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The Maternal Mortality Rate (MMR) remains a key indicator in assessing maternal health in Indonesia. Prolonged labor, particularly in the first stage, contributes to the high MMR. Prolonged labor can increase the risk of complications for both mother and baby. Birthballs are a non-pharmacological method used to help accelerate labor by increasing comfort, reducing pain, and accelerating cervical dilation. This method is increasingly popular because it does not involve medication and is safer for pregnant women. This study aims to determine the effect of birthball use on the progress of first-stage labor in women giving birth at the Cantika Clinic, Deli Tua District, Deli Serdang Regency in 2022. The study design used a Quasi Experiment with a Two Group Design. The study sample consisted of 20 respondents divided into two groups: an intervention group using a birthball and a control group not using a birthball, each consisting of 10 respondents. Data were analyzed using the Mann-Whitney test. The results of the study showed that the group using the birthball had an average duration of the first stage of labor of 7 hours, while the group not using the birthball had an average duration of 8 hours and 40 minutes. The results of the statistical analysis showed a p value = 0.029 (<0.05), which means there is a significant effect of the use of the birthball on the progress of the first stage of labor. The conclusion of this study is that the use of the birthball can accelerate the process of the first stage of labor, so it is recommended to be implemented as a non-pharmacological intervention that can support a smoother and more comfortable delivery for pregnant women.  

Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases, characterized by recurrent and painful ulcerations of the mobile or non-keratinized oral mucosa. These lesions are often found on the tongue, labial, and buccal mucosa. Clinically, RAS is divided into three types: minor, major, and herpetiform. The minor type is the most common and has smaller lesions, while the major type has larger lesions and often leaves scars. The herpetiform type is characterized by numerous small lesions appearing simultaneously. Factors influencing the immunological response in RAS include genetic predisposition, viral and bacterial infections, food allergies, vitamin and microelement deficiencies, systemic diseases, stress, and hormonal disorders. Several studies have shown that these factors can trigger or worsen the occurrence of RAS lesions. In addition, emotional and physical stress can contribute to increasing the frequency or duration of ulceration. A 36-year-old female patient presented with pain on the inside of the lower lip that had lasted for 10 days. An intraoral examination revealed a unilateral, yellowish-white ulcer on the inner lower lip surrounded by a distinct, reddish erythema. The lesion was approximately 2-3 mm in size, single in size, soft in consistency, and symptomatic. Based on these findings, the treatment plan includes a complete blood count (CBC), which measures various blood components, including red blood cells, white blood cells, and platelets. This examination is necessary to obtain further information regarding the cause of RAS in this patient. RAS is a multifactorial lesion that can occur in the oral mucosa. Supportive tests such as a complete blood count (CBC) are very useful in establishing the diagnosis and providing further guidance in planning appropriate therapy. Appropriate medication is expected to help the patient recover from complaints and prevent recurrence.   Keywords : Recurrent Apthous Stomatitis, Laboratory, Stress

Pregnancy is a physiological process accompanied by significant physical and psychological changes in pregnant women. One of the most common complaints, particularly in the third trimester, is back pain and decreased physical fitness. Prenatal exercise is a non-pharmacological method proven effective in improving fitness, reducing discomfort, and preparing both physically and mentally for childbirth. This community service program aimed to enhance the knowledge and skills of pregnant women in Kedungjaya Village, Kedawung Sub-district, Cirebon Regency, through education and practical sessions on prenatal exercise. The method included a 60-minute educational session covering the definition, objectives, benefits, and precautions before performing prenatal exercise, followed by a 90-minute practical session guided by a qualified instructor. The results showed an increase in participants’ understanding of the benefits of prenatal exercise and their ability to implement it independently. This program is expected to improve maternal fitness, reduce physical complaints during pregnancy, and optimize physical and psychological readiness for labor.

