Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline survey

Abstract Background Women´s index pregnancy emotional fertility intention was measured by asking the pregnant women how they would felt when they learned about their index pregnancy. Emotional health and couples´ communication are key during pregnancy and child birth with simultaneous minimization o...

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Main Authors: Solomon Abrha Damtew, Tariku Dejene Demissie, Assefa Seme, Niguse Tadele Atnafu, Fitsum Tariku Fantaye, Mahari Yihdego Gidey, Kelemua Mengesha Sene, Bezawork Ayele Kassa, Hailay Gebremichael Gebrekidan, Tariku Tesfaye Bekuma, Aynaw Amogne, Solomon Shiferaw
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Reproductive Health
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Online Access:https://doi.org/10.1186/s12978-025-02076-0
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author Solomon Abrha Damtew
Tariku Dejene Demissie
Assefa Seme
Niguse Tadele Atnafu
Fitsum Tariku Fantaye
Mahari Yihdego Gidey
Kelemua Mengesha Sene
Bezawork Ayele Kassa
Hailay Gebremichael Gebrekidan
Tariku Tesfaye Bekuma
Aynaw Amogne
Solomon Shiferaw
author_facet Solomon Abrha Damtew
Tariku Dejene Demissie
Assefa Seme
Niguse Tadele Atnafu
Fitsum Tariku Fantaye
Mahari Yihdego Gidey
Kelemua Mengesha Sene
Bezawork Ayele Kassa
Hailay Gebremichael Gebrekidan
Tariku Tesfaye Bekuma
Aynaw Amogne
Solomon Shiferaw
author_sort Solomon Abrha Damtew
collection DOAJ
description Abstract Background Women´s index pregnancy emotional fertility intention was measured by asking the pregnant women how they would felt when they learned about their index pregnancy. Emotional health and couples´ communication are key during pregnancy and child birth with simultaneous minimization of reproductive coercion. Emotional fertility intention is critical for healthy and spaced pregnancies, as well as for better maternal and newborns outcomes. Besides, intentions to conceive and emotional fertility intention on pregnancy are the integral parts of women reproductive health (RH) right and can be considered as women decision-making ability over their fertility. Moreover, in low and middle-income countries including Ethiopia where the sole male´s dominance is culturally accepted and socially constructed, males take the lead in each decision making process including household-level decision, determining the family´s fertility and reproductive health service use. This dominance interferes with women fertility intention and their health status including their emotional feeling towards conception. In such a scenario, women are less likely for their say to be heard. Hence, this study aimed to determine pregnant women index pregnancy emotional fertility intention and to identify the associated covariates contributing to it in Ethiopia. This is a very critical step to generate and make actionable evidence available for the health ministry and relevant partners working on reproductive and women´s psycho-social health. This evidence could serve as an action point to empower women regarding their reproductive health right and the control over their fertility. Methods Nationally representative cross sectional baseline data from the Ethiopian performance monitoring for action (Ethiopian PMA) cohort one survey, which enrolled and collected data from currently pregnant and 6 weeks postpartum women were used for this study. This study collected real time data on various sexual, reproductive, maternal and new born nationwide priority indicators using customized Open Data Kit Mobile application. These data were collected using standard pretested questionnaire prepared in English and the three local languages (Amharic, Afan Oromo and Tigrigna) by well experienced resident enumerators. This study was restricted to 2,236 pregnant women at the enrollment. Frequencies were computed to characterize pregnant women, and chi-square statistics was used to assess cell sample size adequacy. Multinomial logistics regression statistical modeling was fitted to identify correlates affecting index pregnancy women´s emotional fertility intention. Results were presented in the form of percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using a p-value of 0.25. Statistical significance was declared at p-value of 0.05. Result The overall proportion of index pregnancy emotional fertility intention of being happy was found to be 67.81%: (95%CI: 65.38, 70.13). The proportion of pregnant women who felt very unhappy was 8% (95%CI: 6.64, 9.5) while 8.45% (95%CI: 7.13, 10.0) and 15.79% (95%CI: 14.01, 17.76) of the pregnant women reported that they felt a sort of unhappy and mixed feelings respectively. Besides, older women, those from the well to do households, those who wanted to have another child were found to have (AOR 95%CI: 2.82 (1.30, 6.13), (AOR 95%CI: 2.05 (1.04, 4.04) and (AOR 95%CI: 2.96 (1.95, 4.52) times increased likelihood of index pregnancy emotional fertility intention of being happy when they have learned about their index pregnancy. The likelihood of index pregnancy emotional fertility intention was found to be AOR 95%CI: 0.34 (0.19, 0.62), (AOR 95%CI: 0.50 (0.32, 0.78), (AOR 95%CI: 0.26 (0.17, 0.40) and (AOR 95%CI: 0.38 (0.25, 0.58) lower among women with high birth order, those who intended to have no more child, among residents of Oromiya and among the residents of the former Southern nations, nationalities and peoples regions. Moreover, the likelihood of index pregnancy women emotional fertility intention of being in a mixed feelings was found to be (AOR 95%CI: 0.62 (0.41, 0.95), (AOR 95%CI: 0.30 (0.13, 0.67) and (AOR 95%CI: 0.33 (0.14, 0.77) among women who attended primary education, those whose desired birth attendant was health professional and family member respectively. Conclusion The finding that 2/3 of the pregnant women felt happier calls us up to work on intended and spaced pregnancies by ensuring women reproductive and economic empowerment. Region specific and age sensitive activities and efforts that promote intended pregnancy, empower women economically; increase women´s enrollment to secondary education or above and assisting them in identifying their desired birth attendant as part of birth preparedness and complication readiness are hoped to enhance pregnant women index pregnancy emotional fertility intentions. Empowering women economically and improving women educational enrollment were found very critical to address women emotional fertility intention. Installing inter pregnancy preconception care packages in the health care system and postpartum contraceptive counseling’s and provision were found to be the main implications of the study´s findings.
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spelling doaj-art-b7f9457b9e554eb2866550b13ab2c27d2025-08-20T04:02:54ZengBMCReproductive Health1742-47552025-07-0122111410.1186/s12978-025-02076-0Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline surveySolomon Abrha Damtew0Tariku Dejene Demissie1Assefa Seme2Niguse Tadele Atnafu3Fitsum Tariku Fantaye4Mahari Yihdego Gidey5Kelemua Mengesha Sene6Bezawork Ayele Kassa7Hailay Gebremichael Gebrekidan8Tariku Tesfaye Bekuma9Aynaw Amogne10Solomon Shiferaw11Department of Epidemiology and Biostatistics, School of Public Health, Wolaita Sodo UniversityCenter for Population Studies, College of Developmental Studies, Addis Ababa UniversitySchool of Public Health, Addis Ababa UniversitySchool of Nursing and Midwifery, Addis Ababa UniversityFTF Research consult PLCEthiopian PMA Project at Addis Ababa University, Addis Ababa UniversityDepartment of English Language, Kotebe Metropolitan UniversityUniversity of the Western CapeCollege of Health Sciences, Mekelle UniversityDepartment of Public Health, Institute of Health Sciences, Wollega UniversityEthiopian PMA Project at Addis Ababa University, Addis Ababa UniversitySchool of Public Health, Addis Ababa UniversityAbstract Background Women´s index pregnancy emotional fertility intention was measured by asking the pregnant women how they would felt when they learned about their index pregnancy. Emotional health and couples´ communication are key during pregnancy and child birth with simultaneous minimization of reproductive coercion. Emotional fertility intention is critical for healthy and spaced pregnancies, as well as for better maternal and newborns outcomes. Besides, intentions to conceive and emotional fertility intention on pregnancy are the integral parts of women reproductive health (RH) right and can be considered as women decision-making ability over their fertility. Moreover, in low and middle-income countries including Ethiopia where the sole male´s dominance is culturally accepted and socially constructed, males take the lead in each decision making process including household-level decision, determining the family´s fertility and reproductive health service use. This dominance interferes with women fertility intention and their health status including their emotional feeling towards conception. In such a scenario, women are less likely for their say to be heard. Hence, this study aimed to determine pregnant women index pregnancy emotional fertility intention and to identify the associated covariates contributing to it in Ethiopia. This is a very critical step to generate and make actionable evidence available for the health ministry and relevant partners working on reproductive and women´s psycho-social health. This evidence could serve as an action point to empower women regarding their reproductive health right and the control over their fertility. Methods Nationally representative cross sectional baseline data from the Ethiopian performance monitoring for action (Ethiopian PMA) cohort