Multinomial Logistics Regression Modeling On Pregnant Women Index Pregnancy Emotional Fertility Intention and Its Correlates in Ethiopia: Performance Monitoring for Action Community Based Cohort Study
Authors: Damtew Solomon Abrha , Atianfu Niguse Tadele , Fentaye Fitsum Tariku , Gidey Mahari Yihdego , Sene Kelemua Mengesha , Kassa Bezwork Ayele , G/Michael Hailay , Tesfaye Tariku , Amogne Aynaw , Dejene Tariku , Seme Assefa , Shiferaw Solomon 
Published: April 2024

Background
Intention to conceive and emotional fertility intention on pregnancy is an integral part of reproductive health (RH) right and can be considered as decision making on fertility. In low and middle income countries including Ethiopia where male dominance is culturally accepted and socially constructed, males take the lead in every decision making process for the family ranging from household level decision to determining fertility and reproduction including reproductive health service use. This dominance interferes on women fertility desire and their health status including their emotional feeling towards conception among others. In such a scenario, women are less likely for their say to be heard. Hence, this study aimed at determining how they would pregnant women felt when learned their index pregnancy and the covariates contributing in Ethiopia so as to generate and avail actionable evidence for the ministry and relevant partners working on reproductive and women health. This evidence can be used as an action point to empower women on their reproductive health right as well as their control over their fertility.
Methods
Nationally representative data which enrolled and collected data from currently pregnant women from PMA cohort one baseline were used for this study used. Frequency was computed to characterize pregnant women. Multinomial logistics regression was employed to identify correlates affecting pregnant women emotional intention when learned about their index pregnancy. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05.
Result
A little higher than 2/3 (67.81%: 65.38%, 70.13%) of the pregnant women reported that they felt happy or sort of happy (4 in 10 very happy and 1 in 4 sort of happy) when they learned about their index. The proportion of pregnant women who felt very unhappy was 8% (6.64%, 9.5%) while 8.45% (7.13%, 10.0%) and 15.79% (14.01%, 17.76%) of the pregnant women reported that they felt sort of unhappy and mixed happy unhappy respectively. Older women, those from the well to do household, who wanted to have another child were found to have an increased likelihood of being very happy or sort of happy when they learned about their index pregnancy while this this likelihood was lowered among women with high birth order, who intended to have no more child, those who live in Oromiya and in the former SNNPR regions. Moreover, women who attended primary education and whose desired birth attendant was health professional/ Family member had lower likelihood of feeling mixed happy and unhappy when they learned they were pregnant.
Conclusion
The finding that 2/3 felt very happy or sort of happy calling up on intended and spaced pregnancies by ensuring women reproductive and economic empowerment to take control over their fertility. Activities and efforts that promote intended pregnancy, empowering women economically; increasing women enrollment to secondary education or above and assisting them in identify their desired birth attendant as part of birth preparedness and complication readiness are hoped to improve pregnant women index pregnancy fertility emotion. The activities need to be region and age specific.