Contraceptive Intentions and Use throughout the Extended Postpartum Period: A Panel Study in Ethiopia

The postpartum period is an ideal time for women to access contraception, but the prevalence of postpartum contraceptive use remains low in sub-Saharan Africa. To better understand the gap between women's desires to space or limit births and their contraceptive behaviors, intention to use contraception has been proposed as a person-centered measure of contraceptive demand. Using data from a panel study of Ethiopian women aged 15-49 who were interviewed at six weeks, six months, and one year postpartum, we examined the dynamics of contraceptive intention in the first year postpartum and its relationship with contraceptive use. Contraceptive intention fluctuated considerably in the year after childbirth. At six weeks, 60.9 percent of women intended to use a contraceptive method in the next year; 23.2% did not. By one year, less than half (43.5 percent) were using a method, and those who had no intention to use doubled (44.5 percent). Women who developed or sustained their intention to use a method in the postpartum period were more likely to adopt a method by one year than those who did not, showing that contraceptive intention is a strong predictor of use and has the potential to inform person-centered reproductive health programming in the extended postpartum period.