Unintended Pregnancy During COVID-19 Pandemic Among Women Attending Antenatal Care in Northwest Ethiopia: Magnitude and Associated Factors

Background: COVID-19 pandemic has a great impact on the disruption of maternal health-care services. Family planning is one component of maternal health-care service that needs attention during this devastating time. Compromise on family planning services and the preventive strategies of COVID-19 might increase the burden of unintended pregnancy, but there is limited evidence that shows the magnitude of unintended pregnancy during the COVID-19 pandemic. Therefore, the objective of this study was to assess unintended pregnancy during the COVID-19 pandemic and its associated factors among women attending antenatal care in northwest Ethiopia. Methods: This study was an institutional-based cross-sectional study, including 424 women attending antenatal care from November 12/2020 to December 12/2020. The study participants were selected using a systematic random sampling technique. A pretested questionnaire was used. Binary logistic regression (bivariable and multivariable) was employed. The adjusted odds ratio with a 95% confidence interval was used to declare statistically significant variables based on p<0.05 in the multivariable logistic regression model. Results: The magnitude of unintended pregnancy during the COVID-19 pandemic among women attending antenatal care was found to be 47.17% (42.2-52.2%). Women did not expose to community education (AOR=2.2, 95% CI1.1-4), women with no bad obstetric history (AOR=2.3; 95% CI1.3-4.1), a woman was not the primary decision maker for family planning service (AOR=2.9; 95% CI 1.5-5.7), no complication during index pregnancy (AOR=5.4; 95% CI 2.2-13) and women with no health-care provider support (AOR=2.4, 95% CI1.4-3.9) were significantly associated with unintended pregnancy. Conclusions: The magnitude of unintended pregnancy was found to be high. Community education about maternal health services including family planning, improving women's decision-making power for maternal health-care services, giving emphasis on pregnancy-related complications with health-care provider support, and pregnant women with bad obstetric history were suggested to reduce the problem.