The effect of contraceptive empowerment during pregnancy on postpartum family planning use in Ethiopia: evidence from a longitudinal panel study

Abstract

Contraceptive empowerment and post-partum family planning in Ethiopia This study explored how women’s empowerment in making contraceptive decisions influences the use of family planning after childbirth in Ethiopia. Family planning during the postpartum period is critical for maternal and child health, yet uptake remains uneven across the country. Using data from the Performance Monitoring for Action Ethiopia project (2021–2023), researchers followed 1,759 pregnant women across four regions and analyzed their contraceptive use one year after delivery. The findings show that women who reported medium or high levels of contraceptive empowerment during pregnancy were significantly more likely to adopt family planning methods postpartum compared to those with low empowerment. Empowerment here refers to women’s confidence, autonomy, and ability to make informed choices about contraception. Other factors also played a role: women attended by skilled birth attendants, those with fewer children, and those with prior contraceptive experience were more likely to use postpartum family planning. In contrast, women living in Amhara and Oromia regions had lower rates of use, highlighting regional disparities. Overall, the study demonstrates that strengthening contraceptive empowerment during pregnancy can have lasting effects on family planning uptake after childbirth. It suggests that interventions should focus not only on expanding access to services but also on building women’s decision-making power, supporting skilled birth attendance, and addressing regional inequalities. These efforts could contribute to more equitable and sustained improvements in maternal and child health outcomes in Ethiopia.