The Role of Women’s Empowerment in Fertility Preferences and Outcomes: Analysis of the 2017 Indonesia Demographic and Health Survey

BMC Womens Health. 2025 Apr 30;25(1):211. doi: 10.1186/s12905-025-03748-6.

ABSTRACT

BACKGROUND: With a population of 275 million, Indonesia is the world’s fourth most populous country and has made considerable efforts to reduce its Total Fertility Rate from 5.6 in 1971 to a target of 2.1 by 2024. Women’s empowerment has been identified as a critical factor influencing fertility dynamics, gender equality, reproductive autonomy, and broader socioeconomic development. This study examines the association between four dimensions of women’s empowerment and three fertility-related outcomes among married women aged 22 years and older in Indonesia.

METHODS: We used cross-sectional data from 34,017 married women participating in the 2017 Indonesia Demographic and Health Survey (IDHS). An outcome-wide analytical approach was adopted to explore three outcomes: total number of children ever born, ideal number of children, and fertility preference alignment, i.e. whether actual fertility matched stated preferences. Four empowerment domains were assessed: household decision-making, attitudes toward wife beating, attitudes toward refusing sex, and labour force participation. Stepwise multivariate Poisson regression modelling was applied, adjusting for key demographic and socioeconomic covariates.

RESULTS: Our study found that the association between each type of women’s empowerment and fertility-related outcomes varied, reinforcing the notion that empowerment does not uniformly affect reproductive behaviour. Among the four empowerment indicators, rejecting all justifications for wife beating emerged as the most consistent and significant predictor across all fertility outcomes. It was association with fewer children ever born (β = 0.03), a lower ideal number of children (β = 0.04), and a higher likelihood of meeting fertility preferences (PR = 1.02). Attitudes toward refusing sex were also significantly associated with fewer children (β = 0.02) and lower fertility ideals (β = 0.07). However, participation in decision-making and labour force participation showed mixed or non-significant associations, indicating that different empowerment dimensions may influence reproductive behaviour in diverse ways.

CONCLUSIONS: Women’s empowerment – particularly in the domains of gender-based violence and sexual autonomy – is closely linked to fertility preferences and behaviours. The findings underscore that empowerment is a multidimensional construct, with varying influences across its domains. Strengthening women’s autonomy and addressing gender-based violence are essential steps toward enhancing reproductive rights and achieving Sustainable Development Goal 5 in Indonesia. Gender-sensitive data systems and interventions tailored to different aspects of empowerment are urgently needed.

PMID:40307733 | DOI:10.1186/s12905-025-03748-6