Copyright (c) 2026 Yuliwati, Lina Marliana
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
A Comprehensive Overview of Postpartum Visits and Postpartum Complications Among Mothers in Indonesia
Corresponding Author(s) : Yuliwati Yuliwati
International Research of Multidisciplinary Analysis,
Vol. 4 No. 1 (2026): International Research of Multidisciplinary Analysis
Abstract
Background. Most maternal deaths occur during the postpartum period, making postpartum visits (PPV) a critical opportunity to detect complications. However, PPV coverage in Indonesia varies depending on the data source and region.
Objectives. To describe the coverage of the first postpartum visit (KF1) and complete postpartum visits by province; to analyze their association with antenatal care, delivery services, and the maternal mortality rate (MMR); and to compare routine reporting data with survey data.
Methods. A cross-sectional ecological study across 33 provinces using data from the 2020 Indonesia Health Profile, the 2020 Population Census (SP2020) Long Form on MMR, and national figures from the 2023 Indonesia Health Survey (SKI). Analyses employed the Mann–Whitney test and Spearman’s correlation with a 95% confidence interval, accompanied by sensitivity analyses.
Results. National coverage of complete antenatal care (ANC) in the 2020 routine reports was 88.3%, with an interprovincial median of 83.3% (IQR 77.5–91.1); 12 provinces were below 80%, with the lowest rate in West Papua (30.7%). Complete postpartum care was strongly correlated with K4 (rho = 0.89) and delivery at a health facility (rho = 0.94), and was negatively correlated with maternal mortality (rho = −0.76; p < 0.001; n = 20). The 2023 SKI reported a complete postpartum care rate of only 26.8%, postpartum complications at 9.1%, and knowledge of postpartum danger signs at 47.8%. Hemorrhage (28.6%) and hypertension during pregnancy (23.9%) were the leading causes of maternal mortality in 2020.
Conclusion. Postpartum care is the weakest link in the maternal health care continuum, particularly in eastern Indonesia. Strengthening postpartum visits by midwives, counseling on danger signs, and routine data validation are necessary to reduce maternal mortality.
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- Adnani, Q. E. S., Maulina, R., Ramadhan, K., Argaheni, N. B., Kennedy, H. P., & Telfer, M. (2025). Trends and determinants of antenatal, intranatal, and postnatal care utilization among Indonesian women (2012–2017): Associated factors in midwifery service utilization between midwives and other health professionals. BMC Nursing, 24(1), Article 912. https://doi.org/10.1186/s12912-025-03527-6
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- Idris, H., & Syafriyanti, W. (2021). Determinants of postnatal care service utilization in Indonesia: A secondary analysis using the Indonesian Health and Demographics Survey. Makara Journal of Health Research, 25(1), Article 7. https://doi.org/10.7454/msk.v25i1.1260
- Ministry of Health of the Republic of Indonesia. (2014). Minister of Health Regulation No. 97 of 2014 concerning Health Services During the Pre-pregnancy, Pregnancy, Childbirth, and Postpartum Periods. Ministry of Health of the Republic of Indonesia.
- Ministry of Health of the Republic of Indonesia. (2019). 2018 Riskesdas National Report. Agency for Health Research and Development. https://www.kemkes.go.id/id/potret-sehat-indonesia-riskesdas-2018
- Ministry of Health of the Republic of Indonesia. (2021a). Indonesia Health Profile 2020. Ministry of Health of the Republic of Indonesia. https://layanandata.kemkes.go.id/file/profil-kesehatan/2020/bab-5.pdf
- Ministry of Health of the Republic of Indonesia. (2021b). Minister of Health Regulation No. 21 of 2021 on the Provision of Health Services During the Pre-pregnancy, Pregnancy, Childbirth, and Postpartum Periods, Contraceptive Services, and Sexual Health Services. Ministry of Health of the Republic of Indonesia.