This community service program was implemented to address the needs of farmers in Kalicaah Village, Tanjung Jaya Village, Panimbang District, for an affordable, simple, and user-friendly fertilizing tool. Traditionally, the application of solid fertilizer has been done manually, which not only leads to inefficiency but also significantly increases the physical workload of farmers. To overcome this issue, the program team designed a solid fertilizer spreader using appropriate technology, constructed from recycled materials such as PVC pipes and used water gallons. This innovation was aimed at creating a sustainable, low-cost solution for the local agricultural community. The program’s implementation involved several key activities, including identifying the farmers' challenges, conducting assembly training sessions, demonstrating the tool’s use, and running direct field trials in local farms. The results showed that the use of the newly developed fertilizer spreader led to a 45% reduction in the time spent applying fertilizer, which directly contributed to more efficient farming practices. Additionally, there was a significant reduction in physical complaints, particularly lower back pain, which had been a common issue due to the manual labor involved in fertilizing. The tool proved to be easy to construct, requiring minimal technical knowledge, and the farmers were able to adopt the technology independently. The high rate of adoption among farmers further emphasizes the tool’s potential for widespread use. The success of this program also suggests that this simple, affordable technology could be replicated in other agricultural regions, benefiting more communities by improving work efficiency, reducing physical strain, and fostering a sustainable approach to farming practices.

Background: Anxiety before childbirth is a psychological disorder often experienced by pregnant women, especially in the third trimester of pregnancy. Fear of pain, worry about the condition of the fetus, and uncertainty about the delivery process are the main triggering factors. If not handled properly, this anxiety can have serious consequences, such as increased stress hormones (cortisol), sleep disorders, high blood pressure, and even labor complications. Therefore, interventions are needed that not only focus on physical aspects, but also support mental and emotional balance. Objective: The purpose of this activity is to provide education and practical training to pregnant women on anxiety management before childbirth through the application of complementary therapies, and to evaluate the effectiveness of this approach in increasing the readiness and calmness of participants. Method: The activity was carried out at PMB Lismarini, Tulungagung, involving 20 pregnant women in their third trimester. Education was carried out interactively using visual media and group discussions. Next, participants participated in the practice of three types of complementary therapies: (1) deep breathing relaxation with diaphragmatic breathing techniques, (2) aromatherapy using lavender as a relaxation agent, and (3) classical music with a slow rhythm played during the session. Results: This activity showed positive results. Eighty-five percent of participants experienced an increase in knowledge scores after the educational session, and 60% showed a significant decrease in anxiety levels based on questionnaire results. Most participants also reported feeling calmer, more prepared, and more confident in facing childbirth. The satisfaction rate with the activity reached 90%, indicating that the methods implemented were well-received by participants. Conclusion: Complementary therapy combined with education is effective in helping pregnant women manage anxiety before childbirth. This activity emphasizes the importance of a holistic approach to antenatal care.

Background: Anxiety before childbirth is a psychological disorder often experienced by pregnant women, especially in the third trimester of pregnancy. Fear of pain, worry about the condition of the fetus, and uncertainty about the delivery process are the main triggering factors. If not handled properly, this anxiety can have serious consequences, such as increased stress hormones (cortisol), sleep disorders, high blood pressure, and even labor complications. Therefore, interventions are needed that not only focus on physical aspects, but also support mental and emotional balance. Objective: The purpose of this activity is to provide education and practical training to pregnant women on anxiety management before childbirth through the application of complementary therapies, and to evaluate the effectiveness of this approach in increasing the readiness and calmness of participants. Method: The activity was carried out at PMB Lismarini, Tulungagung, involving 20 pregnant women in their third trimester. Education was carried out interactively using visual media and group discussions. Next, participants participated in the practice of three types of complementary therapies: (1) deep breathing relaxation with diaphragmatic breathing techniques, (2) aromatherapy using lavender as a relaxation agent, and (3) classical music with a slow rhythm played during the session. Results: This activity showed positive results. Eighty-five percent of participants experienced an increase in knowledge scores after the educational session, and 60% showed a significant decrease in anxiety levels based on questionnaire results. Most participants also reported feeling calmer, more prepared, and more confident in facing childbirth. The satisfaction rate with the activity reached 90%, indicating that the methods implemented were well-received by participants. Conclusion: Complementary therapy combined with education is effective in helping pregnant women manage anxiety before childbirth. This activity emphasizes the importance of a holistic approach to antenatal care.

