Skip to main content
Download PDF

Contraceptive experience and factors associated with desire for postpartum family planning among pregnant women of the nkongsamba health district, Littoral Region, Cameroon

BMC Women's Health volume 25, Article number: 10 (2025) Cite this article

Abstract

Background

The postpartum period remains a very important period during which contraceptive needs can be met and a significant reduction of maternal and foetal morbi-mortality achieved. This study aimed to evaluate past contraceptive experience and identify factors associated with the desire for postpartum family planning among women in late pregnancy.

Methods

We conducted a cross-sectional survey from September 2020 to December 2021 in four major health facilities of the Nkongsamba Health District, Cameroon, and consecutively included all pregnant women in late pregnancy, who came for antenatal follow-up in these health facilities. Data were collected using a semi-structured interviewer-administered questionnaire. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) for the factors associated with desire for postpartum family planning. Two-tailed p-values < 0.05 were considered statistically significant.

Results

Among the 1074 participants, 41.71% [95% CI: 38.78–44.70] reported a future desire for modern postpartum contraception. The self-reported prevalence of use of modern contraception in the past in the study population was 48.87% [95%CI: 45.86–51.88]. Only 17.64% [95%CI: 14.59–21.16] of women had adopted a modern contraceptive method other than the barrier methods in the past. Among pregnant women who had used modern contraception in the past, 11.50% [95%CI: 9.02–14.55] reported to have had their modern contraceptive experience with long-acting reversible contraceptives (LARCs). The prevalence of unintended pregnancy (current pregnancy) was 40.04% [37.15-43.00], with 11.55% being unwanted, and 28.49% mistimed. Compared to their respective counterparts, participants ≤ 30 years old (AOR = 0.71[0.52–0.99]), with monthly revenue below 100 thousand FCFA (AOR = 0.45[0.32–0.62]), who were single (AOR = 0.38[0.27–0.54]), had lower odds for desire of postpartum family planning. In contrast, women who were Christians (AOR = 2.13[1.27–3.58]), with a history of use of modern contraception before conception (AOR = 2.80[2.02–3.90]), and had a current unintended term pregnancy had higher odds of desiring postpartum contraception (AOR = 2.91[2.13–3.99]).

Conclusion

The desire for postpartum family planning is still low among pregnant women. This desire for postpartum family planning depends on sociodemographic factors and past contraceptive practices.

Peer Review reports

Background

Even though reported to have dropped significantly over the years, the prevalence of unintended pregnancy in Sub-Saharan Africa remains relatively high, varying between 10.8 and 54.5% [1]. In 2013, it was estimated that up to 40% of pregnancies among Cameroonian women were unintended [2]. About 30% of pregnancy-related deaths occur from unintended pregnancies. While half of these unintended pregnancies end as abortions, the other half is usually carried on to ages of viability and subsequent delivery [2]. According to the report of the 2018 National Demographic and Health Survey in Cameroon, 22% of pregnancies within the past 5 years were unintended [3]. Among sex workers in Cameroon, 57.6% reported a history of unintended pregnancy [4], while among urban adolescent and young adults, 76.9% had experienced an unintended pregnancy in the past [5]. Unintended pregnancy is associated with heavy maternal, neonatal and child morbidity and mortality.

It directly leads to high rates of induced abortions, of which a majority are unsafe [6]. Unintended births are associated with no preconception care, late initiation of antenatal care, maternal stress and poor mental health, poor drug use [7], premature delivery and low birth weight, poor breastfeeding practices, inadequate childhood vaccination [8], decreased mother-to-child bonding [9], child neglect and abuse [10, 11] all with the potential of leading to adverse maternofoetal and child outcomes. It is a major cause of school dropouts, psychological stress, and suicide among adolescents [12]. In addition, it has been described to affect infant health and well-being, hamper family welfare, leads to unexpected expenditures [2], and even child maltreatment [10]. It leads to higher rates of pregnancy complications like pre-eclampsia, eclampsia, and postpartum haemorrhage [13].

The World Health Organisation recommends that the gap between the last birth and the subsequent pregnancy be at least two years to optimise maternal and infant outcome. Shorter spacing between delivery and conception has been associated with an increased risk of obstetric complications, premature delivery and neonatal death [14].

