References

Acharya DR, Bell JS, Simkhada P, Van Teijlingen ER, Regmi PR. Women's autonomy in household decision-making: a demographic study in Nepal. Reprod Health. 2010; 7:(1) https://doi.org/10.1186/1742-4755-7-15

Acharya K, Paudel YR, Silwal P. Sexual violence as a predictor of unintended pregnancy among married young women: evidence from the 2016 Nepal demographic and health survey. BMC Pregnancy Childbirth. 2019; 19:(1) https://doi.org/10.1186/s12884-019-2342-3

Ahmed A, Hafez A. Factors affecting the family planning methods used by the currently married women in rural Egypt. Am J Res Comm. 2014; 2:(10)324-341

Adolescent reproductive health in Yemen; status, policies, programs, and issues. 2003. https://bit.ly/3MkWnBJ (accessed 5 October 2022)

Alhassan AY, Abdul-Rahim A, Akaabre PB. Knowledge, awareness and perceptions of females on clandestine abortion in Kintampo north municipality, Ghana. Eur Sci J. 2016; 12:(12)95-95 https://doi.org/10.19044/esj.2016.v12n12p95

Arifin H, Widiasih R, Pradipta RO, Kurniawati Y. Regional disparities and their contribution to the coverage of the tetanus toxoid vaccine among women aged 15–49 years in Indonesia. F1000Research. 2021; 10:437-437 https://doi.org/10.12688/f1000research.53004.1

Ajayi AI, Ezegbe HC. Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa. BMC Public Health. 2020; 20:(1) https://doi.org/10.1186/s12889-020-09488-6

Badan Pusat Statistik. Peraturan Kepala Badan Pusat Statistik Nomor 37 Tahun 2010 Tentang Klasifikasi Perkotaan dan Perdesaan di Indonesia. 2010. https://bit.ly/3eqVqei (accessed 5 October 2022)

Bain LE, Muftugil-Yalcin S, Amoakoh-Coleman M, Zweekhorst MBM, Becquet R, De Cock Buning T. Decision-making preferences and risk factors regarding early adolescent pregnancy in Ghana: stakeholders' and adolescents' perspectives from a vignette-based qualitative study. Reprod Health. 2020; 17:(1)1-12 https://doi.org/10.1186/s12978-020-00992-x

Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disorders. 2016; 191:62-77 https://doi.org/10.1016/j.jad.2015.11.014

Bledsoe SE, Rizo CF, Wike TL Pregnant adolescent women's perceptions of depression and psychiatric services in the United States. Women Birth. 2017; 30:(5)e248-e257 https://doi.org/10.1016/j.wombi.2017.02.006

Brauer M, van Ditzhuijzen J, Boeije H, van Nijnatten C. Understanding decision-making and decision difficulty in women with an unintended pregnancy in the Netherlands. Qual Health Res. 2019; 29:(8)1084-1095 https://doi.org/10.1177/1049732318810435

Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Biol Med. 2008; 3:(1) https://doi.org/10.1186/1751-0473-3-17

Croft TN, Marshall AMJ, Allen CK. Guide to DHS statistics.Virginia, US: ICF International; 2018

Darroch JE, Woog V, Bankole A. Adding it up: costs and benefits of meeting the contraceptive needs of adolescents.New York: Guttmacher Institute; 2016

Dharma ADS Keberagaman Pengaturan Batas Usia Dewasa Seseorang Untuk Melakukan Perbuatan Hukum Dalam Peraturan Perundang-Undangan Di Indonesia. Repertorium. 2015; 2:(2)2355-2646

Dehlendorf C, Harris LH, Weitz TA. Disparities in abortion rates: a public health approach. Am J Public Health. 2013; 103:(10)1772-1779 https://doi.org/10.2105/AJPH.2013.301339

The Demographic and Health Survey Program. Demographic Health Survey - guide to DHS statistics. 2017. https://bit.ly/3MlkDUb (accessed 5 October 2022)

The Demographic Health Survey Program. Wealth quintiles. 2018. https://bit.ly/3rK1z8C (accessed 5 October 2022)

Frederico M, Michielsen K, Arnaldo C, Decat P. Factors influencing abortion decision-making processes among young women. Int J Environ Res Public Health. 2018; 15:(2) https://doi.org/10.3390/ijerph15020329

