61
Husband’s Support Toward Anxiety dealing with Labor and Outcomes of Maternal Birth in Primigravida
(a prospective cohort study in Bandung Area)
1
R Noucie Septriliyana
*,2Yeni Rosyeni
1,2Stikes Jenderal Achmad Yani Cimahi
*Email: [email protected]
Abstract
Anxiety is the highest position which was experienced by mother during pregnancy and delivery. That condition is caused, for woman psychology when facing delivery process, would always be covered with fear and more intense approaching the delivery process, especially, on primigravida. Therefore, support from husband is needed to give secure and comfortable feeling and a good outcome of delivery. The aim of research is to analiyze the relationship of husband‘s support and the anxiety of primigravida in facing delivery and analyzing the relationship of anxiety and outcome of delivery. Research design was using prospective cohort an number of sample were 95 respondents. Chi square calculation result showed there was relationship (p=
0,001) between husband‘s support and anxiety of pimigravida, if the husband did not give support with probability 97,94% have anxiety. There was relationship between mother‘s anxiety in facing over outcome of delivery (mothers : p= 0,013 and fetal p= 0,038) and if the husband did not give support and have anxiety have delivery with probability 54,5%, and then mother with anxiety have under of APGAR with probability of 51,9%.
Key Words : Anxiety, out come of delivery, support Introduction
Pregnancy and childbirth are the chain of life events in the development of female reproduction. Every development of reproduction will experience changes that will cause a stressor in a woman's life. If this condition continues to occur it will affect the quality of life of women and children born.1-6
Anxiety ranks the top most frequently experienced mother during pregnancy and childbirth.
Taylor states that anxiety in pregnant women occurs as a result of the aging of pregnancy. The condition is caused by the psychological of women who face the process of childbirth will always be overwhelmed by an increasingly intensive fear before the birth process comes primarily on primigravida. The fear of pain and pain experienced in labor leads to painful labor especially in the primigravida pregnant women.7,8
The smoothness of a labor process in addition to being influenced by factors Power (motherhood), passage (birth path), and passanger (fetus) is also influenced by psyche (psychological). Pregnant women who experience anxiety in the process of labor will result in muscular tension in the birth canal. According to Dayan and Conde, in his research on pregnant and maternal women showed that the incidence of fetal distress, asphyxia, premature, low birth weight in newborn contributed by mothers who experienced anxiety and depression.9-14
The above conditions can be helped by the role of the husband through support during pregnancy and childbirth. This support is in the form of goods, services, information, and advice which makes the recipient of support will feel loved, appreciated, and peaceful.
Methods
The method to be used in this research is analytic observational method with prospective cohort design research on primigravida mother. The population of this study was primigravida during the third trimester of pregnancy examined pregnancy in RSKIA Bandung. The sample in
Internasional Seminar on Global Health (ISGH) 2017 Stikes Jenderal Achmad Yani Cimahi
this study were primigravida mothers with the third trimester of pregnancy and monitored until labor. The sample size in the cohort study can be calculated using the sample formula based on the Lameshow that is 95 respondents. Data analysis using Bivariate. Inclusion criteria have been established in this study are: Married and have a husband, the first pregnancy, age of pregnancy 37-42 weeks. Exclusion criteria of research subjects are: Not located in the region of Bandung and pregnant women who are not willing to be the subject of research.
Results
Tabel 1. Relationship between Husbands supporrt during Anxiety in Primary Mother at RSKIA Bandung Period September 2010 - July 2011
Suppor t
Anxiety
High Low Total P Coun
ted RR
X2
n % n % n %
Unsupport 36 ed 20
76,6 11
41,7 28
23,4
58,3
47 100
48 100
0,001
11.97 1,84 (1,27–2,66) Supported
56 58,9 39 41,1 95 100
Total
Statistical test results obtained p value = 0.001 and X2 count 11.97 then there is a significant relationship between husband support during delivery with anxiety mother primigravida third trimester in the face of labor. The value of RR = 1.84 (95% CI: 1.27-2,66), means that the primigravida mother has 1.84 times chance of anxiety if not get support (Unfavorable) from husband at delivery.
Tabel 2. Relationship of Anxiety with Outcomes of Maternal Birth to Primigravida Anxiet Labor out put (mother)
Total P Coun
UnSpontaneus Spontaneus Labor
n % n % n %
ted RR X2
High Low
33 58,9
12 30,8
23 41,1 56
69,2 39
27
100
100 0,013
7.31
1,91 (1,14–
3,32)
Total
45 47,4 50 52,6 95 100
Mother at RSKIA Bandung September 2010 period - July 2011
Statistical test results obtained p value = 0.013 and caunted X2 7.31 it can be concluded that there is a meaningful relationship between anxiety facing childbirth with the outcome of maternal delivery. The analysis results also obtained RR = 1.91 (95% CI: 1.14-3.32), which means that anxious mothers have a chance of 1.91 times of labor with help.