Unintended pregnancy is a direct consequence of the failure or the non-use of modern contraception. Of the 493,000 unintended pregnancies registered in Cameroon in 2013, 79% and 21% occurred due to the non-use of contraception and failure of methods, respectively [2]. In Cameroon, about 60% of women with no intention to conceive do not use modern contraception or use relatively ineffective folklore methods [2]. According to the 2018 demographic and health survey, the prevalence of unmet need for contraception among women of childbearing age was 23.0%. The satisfaction of this unmet need for family planning was only at 19% [3].

To control unintended pregnancy among women after childbirth, women are advised to take up family planning immediately after delivery. In Sub-Saharan Africa, the pooled prevalence of postpartum contraception is 37.41% [15]. In a recent study in Cameroon, only 17.6% of women adopted modern contraceptive methods within the first year following delivery [16]. In Sub-Saharan Africa, factors associated with postpartum family planning include the level of education, resumption of menses, discussion with partner, knowledge of woman on contraception and family planning counselling during antenatal care [15].

To the best of our knowledge, no study has evaluated contraceptive experience before conception and future desire for postpartum family planning among term pregnant women in Cameroon. In one recent study carried out in Nigeria and Ivory Coast, contraceptive trends were evaluated before abortion. It was found that the contraceptive prevalence before abortion was 42.1% and 32.4% in Nigeria and Ivory Coast, respectively [17]. The desire for postpartum family planning among Cameroonian women, which is a potential indicator for uptake of postpartum family planning has not been fully evaluated. Significant differences between the desire and actual uptake of family planning in the postpartum period could open doors to studies of other barriers and more focused interventions. This study aimed to evaluate past contraceptive experience and identify factors associated with the desire for postpartum family planning among women in late pregnancy.

Methods

Study design

This was a cross-sectional study targeting women in late pregnancy in the Nkongsamba Health District. All eligible pregnant women visiting the study sites for their routine antenatal care or childbirth, and who consented to the study were consecutively enrolled. Data were collected using a semi-structured interviewer-administered questionnaire, and analyses were done using the statistical software Epi-Info version 7.2.3.1.

Setting

We conducted this study in four health facilities in the NHD. These health facilities included the Catholic Medicalised Health Centre, the Nkongsamba Regional Hospital, Good Samaritan Medicalised Health Centre and the Fultang Polyclinic. According to statistics, these health facilities receive, follow and deliver about 80% of the women in the health district. Nkongsamba as a town is one of the major cities of the Moungo Division with a cosmopolitan population of about 104 050 inhabitants (2005 population census).

Study duration and study population

This study was carried out between September 2020 and December 2021. This study targeted all term (≥ 37 weeks of pregnancy) pregnant women who were received at the maternities of the four health facilities. Term pregnant women were selected because these women were likely to have gone through antenatal care and the pregnancy experience to be able to make a decision on future contraception in postpartum.

Sampling and sample size

Using Cochran’s (single proportion sample size formula) [18], the sample size of the study was estimated. This formula was used with 37.41% as the prevalence of postpartum family planning in Sub-Saharan Africa [15]. The absolute precision on either side of the proportions was set at 0.03, while the acceptable two-sided alpha error was set at 5%. This gave us a minimum required sample size of 1000 participants. Women were consecutively included in the study as they arrived at the maternities of the chosen health facilities during the study period.

Data collection

Administrative authorisation was obtained from the District Medical Officer of the Nkongsamba Health District. Questionnaires were pretested for suitability, adaptability and capacity to meet research objectives on a sample of 15 women in the Kekem District Hospital, West Region of Cameroon. The data collected from the 15 women for the pretest were not included in our study database. Midwives already working in these maternities were responsible for data collection following a 5-hour training on the ethical consideration of the research and data collection procedures.

All data were collected through face-to-face interviews, which lasted for eight to ten minutes each. Interviews were conducted only after the complete package of routine health care had been administered (exit interviews). Data collected included sociodemographic data (like age, level of education of woman and partner, marital status, occupation, and number of household occupants), and economic characteristics (monthly revenue), contraceptive behaviour and use prior to current pregnancy, pregnancy intendedness, and desire for contraception following delivery.

Any woman who reported to have adopted any modern contraceptive method in the past (before her conception) was considered to have had modern contraceptive experience. Future desire for postpartum family planning was measured from a “Yes/No” question which wanted to know if the woman was ready or planning to take any modern method of family planning after delivery.

To limit social desirability or reporting bias, data collectors were trained on the procedure of interview with emphasis on the fact that data collected was purely for research reasons, all questionnaires were designed anonymous with no links of specific identification, and every participant was interviewed on a one-to-one basis.