one survey, which enrolled and collected data from currently pregnant and 6 weeks postpartum women were used for this study. This study collected real time data on various sexual, reproductive, maternal and new born nationwide priority indicators using customized Open Data Kit Mobile application. These data were collected using standard pretested questionnaire prepared in English and the three local languages (Amharic, Afan Oromo and Tigrigna) by well experienced resident enumerators. This study was restricted to 2,236 pregnant women at the enrollment. Frequencies were computed to characterize pregnant women, and chi-square statistics was used to assess cell sample size adequacy. Multinomial logistics regression statistical modeling was fitted to identify correlates affecting index pregnancy women´s emotional fertility intention. Results were presented in the form of percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using a p-value of 0.25. Statistical significance was declared at p-value of 0.05. Result The overall proportion of index pregnancy emotional fertility intention of being happy was found to be 67.81%: (95%CI: 65.38, 70.13). The proportion of pregnant women who felt very unhappy was 8% (95%CI: 6.64, 9.5) while 8.45% (95%CI: 7.13, 10.0) and 15.79% (95%CI: 14.01, 17.76) of the pregnant women reported that they felt a sort of unhappy and mixed feelings respectively. Besides, older women, those from the well to do households, those who wanted to have another child were found to have (AOR 95%CI: 2.82 (1.30, 6.13), (AOR 95%CI: 2.05 (1.04, 4.04) and (AOR 95%CI: 2.96 (1.95, 4.52) times increased likelihood of index pregnancy emotional fertility intention of being happy when they have learned about their index pregnancy. The likelihood of index pregnancy emotional fertility intention was found to be AOR 95%CI: 0.34 (0.19, 0.62), (AOR 95%CI: 0.50 (0.32, 0.78), (AOR 95%CI: 0.26 (0.17, 0.40) and (AOR 95%CI: 0.38 (0.25, 0.58) lower among women with high birth order, those who intended to have no more child, among residents of Oromiya and among the residents of the former Southern nations, nationalities and peoples regions. Moreover, the likelihood of index pregnancy women emotional fertility intention of being in a mixed feelings was found to be (AOR 95%CI: 0.62 (0.41, 0.95), (AOR 95%CI: 0.30 (0.13, 0.67) and (AOR 95%CI: 0.33 (0.14, 0.77) among women who attended primary education, those whose desired birth attendant was health professional and family member respectively. Conclusion The finding that 2/3 of the pregnant women felt happier calls us up to work on intended and spaced pregnancies by ensuring women reproductive and economic empowerment. Region specific and age sensitive activities and efforts that promote intended pregnancy, empower women economically; increase women´s enrollment to secondary education or above and assisting them in identifying their desired birth attendant as part of birth preparedness and complication readiness are hoped to enhance pregnant women index pregnancy emotional fertility intentions. Empowering women economically and improving women educational enrollment were found very critical to address women emotional fertility intention. Installing inter pregnancy preconception care packages in the health care system and postpartum contraceptive counseling’s and provision were found to be the main implications of the study´s findings.https://doi.org/10.1186/s12978-025-02076-0Women´s healthEmotional healthWomen psycho-social healthWomen mental healthEmotional fertility intentionEthiopian PMA
spellingShingle Solomon Abrha Damtew
Tariku Dejene Demissie
Assefa Seme
Niguse Tadele Atnafu
Fitsum Tariku Fantaye
Mahari Yihdego Gidey
Kelemua Mengesha Sene
Bezawork Ayele Kassa
Hailay Gebremichael Gebrekidan
Tariku Tesfaye Bekuma
Aynaw Amogne
Solomon Shiferaw
Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline survey
Reproductive Health
Women´s health
Emotional health
Women psycho-social health
Women mental health
Emotional fertility intention
Ethiopian PMA
title Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline survey
title_full Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline survey
title_fullStr Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline survey
title_full_unstemmed Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline survey
title_short Index pregnancy emotional fertility intention and its correlates in Ethiopia: evidence from a national women and newborns baseline survey
title_sort index pregnancy emotional fertility intention and its correlates in ethiopia evidence from a national women and newborns baseline survey
topic Women´s health
Emotional health
Women psycho-social health
Women mental health
Emotional fertility intention
Ethiopian PMA
url https://doi.org/10.1186/s12978-025-02076-0
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