BIRTH CONTROL IN THE PHILIPPINES: CONTRACEPTIVES, FAMILY PLANNING, SUCCESSES

POPULATION CONTROL IN INDONESIA

There was widespread agreement within the Indonesian government and among foreign advisers that one of the most pressing problems facing Indonesia in the early 1990s was overpopulation. While Indonesia still had high fertility rates, there were significant reductions in these levels in the 1980s. The overall population annual growth rate was reduced to an estimated 2.0 percent by 1990, down from 2.2 in the 1975-80 period. The crude birth rate declined from 48.8 births per 1,000 in 1968 to 29 per 1,000 in 1990. Although the widely publicized goal of 22 per 1,000 by 1991 was not achieved, the results were impressive for a country the size of Indonesia. The effect of the programs of the National Family Planning Coordinating Agency (BKKBN) was particularly dramatic in Java, Bali, and in urban areas in Sumatra and Kalimantan, despite cutbacks in funding. The success of the program in these areas seemed to be directly linked to the improved education of women, their increasing tendency to postpone marriage, and, most important, to a growing awareness and effective use of modern contraceptives. [Source: Library of Congress *]

The reason behind Indonesia's overall decline in fertility rates was a matter of debate in 1992, because it was not clear that economic conditions had improved for most Indonesians during the 1970s and 1980s (the middle class did experience some improvement). Indeed, although the number of poor decreased in the 1970s and 1980s, landlessness, malnutrition, and social and economic inequality may have increased for many of the rural poor. However, some observers argued that, despite the lack of social and economic improvements among Indonesia's poor, easy availability of birth control procedures, mass education, and more mobile family structures may be sufficient to explain this impressive change. *

Even though Indonesia's growth rate had decreased over the decades since independence, the population continued to grow and population density increased significantly, particularly on the main islands. In July 1992, Indonesia's population had reached 195,683,531, with an annual growth rate of 1.7 percent, according to United States estimates. The Indonesians themselves claimed 179,322,000 in their 1990 census and various foreign estimates for 1992 ranged between 183 million and 184 million, with a 1.7 percent growth rate. Population growth placed enormous pressures on land, the education system, and other social resources, and was closely linked to the dramatic rise in population mobility and urbanization. At such rates of growth, the population was expected to double by 2025. Even if birth control programs in place in the early 1990s succeeded beyond expectations and each Indonesian woman had only two children, Indonesia's population was still so young that huge numbers of women would reach their child-bearing years in the first decades of the twentyfirst century. This tremendous ballooning of the younger population groups virtually ensured that overpopulation would continue to be a major source of concern well into the next century. By the year 2000, Indonesia's population was projected to reach at least 210 million, with the country maintaining its position as the fourth most populous nation on earth. *

Although Indonesia's demographic situation was cause for great concern, it had much in common with other Third World nations. Indeed, in some respects Indonesia was slightly better off than other developing countries in the early 1990s because it had initiated some of the world's most ambitious programs to control its population problem. The key features of these initiatives were the national birth control program and the massive Transmigration Program, in which some 730,000 families were relocated to underpopulated areas of the country. *

The population problem was most dramatic among the rice-growing peasants of Java and Bali and in cities — particularly Jakarta, Surabaya, Bandung, and Medan. In 1980 the islands of Java, Madura, and Bali, which comprised 6.9 percent of the nation's land area, were home to 63.6 percent of Indonesia's population. These major islands had a population density of more than 500 persons per square kilometer, five times that of the most densely populated Outer Islands. *

The inability of these islands to support ever larger populations on ever smaller plots of land was apparent in 1992, particularly to the farmers themselves. Although the intensification of padi agriculture had for decades permitted the absorption of this rising labor force, the rural poor from Java, Bali, and Madura were leaving their native areas to seek more land and opportunity elsewhere. Attempts at significant land reform, which might have improved the peasants' lot, were stalled — if not abandoned — in many areas of Java because of riots and massacres following the alleged communist coup attempt of 1965. Reformers were cautious about raising the issue of land redistribution for fear of being branded communists. *

Fertility and Birth Statistics for Indonesia

Total fertility rate: 1.93 children born/woman (2025 estimate). The total fertility rate in 2014 was 2.18 children born/woman (102nd in the world). Fertility rates for women, based on births per woman, decreased slightly, from 2.6 in 2000 to an estimated 2.3 in 2009, One consequence of a low birth rate is an increasingly older population. [Source: CIA World Factbook, 2025]

Gross reproduction rate: 0.94 (2025 estimate)

Birth rate: 14.55 births/1,000 population (2025 estimate).