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- Li, X. F., Fortney, J. A., Kotelchuck, M., & Glover, L. H. (1996). The postpartum period: The key to maternal mortality. International Journal of Gynecology & Obstetrics, 54(1), 1–10. https://doi.org/10.1016/0020-7292(96)02667-7
- Mohan, D., LeFevre, A. E., George, A., Mpembeni, R., Bazant, E., Rusibamayila, N., Killewo, J., Winch, P. J., & Baqui, A. H. (2017). Analysis of dropout across the continuum of maternal health care in Tanzania: Findings from a cross-sectional household survey. Health Policy and Planning, 32(6), 791–799. https://doi.org/10.1093/heapol/czx005
- Ouedraogo, M., Kurji, J., Abebe, L., Labonté, R., Morankar, S., Bedru, K. H., Bulcha, G., Abera, M., Potter, B. K., Roy-Gagnon, M.-H., & Kulkarni, M. A. (2019). A quality assessment of Health Management Information System (HMIS) data for maternal and child health in the Jimma Zone, Ethiopia. PLOS ONE, 14(3), Article e0213600. https://doi.org/10.1371/journal.pone.0213600
- Probandari, A., Arcita, A., Kothijah, K., & Pamungkasari, E. P. (2017). Barriers to the utilization of postnatal care at the village level in Klaten District, Central Java Province, Indonesia. BMC Health Services Research, 17(1), Article 541. https://doi.org/10.1186/s12913-017-2490-y
- Rachel, T. L., & Yulianti, N. (2025). Effectiveness of the counseling module (Design By Empathy) on the knowledge and attitudes of postpartum mothers. Journal of Vocational Health, 10(1), 1–13. https://doi.org/10.22146/jkesvo.104481
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- Thaddeus, S., & Maine, D. (1994). Too far to walk: Maternal mortality in context. Social Science & Medicine, 38(8), 1091–1110. https://doi.org/10.1016/0277-9536(94)90226-7
- Titaley, C. R., Dibley, M. J., & Roberts, C. L. (2009). Factors associated with non-utilisation of postnatal care services in Indonesia. Journal of Epidemiology and Community Health, 63(10), 827–831. https://doi.org/10.1136/jech.2008.081604
- Titaley, C. R., Hunter, C. L., Heywood, P., & Dibley, M. J. (2010). Why don’t some women attend antenatal and postnatal care services?: A qualitative study of community members’ perspectives in the Garut, Sukabumi, and Ciamis districts of West Java Province, Indonesia. BMC Pregnancy and Childbirth, 10(1), Article 61. https://doi.org/10.1186/1471-2393-10-61
- World Health Organization. (2022). WHO recommendations on maternal and newborn care for a positive postnatal experience. World Health Organization. https://www.who.int/publications/i/item/9789240045989
References
Adnani, Q. E. S., Maulina, R., Ramadhan, K., Argaheni, N. B., Kennedy, H. P., & Telfer, M. (2025). Trends and determinants of antenatal, intranatal, and postnatal care utilization among Indonesian women (2012–2017): Associated factors in midwifery service utilization between midwives and other health professionals. BMC Nursing, 24(1), Article 912. https://doi.org/10.1186/s12912-025-03527-6
Health Development Policy Agency. (n.d.). Key Findings of the 2023 Indonesian Health Survey (SKI). Ministry of Health of the Republic of Indonesia. https://www.badankebijakan.kemkes.go.id/daftar-frequently-asked-question-seputar-hasil-utama-ski-2023/hasil-utama-ski-2023/
Health Development Policy Agency. (2024). The 2023 Indonesian Health Survey (SKI) in Figures. Ministry of Health of the Republic of Indonesia. https://www.badankebijakan.kemkes.go.id/ski-2023-dalamangka/
Central Statistics Agency. (2023). Mortality in Indonesia: Results from the 2020 Long-Form Population Census. Central Statistics Agency. https://indonesia.unfpa.org/sites/default/files/pub-pdf/mortalitas-di-indonesia-hasil-long-form-sensus-penduduk-2020.pdf
Baten, A., Biswas, R. K., Kendal, E., & Bhowmik, J. (2025). Continuum of maternal healthcare services utilization in low- and middle-income countries: A multi-level analysis. Midwifery, 149, Article 104549. https://doi.org/10.1016/j.midw.2025.104549
Idris, H., & Syafriyanti, W. (2021). Determinants of postnatal care service utilization in Indonesia: A secondary analysis using the Indonesian Health and Demographics Survey. Makara Journal of Health Research, 25(1), Article 7. https://doi.org/10.7454/msk.v25i1.1260
Ministry of Health of the Republic of Indonesia. (2014). Minister of Health Regulation No. 97 of 2014 concerning Health Services During the Pre-pregnancy, Pregnancy, Childbirth, and Postpartum Periods. Ministry of Health of the Republic of Indonesia.
