Intention to use modern contraceptives and associated factors among primiparous postpartum mothers in Wolaita Zone Public Hospitals, Ethiopia

Postpartum contraceptives prevent unintended pregnancies and closely spaced births but are underused globally, raising maternal mortality. Despite efforts like male involvement, gender equality, and provider training, gaps remain. Limited evidence in Africa and none in Ethiopia underscore the need to assess factors influencing the intention to use postpartum contraception to boost its uptake. To assess the intention to use modern contraceptives and associated factors among primiparous postpartum Mothers in Wolaita Zone public hospitals, Ethiopia, 2024. An institution-based cross-sectional study was conducted among 396 respondents selected using a systematic random sampling technique from September 19 to November 19, 2024. Data were collected using interviewer-administered questionnaires via Kobo Toolbox and exported to SPSS version 27 for analysis. In the bivariate analysis, variables with a p-value of less than 0.25 were considered candidate variables for multivariable logistic regression. The statistical significance of associations was declared at a p-value of less than 0.05. A total of 396 postpartum women participated in the study, with a response rate of 98.2%. The prevalence of the intention to use modern contraceptives among primiparous mothers was 176 (44.4%; 95% CI (39.5%–49.5%). Factors statistically associated with the intention to use modern contraceptives included attending antenatal care clinics (AOR = 2.0; 95% CI (1.201–3.377%), good knowledge (AOR = 1.7; 95% CI (1.048–2.764%), positive attitude (AOR = 1.6; 95% CI (1.032–2.530%), and tertiary level of education (AOR = 1.9; 95% CI (1.066–3.461%). Fewer than half of participants intended to use postpartum contraceptives, with intention significantly associated with ANC attendance, knowledge, attitude, and education level. These findings suggest health education and healthcare engagement may help improve postpartum contraceptive uptake and improve maternal health outcomes.