Background: Tanzania is among countries that have made slow progress towards achieving family planning goals. It has a high unmet need for contraceptives 25% and has high total fertility rate 5.4, Grand multipara has been associated with low prevalence of contraceptive use and low child spacing hence impairing contraceptive use.
Methodology: A cross section hospital-based study involved 227 grand multipara attended antenatal clinic at Sekou Toure regional hospital done from August to January 2019. Data was obtained through structured questionnaire and data analysis was done by using SPSS version 20.
Results: The prevalence among grand multipara was 32.4%, and it was associated with education level, marital status, heavy bleeding, weight changes and religion with p value of 0.037, 0.01, 0.00, 0.000 and 0.03 respectively. However no association with delay in fertility with p value of 0.076.
Conclusion: There was high awareness of contraceptive methods among grand multiparous women; however there was low use prevalence of 32.2%. Contraceptive use was associated with education level, marital status, religion, heavy bleeding and weight changes. Also the reason of not using contraceptives were due to desire for a large family, complication associated with contraceptives use like heavy bleeding, weight changes, delay in fertility and religious reasons.