Currently married women (ages 15-49): 70.3 percent (2022 estimate). Mother's mean age at first birth ( among women 25-49): 22.4 years (2017 estimate); The mother's mean age at first birth in 2014 was 22.8. [Source: CIA World Factbook, 2025]

Contraception Use in Indonesia

Contraceptive Use (any method, women ages 15-49): 53 percent (2023, compared to 13 percent in Sudan and 76 percent in the United Kingdom) [Source: World Bank] Contraceptive prevalence rate: 61.9 percent (2012). This figure is the percent of women of reproductive age (15-49) who are married or in union and are using, or whose sexual partner is using, a method of contraception. [Source: CIA World Factbook]

Types of birth control used (2015); female sterilization: 3.2 percent; male sterilization: 0.2 percent; pill: 13.9 percent; injectible: 32.6 percent; implant: 3.3; IUD: 3.9 percent; male condom: 1.2 percent; early withdrawal: 1.9 percent; rhythm method: 4.8 percent; traditional 0.4 percent total: 62.9 percent [Source: Trends in Contraceptive Use Worldwide 2015 - the United Nations un.org/en/development/desa/population/publications ]

Types of birth control used (1994): female sterilization: 3.1 percent; male sterilization: 0.7 percent; pill: 16.9 percent; injectible: 15.1 percent; implant: 4.9 percent; IUD: 10.2 percent; male condom: 0.9 percent; vaginal barrier: 0.9 percent; early withdrawal: 0.6 percent; rhythm method: 0.8 percent; total: 53.7 percent [Source: Trends in Contraceptive Use Worldwide 2015]

Various ethnic groups in Indonesia used different kinds of traditional contraceptives in the past and to some extent today. plant-based contraceptives and abortifacients were not used, and infanticide was virtually unknown. A postpartum taboo on sexual intercourse was observed for several years after the birth of a child to allow for adequate weaning. During swiddening cycles, however, such taboos were more relaxed; as a result, when groups returned to a nomadic foraging lifestyle, women sometimes had more children than they could easily support. “Blood money” (bangun) was paid to a woman’s parents if a child was believed to have died from milk deprivation caused by closely spaced pregnancies, which were thought to disrupt the infant’s weaning cycle (Sandbukt 1988).[Source: International Encyclopedia of Sexuality, edited by Robert T. Francoeur, Ph.d., A.c.s and Raymond J. Noonan, PhD., Continuum International Publishing Group, 2004, online at the Kinsey Institute]

Family Planning in Indonesia the Suharto Era

Suharto was President of Indonesia from the mid 1960s to the late 1990s. Indonesia's family planning program was formally established under President Suharto in 1970, following years in which rapid population growth was not considered problematic, and was even encouraged at times. Between the 1970s and 1990s, contraceptive use increased from 10 percent per couple to 50 percent. As a result, the average family size fell by a third to four children per couple in the 1980s. Although birth rates among the middle class were lowered, birth rates remained high among the poor and some Muslims. Source: Matthew Easton, Worldmark Encyclopedia of National Economies, Gale Group Inc., 2002; William Branigin, Washington Post]

Beginning in 1970, the government provided free contraceptives at public health centers. By 1988, as economic conditions improved and awareness of family planning increased, government support was gradually reduced, encouraging those who could afford it to obtain contraceptives from private physicians or midwives for reasonable fees. Poorer individuals, however, continued to receive free services at public health centers, paying only a small admission fee. [Source: International Encyclopedia of Sexuality, edited by Robert T. Francoeur, Ph.d., A.c.s and Raymond J. Noonan, PhD., Continuum International Publishing Group, 2004, online at the Kinsey Institute ^^]

The "national family-prosperity" birth control program set by Suharto’s national Family Planning Coordinating Board was very successful in reducing the birth rate in Indonesia in a way that was less draconian than in China and India. "Indonesia's authoritarian government," wrote William Branigin in the Washington Post was "able to stiff-arm Muslim foes and pursue its widely praised family planning program...Its 24-year-old family planning program, considered the most successful in the Muslim world, managed to bring annual population growth down from 2.5 percent in the 1970s to 1.6 percent at the time." [Source: William Branigin, Washington Post]

After years of looking upon Western attitudes as immoral, in the early 1970s contraceptives were suddenly made available and signs sprang up in villages all over the country encouraging couples to have two or fewer children. One Western diplomat in Jakarta told Branigin, "What made it so special was that the government had worked very hard with religious leaders to bring them along. The need to get religious leaders to go along with it was the biggest challenge they faced."

