The first year after a woman has given birth is critical for use of contraceptives although many women do not realize that they are at a risk for pregnancy. The main objective of this study was to assess the utilization of modern Postpartum Family Planning (PPFP) and associated factors among postpartum women in a rural district, Ethiopia. A cross-sectional study involving randomly selected 389 postpartum women was conducted in Ambo rural district from May 20, 2021 to June 10, 2021. Data were collected through face to- face interviews, entered into EPI Data version 3.1, and analyzed by SPSS version 25.0. In multivariable binary logistic regression, adjusted odds ratios (AOR) with 95% confidence interval (CI) were computed and statistical significance was declared at p < 0.05. The prevalence of modern PPFP was 72.5% (95% CI: 68%, 77%). Utilization of PPFP was significantly associated with women’s self decision making (AOR = 6.43, 95% CI: 1.98, 20.90), counseling during antenatal care (AOR = 9.71, 95% CI: 3.83, 24.61), visit health facility after delivery (AOR = 5.24, 95% CI: 2.32, 11.84), ever heard of modern family planning (AOR = 5.17, 95% CI: 1.88, 14.23), perceived partner approval (AOR = 4.31, 95% CI: 1.62, 11.47), and the lowest income (AOR = 0.12, 95% CI: 0.02, 0.68). The use of modern PPFP in the study area was encouraging, which helps to prevent unplanned and unwanted pregnancies and spacing pregnancies. Therefore, family planning providers should focus on raising women’s awareness and counseling their partners as part of a continuum of points of contact to encourage women to use the service.

Background The first year after a woman has given birth is crucial for use of contraceptives even though many women do not realize that they are at a risk for pregnancy and contraceptive use is low during this period. This study was conducted to assess the utilization of modern contraceptives and associated factors among postpartum women in Ambo rural district, central Ethiopia. Methods A community-based cross-sectional study involving randomly selected 394 postpartum women was conducted from May 20, 2021 to June 10, 2021. Data were collected through interview, entered into EPI Data version 3.1, and analyzed by SPSS version 25.0. Adjusted odds ratios with 95% confidence intervals were computed using multivariable binary logistic regression and p < 0.05 was used to declare statistical significance. Results The prevalence of postpartum modern family planning was 72.5% (95% CI: 68%, 77%). It was significantly associated with women's self-decision making (AOR = 6.43, 95% CI: 1.98, 20.90), counseling on family planning during antenatal (AOR = 9.71, 95% CI: 3.83, 24.61), visiting health facility after delivery (AOR = 5.24, 95% CI: 2.32, 11.84), ever heard modern contraceptives (AOR = 5.17, 95% CI: 1.88, 14.23), perceived partner approval (AOR = 4.31, 95% CI: 1.62, 11.47), and the lowest income (AOR = 0.12, 95% CI: 0.02, 0.68). Conclusions The utilization of modern postpartum family planning in Ambo rural was promising. Therefore, family planning providers should strengthen making awareness of the women and counseling of their partners integrated with other services at a continuum of points of contact.