Determinants of contraceptive use prior to onset of childbearing among ever-married women in Indonesia: a secondary data analysis

Abstract

Background: Despite high rates of early marriage and adolescent childbearing in Indonesia-which increase risks for both maternal and child health-family planning efforts largely focus on birth spacing or limiting the number of children. Few programs specifically address the reproductive needs of ever-married women who wish to prevent or delay their first birth. This study investigates the sociodemographic factors influencing contraceptive use prior to childbearing among ever-married women in Indonesia.

Methods: We analyzed weighted data from 121,916 ever-married women using the 2002-2017 Indonesia Demographic and Health Surveys. Variables were selected based on prior research and bivariate screening. Univariate and multiple survey logistic regression analyses were performed; model selection was guided by the Akaike Information Criterion, and Nagelkerke R-square quantified the explained variance.

Results: Overall, 4.66% of ever-married women reported using contraception before having any children. Younger women (15-19 years), those preferring a smaller family size, being employed, and residing in Java were significantly associated with higher usage. Contrary to conventional assumptions, the poorest wealth quintile had notably high odds of pre-childbearing contraceptive use, second only to the richest. Interactions involving education and rural residence highlighted the multifaceted nature of these reproductive decisions.

Discussion: These findings underscore the need for targeted policies to address diverse socioeconomic barriers and to empower women who wish to delay their first birth.

Keywords: Childless; Contraceptive; Ever-married.