The relationship between preparation for gentle birth and the degree of anxiety of first pregnant women in facing labor at

ABSTRACT

There are some pregnant women who experience anxiety because of possible conditions that may occur during childbirth, such as pain, security, and financial problems. Pregnant women feel anxious about the delivery process because there are several risks that may occur during the delivery process, such as pain during labor or post-delivery costs. During pregnancy, pregnant women experience psychological changes, especially feelings of anxiety. The fundamental reasons that make pregnant women experience anxiety in facing the delivery process include conditions that may occur during the delivery process, such as pain during childbirth, safety of the mother and baby during the delivery process, financing after delivery. and mothers can give birth normally or through surgery (SC) (Hidayat & Sumarni, 2013).
As labor approaches, primigravida mothers who are pregnant for the first time experience feelings of anxiety. because it's getting closer to the delivery process. the risk is that the mother will experience feelings of anxiety and fear during childbirth. (aniroh and riris, 2019).
There are physical changes that occur during pregnancy that can affect the mood and development of the baby. These can include changes in nutrition and sleep, which can negatively affect the mother's self-esteem and health. Anxiety can increase the risk of getting pregnant, giving birth to premature babies, low birth weight babies, and low APGAR scores at birth. If anxiety disorders are not controlled during pregnancy, it will affect the mother's ability to care for her child after giving birth (Cameron et al., 2020).
The maternal mortality rate in Indonesia decreased to 305 deaths per 100,000 live births in 2015. To 33.07% maternal deaths due to hypertension, 27.3% obstetric bleeding, 15.7% non-obstetric complications, 12.04% other obstetric complications, 6.06% pregnancy infection, 4.81% due to other causes. death due to anxiety during childbirth because pregnant women experience it.
. Of the 107,000 women who experienced anxiety during childbirth, 28.7% experienced it during the delivery process. According to Novitasari, anxiety occurs more frequently in primigravida mothers than in multigravida mothers (Lagora R, 2014).
Due to the large number of symptoms of pregnancy anxiety experienced by primigravida mothers, pregnancy and delivery services that provide comfort can help primigravida mothers not to worry too much, but also for the babies and family members who are present. Mothers can give birth calmly and without fear or anxiety during a gentle delivery, which is one of the advantages for pregnant women. Anxiety before delivery is a common problem for pregnant women.
According to Aprilia (2013) claims that gentle birth can stimulate the hormone endorphin which is produced naturally by the body, which can reduce anxiety, where the best painkiller and stress reliever hormone is the hormone endorphin. Therefore, gentle birth is a delivery method that utilizes all the body's natural components and is calm, gentle, polite and utilizes all natural elements in the human body (novita et al, 2020). Pregnancy services are one of the services offered by the PMB Mutiara health facility for maternal and child health. According to interviews with 5 first-time mothers (primigravidas), the average mother expressed concern about her pregnancy, especially before delivery. Some women said they were worried about pain during delivery, others said they were worried about bleeding, and still others said they were worried about perineal injuries.

METHODOLOGY
Thus pregnant women and their families must prepare themselves both health, economically and mentally so that mothers and families can carry out their roles as parents for their babies. This research can also support the process of pregnancy care services and can empower pregnant women from an early age so as to reduce anxiety.
The population in this study were 30 respondents. The sampling technique used was total sampling. The total sample taken is 100% so that a sample of 30 people is obtained. This research uses a questionnaire as a research instrument that contains statements related to the variables being examined.
This study uses a research method with a quantitative approach. This study aims to determine the relationship between preparation for gentle birth with the degree of anxiety of first pregnant women (primigravidas) in facing labor. This study uses a cross-sectional design, namely activities carried out at a certain time. The research was conducted at PMB Mutiara Medan Sunggal, which was carried out from October to November 2022.  Table 3

. Frequency distribution of anxiety levels for first pregnant women at PMB Mutiara Medan Sunggal
From Table 2 above it can be seen that the respondents had good preparation for gentle birth, namely 24 people with a percentage of 80%, and those who had preparation for gentle birth that were not good, namely 6 people with a percentage of 20%.

