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APPLICATION OF PREGNANT EXERCISE AND HYPNOSIS
TECHNIQUES AS EFFORT TO IMPROVE HEALTH IN
PREGNANT MOTHERS TRIMESTER III
Sulastry Pakpahan
1
, Hetty Panggabean
2
1,2
DIII Midwifery Study Program Tarutung Poltekkes Kemenkes,Medan, Indonesia
Email : lastr[email protected]
1
, [email protected]
2
KEYWORDS
Pregnancy exercise,
Hypnotherapy
ARTICLE INFO
Accepted:
June 27
th
2022
Revised:
July 9
th
2022
Approved:
July 14
th
2022
ABSTRACT
Pregnancy exercise is one of the sports that can be done by pregnant
women in the third trimester . Pregnancy can cause worry and
anxiety in pregnant women, making them vulnerable to mental and
psychological disorders . Severe anxiety during pregnancy can cause
changes in blood flow to the baby, so that the flow of oxygen and
other important nutrients to the baby's organs is disrupted . The
purpose of this study was to analyze efforts to improve health in
pregnant women. This study used a field method with pre-test and
post-test techniques to determine the increase in participants '
knowledge about pregnancy exercise and hypnosis techniques. The
results of this study indicate that community service activities What
is done can be well received by pregnant women in the third
trimester as a target. Pregnant women seemed very enthusiastic
about participating in this activity and based on the results of the
posttest given there was an increase in the mother's understanding
and knowledge about pregnancy exercise and hypnosis techniques.
This is also an effort to improve maternal health during pregnancy,
especially in the third trimester of pregnancy to prepare for a safe
and easy delivery.
INTRODUCTION
Pregnancy is a very important period for the mother and the fetus. The fetus requires
the intake of nutrients and oxygen through the utero-placental vasculature from the mother to
be able to develop while in the womb (Basak & Duttaroy, 2022). The third trimester of
pregnancy lasts from 28-40 weeks of gestation, which in this trimester pregnant women
experience many physical and psychological changes. This gestational age is a time to
prepare for birth and the role of parents. Mothers must maintain healthy food intake to meet
the nutritional needs of the mother and fetus. In addition, pregnant women are recommended
to exercise regularly to maintain and improve the health of pregnant women. One of the
sports that can be done by pregnant women in the third trimester is pregnancy exercise .
Pregnancy exercise aims to increase flexibility, stamina, relieve back pain, maintain the
circulatory system and prepare mentally and physically for pregnant women. (Beetham et al.,
2019) . Pregnancy exercise significantly reduces the risk of cesarean delivery. Regular
pregnancy exercise can prevent pregnant women from gaining excessive weight or
gestational diabetes mellitus and hypertension disorders. Some women are prone to diabetes
and preeclampsia, especially if they are more than 35 years old. S six can improve the overall
health of the mother. (Di Mascio D, 2016).
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Mothers during pregnancy, childbirth and post partum are a group that is vulnerable to
psychological disorders, including anxiety disorders (Green, Furtado, Inness, Frey, &
McCabe, 2022). Feelings of anxiety in pregnancy relatively occur in 10-15% of all pregnant
women. Anxiety or anxiety is a feeling of worry, a fear that is not clear why. Anxiety and
fear during pregnancy will affect the health of the baby. according to several studies that
babies born to mothers who have high levels of anxiety and fear during pregnancy will have a
weak immune system, while babies born to mothers without fear will have a strong immune
system. (Kiruthiga, 2017).
Pregnancy can cause worry and anxiety in pregnant women, making them vulnerable
to mental and psychological disorders. (M. Mirghafourvand, 2021) research by Khoury, et al
said that 57% (t=17.21, p<0.001) pregnant women experienced an increase in clinical
depression, 30% (t=17.21, p<0.0001) experienced an increase in depression. 19% increase in
anxiety and insomnia, which is higher compared to non-pregnant women. (Khoury, Atkinson,
Bennett, Jack, & Gonzalez, 2021).
Anxiety of pregnant women can affect the brain growth of the fetus. Any emotion felt
by a mother will be felt by the fetus. Based on the results of the study, a high level of
maternal anxiety has a significant relationship with mental disorders, emotional problems,
lack of concentration and hyperactivity and impaired cognitive development of children. In
addition, severe anxiety during pregnancy can cause changes in blood flow to the baby, so
that the flow of oxygen and other important nutrients to the baby's organs is disrupted, this
has a significant impact on the biological indicators of newborns such as height, weight, and
head circumference. (Shahhosseini, Pourasghar, Khalilian, & Salehi, 2015).
