Pelvic organ prolapse and reasons for delay in treatment-seeking among women in Dessie Zuriya Woreda, Northeast Ethiopia, 2022

• What is known? • The global prevalence of uterine prolapse is 2–20 %. • Ethiopia the prevalence of depression in women with POP is about 67.7 %. • Women with POP tend to hide their problems for extended period of time, among those women who have POP 78.7 % of women never consulted a doctor for their condition. • What is new? • The prevalence of pelvic organ prolapse was 12.64 %. Women aged ≥55 years, history of pelvic organ prolapse and home delivery, vaginally birth ≥5 times, and parity ≥5 were factors of POP. In this study, 75 % of women were delayed in seeking care. The reasons for the delay in treatment seeking were stigma, wrong perceptions of POP, lack of awareness, women’s powerlessness in decision-making, lack of money, and the use of alternative healing methods. Pelvic organ prolapse (POP) involves the descent of the anterior or posterior vaginal wall, uterus (cervix), or vaginal apex. Research on POP is limited in Ethiopia despite its prevalence, as highlighted by this study. The prevalence estimate emphasizes the widespread nature of POP among Ethiopian women, revealing gaps in existing data. To assess the prevalence, associated factors of pelvic organ prolapse, and reasons for delay in treatment-seeking among women. Community-based mixed cross-sectional studies included quantitative and qualitative components. Simple random sampling and purposive sampling were used for the respective studies. Multivariable logistic regression identified factors associated with pelvic organ prolapse (p < 0.05). Thematic analysis was used for qualitative data analysis. The prevalence of pelvic organ prolapse was 12.64 % (95 % CI, 10.04–15.23). Women aged ≥55 years [AOR = 3.17, 95 % CI: (1.18, 8.51)], pelvic organ prolapse history [AOR = 3.63, 95 % CI: (1.15, 11.43)], home delivery history [AOR = 16.5, 95 % CI: (7.46, 36.63)], vaginally birth ≥5 times[AOR = 10.35.7, 95 % CI: (4.85, 22.08)], and parity ≥5 [AOR = 5.96, 95 % CI: (2.30, 15.46)] were associated factors of pelvic organ prolapse. The reasons for the delay in treatment seeking were stigma, wrong perceptions, lack of awareness, women’s powerlessness in decision-making, lack of money, and use of alternative healing methods. In light of many women experiencing pelvic organ prolapse, promoting family planning, encouraging institutional delivery, offering early screening and treatment, and removing payment fees are recommended interventions.