Abstract Background: Postpartum influences women’s physical health conditions and may affect their quality of life and future health. Some women suffer from health problems which are largely related to delivery mode. Assessing the postnatal quality of life is essential to address the concern of women and provide comprehensive postnatal care and minimizes the morbidity of the mother during and beyond the postnatal period. Objectives: To assess health related quality of life and associated factors among postpartum women after normal vaginal delivery and caesarean section in public hospitals, Addis Ababa, Ethiopia. Methods: A hospital-based comparative cross-sectional study was conducted in public hospitals of Addis Ababa using Short Form-36. Systematic random sampling method was used and telephone interviews were conducted for  171  Caesarian Section and 165  Normal Vaginal Delivery postpartum women. The collected data entered into Epi-info version 7.2 and then analysied by SPSS version 25. The Multiple linear regression model was used after checking the assumptions were met to identify associated factors and p-value of 0.05 and a confidence interval of 95% was employed. Result: Overall 336 postpartum women participated with a response rate of 88%. The mean health-related quality of life was  91.42 and 81.89 for  normal vaginal delivery and cesarean section group respectively.In multivariable linear regression for both groups, age =(β=-0.166;95%CI:-0.504,-0.121), family income (β=-0.188 95%CI-0.001,0.000), gestational age (β =0.131,95%CI:0.44,0.185), normal vaginal delivery (β=0.526; 95% CI: 6.790,9.621), and live birth (β=2.471,95% CI:1.094,9.643) were significantly associated factors and explained 47% of the variance in Health Related Quality of Life among postpartum women. Conclusion and Recommendation: The study finds a higher level of health-related quality of life in the normal vaginal delivery group compared to the cesarean section. Health  workers should give appropriate counseling on modes of delivery, inorder to help patients to make an informed decision about their childbirth experience.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was sought from St. Paul’s Hospital Millennium Medical College, Institutional Research Review Board (IRB) with with Ref. No. of ሕ/ጤ/ት/822/14 . Ethical clearance was obtained from Addis Ababa city administration health bureau research directorate with Ref. No. of A/A/554/227. Then, permission to carry out the study was sought from GMH, ZMH and DMIIH Hospitals’ administrations. Oral consent was obtained from all participants after explaining the aim of the study and confirmed that the information would be used for research purpose and they had the right to refuse at any time. Confidentiality of the information obtained from the interview was maintained throughout the process of data collection. This study was conducted as per the Declaration of Helsinki.

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