During pregnancy, mothers also need to manage stress properly, one of which is by
using hypnosis techniques. If done correctly and regularly, hypnosis can even prevent and
relieve symptoms of mental disorders, such as depression and anxiety disorders in pregnant
women. By doing pregnancy exercises and hypnosis techniques during the third trimester of
pregnancy, it is expected to maintain the health of pregnant women both physically and
psychologically.
The results of the initial survey on the problem partners found were the lack of
knowledge of pregnant women about pregnancy exercises and hypnosis techniques during
pregnancy so that they were not applied during pregnancy. The target of this activity is to
increase the experience, knowledge and skills of pregnant women in doing pregnancy
exercises and hypnosis techniques to improve the health of the mother and fetus which is
indirectly expected to reduce morbidity and maternal mortality.
Based on the description above, the Tarutung Midwifery Study Program lecturer team
through community service activities by providing assistance in the form of education and
demonstrations on the implementation of pregnancy exercises and hypnosis techniques for
third trimester pregnant women at Poskesdes Siborong-borong I, Siborong-borong District,
North Tapanuli Regency.
This activity began with mapping the number of third trimester pregnant women in
the working area of the Siborong-borong 1 Poskesdes in collaboration with the local village
midwife. The activity is carried out in several stages, namely: 1st stage: providing education
about pregnancy exercise and hypnosis techniques to improve the health of pregnant women,
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using leaflet media. The second stage is to carry out a physical examination of pregnant
women. The third stage is a demonstration of pregnant exercise and hypnosis techniques.
Before and after the activity, participants were given a pre-test and post-test to assess the
increase in participants' knowledge about pregnancy exercise and hypnosis techniques to
improve the health of pregnant women. This activity was attended by 12 third trimester
pregnant women in the Siborong-borong 1 Poskesdes area.
RESULTS AND DISCUSSION
The process of the ongoing activities can be seen in the following table which
includes techniques for implementing community service activities that refer to the results
and discussions (Zapata & Tokarz, 2022).
1. Characteristics of pregnant women
During the activity, as many as 12 third trimester pregnant women came to check their
pregnancy. The following is the age distribution of respondents who took part in community
service for pregnant gymnastics and hypnosis techniques:
Table 1. Age Distribution of Respondents Who Participate in Community Service Pregnancy
Gymnastics and Hypnosis Techniques
Source: Community Service Data for 2022
The diagram above shows that the third trimester pregnant women who have their
pregnancy checked are mostly in the 20-35 year age category (58%). This age is a healthy
reproductive age, where mothers at the age of 21 are considered mature in terms of physical,
emotional, personality and social aspects. Meanwhile , age <20 years and >35 years are risk
factors in pregnancy . In women younger than 20 years of age, the uterus and pelvis have not
developed properly, so there may be a risk of complications in childbirth. On the other hand,
age > 35 years is considered vulnerable to complications in pregnancy because the condition
of the female reproductive organs has decreased the ability to reproduce so that there is a
greater chance that pregnant women will have children with disabilities, obstructed labor and
bleeding. (Rochayati P, 2011).
Based on research by Cavazos, et all., found that pregnancy complications were
highest at the age of 11-18 years compared to 25-29 years, while those aged >35 years were
at risk for preterm labor, chorioamnionitis, endometritis, and mild preeclampsia. In addition,
pregnant women aged 15-19 years have a greater chance of severe preeclampsia, eclampsia,
<20 Tahun
17%
20-35 Tahun
58%
>35 Tahun
25%
<20 Tahun
20-35 Tahun
>35 Tahun
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postpartum hemorrhage, poor fetal growth and fetal distress. Pregnant women aged 35 years
have a greater chance of giving birth prematurely, hypertension, preeclampsia, preeclampsia,
and a reduced risk of chorioamnionitis. Older pregnant women (≥40 years) have an increased
risk of mild preeclampsia, fetal distress, and poor fetal growth. (Cavazos-Rehg et al., 2015).
Given the many conditions that can be associated with high-risk pregnancies, every
pregnant woman needs to be aware that pregnancy at the age of <20 years and >35 years is a
risk factor for pregnancy that can lead to complications. In addition, it is necessary to receive
antenatal care to prepare for pregnancy properly so that conditions that have the potential to
pose risks or complications of pregnancy complications can be identified and treated as soon
as possible. (Simbolon & Pakpahan, 2020) .
