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ABSTRAK Penyalahgunaan operasi sesar dan dilakukan tanpa keperluan medis berisiko munculnya masalah kesehatan jangka panjang maupun pendek. Tren persalinan sesar di Indonesia tahun 2007-2012 mengalami peningkatan dua kali lipat. Sikap tenaga pemeriksa kehamilan menjadi isu dalam menurunkan angka persalinan sesar. Penelitian ini bertujuan untuk mengetahui hubungan tenaga pemeriksa kehamilan dengan persalinan sesar. Metode penelitian cross sectional ini menggunakan sampel penelitian 5.143 wanita usia subur (15-49 tahun) yang melahirkan anak terakhir di wilayah perkotaan Indonesia yang terpilih dalam sampel SDKI 2012. Hasil penelitian menunjukkan bahwa pemeriksaan kehamilan pada spesialis kandungan 6,6 kali lebih tinggi (95% CI 3,2-13,7), sedangkan pemeriksaan kehamilan pada spesialis kandungan dan bidan 0,5 kali lebih rendah untuk melakukan persalinan sesar dibandingkan dengan pemeriksaan kehamilan 2,1 kali lebih tinggi (95% CI 1,0–4,3) untuk melakukan persalinan sesar dibandingkan dengan ibu yang melakukan pemeriksaan kehamilannya di bidan setelah dikontrol oleh usia ibu, tempat periksa hamil, paritas, dan tempat melahirkan. Adanya interaksi spesialis kandungan dengan sosial ekonomi untuk persalinan sesar. Penetapan peraturan dilakukannya persalinan sesar oleh institusi kesehatan, serta melakukan upaya protektif dan preventif persalinan pada kelompok masyarakat ekonomi tinggi bertujuan untuk mengurangi terjadinya persalinan sesar yang tidak perlu. Kata kunci: persalinan sesar, tenaga pemeriksa kehamilan, perkotaan
ABSTRACT Abuse of caesarean section and performed without medical purposes risky health long and short problems. Trends cesarean deliveries in Indonesia in 2007 and 2012 has increased two-fold. The attitude of antenatal care provider become an issue in reducing the number of cesarean delivery. The purpose of this study is to know the relationship antenatal care provider with cesarean section. The methods of this this study is cross-sectional, using sample of 5.143 women of childbearing age (15-49 years) who gave birth to the last child through cesarean delivery and cesarean deliveries in urban areas selected in the sample Indonesia Demographic and Health Survey 2012. The results showed that antenatal care in obstetrician 6.6 times higher (95 % CI 3.2 to 13.7), while antenatal care in obstetrician and midwife 0.5 times less likely to perform cesarean delivery compared with antenatal 2.1 times higher (95% CI 1.0 to 4.3 ) to perform cesarean delivery compared with women who undergo pregnancy examinations in midwifery after controlled by maternal age, a pregnancy check, parity, and place of birth. Their interaction with the content of socio-economic specialist for a cesarean delivery. Formation of rules does a cesarean delivery by health institutions, as well as make efforts to protective and preventive labor in high economic communities aim to reduce the occurrence of unnecessary cesarean deliveries. Keywords: cesarean section, antenatal care provider, urban
The high maternal mortality rate (346 per 100.000 live birth) in Indonesia is causedby several factors, one of it is that Indonesia has not been achieved the indicator ofaid deliveries in health facilities. This study aims to look at the influence and thecontribution of individual factors and province factor on deliveries in six provincesin Indonesia based on data from Demographic and Health Survey and healthprofiles of Indonesia in 2012. Based on the analysis of multilevel multinomiallogistic regression, the determinant of delivery aid is the individual factors includethe antenatal care, regions, health insurance, household wealth index, husband'soccupation, employment and education of women of childbearing age, parity andthe age of them. The determinant factor of the province covers the ratio of healthcenters, the ratio of beds and population density. Contextual variables (provincefactors) decrease 24.22% variation deliveries at six provinces in Indonesia.Keywords :Maternal mortality, Deliveries, individual factors, provinces factors, multilevellogistic regression multinomial.
Kata kunci : Kontrasepsi, Unmet Need, Indonesia
Analysis of Indonesia Demographic and Health Survey 2012Unmet need is the proportion of women of childbearing age in marital status werenot using contraception even though they said they want to spacing or limitingbirths. The percentage of unmet need in Indonesia in 2012 was 11 percent, thisproportion still needs to be decreased in accordance with the target of the NationalMedium Term Development Plan in 2014 is 6,5 percent and target of MillenniumDevelopment Goals (MDGs) in 2015 is five percent. The aim of the study is todescribe unmet need for family planning in Indonesia and factors related to it.Data of Indonesia Demographic and Health Survey (IDHS) 2012 were used forunivariate, bivariate and multivariate analysis with the design of cross-sectionalstudy. The results showed that the total of unmet need for family planning inIndonesia is 11,4 percent, seven percent for limiting births and four percent forspacing births. Factors associated with unmet need for family planning inIndonesia is woman's age, number of living children, ideal number of children,region of residence, husband's education, knowledge of contraception, anddiscussions couple about family planning. Most related factor to the case of unmetneed for family planning in Indonesia is discussions couple about family planning.
Key words:Contraception, Unmet Need, Indonesia