Data analysis

The main outcome (desire for postpartum family planning) was a binary variable. Hence the proportions with their 95% confidence intervals (CIs) were calculated for categorical variables. Means with their standard deviations were estimated for normally distributed continuous variables. The strength of the association between the main outcome and selected potential factors was measured using the odds ratio (OR) in simple logistic regression (used for bivariate analysis). All variables with p-values ≤ 0.25 on bivariate analysis [19, 20] were included in the multiple logistic regression model to generate adjusted odds ratios (AOR). The cutoff of 0.25 was considered based on scientific recommendations and existing scientific papers in the field [21,22,23] Two-tailed p-values below 0.05 were considered statistically significant. All analyses were conducted using Epi-info version 7.2.3.1.

Ethics statement

Only willing and consenting participants were included in this study. For each participant, a written and signed informed consent was obtained after a thorough explanation of the study. For participants who were minors, their verbal informed assent coupled to the signed informed consent of their parents or legal representatives was obtained. The ethical clearance approving the study was obtained from the Cameroon Bioethics Initiative/Ethics Review and Consultancy Committee. The ethical clearance reference number is CBI/455/ERCC/CAMBIN. The research was conducted in accordance with the guidelines proposed on the declaration of Helsinki.

Results

Characteristics of the study population

We registered a non-response rate of 6.61% in this study. Data were collected from 1074 eligible participants, aged 15 to 47 years. The mean age of the 1074 participants included in the study was 28.20 ± 6.08 years. Table 1 below presents information on some sociodemographic characteristics of participants. Most of the participants were between 21 and 30 years old (56.52%), had at least secondary education (93.29%), and were cohabiting (39.89%). About 9 in every 10 were Christians (90.81%) and 43.06% earned about 100,000-200,000FCFA per month (Table 1).

Table 1 Sociodemographic characteristics of the participants
Full size table

Modern contraceptive experience before conception and future desire for postpartum family planning

Figure 1 summarises contraceptive past behaviour (experience) before conception and desire for postpartum contraception. The self-reported prevalence of use of modern contraception in the past in the study population was 48.87% [95%CI: 45.86–51.88]. However, a major fraction had adopted only the use of barrier methods in the past (Fig. 1). It was noted that 82.36% [95%CI: 78.84–85.41] of women who had adopted a modern family planning method in the past used only barrier methods. This implies that only 17.64% [95%CI: 14.59–21.16] of women had adopted a modern contraceptive method other than the barrier methods in the past (Fig. 1).

Fig. 1
figure 1

Contraceptive behaviour before conception and future desire for postpartum modern contraception

Full size image

Among pregnant women who had used modern contraception in the past, 11.50% [95%CI: 9.02–14.55] reported to have had their modern contraceptive experience with long-acting reversible contraceptives (LARCs). Considering the whole study population, 41.71% [95%CI: 38.78–44.70] of these women reported a future desire for modern postpartum contraception (Fig. 1).

Among these women in late pregnancy, 40.04 [95%CI: 37.15-43.00] % declared their pregnancies to be unintended (11.55% were unwanted, and 28.49% were mistimed).

Factors associated with the desire for postpartum modern family planning

Table 2 presents factors associated with the desire for modern postpartum family planning. Using simple logistic regression (for bivariate analysis), 14 variables were evaluated for their possible association with a desire for modern postpartum contraception.

Factors significantly associated with higher odds of the desire for postpartum modern contraception included (Table 2): lack of higher education (OR = 1.86[1.38–2.51], p-value < 0.001), lack of higher education by the partner (OR = 1.67[1.26–2.20], p-value < 0.001), use of modern contraception in the past before conception (OR = 3.03 [2.45–3.92], p-value < 0.001), use of any method of modern contraception other than a barrier method in the past before conception (OR = 1.63 [1.06–2.49], p-value = 0.026), the use of LARCs in the past before conception (OR = 2.46[1.46–4.15], p-value = 0.001), and having a current unintended pregnancy for delivery (OR = 2.18[1.69–2.80], p-value < 0.001).

On the other hand, the following factors were significantly associated lower odds for postpartum modern contraception (Table 2): Age ≤ 30 years (OR = 0.52[0.41–0.68], p-value < 0.001), being a student (OR = 0.52[0.39–0.71], p-value < 0.001), being single (OR = 0.52[0.40–0.68], p-value < 0.001), and having an estimated monthly revenue below 100 thousand FCFA (OR = 0.38[0.29–0.50], p-value < 0.001).