Hanifa FN, Kurniawati HF. Teenagers' decision making about abortion as an action to terminate. Midwiferia Jurnal Kebidanan. 2020; 6:(2)44-48 https://doi.org/10.21070/midwiferia.v

Hornberger LL. Options counseling for the pregnant adolescent patient from the American academy of pediatrics. Pediatrics. 2017; 140:(3)20172274-20172274

Kantorová V. Unintended pregnancy and abortion: what does it tell us about reproductive health and autonomy?. Lancet. 2020; 8:(9)e1106-e1107 https://doi.org/10.1016/S2214-109X(20)30342-9

UU No. 20 Tahun 2003 Tentang Sistem Pendidikan Nasional. 2003. https://bit.ly/3MniWpq (accessed 10 October 2022)

Kiranantika A. Pola Pengambilan Keputusan Mengenai Partisipasi dalam Program Keluarga Berencana pada Keluarga Muda di Kota Malang. Jurnal Sejarah dan Budaya. 2013; 7:(1)51-61

Kusnanto K, Arifin H, Kurniawati Y. Determinant of BCG vaccine coverage among Indonesian children aged 0–2 months. Children Youth Serv Rev. 2020; https://doi.org/10.1016/j.childyouth.2020.105238

Loi UR, Lindgren M, Faxelid E, Oguttu M, Klingberg-Allvin M. Decision-making preceding induced abortion: a qualitative study of women's experiences in Kisumu, Kenya. Reprod Health. 2018; 15:(166) https://doi.org/10.1186/s12978-018-0612-6

Mafula D, Satrio Pambudi B. Optimization of telenursing in combating COVID-19: preparation for transitioning from pandemic to endemic era. J Palembang Nurs Stud. 2022; 1:(2)61-63 https://doi.org/10.55048/jpns.v1i2.20

Mahendradhata Y, Trisnantoro L, Listyadewi S The Republic of Indonesia Health System Review (Vol. 7).Geneva: World Health Organization; 2017

Makleff S, Wilkins R, Wachsmann H Exploring stigma and social norms in women's abortion experiences and their expectations of care. Sex Reprod Health Matters. 2019; 27:(3)50-64 https://doi.org/10.1080/26410397.2019.1661753

Maxwell L, Nandi A, Benedetti A, Devries K, Wagman J, García MC. Intimate partner violence and pregnancy spacing: results from a meta-analysis of individual participant time-to-event data from 29 low and middle-income countries. BMJ Glob Health. 2017; 3:1-13 https://doi.org/10.1136/bmjgh-2017-000304

McLeod J. Pengantar Konseling: Teori dan Studi Kasus.Indonesia: Kencana Prenada Media Group; 2006

Mediarti D, Rosnani R, Sukartini T, Arifin H, Kurniawati Y. Coverage and factors associated with complete polio vaccination among Indonesian children aged 0–18 months. Children Youth Serv Rev. 2020; 118 https://doi.org/10.1016/j.childyouth.2020.105399

Moeliono BAdL. Gambaran Pengambilan Keputusan Dalam Risk Taking Behavior Remaja Putri Yang Melakukan Aborsi Tidak Aman. Journal Ilmiah Psikologi MANASA. 2017; 6:(9)58-65

Moore AM, Frohwirth L, Miller E. Male reproductive control of women who have experienced intimate partner violence in the United States. Soc Sci Med. 2010; 70:(11)1737-1744 https://doi.org/10.1016/j.socscimed.2010.02.009

Mulawarman M, Munawaroh E. Psikologi Konseling: Sebuah Pengantar bagi Konselor Pendidikan.Indonesia: Universitas Negeri Semarang; 2016

Mulyanti L. Decision making pro life in teenagers with unwanted pregnancy in Semarang. Jurnal Kebidanan. 2017b; 6:(1) https://doi.org/10.26714/jk.6.1.2017.28-34

Murugesu L, Damman OC, Derksen ME Women's participation in decision-making in maternity care: a qualitative exploration of clients' health literacy skills and needs for support. Int J Environ Res Public Health. 2021; 18:(3) https://doi.org/10.3390/ijerph18031130

