Strengths and Limitations
We investigated the change in C-section rate over two decades in
Indonesia using a nationally representative sample, a strength of our
analysis. The study also had some limitations. There are a few missing
values in reporting mode of delivery (n=243) and childbirth service use
(n=171). Compared to the total number of responses (n=40743), we assume
nonresponse bias should be limited. Women may also suffer from recall
bias during the survey. However, given childbirth is an important event,
it is unlikely to have serious recall bias for the mode of delivery of
the most recent birth. Our categorization of all provinces into three
convenient categories (western, central, eastern) did not support
exploration of variation in C-section use at the provincial level.