnancy among women who had not intended to use contraception in the future (OR = 0.547, CI = 0.341–0.876) in comparison to those who intended to use contraception in the future. This finding is inconsistent with the outcome of the study of Nepal , where there were lower odds of unwanted pregnancy among women who were intended to use contraception in the future. The reason behind this finding might be that this study assessed intention to use contraception in the future as a proxy measure of behavior. The possible gap between intention and actual practice of women could be the presence of some factors that were considered to be constraints to their intentions to use contraception in the future, such as husbands’ opposition and fear side effects. making differences between intentions and actual behavior .
Empowered women with strong decision-making power in major household decision making are more likely to plan their pregnancy. However, in contrast to previous literature, the level of autonomy was not found to be associated with pregnancy intentions in this study, which is similar to the finding of a study of Nepal that was conducted in 2009  and contradicts the finding made from a study based on the NDHS dataset of 2011 in Nepal , Ethiopia , India , and Bangladesh. The study of Bangladesh has shown that a one-unit increase in the autonomy scale decreases the odds of unintended pregnancy by 16% . In this study, most unintended pregnancies were among women with some autonomy. The mechanism behind this might be due to taking previous or current pregnancy unintended because of lower fertility aspiration by empowered women or limited decision-making opportunities to women being in the patriarchal society [6, 16].
Although this study was strengthened by being community-based research and having used the validated pregnancy intentions scale (LMUP tool) to measure the pregnancy intentions of women, it had some notable limitations. This was a cross-sectional study, so it does not allow causal inference for pregnancy intentions and other independent variables, such as sociodemographic and reproductive health-related variables. This study included only married women, whereas the majority of unintended pregnancies resulted from illegitimate sexual intercourse, which is more common among sexually active teenagers and unmarried women. In addition, another limitation might be social desirability bias, leading to reporting intended pregnancy, although it was not. This might lead to underestimating the burden of unintended pregnancies. Similarly, this study does not determine the intentions and associated factors of women who terminate their pregnancy by abortion and miscarriage. Lastly, the results may not be generalized to the whole country, as the study was conducted in one municipality of a district.