Childbirth is a natural physiological process, but it is often accompanied by intense pain, especially during the first stage, the cervical dilation phase. This pain arises from uterine contractions, cervical dilation, and fetal pressure on the pelvic structures. For primiparous mothers, this experience of childbirth is a first-time experience that can cause anxiety, tension, and even trauma if not managed properly. The research design used in this study was a quasi-experimental study with a two-group pretest-posttest. The sample size in this study was 38 participants: 19 in the intervention group and 19 in the control group, using a simple random sampling technique. The data analysis used was the t-dependent and t-independent tests. The results of the study obtained the characteristics of the intervention group respondents, most of the respondents were aged 30-35 years as many as 8 people (40.1%), parity of 2 children as many as 8 people (38.5%), and education level was high school as many as 14 people (73.7%). While in the control group most of the respondents were aged 30-35 years as many as 7 people (32.8%), parity of 2 children) as many as 9 people (40.5%), and education level was high school as many as 18 people (94.7%). The intensity of pain in the intervention group before effleurage massage was an average of 6.26 and after an average of 5.74 while in the control group before massage was an average of 6.97 and after an average of 5.83. The results of the dependent t-test of pain intensity before and after effleurage massage in the intervention group obtained a P value of 0.000 and in the control group before and after massage obtained a P value of 0.006. The results of the independent t-test can be concluded that there is a significant difference after the effleurage massage method was carried out in the intervention group, namely a P value of 0.001. From the results of this study, it is known that there is an effect of the effleurage massage method on reducing the intensity of labor pain in the active phase of the first stage of labor in mothers inpartu. Therefore, it is recommended that midwives apply the effleurage massage method as an intervention to reduce pain in the care of mothers in normal labor.   Keywords: ,   

Pregnancy is divided into three stages: the first trimester, second trimester, and third trimester. During pregnancy, the body undergoes various changes that can cause discomfort. Common discomforts experienced by pregnant women include varicose veins, back pain, muscle and joint aches, and lower back pain. These discomforts can be alleviated through pregnancy exercise (prenatal yoga or maternity gymnastics). The purpose of this study was to examine the relationship between pregnant women’s knowledge about the benefits of pregnancy exercise and the childbirth process at Ampelgading Public Health Center. The research design used was descriptive quantitative. The population consisted of 35 pregnant women in May 2025, with a total sampling technique. Data were collected using a questionnaire and analyzed using univariate analysis. The results showed that 36 respondents (50.0%) had moderate knowledge, 25 respondents (34.7%) had poor knowledge, and 11 respondents (15.3%) had good knowledge about pregnancy exercise. Overall, most pregnant women had a moderate level of knowledge. Based on the Spearman Rank statistical test with a 95% confidence level, the P-value was 0.000 (< 0.05), indicating a statistically significant relationship. The conclusion of this study is that there is a relationship between pregnant women's knowledge of the benefits of pregnancy exercise and the childbirth process at Ampelgading Public Health Center.

Background: Normal delivery is a significant moment in a mother's life, marked by the expulsion of the fetus after a full-term pregnancy, typically between 37 to 40 weeks, accompanied by intense uterine contractions. During the active phase of labor, mothers often experience peak pain due to increased frequency and strength of these contractions. One effective method to alleviate this pain is through counter pressure massage. This study aims to explore the differences in pain intensity among mothers in the active phase of labor before and after the application of counter pressure massage at RSU Permata Hati Klungkung. Method: This study used a pre-experimental design and purposive sampling technique. The population in this study were all mothers who underwent normal delivery in September to November 2024 with a total of 80 people, until a sample of 39 participants was determined. Data were collected through observations using a rating scale based on the Numerical Rating Score. Result: Data analysis was performed using the Wilcoxon test, revealing that the average pain score before the massage was 6.92, which decreased to 3.20 afterward. The Wilcoxon test yielded a p-value of 0.001, indicating a significant difference in labor pain intensity. Conclusion: This study shows that there is a difference in pain intensity before and after counter pressure massage is performed on mothers giving birth in the first active phase at Permata Hati Hospital, Klungkung with a p-value of 0.001.

