Correlation among Puerperium Mother Anxiety with Check-Up Childbed in the Covid-19Pandemic
Yeni Aryani1, Lailiyana2, Hamidah3, Ani Laila4andWawan Rismawan5*
1,2,3,4
Diplom Midwifery Program, POLTEKES KEMENKES RIAU, Indonesia
5Diplom Nursing Program, STIKes BTH Tasikmalaya, West Java, Indonesia
Corresponding Email: [email protected]
Abstract. During a pandemic, the spread and transmission of the SARS-CoV-2 virus is so fast that it can increase anxiety, mothers and families still have to apply the COVID-19 protocol during the postpartum period. This study aims to determine the correlationship among postpartum (puerperium) anxiety with check-up childbed (postpartum) during the COVID-19 pandemic. The design of this study was analytic with a cross sectional approach. The population of this study were all postpartum mothers who gave birth at the Midwives Independent Practice (PMB) from September to November 2020. Purposive sampling (n = 76), using the HRS-A instrument, univariate and bivariate analysis, statistical tests using Chi squre. The results showed that there was a correlationship among postpartum anxiety with postpartum check-up at PMB (P-value = 0.026). Suggestions are expected that health service providers in hospitals, health centers during the COVID-19 pandemic will provide education on how to reduce anxiety in postpartum postpartum mothers and carry out program visits to patient homes or virtual counseling.
Keywords: anxiety, check-up postpartum, childbed, pandemic COVID-19 Introduction
The spread and transmission of the SARS-CoV-2 virus is very fast and very worrying [1]. Masa The puerperium period for 6 months after childbed, there are many physical and psychological changes, especially anxiety[2][3].The Directorate of Family Health revealed that due to the COVID-19 pandemic there were restrictions on almost all routine services including restrictions in maternal and neonatal health services, such as a reduction in the frequency of antenatal care and postponement of classes for pregnant women, even though care is very important to prevent the death of mothers and children. and anxiety disorders[4].
Anxiety and Stress in Postpartum and Breastfeeding Mothers during the Covid-19 Pandemic in Bekasi City, Indonesia said that 64.56% gave normal responses; 17.72% response to mild anxiety; as much as 13.92% moderate anxiety response; 2.53% severe anxiety and 1.27% gave very severe anxiety response[1].
Riau Province Indonesia in 2020 ranks 5th with the incidence of COVID-19 which is increasing by 4,237 days, a preliminary study at the Pratama Afiyah Clinic, Pekanbaru City, that 80% of postpartum mothers experience moderate anxiety and 20% experience mild anxiety, symptoms that appear anxiety , worries and fears[5][6].
Research Method
A cross sectional quantitative research design between anxiety and postpartum check-up at the Mandiri Midwives Practice Ernita and Siti Juleha. Based on the inclusion criteria, 76 respondents obtained permission from the ethics commission, carried out health protocols by wearing masks, washing hands before and after activities, maintaining distance from respondents, respondents would be given informed consent, who were willing to be given a questionnaire / HRS-A instrument (Hamilton Rating Scale For Anxiety), given an explanation of how to fill in, respondents filled in independently after completing the collection, data processing was carried out using univariate and bivariate analysis of the chi square statistical test[7].
Result
Characteristics of Research Respondents:
Table 1 Characteristics of Respondents during the COVID-19 Pandemic at the Health Facilities of Delima Village, Pekanbaru City in 2020 (N = 76)
Number Characteristics of Respondents Frequency Percentage (%)
1 Age
< 20 year 1 1.3
20-35 year 63 82.9
>35 year 12 15.8
2 Education
Junior Hight School 4 5.3
Senior Hight School 62 81.6
College 10 13.2
3 Parity of Pregnancy :
Primipara 26 34.2
Multipara 50 65.8
Source: Empirical Research, 2020
Based on Table 1, it is known that Postpartum in carrying out check-up puerperium on day 4 - 28 days at PMB Ernita and Siti Julaeha are mostly at the age of 20 - 35 years (82.9%) with the majority of high school education 62 people (81.6% ) and the number of Multipara major parity of 50 people (65.8%).
Table 2. Post-Copy Maternal Anxiety during the COVID-19 Pandemic at the Health Facilities of Delima Village, Pekanbaru City in 2020 (N = 76)
Anxiety n Percentage (%)
Anxious 47 61.8
Not Anxious 29 38.2
76 100
Source: Empirical Research, 2020
Based on Table 2, it was found that the majority of postpartum mothers at PMB Ernita and Siti Julaeha were anxious, namely as many as 47 people or 61.8%.
Table 3. Postpartum check-up during the COVID-19 Pandemic at the Health Facilities of Delima Urban Village, Pekanbaru City in 2020 (N = 76)
Check-Up Chilbed n Percentage
Check-up 47 61.8
Not Check-up 29 38.2
76 100
Source: Empirical Research, 2020
Based on Table 3 it was found that postpartum mothers at PMB Ernita and Siti Julaeha did the majority of postpartum check-up, namely 47 people or 61.8%.