Ministry of Health of the Republic of Indonesia. (2019). 2018 Riskesdas National Report. Agency for Health Research and Development. https://www.kemkes.go.id/id/potret-sehat-indonesia-riskesdas-2018
Ministry of Health of the Republic of Indonesia. (2021a). Indonesia Health Profile 2020. Ministry of Health of the Republic of Indonesia. https://layanandata.kemkes.go.id/file/profil-kesehatan/2020/bab-5.pdf
Ministry of Health of the Republic of Indonesia. (2021b). Minister of Health Regulation No. 21 of 2021 on the Provision of Health Services During the Pre-pregnancy, Pregnancy, Childbirth, and Postpartum Periods, Contraceptive Services, and Sexual Health Services. Ministry of Health of the Republic of Indonesia.
Kompas.com. (2024a, February 23). Maternal mortality rate in Papua is the highest in Indonesia. https://lestari.kompas.com/read/2024/02/23/120000786/angka-kematian-ibu-di-papua-tertinggi-di-indonesia
Kompas.com. (2024b, February 26). Maternal mortality rate in DKI Jakarta is the lowest in Indonesia. https://lestari.kompas.com/read/2024/02/26/110000086/angka-kematian-ibu-di-dki-jakarta-terendah-se-indonesia
Li, X. F., Fortney, J. A., Kotelchuck, M., & Glover, L. H. (1996). The postpartum period: The key to maternal mortality. International Journal of Gynecology & Obstetrics, 54(1), 1–10. https://doi.org/10.1016/0020-7292(96)02667-7
Mohan, D., LeFevre, A. E., George, A., Mpembeni, R., Bazant, E., Rusibamayila, N., Killewo, J., Winch, P. J., & Baqui, A. H. (2017). Analysis of dropout across the continuum of maternal health care in Tanzania: Findings from a cross-sectional household survey. Health Policy and Planning, 32(6), 791–799. https://doi.org/10.1093/heapol/czx005
Ouedraogo, M., Kurji, J., Abebe, L., Labonté, R., Morankar, S., Bedru, K. H., Bulcha, G., Abera, M., Potter, B. K., Roy-Gagnon, M.-H., & Kulkarni, M. A. (2019). A quality assessment of Health Management Information System (HMIS) data for maternal and child health in the Jimma Zone, Ethiopia. PLOS ONE, 14(3), Article e0213600. https://doi.org/10.1371/journal.pone.0213600
Probandari, A., Arcita, A., Kothijah, K., & Pamungkasari, E. P. (2017). Barriers to the utilization of postnatal care at the village level in Klaten District, Central Java Province, Indonesia. BMC Health Services Research, 17(1), Article 541. https://doi.org/10.1186/s12913-017-2490-y
Rachel, T. L., & Yulianti, N. (2025). Effectiveness of the counseling module (Design By Empathy) on the knowledge and attitudes of postpartum mothers. Journal of Vocational Health, 10(1), 1–13. https://doi.org/10.22146/jkesvo.104481
Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A.-B., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2014). Global causes of maternal death: A WHO systematic analysis. The Lancet Global Health, 2(6), e323–e333. https://doi.org/10.1016/S2214-109X(14)70227-X
Thaddeus, S., & Maine, D. (1994). Too far to walk: Maternal mortality in context. Social Science & Medicine, 38(8), 1091–1110. https://doi.org/10.1016/0277-9536(94)90226-7
Titaley, C. R., Dibley, M. J., & Roberts, C. L. (2009). Factors associated with non-utilisation of postnatal care services in Indonesia. Journal of Epidemiology and Community Health, 63(10), 827–831. https://doi.org/10.1136/jech.2008.081604
Titaley, C. R., Hunter, C. L., Heywood, P., & Dibley, M. J. (2010). Why don’t some women attend antenatal and postnatal care services?: A qualitative study of community members’ perspectives in the Garut, Sukabumi, and Ciamis districts of West Java Province, Indonesia. BMC Pregnancy and Childbirth, 10(1), Article 61. https://doi.org/10.1186/1471-2393-10-61
World Health Organization. (2022). WHO recommendations on maternal and newborn care for a positive postnatal experience. World Health Organization. https://www.who.int/publications/i/item/9789240045989