An Application of the Confidante Method to Estimate Induced Abortion Incidence in Java, Indonesia

Melissa Stillman, Guttmacher Institute Ellie Leong, Guttmacher Institute Budi Utomo, University of Indonesia, Jakarta Dadun Dadun, University of Indonesia, Jakarta Riznawaty Imma Aryanty, UNFPA Indonesia, Jakarta Gilda Sedgh, Guttmacher Institute Margaret Giorgio, Guttmacher Institute

First published online:

| DOI: https://doi.org/10.1363/46e0120
Abstract / Summary

Induced abortion is legally restricted and highly stigmatized in Indonesia, and is thus extremely difficult to measure. Indirect methods leveraging women's social networks, such as the Confidante Method, have shown promise in estimating hidden behaviors, including abortion, in similar settings.


A community-based survey was conducted among 8,696 women aged 15–49 in Java, Indonesia, in November 2018–January 2019. Data were collected via in-person interviews with respondents about their own abortions and those of up to three of their closest confidantes. One-year induced abortion incidence rates per 1,000 women were estimated using a direct-report approach and the Confidante Method.


The direct-report abortion rate was 3.4 per 1,000 women in 2018, compared with the Confidante Method rate of 11.3 per 1,000. Among the confidantes of women who reported an abortion in the past five years, the abortion rate was 42.0 per 1,000. Half of the women reported that they had no confidantes with whom they shared private information. Among women reporting an abortion and at least one confidante, 58% had disclosed their abortion to their confidante, indicating that substantial transmission bias was present.


The Confidante Method relies on several assumptions that did not hold in this study. Although the method performed better than the direct-report approach, it underestimated the incidence of abortion in Java. More research is needed to understand how abortion-related information is shared within social networks and to assess the appropriateness of applying the Confidante Method to estimate abortion in a given context.

Author's Affiliations

Melissa Stillman is senior research associate; Ellie Leong is senior research assistant; Margaret M. Giorgio is senior research scientist; and at the time of this work, Gilda Sedgh was principal research scientist—all at the Guttmacher Institute, New York. Budi Utomo is professor, Department of Population and Biostatistics, Faculty of Public Health; and Dadun Dadun is senior researcher, Center for Health Research—both at the University of Indonesia, Jakarta. Riznawaty Imma Aryanty is national program officer for reproductive health, UNFPA Indonesia, Jakarta.


The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.