Indonesia has faced significant challenges in implementing population policies due to the size and geographic distribution of its population, as well as occasional cultural and religious objections. Despite this, Indonesia has achieved what the World Bank has called 'one of the most impressive demographic transitions anywhere in the world'. The growth rate fell from 2.5–2.7 per cent in 1970 to 1.63 per cent, and the total fertility rate fell from 5.5 births per woman between 1967 and 1970 to 2.6 births per woman between 1995 and 2000. These efforts are particularly important when you consider that Java is one of the most densely populated areas in the world,

Indonesia is often held up as a model for other developing countries. In 1989, the United Nations recognised the success of Indonesia’s national family planning programme by awarding its Population Award to the Indonesian president. Efforts are being made to achieve zero population growth in the near future

Implementation of Family Planning in Indonesia in the Suharto Era

Indonesia maintained a national program promoting contraception to help married couples plan their families. The program was directed primarily at married individuals and did not initially target adolescents or unmarried adults. Information about contraception was disseminated through women’s organizations, newspapers, and radio and television broadcasts. [Source: International Encyclopedia of Sexuality, edited by Robert T. Francoeur, Ph.d., A.c.s and Raymond J. Noonan, PhD., Continuum International Publishing Group, 2004, online at the Kinsey Institute ^^]

Indonesia's family planning program involved thousands of village-level volunteers, grassroots organisations, religious leaders, and a multifaceted approach that brought together agencies and organisations. The phrase 'dua anak cukup' ('two children are enough') appears on T-shirts, statues and television broadcasts, and family planning and reproductive health programme services are available in over 10,000 clinics, hospitals and community health centres. The National Family Planning Coordinating Board (BKKBN) coordinates these efforts, but does not implement activities independently. [Source: Matthew Easton, Worldmark Encyclopedia of National Economies, Gale Group Inc., 2002]

Under Suharto many different kinds of family planning programs were allowed to be set up. Condom factories were opened and local "supermarket style" family planning centers were established. Clinics were opened that provided free contraceptives. “Two children is enough” slogans were placed on billboards across the country. There were no draconian one-child laws like in China or sterilization clinics like in India. [Source: William Branigin, Washington Post]

The most commonly used contraceptives were oral hormonal pills, hormonal injections, and intrauterine devices (IUDs). Women were required to undergo a medical examination before receiving a prescription for oral contraceptives, though renewals were not restricted. Injections and IUDs were administered by doctors or midwives. Other available methods included hormonal implants and tubectomy. An effort was made to increase male participation in family planning. Traditionally, their participation had been very low and still is. This was due in part to prevailing attitudes of male social dominance, which discouraged men from taking responsibility for contraceptive use, as well as the limited options available to them—primarily condoms and vasectomy. Condom use accounted for only about 5 percent of contraceptive practice in the 1990s.

Despite restrictions on the distribution of contraceptive information to married women, some adolescents and unmarried women also obtained and used contraceptives. These were available in pharmacies and included condoms and vaginal film, and in some cases oral contraceptives could be obtained without a prescription. However, social attitudes generally opposed contraceptive use among unmarried individuals, and there was no formal sex education in schools. As a result, sexually active adolescents and single adults relied on informal sources such as media and seminars, and many lacked adequate knowledge about preventing unwanted pregnancies or understanding fertility cycles. Plans to incorporate sexual education into school curricula were expected to improve access to accurate information about sexuality and contraception. ^^

Problems and Obstacles with the Suharto-Era Family Planning

During Indonesia’s New Order period from , the government introduced a national Family Planning program (Keluarga Berencana) to curb rapid population growth, particularly on the island of Java. The program encouraged couples to have only two children, but in practice contraception was largely directed at women. One widely used method was the intrauterine device (IUD), which at the time had already been restricted or banned in parts of Europe and North America due to health concerns.[Source:“Culture and Customs of Indonesia” by Jill Forshee, Greenwood Press, 2006]

In Indonesia, especially in rural and tropical environments where sanitation was limited and infections were more common, the use of IUDs led to serious medical complications. Many women developed severe infections, some fatal, and others were left infertile. These experiences created widespread fear and mistrust of birth control, particularly in village communities. While the program achieved some success in Java and, to a lesser extent, Bali, resistance remained strong in other regions where people avoided participation. Although safer contraceptive methods were later introduced, the earlier problems associated with IUDs left a lasting impact on public attitudes toward family planning. The perception that birth control could be dangerous persisted and continued to influence decisions about fertility and reproductive health.