Table 4. The relationship between preparation for gentle birth and the degree of anxiety of first pregnant women in facing labor at PMB Mutiiara Medan Sunggal
In Table 3 above, it can be seen that the degree of anxiety for first pregnant women with no anxiety was 13 people with a percentage of 43.3%, the degree of anxiety for first pregnant women with mild anxiety was 6 people with a percentage of 20.0%, the degree of anxiety for first pregnant women with moderate anxiety as many as 7 people with a percentage of 23.3%, the degree of anxiety of first pregnant women with severe anxiety is 4 people 13.3%.

Bivariate analysis
Based on the results of research conducted regarding the relationship between preparation for gentle birth and the degree of anxiety of first pregnant women in facing labor, it is classified into 2 levels, the following results are obtained:

DISCUSSION
The results of the statistical test (Chi Square) obtained a p value of 0.090 meaning that this value was <alpha (0.05) thus it was concluded that H0 was rejected. This means that there is a relationship between preparation for gentle birth and the degree of anxiety of primigravida pregnant women at PMB Mutiara Medan Sunggal.
The results of the analysis of the relationship between preparation for gentle birth and the degree of anxiety showed that the number of respondents who made good preparation for gentle birth with a low degree of anxiety was 19 people (79.2%), respondents with good preparation for gentle birth with high anxiety were 5 people (20 ,8 %). While the respondents who did not prepare for gentle birth with a low degree of anxiety were 2 people (33.3%), the respondents who did not prepare for gentle birth with a high degree of anxiety were 4 people (66.7%).
Gentle Birth is a technique used during pregnancy, childbirth and postpartum to improve mental and physical health as well as the physical health of mothers and their babies but also psychological and mental health (Gunawan, 2013). Preparation for gentle birth is good to do during pregnancy because it can reduce anxiety, and even have a positive impact on the baby.

CONCLUSION
According to the assumption of the researchers, that a series of preparations made from the beginning of pregnancy to delivery has a very positive impact on first-time pregnant women. Mothers can empower themselves during pregnancy, affirm themselves with positive things, and have good mental preparation. It can be seen from the results of table 3.4 that mothers who do good gentle birth preparations have a low level of anxiety, namely 19 people (79.2%). Respondents with good preparation for gentle birth with high anxiety were 5 people (20.8%). Whereas mothers with gentle birth preparations who were not good experienced low anxiety, namely 2 people (33.3%), respondents who did not prepare for gentle birth with a high degree of anxiety, namely 4 people (66.7%). For primigravida pregnant women, pregnancy is their first experience, so when the time of delivery gets closer the mother feels anxious, this can be influenced by Gentle Birth preparations. One of the preparations for Gentle birth is meditation. Meditation is a method to unite the mind and soul on one object that can help calm the mind and mentality of the mother so that the mother is comfortable with her pregnancy. This is in line with the results of Putri Surityawati et al (2019) research entitled "Meditation to Overcome Anxiety" namely because meditation can focus the breath, which can focus the mind on one thing, can help pregnant women to always think positively about how to deal with their pregnancy, which can eliminate anxiety. anxiety during pregnancy. During pregnancy, it's good to prepare for a gentle birth as it can relieve anxiety and even benefit the baby. Therefore, pregnant women feel more anxious when approaching labor because the anxiety they experience for the first time is related to their first experience. Therefore, for pregnant women to overcome anxiety before delivery, especially through gentle labor, it is necessary to feel comfortable and relaxed. For pregnant women to overcome anxiety before birth, namely by gentle birth.
With a gentle and natural birth, minimizing medical intervention is the key to Gentlebirth. Communication skills are absolutely necessary for midwives and the practice is designed to make clients feel like giving birth at home. In the results of this study, based on the findings of this study, there is a significant relationship between the level of maternal anxiety before delivery and the preparation for Gentle Birth.