Determinants of an Unintended Pregnancy among Women Attending Ante Natal Care at Health Facilities in Lemi Kura Sub City, Addis Ababa, Ethiopia: Institution based Case-Control Study

BackgroundUnintended pregnancy refers to a pregnancy that is either unplanned at the time of conception or not wanted at all. It carries significant social, emotional, and health consequences for women, their children, families, and communities. In Ethiopia, approximately one-third of married women report that their pregnancies are unintended. Despite the considerable burden of unintended pregnancies in the country, there remains limited evidence on the factors contributing to this issue, particularly at Lemi Kura sub city. This study, therefore, aimed to identify the determinants of unintended pregnancy among women attending antenatal care services in health facilities within Lemi Kura sub-city, Addis Ababa, Ethiopia. MethodsWe conducted a facility-based case-control study in Lemi Kura sub-city, Addis Ababa, Ethiopia, from January 3 to February 18, 2022. Cluster random sampling technique was used to select 103 cases (women with unintended pregnancies attending antenatal care unit) and 197 controls (women with planned pregnancies attending antenatal care unit). Data were collected through interviewer-administered, pretested questionnaires. The sample size was calculated using Epi-Info version 7. Data analysis was carried out using SPSS version 20, applying multivariable logistic regression to identify determinants of unintended pregnancy. Results were reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI), and statistical significance was declared at p < 0.05. ResultsThe Muslim women (AOR: 3.33, 95% CI: 1.21-9.15); Protestant women (AOR: 3.06, 95% CI: 1.07-8.75); reduced womens autonomy (AOR: 16.58, 95% CI: 2.40-114.15); residing 4 km or more from the antenatal care facility (AOR: 2.70, 95% CI: 1.07-8.75); having two or more living children(parity) (AOR: 5.37, 95% CI: 1.60-18.15); desiring two or fewer children(Ideal) (AOR: 3.63, 95% CI: 1.50-9.01); and having multiple sexual partners (AOR: 4.25, 95% CI: 1.38- 30.38) were significant predictors of unintended pregnancy. ConclusionWomen with Low knowledge about FPMs, unmarried, Protestant and Muslim religious, low autonomy, multiparous, used natural FPM, health service inaccessibility and having multiple sexual partners were primary predicators of the unintended pregnancy. For intervention, Engaging religious leaders and focusing on multiparous with empowering women is essential.