Upon control of eligible factors (p-value ≤ 0.25) in a multiple logistic regression model, only 6 factors came out with a statistically significant association with the desire of modern postpartum contraception (Table 2).

From Table 2, women who were aged ≤ 30 years had a 0.71-fold lower odd of desiring modern postpartum contraception compared with their older counterparts (AOR = 0.71[0.52–0.99], p-value = 0.043). Also, women who had “single” as marital status had a 0.38-fold lower odd of desiring modern postpartum contraception compared to women in a union (AOR = 0.38[0.27–0.54], p-value < 0.001). In the same light, women with an estimated monthly below 100 thousand FCFA had a 0.45-fold lower odd of desiring modern postpartum contraception compared to women who earned higher (AOR = 0.45[0.32–0.62], p-value < 0.001).

Table 2 Factors associated with a desire for postpartum modern family planning
Full size table

On the other hand, being a Christian was associated with a 2.13-fold higher odd of desiring modern postpartum contraception compared to non-Christians (AOR = 2.13[1.27–3.58], p-value = 0.004). In the same light, women who used any method of family planning in the past before conception had a 2.80-fold higher odd of desiring modern postpartum contraception compared to those that had not use any modern contraception in the past (AOR = 2.80[2.02–3.90], p-value < 0.001) [see Table 2].

Having a current unintended term pregnancy was associated with a 2.91-fold higher odd of desiring modern postpartum contraception compared to women who carried intended pregnancies (AOR = 2.91[2.13–3.99], p-value < 0.001) [see Table 2].

In summary, among the 1074 participants, 41.71% [95% CI: 38.78–44.70] reported a future desire for modern postpartum contraception. The self-reported prevalence of use of modern contraception in the past in the study population was 48.87% [95%CI: 45.86–51.88]. Only 17.64% [95%CI: 14.59–21.16] of women had adopted a modern contraceptive method other than the barrier methods in the past. Among pregnant women who had used modern contraception in the past, 11.50% [95%CI: 9.02–14.55] reported to have had their modern contraceptive experience with long-acting reversible contraceptives (LARCs). The prevalence of unintended pregnancy (current pregnancy) was 40.04% [37.15-43.00] with 11.55% being unwanted, and 28.49% mistimed. Compared to their respective counterparts, participants ≤ 30 years old (AOR = 0.71[0.52–0.99]), with monthly revenue below 100 thousand FCFA (AOR = 0.45[0.32–0.62]), who were single (AOR = 0.38[0.27–0.54]), had lower odds for desire of postpartum family planning. In contrast, women who were Christians (AOR = 2.13[1.27–3.58]), with a history of use of modern contraception before conception (AOR = 2.80[2.02–3.90]), and had a current unintended term pregnancy had higher odds of desiring postpartum contraception (AOR = 2.91[2.13–3.99]).

Discussion

Unintended pregnancy caused by low use or failure of family planning is associated with high maternal, neonatal, infant and under-five morbi-mortality. This study aimed at evaluating past contraceptive experience and identifying factors associated with desire for postpartum family planning in term pregnant women.

The prevalence of the past use of modern contraception before conception in this study was relatively high. As expected, this prevalence (48.87%) is by far higher than the national-level prevalence of modern contraception among women of childbearing age, which was reported by the 2018 demographic and health survey in Cameroon (19.3%) [3]. However, this prevalence is lower than the 77% prevalence of ever use of contraception [24]. Similar results have been found in Nigeria where about 49% of women reported to have used a method of contraception in the past [25]. Our results also concord with findings on contraceptive use among women before abortion in Nigeria and Ivory Coast [17]. The discrepancies in the results could be justified by the differences in the sociodemographic and cultural characteristics as well as the definitions of the outcomes in the different studies. This gives a picture of the relative exposure of these women to contraceptive services. Even though seemingly high, it represents an overall exposure of these women at any point in time of their lives to modern contraception. This is different from the point prevalence of modern contraceptive use and matches more with the prevalence of ever use of modern contraception which depicts past contraceptive experience. The type of experience (good or bad) is expected to have a significant impact on the future uptake of modern contraception.

