Background: Self-medication during pregnancy could trigger substantial structural and physiological adverse effects on the health of woman and the newborn’s development. It can also lead to abortion, stillbirth, congenital anomalies, disability and death. In Ethiopia, study findings regarding prevalence, reason and associated factors of self-medication practice have been inconsistently reported and highly variable. Thus, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence, reason and determinants of self-medication practice among pregnant women in Ethiopia.

Methods: Studies were systematically searched PubMed, Medline, EMBASE, Global Health Google Scholar, CINAHL and Scopus from September 21, 2020 to October 22, 2020.  The Newcastle-Ottawa scale was used to evaluate the quality of included articles. The meta-analysis was done using STATA 11. Heterogeneity and publication bias were checked using I² test and Egger’s test respectively. The random effects meta-analysis was used to estimate the pooled prevalence and reason of self-medication practice at 95% (CI).

Results: A total of 14 studies with 6033 pregnant women were included for this study. The pooled magnitude of self-medication practice among pregnant women in Ethiopia was 27.62% (95% CI: 20.10, 35.15). The highest prevalence of self-medication practice among pregnant women was observed in Oromia region with a prevalence of 34.25%(95% CI: 19.89, 48.61). The most common reasons of self-medication among pregnant women were prior experience for drugs 39.2(29.23, 49.20) followed by easy to access non prescribed drug 32.41(7.52, 57.30).  Multigravida (AOR = 2.41; 95% CI: 1.72, 3.37), previous history of self-medication (AOR = 13.94; 95% CI: 2.03, 95.91) and maternal illness during pregnancy (AOR = 4.61; 95% CI: 3.13, 6.79) were factors significantly associated with self-medication practice among pregnant women.

Conclusion: This meta-analysis found that the overall prevalence of self-medication practice among pregnant women in Ethiopia is relatively high, and varies across different regions. The finding of this study suggests the need to enhance regulatory enforcement with a coordinated efforts of policymakers, programmers and other concerned stakeholders. Moreover, health education is recommended to make pregnant women aware of the risks of self-medication, and to stay safe from non-prescribed drug use.

Keywords: Factors, Meta-analysis, Pregnant, Prevalence, Self-medication, Ethiopia