Table 4. The Correlationship Among Puerperium Anxiety with Check-Up Chilbed during the COVID-19 Pandemic at Delima Health Facilities, Pekanbaru City in 2020
No Anxiety
Check-up Chilbed
Total % p Value OR Check-up % Not
Check-up %
1 Not Anxious 23 79,3 6 20,7 29 100
0.026 3,67
2 Anxious 24 51,1 23 48,9 47 100
Total 47 61,8 29 38,2 76
Source: Empirical Research, 2020
In table 4 it can be seen that chilbed check-up is higher (79.3%) among postpartum mothers who are not anxious than postpartum mothers who are anxious (51.1%). The results of statistical tests with chi square at 95% confidence level found that there was a significant correlationships between puerperium anxiety with puerperium check-up (P-value = 0.026) with OR 3.67, which means that postpartum mothers who were not anxious tended to check-up 3.67 times, puerperium compared to anxious postpartum mothers.
Discussion
Based on the results of statistical tests using the Chi square test, the results of this study indicate that there is a correlation between postpartum maternal anxious with postpartum check-up during the COVID-19 pandemic at the Pekanbaru City Health Facility with a p value (p=0.026). The most common reported anxiety and distress related to social media messages of concern, fear of catching infection, social isolation, family members not following infection control and skipping rituals related to childbirth.[5][8]–[10].
In normal situations, maternal mortality and neonatal mortality in Indonesia are still a big challenge, especially at this time, Indonesia is facing a national non-natural disaster COVID-19 so that many postpartum mothers are anxious about carrying out postpartum examinations at puskesmas or health service facilities afraid of contracting. , as well as the unpreparedness of services in terms of personnel and infrastructure, including Personal Protective Equipment. It is feared that this will cause an increase in maternal anxiety about postpartum check-up[4][11]
According to Hawari (2013) in Hasanah 2018, anxiety is an affective disorder characterized by deep and continuous feelings of fear or worry, does not experience disturbances in assessing reality (Reality Testing Ability / RTA, still good), personality is still intact (not experiencing splitting of personality), behavior can be disturbed but still within normal limits. The results of this study in the COVID-19 pandemic situation postpartum mothers experience anxiety but still want to carry out postpartum check-up because postpartum mothers do not experience interference in assessing the reality of the COVID-19 pandemic within normal limits. And this can be seen from 76 postpartum mothers 47 mothers or 61.8% still check-up the health service facilities, the education level of the respondents shows that the majority of postpartum mothers have high school education, as much as 81.6%, the education level of the respondents in this study is relatively good, which is average. high school average. With this high level of education, respondents are considered to have sufficient knowledge about care during the puerperium so that they can minimize the anxiety that occurs[12][13][14][15]
According to (Directorate of Family Health, 2020) Postpartum Visit Services in the Covid-19 Pandemic, the second, third and fourth postpartum visits can be carried out by means of home visits by health personnel or monitoring using online media (adjusted to the conditions of areas affected by COVID-19), with make efforts to prevent the transmission of COVID-19 from officers, mothers and families. In this study, postpartum mothers performed postpartum check-up, which were mostly visited by officers from PMB Ernita and Siti Juleha because they visited the mother after giving birth at the same time as the baby care visit, such as making the baby until the umbilical cord was closed.[4][16].
The results of this study are in line with Sirait's research in 2020 Psychological responses (Anxiety and Stress) in Postpartum and Breastfeeding Mothers during the Covid-19 Pandemic in Bekasi City, which states that 64.56% gave normal responses; 17.72% response to mild anxiety; as much as 13.92% moderate anxiety response; 2.53% of severe anxiety and 1.27% gave a very severe anxiety response and in this study, 76 postpartum mothers responded to anxiety in 47 people or 61.8%
and 29 mothers were not anxious 38.2%. The anxiety of postpartum mothers to carry out postpartum check-up to health facilities in Delima sub-district is because Delima is the highest sub-district in Pekanbaru City with the highest number of COVID-19, but postpartum mothers remain in check-up during the COVID-19 pandemic and can run according to the health program by way of officers health care provider who comes to the patient's home or via online media. Officers carry out IEC, postpartum counseling and lactation using masks and apply the principle of preventing Covid-19 transmission[17][18]
Conclusion
Based on the results of the analysis that has been presented, the authors conclude that the anxiety of postpartum mothers towards postpartum check-up during the COVID-19 pandemic has a positive relationship. It is hoped that health care workers during the COVID-19 pandemic, especially midwives, will provide education at Hospitals, Clinics and PMB about how to reduce anxiety in Post- partum postpartum mothers which can be done both offline and online. The next researcher can conduct qualitative research to dig deeper into the causes of postpartum anxiety.
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