Trend and determinants of unplanned pregnancy among expectant mothers in Ethiopia based on the Ethiopia Demographic and Health Survey (2000–2016) data: a cross-sectional study

Abstract

Objective To investigate the trend and determinants of unplanned pregnancy among expectant women using the four Ethiopia Demographic and Health Survey (EDHS) data (2000–2016).Design Cross-sectional study.Setting Secondary data analysis using EDHS data.Participants The number of weighted participants were 1451 in 2000, 1184 in 2005, 1205 in 2011 and 1135 in 2016.Primary and secondary outcome measures Unplanned pregnancy encompasses both mistimed (occurring earlier than desired) and unwanted (occurring when no further children are desired) forms of conception. Trend and multilevel logistic regression analyses were conducted.Results The rate of unplanned pregnancies in Ethiopia showed a significant decline, decreasing from 45.8% (95% CI 41.8 to 49.8) in 2000 to 29.7% (95% CI 25.3 to 34.4) in 2016, indicating an overall change of 16.1%. Several factors were positively linked to unplanned pregnancy, including being multipara (adjusted OR (AOR)=9.8; 95% CI 1.74 to 15.23) and grand multipara (AOR=12.2; 95% CI 1.62 to 19.3), expressing a lack of desire for additional children (AOR=2.82; 95% CI 1.30 to 6.12), unemployment (AOR=1.91; 95% CI 1.12 to 3.78) and being unmarried (AOR=7.23; 95% CI 4.71 to 15.5), whereas, women residing in the Afar (AOR=0.12; 95% CI 0.02 to 0.79) and Somalia (AOR=0.20; 95% CI 0.07 to 0.67) regions were associated with reduced likelihood of experiencing unplanned pregnancy.Conclusion The study discovered that unplanned pregnancies in Ethiopia decreased significantly from 2000 to 2016. However, around one-third of pregnant women are still affected, indicating a high rate. To address this, policymakers and stakeholders should propose and implement targeted interventions on identified risk factors.