In this study, a majority of these women reported to having used only short-acting reversible methods in the past, with only 11.50% using LARCs before pregnancy. This trend is similar to the general trend of contraceptive use, where women tend to use less effective barrier methods instead of the LARCs [3, 26, 27]. This was also observed in a study on contraceptive behaviour before abortion [17]. The use of LARCs is associated with lower discontinuation rates and very low failure rates in the population. The high rate of use of short acting reversible methods, especially condoms within this population could explain the relatively high rates of unintended pregnancy reported in this study (40.04%).

As stated above, 40.04 [37.15-43.00] % of the participants had unintended pregnancies (11.55% were unwanted, and 28.49% were mistimed). This implies that 4 in every 10 of these women were carrying an unintended pregnancy. of which a majority are unsafe [6]. The findings of this study on unintended pregnancies are not very different from reports from a study conducted in Sri Lanka among women with term deliveries in which only 70% of deliveries were planned [28]. The prevalence of 40.04% is in line with reports in Cameroon, which state that 40% of all pregnancies in Cameroon are unintended [2]. Similar findings have also been reported among women in Nigeria and the Democratic Republic of Congo, with a recorded prevalence of unintended pregnancy of 36.5%, and 51.5%, respectively [29, 30]. The small discrepancies could be associated with the differences in contraceptive behaviours in the different settings.

Unintended births have been associated with no preconception care, late initiation of antenatal care, maternal stress and poor mental health [7], premature delivery and low birth weight, poor breastfeeding practices, inadequate childhood vaccination [8], decreased mother-to-child bonding [9], child neglect and abuse [10, 11].

As stated in the result section, only 41.71% [95%CI: 38.78–44.70] of these women reported a future desire for modern postpartum contraception. This implies that about six in every 10 of these pregnant women had no intentions of taking a modern family planning after delivery. Even though a great proportion of these women may decide to depend on the natural methods of family planning, this is usually associated with higher failure rates. Low desire for postpartum family planning among pregnant women who are in contact with a health facility, and health staff through antenatal consultation and delivery raises concern and questions about the population as a whole, the content of the health education and health promotion provided to these women at the health facility during visits. This implies an urgent need for re-evaluation and adapted intervention.

This study also evaluated factors associated with future desire for postpartum family planning. Factors associated with lower odds of the desire for postpartum family planning were age ≤ 30 years, being single, having an estimated monthly revenue below 100 thousand FCFA, no past experience with modern contraception before conception, not being a Christian, and having a current intended pregnancy.

Contrary to findings in Ethiopia, where low maternal age was found to be associated with reduced uptake of postpartum contraception [31]. Women who are not married (single) were less likely to desire postpartum contraception compared to married women. Similar results have been obtained in South Ethiopia [32], and North West Ethiopia [33], where being married significantly increased the likelihood of postpartum family planning uptake.

Women who had used modern contraception in the past before conception were found to be significantly more likely to take up postpartum family planning. Similar results had been reported in multiple studies carried out on postpartum family planning uptake [33,34,35,36,37,38]. Contrary to findings reported in cross-sectional studies in Ethiopia [31, 32], women with a current unintended pregnancy had higher odds of desiring postpartum family planning than women who carried planned pregnancies. However, in a study that evaluated the effect of birth intendedness on postpartum family planning uptake, women who had unintended births were more likely to adopt highly effective methods of contraception (sterilisation and LARCs) [39].Unintended pregnancy was associated with a better decision on future need for modern contraception. This suggests that the healthcare workers might have given these women specific health education, adapted to their current status and risk or that these women learned from their mistakes.

This study had some limits. This study was cross-sectional, and the interpretation of these associations should consider the limits of cross-sectional designs (only hypotheses can be emitted with no causality). Even though “desire” is the first step towards contraceptive uptake, not all women who desire modern contraception in the postpartum period end up using these methods. However, the desire to use is one of the strongest indicators of family planning uptake. This study failed to evaluate other potential factors that could influence the desire for postpartum family planning, like the quality of antenatal care and the influence of the male partner. Furthermore, our study was a hospital-based study and included only women who came for antenatal and delivery care. We could not study all women in this category because some of them remain in the community and do not come for antenatal care. Nonetheless, this study successfully identified key factors logically backed by existing literature in other settings that cannot be neglected in the strategies to improve postpartum family planning uptake and the subsequent fight against unintended pregnancy in Cameroon.

