Determinants of birthplace among middle-to lower-class women in Indonesia: A study using the Indonesian Demographic and Health Survey

BACKGROUND: One of the factors contributing to a high maternal mortality rate is the utilization of non-healthcare facilities as a birthplace for women. This study analyzed determinants affecting birthplace in middle-to lower-class women in Indonesia. METHODS: This study analyzed the 2017 Indonesian Demographic and Health Survey (IDHS) data. The total national sample size was 49,627 eligible women. Our sample included 11,104 women, aged 15–49, who had delivered babies and were of low-to-middle economic status. The type of survey dataset was individual record dataset. Data were analyzed with chi-square and multivariate logistic regression tests using Stata 16 software. RESULTS: About 64.99% middle to lower class women in Indonesia delivered in healthcare facilities. Women aged 45–49 (OR = 2.103; 95% CI = 1.13–3.93), who graduated from higher schools (OR = 2.885; 95% CI = 1.76–4.73), whose husbands had higher education (OR = 2.826; 95% CI = 1.69–4.74) and were employed (OR = 2.523; 95% CI = 1.23–5.17), who considered access to healthcare facilities was not a problem (OR = 1.528; 95% CI = 1.28–1.82), who had a single child (OR = 2.349; 95% CI = 1.97–2.80), and who lived in urban areas (OR = 2.930; 95% CI = 2.40–3.57) were determinants that significantly correlated with women giving birth in healthcare facilities. CONCLUSION: This study provides insights for policymakers and healthcare centers in the community to strengthen access to healthcare services and devise health promotion strategies for pregnant mothers. Policy interventions designed for middle- to lower-class women should be implemented to support vulnerable groups.