The purpose of this study is to evaluate how effective the laboratory information system is in terms of data transmission and website speed at the UNTIRTA VTE Laboratory. To conduct this study, a literature review and direct observation of the data sending and receiving process, as measured by PageSpeed ​​Insights, were used. The results showed that overall, the website performance was good, with optimal FCP and LCP values ​​on desktop and mobile devices. However, elements such as Interaction to Next Paint (INP) and Speed ​​Index (SI) require additional improvements to improve interactivity and access speed. The student dashboard page is considered the main activity center, according to the analysis of user access pattern data. However, pages with large file sizes require better data transmission management to avoid bottlenecks. The student dashboard page is considered the main activity center, according to the analysis of user access pattern data. However, pages with large file sizes require better data transmission management to avoid bottlenecks. This study provides an overview of how effective data transmission and user experience are on the laboratory website and suggests the development of infrastructure and website optimization elements, such as caching and file size reduction. These results contribute to the continuous improvement of the laboratory website, which is very important to meet the data and information service needs of UNTIRTA VTE Laboratory users in real-time.    

Community service has been carried out by the service team involving students from the Padangsidimpuan Midwifery Study Program, Poltekkes Kemenkes Medan. The community service activities carried out were to provide counseling and demonstrations about Endorphine massage which is a light touch or massage therapy that is quite important to be given to pregnant women, in the time leading up to and during childbirth. This massage can stimulate the body to release endorphin compounds which are pain relievers and can create a feeling of comfort. Endorphins in the body can be triggered through various activities, such as deep breathing and relaxation, and meditation. Endorphine massage should be done to pregnant women who are 36 weeks pregnant. Because endorphin massage can stimulate the release of the hormone oxytocin which can trigger the labor process (Kuswandi, 2014). This Community Service aims to demonstrate endorphin massage to reduce pain in mothers giving birth in the first stage in the Pintu Padang Health Center work area, South Tapanuli Regency. Target pregnant women in the third trimester, young couples, Participants 40, endorphin massage is expected to be implemented in the management of the first stage to reduce pain and speed up the labor process. The results of this community service are an increase in knowledge of 50% and skills of 87% about endorphin massage correctly applied when pregnant women later undergo the labor process. This community service is carried out in collaboration with partners used as the location of this activity, namely Kalurahan Pintu Padang, Batang Angkola District, South Tapanuli Regency and Health Cadres, Village Midwives at the local Health Center. This activity received a positive response from local participants, and as a follow-up, it can be carried out by Health Cadres and midwives at the Health Center to monitor the skills that have been obtained when pregnant women are in the labor process that will be undergone

Mrs. Km visited the Integrated Health Post (Posbindu) in Alue Keureunyai Village with complaints of throbbing neck pain that had occurred intermittently over the past two weeks and worsened in the last day. The pain intensified after consuming fatty or coconut milk-based foods and improved with rest or cholesterol-lowering medication. She also experienced a persistent, heavy, throbbing headache for two weeks and ongoing fatigue for the past three weeks, despite minimal physical activity. These symptoms led to reduced motivation in daily activities. Physical examination showed: BP 160/100 mmHg, HR 88 bpm, RR 20 breaths/min, T 36.8°C. Laboratory results revealed a total cholesterol level of 250 mg/dL. Data were gathered through auto-anamnesis, physical and laboratory examinations, home visits, completion of the family folder, and patient documentation. Assessment was based on holistic diagnosis at the initial, ongoing, and final stages of the visit, using both qualitative and quantitative approaches. Interventions included education on the causes of hypercholesterolemia, the importance of taking medication regularly, and awareness of complications due to high cholesterol levels.

Background: When entering the third trimester of pregnancy, many pregnant women have difficulty sleeping as they face physical and psychological changes, such as back pain, frequent urination, anxiety, and worries about the upcoming labor process. Almost 66% of pregnant women experience sleep disruptions that can jeopardize maternal and fetal health, including the risk of preeclampsia and low birth weight. Prenatal yoga can relieve stress and anxiety, thus contributing to improving the sleep quality of third trimester pregnant women. Purpose: To know the influence of prenatal yoga on sleep quality of third trimester pregnant women at PMB Appi Ammelia Kasihan Bantul Yogyakarta. Methods: This research utilizes the Pre-Experimental research type and One-Group Pretest-Posttest Design. The sample comprised of three trimester pregnant women totaling 24 respondents. The sampling method used total sampling. Sleep quality assessment was evaluated using the PSQI questionnaire and applying Wilcoxon test analysis. Results: Before treatment, 3 respondents (12.5%) of third trimester pregnant women had good sleep quality. After treatment, there was a change so that 18 (75%) respondents had good sleep quality. A p-value of 0.001 was found from the Wilcoxon test analysis. Conclusion: Prenatal yoga affects the sleep quality of third trimester pregnant women at PMB Appi Ammelia Kasihan Bantul Yogyakarta.

