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.