Background: The postpartum period is an important entry point for family planning service providers to reduce unintended and too closely spaced pregnancy. A postpartum modern contraceptive service is one of the recommended public health interventions for reducing maternal and child morbidity and mortalities. However, In Ethiopia modern contraceptive use during the postpartum period is low; resulting in unintended pregnancies and unwanted childbearing . there for this study was done to assess utilization and associated factors of modern contraceptives during the postpartum period among women who gave birth in the last 12 months in Injibara Town Awi Zone, North-Western Ethiopia. Methods: A Community based cross-sectional study design was conducted from March 01 to 15/2019 on 400 women who gave birth in the last 12 months preceding the survey. A simple random sampling technique was used to recruit study subjects. Data was collected using interviewer-administered pretested and structured questionnaires. Data were entered using Epi data 3.5 and exported to SPSS version 23 for analysis. The association between variables was analyzed using Bivariate and multivariable logistic regression models and p-value < 0.05 at 95% Confidence interval was considered as statistically significant. Result: The prevalence of modern contraceptive utilization was 58.5% (95% CI: 53.5- 63%) among postpartum mothers. Secondary school and higher educational levels [AOR= 5.02; 95% CI (1.53-16.47)],[AOR= 4.25; 95% CI:(1.32-13.64) respectively)], previous history of abortion [AOR= 3.93; 95%, CI: (1.43-10.84)], having three and four antenatal care visit [AOR= 4.74; 95%, CI: (1.94-11.54)] [AOR= 5.9; 95%, CI: (2.42-14.39) respectively], family planning counselling during antenatal care [AOR=2.81; 95% ,CI: (1.63- 4.86)], having postnatal care [AOR =1.79, 95%, CI: (1.09-2.96)], menses returning after birth [AOR=2.84, 95% CI: (1.77- 4.57)] and resuming sexual activity [AOR= 2.86, 95% CI: (1.71-4.78)] were factors affecting contraceptive use in postpartum period. Conclusion : The prevalence of modern contraceptive use among postpartum women was found to be high in Injibara town. Therefore, strengthen family planning counseling during antenatal care and postnatal care to reduce the missed opportunity of postpartum women to get family planning methods, especially long-acting reversible contraceptives.

Background: Approximately 10% of deliveries are considered as high risk, which may require cesarean section. Besides, a rise in cesarean section delivery is a real public health concern; cesareans are costly and carry 8-12 and 8 times higher feto-maternal morbidity and mortality, respectively, as compared to vaginal delivery. Like in other countries where unnecessary cesarean delivery is performed, it is also rising in our country, posing potential risk to the mothers and their newborns. Objective: To assess the indications and outcome of cesarean section delivery among pregnant women utilizing delivery services in selected hospitals. Methods: A case-control study design was used among 488 randomly selected pregnant women attending delivery services in Bedelle and Mettu-Kharl Hospitals. Data were collected by interviewer-administered questionnaire and entered into EPI-data version 3.1 and exported to SPSS version 20 for cleaning and analyses. Binary logistic regression analysis was used to control for possible confounders. Association was declared at 95% CI and P-value <0.05 to assess the association between dependent and independent variables. Variables with P-values <0.05 at bivariate analysis were entered to final logistic regression model. Results: Nearly 30% and 24.6% of fetuses had been exposed to unfavorable outcome among those delivered following cesarean and vaginal delivery, respectively. The mean age of study participants was 25.79 (SD 6.76) for mothers who underwent cesarean delivery and 24.76 (SD 4.956) for their counterparts. Unfavorable maternal outcome was experienced by 20.5% and 14.7% of pregnant women who gave birth by cesarean and vaginal delivery, respectively. Those not having antenatal care follow-up were five times more likely to encounter unfavorable outcome than attendees (AOR 5.22, 95% CI 1.85-14.69), while mothers of newborns with low 5th minute Apgar score were 3 times (AOR 2.96, 95% CI 1.07, 8.16), multi-parity 7 times (AOR 7.22, 95% CI 1.45, 36.05) and rural residence were 1.29 times (AOR 1.29, 95% CI 5.09, 12.88) more likely to develop unfavorable feto-maternal outcome. Conclusion:Vaginal delivery results in more favorable feto-maternal outcomes than does cesarean delivery.