Why Educated Indonesian Women Are More Likely to Choose Permanent Contraception

A large national study in Indonesia finds that education is the strongest driver of permanent contraceptive use among women with multiple children, with uptake rising sharply at each higher level of schooling. Access to information, economic security, urban residence, and partner support further increase the likelihood that women choose permanent methods.

Researchers from the Faculty of Public Health at Universitas Sumatera Utara, the National Research and Innovation Agency of the Republic of Indonesia, Universitas Airlangga, Universitas Ahmad Dahlan, and Universitas Muhammadiyah Kalimantan Timur set out to understand why permanent contraception remains unevenly used among Indonesian women who already have several children. Their study shows that education is the strongest factor shaping whether multiparous women decide to end childbearing permanently, outweighing many other social and economic influences. In a country where maternal health risks remain a concern, the findings highlight how schooling can quietly but powerfully shape reproductive choices.

Why Permanent Contraception Matters

Permanent contraception, mainly female sterilization and male sterilization, is one of the most reliable ways to prevent unintended pregnancies. It is highly effective, safe, does not interfere with breastfeeding or sexual life, and does not require ongoing medical follow-up. For women who already have the number of children they want, it can reduce health risks linked to repeated or closely spaced pregnancies. Despite these advantages, its use in Indonesia remains relatively low and uneven across regions, making it an important public health issue rather than just a personal choice.

What the National Data Reveals

The researchers analyzed data from the 2019 Government Performance and Accountability Survey, covering 33,471 women aged 15–49 who had more than one living child. The results show a clear and consistent pattern: the more educated a woman is, the more likely she is to use permanent contraception. Women with primary education were significantly more likely to choose permanent methods than women with no schooling. This likelihood rose sharply among women with secondary education and was highest among those with higher education, who were more than five times as likely to use permanent contraception. Education appears to improve not only knowledge about family planning but also confidence, long-term thinking, and the ability to make independent decisions.

The Role of Place, Income, and Information

Education works alongside other important factors. Women living in urban areas are more likely to use permanent contraception than those in rural settings, reflecting better access to health services and information. Age also matters. Women in their thirties and forties are far more likely to adopt permanent methods than teenagers or women in their early twenties, suggesting that decisions are made once family size feels complete. Having a partner increases the likelihood of use, highlighting the importance of shared decision-making within relationships.

Economic conditions further shape choices. Wealthier and employed women are more likely to use permanent contraception than poorer or unemployed women, even though many services are subsidized. Hidden costs such as travel, time, and navigating health facilities may still discourage poorer households. Exposure to family planning information through radio, television, and the internet strongly increases uptake, showing how mass media can correct myths, raise awareness, and normalize permanent methods.

Culture, Choice, and Policy Lessons

The study also reflects Indonesia’s cultural complexity. Traditional beliefs that value large families still exist alongside modern ideals of small, healthy households. Education helps women navigate these competing expectations by strengthening their ability to process information and assert their preferences in a largely patriarchal society. While the study cannot fully capture personal beliefs or religious influences, its message is clear. Improving women’s education, expanding access to accurate family planning information, and reducing urban–rural gaps in health services are key to supporting informed reproductive choices. Permanent contraception, the researchers argue, should be seen not as a last resort, but as a realistic and empowering option for women who have already completed their families.