2. Distribution of Participants' Knowledge Based on Pretest and Posttest Results
To assess the increase in participants' knowledge, a survey was carried out through
filling out questionnaires that had been prepared and filled out by community service
participants. The results of processing the pretest and posttest questionnaires are presented in
the following diagram:
Figure 1. Posttest and Prettest Analysis Diagrams
The diagram above shows the posttest results reached an average of 45 and posttest
reached 87. With an average increase of 43%. These results illustrate that there is an increase
in understanding after counseling. Knowledge is the final achievement of observation and
what has been experienced and seen by individuals directly on a thing, while perception is the
sensing of an object derived from direct exposure to the five human senses, namely the senses
of hearing, sight, smell, taste and touch. (Notoadmojo, 2018) Information becomes very
important to increase human knowledge.
Based on the results of the posttest conducted by filling out the questionnaire sheet, it
was found that the knowledge of pregnant women increased by 43 times from the initial score
obtained by the mother when filling out the pretest questionnaire after health education
activities were carried out (Barnes & Adamson-Macedo, 2022). Health education is expected
to be able to make people aware of the importance of maintaining health and educating how
to prevent all activities that can damage health. In this community service activity,
information is provided in the form of health counseling related to pregnancy exercise and
hypnosis techniques to increase mother's knowledge so that they can change attitudes to
45
87
0
10
20
30
40
50
60
70
80
90
100
Pretest Postest
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create healthy behavior. With the increase in knowledge of pregnant women about pregnancy
exercise and hypnosis techniques, it is hoped that changes in behavior will occur, namely
pregnant women can apply pregnancy exercises and hypnosis techniques during pregnancy.
3. Distribution of Psychological Disorders With Anxiety Before and After Following
Pregnancy Exercises and Hypnosis Techniques
The picture above shows the changes in anxiety experienced by mothers before and
after doing pregnancy exercises and hypnosis techniques (Carus, Albayrak, Bildirici, &
Ozmen, 2022). Previously there were 6 people who experienced severe anxiety, after
receiving education and demonstration there was a change in the level of anxiety, namely the
severe category to 1 person, moderate anxiety 2 people, mild anxiety 4 people, and the
remaining 5 people were in the normal category. Anxiety in pregnancy is caused by changes
in hormone levels in the body, which affect the levels of chemicals in the brain that play a
role in regulating feelings. Anxiety conditions for third trimester pregnant women can occur
due to concerns about childbirth, predictions of miscarriage, babies, disabilities, premature
babies, twins, and the health conditions of pregnant women (Mirzaee, Hasanpoor-Azghady,
& Amiri-Farahani, 2022). Anxiety in pregnant women can trigger stimulation of uterine
contractions so that it can lead to preeclampsia and miscarriage, the birth of babies with low
birth weight and premature babies. Therefore, pregnant women need to recognize the causes
and symptoms of anxiety in pregnancy so that they can anticipate and overcome them as
early as possible. In addition to consuming healthy food, pregnant women need to carry out
regular exercise such as pregnancy exercise and hypnosis which can reduce anxiety and
improve health in pregnant women.
4. Photos and figures
The following is a documentation of the application of pregnancy exercise and
hypnotherapy for third trimester pregnant women at Poskesdes Siborong-borong I
Normal Ringan Sedang Berat
Sebelum
1 2 3 6
Sesudah
5 4 2 1
0
1
2
3
4
5
6
7
Sebelum Sesudah
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Examination of pregnant women in the third trimester
Counseling about pregnancy exercise and hypnosis techniques
(a)
(b)
Figure 1. (a) The appearance of Poskesdes Siborong-borong 1. (b)
Pemeriksaan ibu hamil trimester III.
Figure 1. Penyuluhan senam hamil dan teknik hipnosis
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Demonstration of pregnancy exercise and hypnosis techniques
CONCLUSION
In general, community service activities carried out can be well received by pregnant
women in the third trimester as targets. Pregnant women seemed very enthusiastic about
participating in this activity. Based on the results of the posttest given, there was an increase
in the mother's understanding and knowledge about pregnancy exercise and hypnosis
techniques. It is expected that pregnant women will apply it in daily life during pregnancy.
This is also an effort to improve maternal health during pregnancy, especially in the third
trimester of pregnancy to prepare for a safe and easy delivery.
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