Reaching everybody and accommodating their needs and customs were also issues. Most groups remained inaccessible to Indonesia’s Department of Health regional and local offices, which primarily served nearby rural village populations. In remote parts of Indonesia sometimes you could find posters promoting birth control devices but you can’t find the devices themselves.

Forest-dwelling Orang Rimba groups living in government-sponsored settlements, or those who had settled independently, were occasionally visited by health workers, nurses, and sometimes government officials. Advice on infant care and family planning was offered, and in later years contraceptive injections were introduced, though they were widely refused. This resistance stemmed largely from distrust and from the disapproval of spouses, particularly men, who preferred that the government not interfere in private family matters. These visits were often viewed as formalities with unclear objectives, involving little evaluation and occurring sporadically without follow-up. During such “courtesy calls,” items such as soap, combs, and other toiletries were distributed—along with biscuits and cigarettes—which many Orang Rimba found insulting. As a result, especially among men, there was resentment toward Department of Health representatives, who were seen as insensitive to their actual needs. [Source: International Encyclopedia of Sexuality, edited by Robert T. Francoeur, Ph.d., A.c.s and Raymond J. Noonan, PhD., Continuum International Publishing Group, 2004, online at the Kinsey Institute \^/]

Contraceptives and Muslim Clerics in Indonesia

About half of Indonesian women of reproductive age use contraception and 90 percent of those said they paid for it, according to official data. According to Bloomberg: “Asih, a mother of seven, is among them. After her third child she tried injections — the most common form of female contraception in the country — because the pill made her sick. At 15,000 rupiah a shot, she couldn’t afford to keep taking them and in the following years, she had four more children. “The government’s goal is to try to shift the mix away from short-term methods to longer-term ones,” said Todd Callahan, Indonesian country director of DKT International, one of the largest private providers of contraceptives and family planning services in the developing world. “To change the trends in usage is going to need a few years.” [Source: Shamim Adam, Berni Moestafa and Novrida Manurung, Bloomberg, January 28, 2014 -]

“The government must also overcome cultural and religious barriers. The National Family Planning Coordination Board, which has a campaign with the slogan “Two Children Are Enough,” said in July it’s working with Muhammadiyah, one of Indonesia’s largest Muslim groups, to open centers in high schools and colleges that will discuss family planning and sexual reproductive health. “In some circles, the thinking remains that if couples follow family planning, they aren’t being grateful to God,” said Emi Nurjasmi, head of the Indonesian Midwives Association, which has more than 250,000 members. She said the midwives try to change people’s attitude as well as administering injections and inserting intrauterine devices. -

“In a religious school, or madrasah, in Lamongan in East Java province, Ainul Fahri, 17, says sex education was non-existent until a non-government organization for women’s rights persuaded four local schools to introduce the subject. “Even though this is a madrasah there are cases of early pregnancies,” Fahri said. “People here are completely in the dark about sex education.” -

“Plans to slow population growth may see most resistance in rural areas where bigger families mean more farmhands and support for parents in their old age. “There was family planning back in Suharto’s time and some of my neighbors took part, but I thought that having more children is better,” said Ikrar, a father of 11 who grows organic vegetables in Cibuntu village in Sukabumi, one of the two least-developed regencies in West Java. -

Putting Family Planning Back on Indonesia’s Agenda

In 2014, the Indonesian government expanded free family planning nationwide from seven to all 33 provinces. Bloomberg reported: “The Indonesian government wants families to stop at two children to prevent a burgeoning population overwhelming schools and services. Asih, a cleaner in Tangerang, near Jakarta, is stopping at seven. “In my family, we always had a lot of children, and as long as we still had something to eat, why do family planning?” said Asih, 35. “Now I have two children in primary school and more that will have to go in the next few years and I have no money to pay school fees. Seven kids are enough.” [Source: Shamim Adam, Berni Moestafa and Novrida Manurung, Bloomberg, January 28, 2014 -]

“That prospect has brought the revival of a birth-control program begun in 1968 by former President Suharto, who managed to halve the fertility rate to about 2.6, where it’s been stuck ever since. The government wants to cut the rate to the replacement level of 2.1 within two years to prevent the 250 million population doubling by 2060. “We have to go back to the policies of the Suharto era, to make strong campaigns and bring the fertility rate down,” said M Sairi Hasbullah, head of Indonesia’s statistics bureau for East Java province. “It’s not going to be easy to provide food, education, health facilities and infrastructure for 500 million people. It’s a big danger for Indonesia.” -

