Data sources and methods
The current study used national data from the 2017, 2012, 2007, and 2002-3 Indonesia Demographic and Health Surveys (IDHS). We obtained approval to access IDHS birth records. All data reported in this paper is aggregate, and no attempt was made to identify study participants. Data used was the individual recode women’s survey from the four most recent waves, from 1997 to 2017. Due to political instability, there is no data from the provinces Aceh, Maluku, North Maluku, and Papua during the first wave. Maluku, North Maluku, and Papua are grouped into the Eastern region, so there is no data from the Eastern region during this timeframe. Aceh is a part of the Western Region, so only data from the 17 other Western provinces are reported during this time. IDHS used two-stage stratified sampling methods distributed across census blocks nationwide and weighted by province. More details of the sampling procedure have been described elsewhere (https://dhsprogram.com/publications/publication-FR342-DHS-Final-Reports.cfm).
All data from 1997 was dropped due to low participant numbers. Women who had given birth within the past five years were included in the analysis. If a participant had given birth more than once within the last five years, only data on the most recent birth was used. We excluded data from overlapping birth dates from different survey waves to avoid statistical spikes in births every 5 years. The birth records included questions regarding demographic characteristics, obstetric history, childbirth service usage, and C-section. IDHS is funded by USAID and the government of Indonesia.