Conclusion

The prevalence of the future desire for postpartum family planning is still low. The likelihood for future desire of postpartum family planning depends on sociodemographic factors like age, marital status, religion, and monthly revenue. Past contraceptive experience and the intendedness of the current pregnancy also have a key role to play. Given the low rate of desire for postpartum family planning, adapted interventions to improve contraception desire are indispensable. At this stage, it is useful for the scientific community and local health actors (at the health district level) to investigate further on the package of health promotion provided to pregnant women during antenatal visits and barriers to contraception access and use at the community level. Public health and community health interventions aimed at reducing unintended pregnancy and improving postpartum family planning uptake should consider sociodemographic factors and past contraceptive experiences.

Data availability

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AOR:

Adjusted Odds Ratio

LARCs:

Long-acting reversible contraceptives

NHD:

Nkongsamba Health District

OR:

Odds Ratio

CI:

Confidence Interval

References

  1. Ameyaw EK, Budu E, Sambah F, Baatiema L, Appiah F, Seidu AA, Ahinkorah BO. Prevalence and determinants of unintended pregnancy in sub-saharan Africa: a multi-country analysis of demographic and health surveys. PLoS ONE. 2019. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0220970.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Vlassoff M, Jerman J, Beninguisse G, Kamgaing F, Zinvi-Dossou F. (2014) Benefits of meeting the contraceptive needs of Cameroonian women. Issues Brief (Alan Guttmacher Inst) 1–13.

  3. Institut National de la Statistique/INS et ICF. Enquête Démographique et de Santé du Cameroun 2018. Maryland, USA: INS et ICF, Yaoundé, Cameroun et Rockville; 2020.

    Google Scholar 

  4. Bowring AL, Schwartz S, Lyons C, et al. Unmet need for family planning and experience of unintended pregnancy among female sex workers in urban Cameroon: results from a national cross-sectional study. Glob Health Sci Pract. 2020;8:82–99.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mohnchimbare CM, Tendongfor N, Asu CN, Etame LG, Assob N, Jules C. Unintended pregnancy and sexually transmissible infections amongst adolescents and young adults in Douala IV municipality, Cameroon: prevalence, knowledge, and associated factors. J Public Health Epidemiol. 2023;15:254–63.

    Article  Google Scholar 

  6. Obare F, Kabiru C, Chandre-Mouli V. Family planning evidence brief: reducing early and unintended pregnancies among adolescents. Evid Brief. 2020. https://doiorg.publicaciones.saludcastillayleon.es/10.1596/33968.

    Article  Google Scholar 

  7. Hajizadeh M, Nghiem S. Does unwanted pregnancy lead to adverse health and healthcare utilization for mother and child? Evidence from low- and middle-income countries. Int J Public Health. 2020;65:457–68.

    Article  PubMed  Google Scholar 

  8. Singh A, Singh A, Mahapatra B. The consequences of unintended pregnancy for maternal and child health in rural India: evidence from prospective data. Matern Child Health J. 2013;17:493–500.

    Article  PubMed  Google Scholar 

  9. Mohamed EAEB, Hamed AF, Yousef FMA, Ahmed EA. Prevalence, determinants, and outcomes of unintended pregnancy in Sohag district, Egypt. J Egypt Public Health Assoc. 2019;94:1–9.

    Article  Google Scholar 

  10. Guterman K. Unintended pregnancy as a predictor of child maltreatment. Child Abuse Negl. 2015;48:160–9.

    Article  PubMed  Google Scholar 

  11. Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann. 2008;39:18–38.

    Article  PubMed  Google Scholar 

  12. Yazdkhasti M, Pourreza A, Pirak A, Abdi F. Unintended pregnancy and its adverse social and economic consequences on health system: a narrative review article. Iran J Public Health. 2015;44:12–21.

    PubMed  PubMed Central  Google Scholar 

  13. Dehingia N, Dixit A, Atmavilas Y, Chandurkar D, Singh K, Silverman J, Raj A. Unintended pregnancy and maternal health complications: cross-sectional analysis of data from rural Uttar Pradesh, India. BMC Pregnancy Childbirth. 2020. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12884-020-2848-8.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Heller R, Cameron S, Briggs R, Forson N, Glasier A. Postpartum contraception: a missed opportunity to prevent unintended pregnancy and short inter-pregnancy intervals. J Fam Plann Reprod Health Care. 2016;42:93–8.