“The government increased the budget for family planning programs almost fourfold since 2006, to 2.6 trillion rupiah ($214 million) in 2013, funding everything from training rural midwives via text messages, to persuading Muslim clerics to encourage vasectomies. The measures extend efforts dating back to 1968, when Suharto set up the National Family Planning Institute to provide advice and contraceptives. -

Abortion in Indonesia

A 2018 study in Java, Indonesia, estimated an abortion rate of 43 per 1,000 women aged 15–49. While abortion is highly restricted by law, it is common, with an estimated 1.7 million cases annually in Java alone. Another estimate suggests around 2.5 million cases nationwide, with many taking place under unsafe conditions. [Source: Google AI; Guttmacher Institute]

Abortion is illegal throughout Indonesia, except in rare medical cases where it is necessary to save the mother’s life. It is impossible to obtain an accurate estimate of the number of abortions performed in Indonesia, simply because it is illegal. However, it is clear that many abortions are performed. [Source: International Encyclopedia of Sexuality, edited by Robert T. Francoeur, Ph.d., A.c.s and Raymond J. Noonan, PhD., Continuum International Publishing Group, 2004, online at the Kinsey Institute \^/]

As well as illegal abortions performed by medical doctors, traditional healers also perform abortions using traditional methods that are often unsafe and result in complications. One such method involves inserting the stem of a coconut tree leaf into the uterus through the vagina and cervix. This method is very risky because the equipment is not sterile and the healers do not understand sexual anatomy. Some deaths have been reported following abortions performed by traditional healers due to uterine rupture, bleeding or infection.

It is estimated that around 2.5 million abortions were performed each year throughout Indonesia, on both married and unmarried women in the early 2000s. Around one million of these were performed on teenagers. Some doctors have been arrested for performing abortions in their clinics. A few of these cases were reported in the news when the police found many dead fetuses buried in the clinic's yard or in plastic bags thrown into garbage bins or dumps.

Teenage and Unmarried Pregnancies in Indonesia

Unmarried pregnancies are not uncommon, but data on them are non-existent. The limited information available from routine clinical statistics merely documents the number of unmarried pregnancies in different years. Unpublished data from one urban clinic, for example, revealed that 473 unmarried pregnant women sought assistance in 1985–1986. A second clinic served 418 unmarried pregnant women between 1983 and 1986, while a third clinic reported 693 unmarried pregnancies between 1984 and 1990. [Source: International Encyclopedia of Sexuality, edited by Robert T. Francoeur, Ph.d., A.c.s and Raymond J. Noonan, PhD., Continuum International Publishing Group, 2004, online at the Kinsey Institute \^/]

These reports only provide raw data, offering no perspective. The frequency and incidence of unmarried pregnancies are much higher than these few studies suggest. Likewise, there are no data that would allow one to compare the incidence of unmarried pregnancies in cities and rural areas. However, the incidence of illegal abortions performed by doctors or traditional healers suggests that unwanted pregnancies are not uncommon in either cities or rural areas.

Some unwanted pregnancies result in abortion but not all. Some pregnant adolescents are forced to marry even though they do not want to. The unwanted babies born to unmarried adolescents or young adults who are taken care of in orphanages also indicate that unmarried pregnancies are not uncommon. Some unwanted babies are left by their mothers in clinics after delivery. Others are simply left outside someone's house to be found. Based on an estimated one million teenage abortions a year and the fact that not all unmarried pregnancies result in abortion, it is believed that the actual number of teenage unmarried pregnancies is well over a million a year.

Image Sources: Wikimedia Commons

Text Sources: “Encyclopedia of World Cultures Volume 5: East/Southeast Asia:” edited by Paul Hockings, 1993; “Culture and Customs of Indonesia” by Jill Forshee, Greenwood Press, 2006; National Geographic, New York Times, Washington Post, Los Angeles Times, Smithsonian magazine, Encyclopedia.com, Library of Congress, Indonesia Tourism website (indonesia.travel), Indonesia government websites, Live Science, The Conversation, The New Yorker, Time, BBC, CNN, Reuters, Associated Press, AFP, Lonely Planet Guides, Google AI, Wikipedia, The Guardian and various websites, books and other publications.

Last updated April 2026