Nadeem M, Malik MI, Anwar M, Khurram S. Women decision making autonomy as a facilitating factor for contraceptive use for family planning in Pakistan. Soc Indicat Res. 2021; https://doi.org/10.1007/s11205-021-02633-7

Newnham EA, Chen Y, Gibbs L The mental health implications of domestic violence during COVID-19. Int J Public Health. 2022; https://doi.org/10.3389/ijph.2021.1604240

Nkhoma DE, Lin CP, Katengeza HL Girls' empowerment and adolescent pregnancy: a systematic review. Int J Environ Res Public Health. 2020; 17:(5)1-14 https://doi.org/10.3390/ijerph17051664

Rata-rata Hamil Luar Nikah, Pernikahan Anak di Bone Tembus 463 Kasus. 2022. https://bit.ly/3rGFJ5R (accessed 10 October 2022)

Rachmawati PD, Kurnia ID, Asih MN Determinants of under-five mortality in Indonesia: a nationwide study. J Pediatr Nurs. 2022; https://doi.org/10.1016/j.pedn.2022.02.005

Rahman M. Women's autonomy and unintended pregnancy among currently pregnant women in Bangladesh. Mat Child Health J. 2012; 16:(6)1206-1214 https://doi.org/10.1007/s10995-011-0897-3

Ralph L, Gould H, Baker A, Foster DG. The role of parents and partners in minors' decisions to have an abortion and anticipated coping after abortion. J Adolesc Health. 2014; 54:(4)428-434 https://doi.org/10.1016/j.jadohealth.2013.09.021

Rosnani R, Setyowati S, Koestoer RA, Widjaja BT, Mediarti D, Arifin H. Photobiomodulation: a cultural nursing intervention for physical and psychological adaptation. Br J Midwifery. 2022; 30:(5)258-268 https://doi.org/10.12968/bjom.2022.30.5.258

Rizkianti A, Afifah T, Saptarini I, Rakhmadi MF. Women's decision-making autonomy in the household and the use of maternal health services: an Indonesian case study. Midwifery. 2020; 90 https://doi.org/10.1016/j.midw.2020.102816

Santelli J, Rochat R, Hatfield-Timajchy K The measurement and meaning of unintended pregnancy. Perspect Sex Reprod Health. 2003; 35:(2)94-101 https://doi.org/10.1363/3509403

Sarder A, Islam SMS, Maniruzzaman Talukder A, Ahammed B. Prevalence of unintended pregnancy and its associated factors: evidence from six south Asian countries. PLoS One. 2021; 16:(2) https://doi.org/10.1371/journal.pone.0245923

Sarmita IM. Lokika Sanggraha: Pengaruhnya Terhadap Aborsi dan Kesehatan Reproduksi Remaja Perempuan Bali. Media Komunikasi Geografi. 2015; 16:(1)53-66

Shah IH, Åhman E. Unsafe abortion differentials in 2008 by age and developing country region: high burden among young women. Reprod Health Matters. 2012; 20:(39)169-173 https://doi.org/10.1016/S0968-8080(12)39598-0

Sharma KK, Vatsa M, Kalaivani M, Bhardwaj D. Mental health effects of domestic violence against women in Delhi: a community-based study. J Family Med Primary Care. 2019; 8:(7)2522-2527 https://doi.org/10.4103/jfmpc.jfmpc_427_19

Sharman LS, Douglas H, Price E, Sheeran N, Dingle GA. Associations between unintended pregnancy, domestic violence, and sexual assault in a population of Queensland women. Psychiatr Psychol Law. 2019; 26:(4)541-552 https://doi.org/10.1080/13218719.2018.1510347

Silverman JG, Raj A. Intimate partner violence and reproductive coercion: global barriers to women's reproductive control. PLoS Med. 2014; 11:(9) https://doi.org/10.1371/journal.pmed.1001723

Smith W, Turan JM, White K Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama. Perspect Sex Reprod Health. 2016; 48:(2)73-81 https://doi.org/10.1363/48e9016

Sopiatun R. Proses Pengambilan Keputusan tentang Aborsi di Perkumpulan Keluarga Berencana Indonesia (PKBI) Propinsi Nusa Tenggara Barat (NTB). Jurnal Kesehatan Prima. 2011; 5:(2)778-790

