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.

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.