Understanding the Effects of Pregnancy Intentions on Maternal and Child Health: Evidence from the Gilgel Gibe Demographic Surveillance in Southwest Ethiopia

Background: Although the prevention of unintended pregnancy has been the major rationale for family planning and reproductive health programs throughout the world, a significant level of unintended pregnancy still exists in almost all countries of the world. The highest rate of unintended pregnancy occurs in Sub-Saharan Africa, where maternal and child mortality rates are also the highest. Unintended pregnancy has a number of costs to women including abortion related maternal deaths, as well as to the unwanted child in terms of health and development. Few studies have examined the effects of unintended pregnancy on maternal and child health and well-being in developing countries including Ethiopia. Objectives: The aims to examine the effects of unintended pregnancies on maternal and child health and health behavior in Gilgel Gibe Demographic Surveillance area, Jimma zone, southwest Ethiopia. Methods: The study is designed as a mixed method study in which both quantitative and qualitative data collection and analysis were employed. The quantitative study involved a follow up study among pregnant women and a cross-sectional survey among women with a live birth in the two years before the survey respectively. The prospective cohort study was conducted among 622 pregnant women, identified from the 11 Demographic Surveillance Site (DSS) villages, who were followed from pregnancy through to delivery. Baseline survey was conducted in June and July 2012 to collect data on pregnancy intention, depressive symptoms, social support and other variables. Birth weight was measured within 72 hours of birth to examine the effects of pregnancy intention and related maternal health behaviors on birth weight. Moreover, a cross-sectional survey among 1370 women who have had a birth in the two years before the survey was conducted to assess the associations of pregnancy intention and related fertility behaviors on maternal and child health care and child survival. Women with live births in the two years before the survey were ...