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Few studies have examined the impact of unintended pregnancy on women in developing countries. This paper examines the impact of unintended pregnancy on Indonesian women's psychological well-being. It is hypothesized that experiencing unintended pregnancy is associated with lower psychological well-being and that use of family planning and small family size are associated with higher levels of psychological well-being. Data are drawn from a 1996 survey of 796 women aged 15-49 from two Indonesian provinces, Lampung and South Sumatra. This article focuses on the 71% of women (n=562) who answered all 41 survey items related to psychological well-being. In cluster analysis, women grouped into three clusters, differentiated by their scores on four scales of well-being established through factor analysis (general negative feelings, satisfaction with relationships, satisfaction with economic/family/personal conditions, and negative feelings regarding domestic issues). Women in cluster 3 were characterized mainly by their high level of psychological well-being. Women in cluster 1 had the lowest level of well-being, and women in cluster 2 were in the middle. Multinomial logistic regression was used to assess jointly the effect of unintended pregnancy, contraceptive use, number of children and other factors on a woman's level of psychological well-being. Unintended pregnancy was associated with lower levels of psychological well-being and contraceptive use was associated with higher levels of psychological well-being, while number of children was not associated with level of well-being. Women who had experienced an unintended pregnancy were less likely to be in the high psychosocial well-being cluster versus both the medium and low clusters. In addition, women using contraception were more likely to be classified in the high than in the low or medium well-being clusters.

In Indonesian primary schools, sex education is implicitly integrated into various related subjects, such as science, biology, social studies and religion. The technical facts of ovulation and sperm are mentioned in biology, although little or no connection is made between this process and sexual intercourse. By the end of primary school, therefore, children are likely to have a poor understanding of how pregnancy can occur. Given that young girls at this age have already experienced or will soon experience menarche, and given the increasing trend towards delaying the age at marriage in Indonesian society, this lack of knowledge places young people at risk of various negative consequences, including unwanted pregnancy. In this paper, we investigate the level of understanding regarding human reproduction amongst 1762 students attending the last year of primary school, distributed across 32 different schools in Indonesia. Despite the fact that all schools follow a national curriculum, our results reveal widespread variability in the students' comprehension of how pregnancy can occur. In particular, students attending Islamic religious schools and those in less developed provinces of Indonesia appear to have a much poorer understanding of the link between sexual intercourse and conception.

In Indonesian primary schools, sex education is implicitly integrated into various related subjects, such as science, biology, social studies and religion. The technical facts of ovulation and sperm are mentioned in biology, although little or no connection is made between this process and sexual intercourse. By the end of primary school, therefore, children are likely to have a poor understanding of how pregnancy can occur. Given that young girls at this age have already experienced or will soon experience menarche, and given the increasing trend towards delaying the age at marriage in Indonesian society, this lack of knowledge places young people at risk of various negative consequences, including unwanted pregnancy. In this paper, we investigate the level of understanding regarding human reproduction amongst 1762 students attending the last year of primary school, distributed across 32 different schools in Indonesia. Despite the fact that all schools follow a national curriculum, our results reveal widespread variability in the students' comprehension of how pregnancy can occur. In particular, students attending Islamic religious schools and those in less developed provinces of Indonesia appear to have a much poorer understanding of the link between sexual intercourse and conception. [ABSTRACT FROM AUTHOR]

Background: Care for women during pregnancy, labour, birth and the postpartum period is essential to reducing maternal and neonatal mortality and morbidity, however the ideal place and organisation of care provision has not been established. The World Health Organization recommends a two-tier maternity care system involving first-level care in community facilities, with backup obstetric hospital care. However, evidence from high-income countries is increasingly showing benefits for low risk women birthing outside of hospital with skilled birth assistance and access to backup care, including lower rates of intervention. Indonesia is a lower middle-income country with a network of village based midwives who attend births at homes, clinics and hospitals, and has reduced mortality rates in recent decades while maintaining largely low rates of intervention. However, the country has not met its neonatal or maternal mortality reduction goals, and it is unclear whether greater improvements could be made if all women birthed in hospital. Body: This paper reviewed the literature on birth outcomes by place of birth and/or caregiver for women considering their risk of complications in Indonesia. A systematic literature search of Pubmed, CINAHL, CENTRAL, Web of Science, Popline, WHOLIS and clinical trials registers in 2016 and updated in 2018 resulted in screening 2211 studies after removing duplicates. Twenty four studies were found to present outcomes by place of birth or caregiver and were included. The studies were varied in their findings with respect of the outcomes for women birthing at home and in hospital, with and without skilled care. The quality of most studies was rated as poor or moderate using the Effective Public Health Practice Project Quality Assessment Tool. Only one study gave an overall assessment of the risk status of the women included, making it impossible to draw conclusions about outcomes for low risk women specifically; other studies adjusted for various individual risk factors. Conclusion: From the studies in this review, it is impossible to assess the outcomes for low risk women birthing with health professionals within and outside of Indonesian hospitals. This finding is supported by reviews from other countries with developing maternity systems. Better evidence and information is needed before determinations can be made about whether attended birth outside of hospitals is a safe option for low risk women outside of high income countries. [ABSTRACT FROM AUTHOR]