Profil Penduduk Indonesia Hasil SUPAS 2015.Indonesia: Statistics Indonesia; 2016

Indonesia young adult reproductive health survey 2007.Indonesia: BPS and Macro International; 2008

Preferences of adolescent in family planning in the future universitas Jember. 2015. https://bit.ly/3enAwg7 (accessed 10 October 2022)

Tegegn A, Yazachew M, Gelaw Y. Reproductive health knowledge and attitude among adolescents: a community based study in Jimma Town, southwest Ethiopia. Ethiop J Health Dev. 2008; 22:(3)143-151

Testa MR. On the positive correlation between education and fertility intentions in Europe: individual- and country-level evidence. Adv Life Course Res. 2014; 21:28-42 https://doi.org/10.1016/j.alcr.2014.01.005

Skosana MT, Peu MD, Mogale RS. Disconnections and exclusions of parents in the prevention of teenage pregnancy: a phenomenological approach. Int J Africa Nurs Sci. 2020; 13 https://doi.org/10.1016/j.ijans.2020.100251

Laporan Akhir Penelitian Hukum tentang Perkembangan Hukum Adat di Propinsi Sulawesi Selatan. 2005. https://bit.ly/3EyK4j9 (accessed 10 October 2022)

Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Planning. 2006; 21:(6)459-468 https://doi.org/10.1093/heapol/czl029

World Health Organization. Adolescent pregnancy. 2019. https://bit.ly/2REOUA5 (accessed 5 October 2022)

Zeleke LB, Alemu AA, Kassahun EA. Individual and community level factors associated with unintended pregnancy among pregnant women in Ethiopia. Scientific Reports. 2021; 11:1-9 https://doi.org/10.1038/s41598-021-92157-4

Zia Y, Mugo N, Ngure K Psychosocial experiences of adolescent girls and young women subsequent to an abortion in sub-Saharan Africa and globally: a systematic review. Front Reprod Health. 2021; 3:(May)1-13 https://doi.org/10.3389/frph.2021.638013

Unwanted pregnancy in Indonesia: prevalence and decision making

02 November 2022
Volume 30 · Issue 11

Abstract

Background/Aims

Young women in Indonesia who experience an unwanted pregnancy may not have the necessary support to make an informed decision about whether to continue with or terminate the pregnancy. The aim of this study was to determine factors that influence the decision to terminate or continue with an unwanted pregnancy among women aged 15–24 years old in Indonesia.

Methods

Data from the 2017 Indonesian demographic and health survey were used. These data included 9218 women aged 15–24 years from eight regions in Indonesia. Chi-squared tests and binary and multivariable logistic regression were used to analyse the data.

Results

Almost 20% of women in Indonesia decided to terminate an unwanted pregnancy, and 25% experienced physical partner violence. Respondents who lived in Sulawesi, had primary education, lived in a rural area or had experienced physical partner violence were more likely terminate an unwanted pregnancy. Respondents who had a higher economic status were less likely terminate.

Conclusions

The decision to terminate a pregnancy may be more likely to be made by women under certain circumstances. Programmes for pregnant women involving counselling should be initiated via cross-collaboration with government, parents and healthcare workers, to provide support for decision making in the case of an unwanted pregnancy.

Women who have an unwanted pregnancy may decide to terminate that pregnancy and will experience social and, potentially, psychological changes that can affect their future (Frederico et al, 2018). Pregnancy at a young age increases the likelihood of a woman not finishing school, and teenagers who become pregnant must consider how to communicate with their parents, as they may encounter family disharmony or even a partner's demand for an abortion (Frederico et al, 2018). Women with an unwanted pregnancy may feel depressed, afraid, confused or embarrassed, and may be prone to emotional turmoil (Biaggi et al, 2016). They may also be pressured by their family, peers or environment and experience physical and psychological changes as a result of the pregnancy (Bledsoe et al, 2017; Rosnani et al, 2022). These factors may put pressure on women with an unwanted pregnancy to make a decision quickly, without considering the potential consequences, and can result in women having an abortion without indication or medical assistance (Kantorová, 2020).

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