BACKGROUND: The fertility behavior of women is characterized by maternal age, birth spacing and order, and it impacts the health of women and children. Evidence on the factors associated with maternal high-risk fertility behavior is scant in Ethiopia. Thus, the aim of this study was to identify the factors associated with maternal high-risk fertility behavior in Hadiya Zone, Southern Ethiopia.

METHODS: A facility-based cross-sectional study was conducted. Three hundred women of reproductive age admissions to public hospitals in the Hadiya Zone who gave birth in the five years preceding this study were selected using systematic random sampling. Face-to-face interviews were held to gather data using interviewer-administered questionnaires. Descriptive statistics and binary logistic regression models were used to analyze data. Statistical significance was assessed using odds ratios and 95% confidence intervals and declared at a p-value of less than 0.05.

RESULTS: The overall proportion of maternal high-risk fertility behavior was 60.3%. Mother, who lived in rural areas (AOR = 4.85; 95%CI: 2.56, 9.19), had early marriage (AOR = 3.39; 95%CI: 1.87, 6.14) and had unplanned last pregnancy (AOR = 2.62; 95%CI: 1.28, 5.39) were more likely engaged in high-risk fertility patterns. 

CONCLUSIONS: In the study area, there was a high overall proportion of married women engaging in high-risk fertility behavior. Mothers with early marriages, unplanned pregnancies, and rural residence were more likely engaged in high-risk fertility behaviors. Plans for interventions aimed at preventing maternal high-risk fertility behavior should center on expanding access to family planning services and ending the practice of early marriage by giving rural women extra care and attention.

KEYWORDS: High-risk fertility, associated factors, Ethiopia