One of the causes of the high Maternal Mortality Rate (AKI) is long childbirth. If the delivery process lasts a long time, it can cause the mother to be exhausted because she runs out of energy. This results in inadequate uterine contractions (his) so that it can cause failure in the progress of labor. In addition to the inadequacy of uterine contractions (his), psychological conditions are also one of the factors that affect the length of labor progress. The psychological condition in question is the mother's perception of anxiety and pain during the childbirth process. One of the non-pharmacological therapies is self-healing , which is one of the methods used to manage emotions in order to avoid things that cause stress. This study aims to analyze the Effectiveness of Self-Healing to Reduce the Intensity of Pain in Maternal Mothers at PMB Winda Nainggolan, Hutabayu District, Simalungun Regency, North Sumatra Province in 2024. This research method uses a quantitative research approach with a quasi-experimental design research method in one group (one group prestest posttest). The research will be conducted in May 2024-July 2024. The sample size was 16 people with nonprobability sampling techniques. The data analysis used was using the Pairet t Test with an error value of α 0.05. The results of the study based on the output test statistics obtained a significance value of 0.000 which is smaller than the significance level of 5% (p-value = 0.000 < 0.05). The conclusion of the study is that Ha is accepted, which means that there is an effect of self-healing on the reduction of Period I labor pain in Primigravida mothers at PMB Winda Nainggolan, Hutabayu District, Simalungun Regency, North Sumatra Province in 2024. It is hoped that health workers can improve the quality of service, self-healing can be an intervention as one of the non-pharmacological therapies for maternal mothers.

Pneumonia is a lung infection that causes inflammation in the lung parenchyma. Pneumonia is the third leading cause of death globally. In Indonesia, in 2018, the prevalence of pneumonia among all age groups reached 2.21%. This case report was obtained from primary data through anamnesis, physical examination, and supporting tests. The patient complained of shortness of breath. The shortness of breath occurred during moderate physical activity and improved with rest. The shortness of breath was not affected by the weather. The patient also complained of left chest pain, productive cough, fever, diarrhea, and weakness. Upon physical examination, the general status showed vesicular breath sounds and rhonchi in the left lung field. Chest X-ray revealed diffuse consolidation in the bilateral paracardial pulmonary areas, suggesting pneumonia. Laboratory tests showed elevated white blood cell count. The patient was given pharmacological and non-pharmacological management in the form of respiratory fluoroquinolone.

Labor pain is a complex experience, with 65-80% of mothers in Indonesia experiencing severe pain during childbirth, requiring effective management. The SP6 (Sanyinjiao) acupressure technique offers a non-pharmacological, easy-to-apply, and safe alternative with minimal side effects for reducing labor pain. This study aimed to evaluate the effect of SP6 acupressure on labor pain in mothers giving birth at the Obstetrics Emergency Room of Tidore Islands City Hospital. A quasi-experimental design with a pre-test and post-test approach was used. The sample included 30 mothers in the active phase of labor (4-7 cm dilation), with singleton pregnancies and gestational ages of 37-42 weeks, selected through purposive sampling. The intervention involved applying acupressure at the SP6 point for 20 minutes with moderate pressure. Pain intensity was measured before and after the intervention using a Numeric Rating Scale (NRS) from 0-10. The Wilcoxon Signed Rank Test showed a significant decrease in pain intensity (p = 0.000), with 50% of participants reporting moderate pain post-intervention, and no participants experiencing uncontrolled severe pain. In conclusion, SP6 acupressure significantly reduced labor pain intensity and can be recommended as an effective, safe, and easy-to-apply method for managing labor pain.

