Factors Influencing the Inter-Pregnancy Intervals of Pregnant Women in Three District Hospitals in the Volta Region of Ghana

Abstract

Background: The World Health Organization recommends that after a live birth, the appropriate interpregnancy interval (IPI) should be at least 24 months in order to reduce the risk of adverse maternal, perinatal, neonatal and infant health outcomes. The postpartum period offers a window of opportunity for women to be offered family planning (FP) counselling because of the likelihood of their encounter with the health system. Method: The study used health facility-based cross-sectional design to interview pregnant women who had at least one child and were presenting to the antenatal clinics in Keta, Ketu-South and Akatsi-South Districts in the Volta Region of Ghana. It was planned to interview all attendants to the facility who consented to participation between January and February, 2017. The questionnaire was structured and developed as an adaptation of questions used in similar work in Ghana. Data was collected on respondents’ socio-demographic characteristics, obstetric history including time of last previous delivery, spousal role of FP choices and intentions to adopt postpartum family planning (PPFP). Analyses using Stata version 14 were performed with IPI status (relative to the time of delivery in the previous pregnancy) as the major outcome of interest. Results: Four hundred pregnant women were interviewed. The mean age and parity of respondents were 29 (standard deviation (SD) ±5) years and 2 (SD±1) children respectively. The mean and median IPI were 35 (SD±5) months and 28 months respectively. The prevalence of short (less than 2 years) IPI was about 40%. The independent predictors of IPI longer than two years were adoption of PPFP (aOR = 2.55, CI 1.29-5.04), current pregnancy having been planned (aOR = 4.5, CI 1.83-11.21), partner having made the decision on the adoption of PPFP (aOR = 5.82, CI 1.77 – 19.15), being among those with middle (aOR = 2.00, 95% CI 1.03 - 3.90) and high socio-economic status (aOR = 1.26, CI 1.26-20.50) and being older than 25 years (aOR = 1.12, CI 1.02-1.22). Conclusion: To ensure healthier choices among pregnant women on their IPI in these study areas, there is the need to design PPFP interventions that promote male partner participation.