    Article  PubMed  Google Scholar 

  15. Yemane TT, Bogale GG, Egata G, Tefera TK. Postpartum Family Planning Use and its determinants among women of the Reproductive Age Group in Low-Income Countries of Sub-saharan Africa: a systematic review and Meta-analysis. Int J Reprod Med. 2021;2021:1–14.

    Article  Google Scholar 

  16. Fotso JC, Cleland JG, Ngamby MK, Baye ML, Olaïtan EA. Pregnancy risks and contraceptive use among postpartum mothers in Cameroon: implications for improving the coverage of postpartum family planning services. Res Sq. 2022. https://doiorg.publicaciones.saludcastillayleon.es/10.21203/rs.3.rs-1322234/v1.

    Article  Google Scholar 

  17. Magalona S, Byrne M, OlaOlorun FM, Mosso R, Omoluabi E, Moreau C, Bell SO. Contraceptive use before and after abortion: a cross-sectional study from Nigeria and Côte d’Ivoire. Stud Fam Plann. 2022;53:433–53.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Nanjundeswaraswamy TS, Divakar S. (2021) DETERMINATION OF SAMPLE SIZE AND SAMPLING METHODS IN APPLIED RESEARCH. 03:25–32.

  19. Hosmer DW, Lemeshow S, Sturdivant RX. (1989) Applied Logistic Regression, 3rd Edition. Wiley Ser Probab Stat 528.

  20. Zhang Z. Model building strategy for logistic regression: purposeful selection. Ann Transl Med. 2016. https://doiorg.publicaciones.saludcastillayleon.es/10.21037/atm.2016.02.15.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Ranganathan P, Pramesh C, Aggarwal R. Common pitfalls in statistical analysis: intention-to-treat versus per-protocol analysis. Perspect Clin Res. 2016;7:144.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Chowdhury MZI, Turin TC. Variable selection strategies and its importance in clinical prediction modelling. Fam Med Community Health. 2020;8:e000262.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Grant SW, Hickey GL, Head SJ. Statistical primer: multivariable regression considerations and pitfalls. Eur J Cardio-Thorac Surg off J Eur Assoc Cardio-Thorac Surg. 2019;55:179–85.

    Article  Google Scholar 

  24. Seidu AA, Ameyaw EK, Ahinkorah BO, Baatiema L, Dery S, Ankomah A, Ganle JK. Sexual and reproductive health education and its association with ever use of contraception: a cross-sectional study among women in urban slums, Accra. Reprod Health. 2022. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12978-021-01322-5.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Olugbenga-Bello AI, Adeyemi A, Adeoye O, Salawu M, Aderinoye A, Agbaje M. (2016) Contraceptive prevalence and determinants among women of reproductive age group in Ogbomoso, Oyo State, Nigeria. Open Access J Contracept 33.

  26. Ajong AB, Njotang PN, Kenfack B, Essi MJ, Yakum MN, Iballa FBS, Mbu ER. Contraceptive method mix and preference: a focus on long acting reversible contraception in Urban Cameroon. PLoS ONE. 2018. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0202967.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Samimi P, Basu T. Contraception and family planning. Handb Gynecol. 2017. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/978-3-319-17798-4_17.

    Article  Google Scholar 

  28. Ranatunga IDJC, Jayaratne K. Proportion of unplanned pregnancies, their determinants and health outcomes of women delivering at a teaching hospital in Sri Lanka. BMC Pregnancy Childbirth. 2020;20:1–15.

    Article  Google Scholar 

  29. Afolabi AO, Olaogun AA, Afolabi KA, Afolabi EK. Determinants of unintended pregnancies among nursing mothers in southwest Nigeria. Afr J Midwifery Womens Health. 2020;14:1–17.

    Article  Google Scholar 

  30. Dhakal S, Song JS, Shin DE, Lee TH, So AY, Nam EW. Unintended pregnancy and its correlates among currently pregnant women in the Kwango District, Democratic Republic of the Congo. Reprod Health. 2016. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12978-016-0195-z.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Silesh M, Lemma T, Abdu S, Fenta B, Tadese M, Taye BT. Utilisation of immediate postpartum family planning among postpartum women at public hospitals of North Shoa Zone, Ethiopia: a cross-sectional study. BMJ Open. 2022. https://doiorg.publicaciones.saludcastillayleon.es/10.1136/bmjopen-2021-051152.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wassihun B, Wosen K, Getie A, et al. Prevalence of postpartum family planning utilization and associated factors among postpartum mothers in Arba Minch town, South Ethiopia. Contracept Reprod Med. 2021. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40834-021-00150-z.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Taye EB, Mekonen DG, Debele TZ. (2019) Prevalence of post partum modern family planning utilization and associated factors among postpartum mothers in Debre Tabor town, North West Ethiopia, 2018. BMC Res Notes. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13104-019-4464-0

  34. Koboto DD, Assefa S. Uptakes and associated factors of postpartum family planning in southern Ethiopia: a cross-sectional study. Indian J Obstet Gynecol Res. 2021;8:388–96.

