One Year Postpartum Emotional Fertility Intentions among a Cohort of Pregnant Women followed for 2 Years and its Correlates in Ethiopia: Community based longitudinal data from Performance Monitoring for Action; Generalized Ordered Logistics Regression Modeling

Abstract Background: Emotional health and couples communication are key during pregnancy and childbirth with simultaneous minimization of reproductive coercion which should be maintained in the postpartum period to maintain inter pregnancy period healthy and make the next pregnancy planned and successful. The postpartum period is key in the newborn development milestone and maintain maternal health. Women intentions to conceive are an integral part of Reproductive Health (RH) right and can be consider as decision making on their fertility control. However, in low and middle income countries including Ethiopia where male dominance is culturally constructed and socially acceptable, males take the lead in every decision making process for the family ranging from house level decision including to determine number of children that the family and new born RH rights and RH health service use. In such a scenario women may say not have heard likely hence, this study aimed at determining the level of women emotional fertility readiness and its correlates so as to avail actionable evidence for the ministry and partners working Reproductive and women health so as to be used as an action point to empower women on their reproductive health right to control their fertility. Methods: Nationally representative 2-year cohort data collected from pregnant women in four rounds were used. Frequency was computed to describe the study participant’s characteristics. Generalized ordered logistics regression was employed to identify correlates of the hierarchical variation in one year postpartum women fertility intention if they became pregnant. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of0.25. Statistical significance was declared at p-value of 0.05. Results: One in 20, (4.63% (3.60%, 5.94%)) postpartum women have reported that they felt very happy. Nearly two third 64.87% (62.20%, 67.45%) of one year postpartum women have reported that they very or a sort of unhappy by one year post-partum when asked what do they feel if they became pregnant. Nearly one in 6, (17.12% (15.15%, 19.29%)) women reported mixed feeling in the same period. Women who reported they have ever used contraceptive and those who reported that they have started contraceptive use one year postpartum had a proportional cumulative logit of 0.66 (0.44, 0.97) and 0.43 (0.29, 0.63) respectively across the higher level categories of one year postpartum women emotional fertility intention compared with their counter parts. The likelihood of one year postpartum emotional fertility intention among women with higher birth order and those who do not wanted additional child was found lower and asymmetrically across the higher level categories. Conclusion: Nearly 2/3 of one year post-partum women have reported very unhappy or a sort of unhappy if they became pregnant while one in 6 and one in five felt mixed feeling if they became pregnant one year postpartum respectively calls up on intended and spaced pregnancies by ensuring women reproductive decision making to control over their fertility. Activities and efforts that promote intended and spaced pregnancies; and diversifying access to contraceptive methods are likely to improve the level of one year postpartum women emotional fertility intention. Activities that enable women to decide their contraceptive use along with patient centered contraceptive use counseling as well. The implication the findings is that awareness creation on preconception and availing the service is also hoped to address the varying level of one year postpartum emotional fertility intention.