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Kata kunci : Komplikasi persalinan, penolong persalinan, wanita usia subur
West Java is one of the largest province which contribute to maternal mortality inIndonesia and has a number of labor complications are quite high, 22.2%.Incidence of labor complications common in mothers who gave birth not byhealth workers (46%). This study is an analysis of data IDHS 2012 with a sampleof 1,609 women of childbearing age (15-49 years). This study aimed to determinethe relationship between the incidence of labor complications with the birthattendants in West Java. The analysis showed that mothers who give birth ratherthan by health workers 7.948 times higher risk to develop complications of laborcompared with women who gave birth by health professionals after beingcontrolled by a variable history of childbirth complications, place of delivery,neonatal visits, and access to information.
Keywords : Labor complication, birth attendants, women of childbearing age
Kata Kunci : Penolong Persalinan, Bidan, Paraji, Kesehatan Ibu.
Delivery by health personnel is an important factor in efforts to reduce MaternalMortality Rate (MMR). Scope aid by health workers at the village PuskesmasWanaherang Gunung Putri amounted to 82.38% is still below the target SPM. Thisstudy aims to reveal the birth attendant election at 6 postpartum mother in theWanaherang District the work area of Gunung Putri Health Center 2016. Factorsstudied were knowledge, attitude, labor costs, ownership BPJS, resources, support thehusband, family and peers. The design study is qualitative primary data collectedthrough in-depth interviews to 10 informants and discussion groups to three groupshusband, grandmother and peers. The analysis showed a good knowledge in choosinga birth attendants do not always lead in determining the delivery assistance by healthprofessionals because it is influenced by the enabling factor that is the source ofinformation. The cost of labor and ownership BPJS card has no role in the selectionof birth attendants. Support of her husband and family play a role in determining thebirth attendant.
Keywords: Helper Delivery, Midwives, Paraji, Maternal Health.
Setiap tahunnya, 585.000 ibu meninggal akibat komplikasi kehamilan dan persalinan, dan hampir 99% dari kematian tersebut terjadi di negara berkembang. Pada tahun 1995, Angka Kematian Ibu (AKI) di Indonesia di perkirakan sekitar 373 per 100.000 kelahiran hidup. Angka tersebut merupakan yang tertinggi dibandingkan negara ASEAN. Persalinan lama atau macet merupakan salah satu dari lima penyebab kematian ibu di negara berkembang. Berdasarkan hasil SKRT 1995, persalinan lama juga merupakan komplikasi persalinan yang paling sering dikeluhkan oleh ibu. Persalinan lama atau macet merupakan satu-satunya komplikasi persalinan yang mengakibatkan begitu banyak morbiditas kronis. Tujuan penelitian ini adalah untuk mengetahui hubungan antara penolong persalinan dengan kejadian persalinan lama, faktor-faktor yang berhubungan dengan persalinan lama dan untuk mengetahui informasi mengenai kebijakan dan program penatalaksanaan persalinan lama di tingkat pelayanan kesehatan dasar dan rujukan. Penelitian ini memadukan metode kuantitatif dan kualitatif. Metode kuantitatif menggunakan data Studi Morbiditas dan Mortalitas SKRT 1995 di Jawa Barat, sedangkan metode kualitatif menggunakan wawancara mendalam dan studi kasus di Kabupaten Tangerang. Hasil penelitian memperlihatkan bahwa angka kejadian persalinan lama di Jawa Barat sebesar 6,4%. Analisis data multivariat menemukan bahwa penolong persalinan dan tempat tinggal berhubungan dengan persalinan lama. Ibu yang tinggal di desa berpeluang mengalami persalinan lama 2,7 kali dibandingkan ibu yang tinggal di kota setelah dikontrol variabel penolong persalinan. Penelitian ini menunjukkan bahwa asuhan persalinan oleh tenaga kesehatan terlatih dapat menurunkan risiko komplikasi persalinan. Persalinan lama sering terlambat dirujuk karena dukun tidak mampu menilai kemajuan persalinan dan tidak mengetahui tanda-tanda atau penyebab ketika persalinan lama terjadi. Program pencegahan persalinan lama harus ditujukan untuk meningkatkan cakupan persalinan oleh tenaga kesehatan terlatih, menyediakan kartu sehat bagi kelurga tidak mampu, memperbaiki sistem transportasi, menunda pernikahan melalui program wajib belajar sembilan tahun serta meningkatkan status gizi dan kondisi lingkungan anak perempuan sehingga mereka dapat mencapai tinggi badan yang optimal.
Relationship between Birth Attendant and the Occurance of Prolonged Labor in West JavaAt least 585,000 women die each year from the complications of pregnancy and childbirth, and almost 99% of these deaths occur in developing countries. In 1995, Maternal Mortality Ratio (MMR) in Indonesia is estimated 373 per 100,000 live births. This figure is relatively high when compares to ASEAN countries. Prolonged or obstructed labor is one of the five major causes of maternal mortality in developing countries. Based on the 1995 Household Health Survey, prolonged labor is also the most common reported obstetric complication. No other complication of delivery is associated with as much chronic morbidity as prolonged or obstructed labor. The purposes of this research are to examine the relations between birth attendant and prolonged labor, to examine factors that might affects the occurance of prolonged labor and to review the policies and programs on the management of prolonged labor at primary and referral health services. This research combined quantitative and qualitative method. The quantitative method used the Maternal Morbidity and Mortality data from the 1995 Household Health Survey in West Java, and qualitative method used in-depth interview and case study in the District of Tangerang_The result showed that the prevalence of prolonged labor in West Java was 6.4%. The multivariate logistic regression analysis found that the birth attendant and the residence were associated with the occurance of prolonged labor. Women who lived in the rural area are 2.7 times as likely to experience prolonged labor than those who lived in the urban area, controlled by birth attendant. This study revealed that delivery care by trained health care provider could reduce the risks of prolonged labor. Prolonged labour were often referred too late because the traditional birth attendant (TBA) could not be able to assess the progress of labor, they did not know the symptoms and the causes when prolonged labour occur. Intervention programs should be directed to increase the coverage of delivery attended by trained health care provider, provide health card for poor family, improve transportation system, delay marriage until women have reached full physical maturity through compulsory universal education and improve nutrition status and living conditions for girls to prevent stunded growth.
