Immediate Postpartum Family Planning Utilization and Associated Factors Among Postpartum Women at Public Hospitals in Addis Ababa, Ethiopia

Introduction Immediate postpartum family planning refers to the provision of family planning counseling and contraception methods to a woman within the first 48 hours after childbirth. This provision of family planning fills gaps in terms of Knowledge (limited evidence on overall IPPFP utilization beyond single methods inadequate data on how women’s empowerment, partner involvement and counseling quality jointly influence IPPFP utilization), practice (poor understanding of health facility- and provider-related barriers such as;- counseling practices, staff training, method availability and documentation), Methodologically, the study generates, the current status of IPPFP utilization, and identify the barriers of IPPFP utilization. Methods An institution-based cross-sectional study was conducted at public hospitals in Addis, Ababa, from February to March 2025 with a total of 442 study participants. Systematic random sampling technique was used to select the study participants. Pretested, structured interviewer-administered questionnaire was used to collect the data. Collected data were entered into Epi-data version 3.1 and analyzed using the Statistical Package for the Social Sciences (SPSS). Bi-variable logistic regression analysis was carried out and Statistical significance was declared at a p value <0.05 with a 95% confidence interval. Results The prevalence of immediate postpartum family planning utilization was 17.5% (95% CI: 14.3–21.5). Factors significantly associated with IPPFP utilization included good knowledge (AOR = 4.8; 95% CI: 1.73–13.3), receiving postnatal counseling (AOR = 2.11; 95% CI: 1.07–4.17), awareness of contraceptive contraindications (AOR = 2.82; 95% CI: 1.02–3.23), and having 2–4 living children (AOR = 2.7; 95% CI: 1.35–5.40). Conclusions IPPFP utilization was low compared to the national target (40%). Key factors influencing utilization included knowledge, postnatal counseling, awareness of contraindications, and parity. Strengthening counseling before discharge, improving community awareness, and ensuring providers consistently offer IPPFP to all eligible women are recommended to enhance utilization.