Disccusion
Statistical test results obtained p value = 0.001 and X2 count 11.97 it can be concluded that there is a meaningful relationship between husband support during delivery with anxiety mother primigravida third trimester in the face of labor. The value of RR = 1.84 (95% CI: 1.27-2.66), means that the primigravida mother is 1.84 times more likely to experience anxiety if she does not get support from her husband during childbirth.
y
63 According to some experts stated that the psychological and emotional conditions of primigravid moms are dominated by feelings and thoughts about impending labor, causing anxiety, anxiety, fear and tension in the face of labor pain. This psychological state will cause anxiety and intensification of intensive primigravida during the last weeks before delivery.
34,60
Husband's support given during primigravida and labor may affect the occurrence of anxiety. According to Ruth, the husband in providing support during labor can do things like:
give encouragement that will be needed if labor is longer than anticipated, massage the body (effleurage) so as not to be too tense or to distract the wife from contraction, make sure the wife feels comfortable, holding a wife while straining for the wife to have a handle when encouraging and leading the wife to mengedan the most effective way. 23,24,60,61,44
In a study conducted by Sengane (2006), an increase in both physical and psychological dependence occurred in primigravid women. Physical and psychological changes occurring in primigravid women increase dependency need which indicates the need for greater attention, the desire to ensure that the necessary assistance is available, and the desire for husband's involvement.61
Statistical test results obtained p value = 0.001 and X2 count 11.97 it can be concluded that there is a meaningful relationship between husband support during delivery with anxiety mother primigravida third trimester in the face of labor.
According to some experts stated that the psychological and emotional conditions of primigravid moms are dominated by feelings and thoughts about impending labor, causing anxiety, anxiety, fear and tension in the face of labor pain. This psychological state will cause anxiety and intensification of intensive primigravida during the last weeks before delivery.
34.60
Husband's support given during primigravida and labor may affect the occurrence of anxiety. According to Ruth, the husband in providing support during labor can do things like:
give encouragement that will be needed if labor is longer than anticipated, massage the body (effleurage) so as not to be too tense or to distract the wife from contraction, make sure the wife feels comfortable, holding a wife while straining for the wife to have a handle when encouraging and leading the wife to mengedan the most effective way.23,24,60,61,44
In a study conducted by Sengane, an increase in both physical and psychological dependence occurred in primigravid women. Physical and psychological changes occurring in primigravid women increase dependency need which indicates the need for greater attention, the desire to ensure that the necessary assistance is available, and the desire for husband's involvement.
Statistical test results obtained p value = 0.013 and X2 count 7.31 it can be concluded that there is a meaningful relationship between the anxiety of the delivery with the outcome of maternal delivery. Pregnancy and childbirth for a woman involves not only the somatic process, but having psychological effects, as well as the close connection with the feelings of self, the fetus it contains, the husband, and the environment. These life changes are stressors of life manifested as anxiety and fear.46,47
The anxiety that occurs is caused by feelings of fear, tension and pain or so-called fear- strained pain syndrome. This feeling is felt by many respondents in this research when facing childbirth. The syndrome is described as a vicious circle (circulus vitiosus). The pain that is felt by the mother is due to his form of heartburn the longer the stronger the impulse sends through the thalamo-limbic system to the brain which can then lead to psychlogic changes characterized by feelings of fear and anxiety.
Feelings of fear and anxiety in labor lead to the emergence of vegetative tension in the smooth muscles and blood vessels so that this state will be manifested in the cervical stiffness so that the pain impulse increases and affects the progress of labor.47
When mothers are cared for and supported during pregnancy and childbirth and knowing well the process of childbirth and care they will receive, they will gain a sense of security and better outcomes. Among other things mentioned besides delivery will take place more quickly, the care will also reduce the number of deliveries with acts such as vacuum extraction, and caesarea seksio. 13.15
Internasional Seminar on Global Health (ISGH) 2017 Stikes Jenderal Achmad Yani Cimahi
Anxiety experienced by pregnant women before delivery will greatly affect the birth process of the fetus it contains. Anxiety in pregnant women brings impact and influence to physical and psychic to mother that it contains; with a marked increase in some 'stress' hormones that can lead to an event called: vasoconstriction, or spasm of the maternal blood vessels, with a marked decrease in blood flow from the uterus to the placenta, resulting from a decrease in the flow of acidic substances, or oxygen and nutrient flow, or nutrients from the mother's bloodstream to the fetus's bloodstream in the placenta thus affecting the well-being of the fetus. 27-29,47
Conclussion
Conclusion of research result and discussion about Husbandry Support Relationship to Anxiety Facing Delivery and Outbreak of Birth at Primigravida Mother that is as follows; 1) There is a significant relationship between husband support and anxiety when facing childbirth in primigravida mother, 2) There is a significant relation between anxiety when faced with delivery of maternal and fetal delivery in primigravida mother.
this finding suggest that it is necessary to provide information or knowledge about anxiety and how to deal with it during pregnancy and childbirth. In order to prepare the physical and psychological conditions of mother and husband in the face of pregnancy and childbirth through, 2) The need to improve the quality of support provided by the birth of the husband so that mothers feel comfortable and safe during labor. 3) The need for support by health workers, especially midwives in applying support for delivery by husbands so that the maternal mothers become more comfortable during the birth process takes place.