Labor pain during the first stage of active phase is visceral, arising from uterine contractions and cervical dilation, processed through sympathetic efferent nerve fibers. One therapy that can be used to reduce this pain is the administration of red ginger extract, which is known to have the highest oleoresin content compared to other types of ginger. This study aims to assess the factors influencing the knowledge of third-trimester pregnant women about the benefits of red ginger drink as a pain reliever during the first stage of active labor at the RSUD Daerah Perdagangan. The study used an analytic cross-sectional design involving 66 respondents who met specific inclusion and exclusion criteria. The results showed that education, age, received information, and culture influenced pregnant women’s knowledge about the benefits of red ginger. Based on statistical tests, it was found that education, age, information, and culture have a significant impact on the level of knowledge among pregnant women. This study is expected to contribute to increasing pregnant women’s knowledge of alternative pain relief methods using red ginger and to enrich awareness of the importance of health information during pregnancy.

Mothers who have difficulty adapting to labor pain can cause uterine contractions to become uncoordinated, which risks prolonging the first phase of labor and disrupting fetal well-being. This study aims to analyze the effect of breathing relaxation techniques on the intensity of labor pain in the first stage at the Pagar Merbau Health Center, Pagar Merbau District, Deli Serdang Regency in 2023. This study used a quantitative method with a One Group Pre-Test Post-Test design. The study population included all mothers giving birth in the period from April to June 2023, with a sample size of 15 respondents. The results showed that before the intervention, there were 2 respondents (13.3%) who experienced mild pain, 6 respondents (40.0%) with moderate pain, and 7 respondents (46.7%) experienced severe pain. After the intervention, the number of respondents with mild pain increased to 8 people (53.3%), moderate pain decreased to 4 people (26.7%), and severe pain decreased to 3 people (20.0%). The results of this study indicate a significant change in the level of pain in mothers giving birth before and after treatment. Therefore, it is expected that midwives at the Pagar Merbau Health Center can optimize the application of breathing relaxation techniques as a method to reduce labor pain, especially in the first phase of labor.

Childbirth causes pain due to shortening of the uterine muscles. Normal childbirth occurs because of pain, which is an important part of labor. During labor, pain can influence uterine contractions through the secretion of catecholamines and cortisol. It improves the function of the sympathetic nervous system, changing blood pressure, heart rate, breathing, and length of labor. The aim of this research is to find out how warm compresses impact how severe the pain of labor during the first active phase is. This research design is pre-experimental with a one group pre test and post test design. The population in this study were all mothers giving birth at BPM Nursehan Dahliana Birayang (Hulu Sungai Tengah Regency, South Kalimantan Province), using an accidental sampling technique and a sample size of 30 respondents was obtained. A warm compress is placed on the lower abdomen using a hot bladder. Data analysis used the Paired T - test. Based on the research results obtained, the average pain score before treatment was 8.13 and the average pain score after treatment was 4.66. The results of statistical analysis of tests of differences in pain intensity before and after treatment showed significant differences (p=0.000; 95% CI -3.900-(-3.031). The conclusion of this study is: warm compresses can reduce the intensity of labor pain in the active phase of the first stage. Warm compresses can be used as a way to reduce the intensity of labor pain.

Maternal Mortality Rate (MMR) is a component of the development index and quality of life index which is calculated by taking into account and considering women's health status (MMR). The aim of this research is to determine the factors associated with hyperemesis gravidarum at the Birem Bayuem Community Health Center in 2024. The design of this research is an analytical survey using a cross-sectional approach. The sample in this study was all 1st trimester pregnant women who visited ANC at the Birem Bayuem Community Health Center in 2024, namely 26 pregnant women. The results of the analysis using the Telst Chi-sqularel test showed a value of p=0.008 (95% CI 1.522-26.081). Mothers who are working have a rate of 6,300 times more likely to experience hyperreleasing disease compared to mothers who are not working. It is hoped that by increasing the number of antenatal care, follow-up or maternal visits in research will reduce the number of cases of hyperelelmosis. Apart from that, it is highly recommended that you learn about health regularly by actively asking health professionals every time you visit a health care facility.