    Article  Google Scholar 

  35. Seifu B, Yilma D, Daba W. Knowledge, utilization and Associated factors of Postpartum Family Planning among women who had delivered a baby in the Past Year in Oromia Regional State, Ethiopia. Open Access J Contracept Volume. 2020;11:167–76.

    Article  Google Scholar 

  36. TI IH TA, MH S, S Z. Factors Associated with Postpartum Family Planning in a cohort of Kelantanese Women with previous caesarean delivery in Malaysia. IIUM Med J Malays. 2020. https://doiorg.publicaciones.saludcastillayleon.es/10.31436/imjm.v19i1.1336.

    Article  Google Scholar 

  37. Joshi AK, Tiwari DP, Poudyal A, Shrestha N, Acharya U, Dhungana GP. Utilization of family planning methods among postpartum mothers in Kailali District, Nepal. Int J Womens Health. 2020;12:487–94.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Eliason S, Baiden F, Quansah-Asare G, Graham-Hayfron Y, Bonsu D, Phillips J, Awusabo-Asare K. Factors influencing the intention of women in rural Ghana to adopt postpartum family planning. Reprod Health. 2013. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/1742-4755-10-34.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Guzzo KB, Eickmeyer K, Hayford SR. Does Postpartum Contraceptive Use Vary by Birth Intendedness? Perspect Sex Reprod Health. 2018;50:129–38.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Our sincere thanks to all the midwives who contributed to collect data and to all the women who accepted to participate in this study.

Funding

The authors received no funding from any specific sources.

Author information

Authors and Affiliations

  1. Kekem District Hospital, Kekem, West Region, Cameroon

    Atem Bethel Ajong & Larissa Matcha Waffo

  2. Department of Epidemiology and Biostatistics, School of Medical and Health Sciences, Kesmonds International University, Mile 3 Nkwen, Bamenda, Cameroon

    Atem Bethel Ajong & Martin Ndinakie Yakum

  3. Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon

    Fulbert Nkwele Mangala

  4. Maternity unit, Nkongsamba Regional Hospital, Nkongsamba, Littoral Region, Cameroon

    Fulbert Nkwele Mangala

  5. Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon

    Cavin Epie Bekolo

  6. Nuffield Department of Population Health, University of Oxford, Oxford, UK

    Valirie Ndip Agbor

  7. Department of Obstetrics / Gynaecology and Maternal Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, West Region, Cameroon

    Bruno Kenfack

Authors
  1. Atem Bethel Ajong
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Martin Ndinakie Yakum
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Fulbert Nkwele Mangala
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Cavin Epie Bekolo
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Valirie Ndip Agbor
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Larissa Matcha Waffo
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Bruno Kenfack
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

A.B.A., M.N.Y., V.N.A., C.E.B., F.N.M., and B.K. designed the study, guided and supervised data collection. A.B.A. and L.M.W. carried out data management and analysis. A.B.A. drafted the original manuscript. All authors contributed in reviewing and approving the final manuscript.

Corresponding author

Correspondence to Atem Bethel Ajong.

Ethics declarations

Ethics approval and consent to participate

Only willing and consenting participants were included in this study. For each participant, a written and signed informed consent was obtained after a thorough explanation of the study. For participants who were minors, their verbal informed assent coupled to the signed informed consent of their parents or legal representatives was obtained. The ethical clearance approving the study was obtained from the Cameroon Bioethics Initiative/Ethics Review and Consultancy Committee. The research was conducted in accordance with the guidelines proposed on the declaration of Helsinki.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ajong, A.B., Yakum, M.N., Mangala, F.N. et al. Contraceptive experience and factors associated with desire for postpartum family planning among pregnant women of the nkongsamba health district, Littoral Region, Cameroon. BMC Women's Health 25, 10 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12905-025-03546-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12905-025-03546-0

Keywords

BMC Women's Health

ISSN: 1472-6874

Contact us