Acknowledgment
References
Moeloek FA, Purwadianto A, Suharto A. Kesehatan dan Hak Asasi Manusia. Ikatan Dokter Indonesia. Jakarta. 2005
Maartadisoebrata D, Sastrawinata RS, Saifudin AB. Bunga Rampai Obstetri dan Ginekologi Sosial. Yayasan Bina Pustaka Sarwono Prawirihardjo. Jakarta.2005 : 221-242 Departemen Kesehatan RI. Upaya akselerasi penurunan Angka kematian Ibu. DepKes RI.
Jakarta.2000
---. Human Development Index. United Nation Development Program. New York : 2009
Muchtar A. Majalah Bidan. Ikatan Bidan Indonesia. Jakarta. 2003 : 6
. Akibat ―Beban Ganda‖ Perempuan Rentan Stress. Melalui Http://www.google//pikiranrakyatbandung.com (25-03-2008)
Al R.A, Yalvac S, Altar OY, Dolen I. Perceived pain and anxiety before and after amniocentesis among pregnant Turkish women. Journal Unit of Perinatology, Maternity and Women's Health Teaching Hospital. Turkey. 2009 : 184-6
Karanina S. D, Suyasa P. T. Hubungan Persepsi Terhadap Dukungan dan Penyesuaian Diri Istri pada Kehamilan Anak Pertama. Jurnal Pronesis, Vol 7, 2005 : 79-101
Vythilingum B. Anxiety Disorder in Pregnancy. Journal Department of Psychiatry, Faculty of Health Sciences University of Cape Town. South Africa. 2008 : 331-5
Prawirohardjo SWH, Sumaprdja S, Saifuddin AB. Ilmu Kebidanan. Yayasan Pustaka Sarwono Prawirohardjo. 2004
Hertling S.E, Perrotin F, de Poncheville L, Lansac J, Body G. Maternal anxiety induced by prenatal diagnostic techniques: detection and management. Pubmed. 2001 : 440-6 Departemen Kesehatan RI, JNPK-KR, IBI, IDAI, POGI. Asuhan Persalinan Normal. Jakarta.
Depkes RI. 2007 : 12
Alhamdulillahi rabil ‗alamin, the researcher expresses his highest gratitude to Allah SWT for blessing, love, opportunity, health, and mercy to complete this research. In arranging this reasearch, a lot of people have provided motivation, advice, and support for the researcher. In this valuable chance, the researcher intended to express his gratitude and appreciation to all of them.
I gratefully thank to the principal of Dean of Stikes Jenderal Achmad Yani Cimahi, and Chairman of RSKIA kota Bandung for allowing me to conduct the research there.
65 Knuppel R.A. Drukker, JE. High-Risk Pregnancy a Team Approach. Philadelphia : W.B. Saunder
Co. 2000
Yanuasti IM. Hubungan Suami Terhadap Istri Dengan Kestabilan Emosi Istri Pada Masa Kehamilan. Skripsi. Tidak Diterbitkan. Semarang: Fakultas Psikologi Universitas Katolik Soegijapranata. 2001.
Astuti AB. Hubungan Antara Dukungan keluarga dengan Penyeseuaian Diri Perempuan Pada Kehamilan Pertama. Fakultas Psikologi Universitas Gajah Mada. Yogyakarta. 2000 Muera, Ribera. Health Seeking Behavior And The Health System Responses. 2003 : 10 Varney H, Kriebs JM, Gegor CL. Asuhan Kebidanan. Ed. 4, Vol.2. EGC. Jakarta. 2007 : 686 Farrer H. Perawatan Maternitas. EGC. Jakarta. 2001
Levine RE, et al. Anxiety Disorders During Pregnancy and Postpartum. Am J Perinatol. 2003 : 239-248.
Westheimer RK, Grunebaum A. Mengkreasikan Kehamilan dan Menjaga Kasih Sayang. PT Raja Grafindo Persada. 2002 : 148
. Manajemen Asuhan Kebidanan Pada Ibu Primigravida dengan Kecemasan di Pukesmas CH.M. Tiahahu Kota Ambon. Melalui Http://devonsantosxe.livejournal.
Com/8601.html. (18-06-2009)
Ibrahim AS. Panik Neurosis dan Gangguan Cemas. Dua AS-AS. Jakarta. 2007 : 14-56
Mander. Pain in Childbering and its Control. Blacwell Science Limited. Oxford. 1998 : 138-193 Mu'arifah A. Hubungan Kecemasan dan Agresivitas. Humanitas: Indonesian Psychological
Journal, Vol 2, 2005: 102-111
Sengane M. The experience of black fathers concerning support for their wives/partners during labour. Nursing Science Department. Journal Nurshing science. 2009.
Internasional Seminar on Global Health (ISGH) 2017 Stikes Jenderal Achmad Yani Cimahi
