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Post-cesarean section (SC) patients with premature rupture of membranes (PROM) require comprehensive nursing care due to their high risk of pain, infection, and limited mobility. This case study aims to describe the nursing care process applied to a 39-year-old woman post-SC with PROM indication. The study was conducted over five days in Nusa Indah Room at RSUD dr. Soeselo, Tegal. Data collection included interviews, observation, physical examination, and medical record review. The nursing interventions were guided by the Indonesian Nursing Diagnosis Standards (SDKI), Interventions (SIKI), and Outcomes (SLKI). Results showed a reduction in pain scale from 6 to 2, improved mobility, and wound healing without signs of infection or bleeding. These findings indicate that structured and holistic nursing care, combined with patient education and family involvement, can significantly enhance recovery outcomes. The implications suggest the need for clinical protocols in managing post-SC patients with PROM to ensure consistent, evidence-based nursing practice.

Dysmenorrhea, or menstrual pain, is a common gynecological problem among adolescent girls and often interferes with their daily activities, school performance, and overall quality of life. Conventional pharmacological treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used but may cause side effects with long-term consumption. Therefore, safe and natural alternatives are needed to manage menstrual pain effectively. Carrot juice, which is rich in beta-carotene, vitamin E, and other antioxidants, has been reported to possess anti-inflammatory and analgesic properties that could potentially reduce the severity of dysmenorrhea. This study aimed to determine the effect of carrot juice on reducing menstrual pain in female students at SMAN 1 Trimurjo. A pre-experimental study with a one-group pretest–posttest design was conducted involving 27 students who experienced dysmenorrhea. Pain intensity was assessed before and after the intervention using the Numeric Rating Scale (NRS). Data were analyzed using the Wilcoxon signed-rank test. The results showed that before the intervention, the majority of respondents (85.2%) reported moderate pain, while after consuming carrot juice, 92.6% reported mild pain and 7.4% reported no pain. Statistical analysis revealed a significant difference in pain levels before and after the intervention (p = 0.000, p < 0.05). These findings indicate that carrot juice is effective in reducing dysmenorrhea intensity among adolescent girls. As a safe, affordable, and easy-to-implement non-pharmacological therapy, carrot juice has the potential to be recommended as a complementary approach to menstrual pain management, especially for adolescents who seek natural remedies. Further research with larger samples and control groups is recommended to strengthen the evidence and explore the long-term benefits of carrot juice in menstrual health.

Hypertension is a global health problem that plays a major role as a leading cause of premature death because it can lead to various serious cardiovascular complications, such as stroke, heart failure, and chronic kidney disease. This condition is often characterized by complaints of severe headaches, especially in the nape of the neck, due to increased blood flow to the brain. In addition to medical therapy in the form of antihypertensive drugs, complementary therapies are also needed to support blood pressure reduction and improve the patient's quality of life. One method that has proven effective is slow deep breathing, a slow, deep breathing technique that helps activate the parasympathetic nervous system, reduce sympathetic activity, improve tissue oxygenation, and produce a relaxation effect that is beneficial in lowering blood pressure and reducing pain. This paper aims to describe the experience of nursing care for hypertensive patients using slow deep breathing therapy. The research method used is a quantitative descriptive with a case report design that is carried out through the stages of assessment, establishing a nursing diagnosis, intervention, implementation, and evaluation. Research data were obtained through interviews, direct observation, and physical examination. The results showed that after three consecutive days of therapy, the patient's pain scale decreased from 5 (moderate pain category) to 2 (mild pain category), while blood pressure, which was initially at 196/122 mmHg, successfully decreased to 140/90 mmHg. These results indicate that slow deep breathing plays an important role in lowering blood pressure and improving the comfort of hypertensive patients. In conclusion, slow deep breathing can be used as a simple, safe, inexpensive, and effective non-pharmacological intervention, and is highly recommended for patients to practice independently in their daily lives to prevent worsening hypertension and optimize disease control efforts.

Acute Respiratory Infection (ARI) is a disease that attacks the respiratory system and is classified as an infectious disease. This disease can be caused by various types of microorganisms such as viruses, bacteria, or fungi, but most cases of ARI are caused by viral infections. ARI includes conditions such as the common cold, bronchitis, pharyngitis, and pneumonia. In developing countries, ARI is a leading cause of death, especially in children under the age of five. Lack of access to health services, poor sanitation, and malnutrition are factors that contribute to this condition. Therefore, efforts to prevent and treat ARI are crucial, both through conventional and alternative medicine. One herbal plant that has long been used in complementary therapy for ARI is Echinacea, which comes from the flowering plant Echinacea purpurea and is native to the United States. Echinacea is believed to have immunostimulant properties, meaning it can stimulate the immune system, thereby helping to prevent and accelerate the healing of upper respiratory tract infections. Several studies have shown that the use of Echinacea can reduce the duration and severity of ARI symptoms, as well as reduce the risk of recurrent infections. However, research findings on the effectiveness and safety of Echinacea continue to show significant variation. Some clinical trials report significant benefits, while others find no significant effect compared to placebo. Therefore, a systematic review aims to gather the latest evidence regarding the effectiveness and safety of Echinacea in the treatment and prevention of acute respiratory infections (ARI). This approach is expected to yield stronger and more reliable conclusions to support the use of Echinacea as a safe and effective alternative therapy.

Background: Pregnancy is a physiological process experienced by every woman, but it can be accompanied by various discomforts, both physical and psychological. In the third trimester, hormonal, physical, and emotional changes often trigger complaints such as anxiety, difficulty sleeping, and discomfort. These conditions, if not managed, can negatively impact the health of the mother and fetus, including increasing the risk of pregnancy complications. One non-pharmacological approach that is increasingly in demand to address these problems is aromatherapy, namely the use of essential oils from plants as a complementary therapy. Objective: This literature study aims to explore the effectiveness of aromatherapy in reducing anxiety levels and improving sleep quality in pregnant women, especially in the final trimester. Methods: A narrative literature review was conducted by analyzing ten national journal articles published between 2014–2024. Articles were selected through a purposive sampling method based on the suitability of the topics with aromatherapy, pregnancy, anxiety, and sleep quality. Results: Most studies show that aromatherapy, especially with lavender, orange, and chamomile essential oils, has a positive effect in reducing anxiety levels and improving sleep quality. The mechanism of action of aromatherapy is thought to involve stimulation of the limbic system in the brain via the olfactory pathway, which plays a role in regulating emotions, inducing relaxation, and reducing sympathetic nervous system activity. These effects help reduce tension and facilitate better sleep in pregnant women. Conclusion: Aromatherapy has been shown to be a safe, easy-to-implement, and effective complementary intervention for addressing anxiety and sleep disturbances in pregnancy. Healthcare providers, particularly midwives, are advised to integrate this therapy into holistic antenatal care to support the overall well-being of pregnant women.

Hypertension, commonly known as high blood pressure, is a condition where blood pressure in the blood vessels consistently exceeds the normal range of 140/90 mmHg. Central Java Province has the highest prevalence of hypertension in Indonesia, at 13.4%. In 2020, Purbalingga Regency reported 268,936 cases of hypertension. According to data from the Bojongsari Health Center, there were 11,596 hypertension patients in 2023. Among the 13 villages in Bojongsari District, there are villages that have experienced an increase in hypertension cases of over 20% annually, one of which is Karangbanjar Village, with 542 cases of hypertension in 2022 and an increase to 858 cases (26%) in 2023. Hypertension treatment can be done through complementary therapy such as progressive muscle relaxation therapy and hydrotherapy. This Community Service Program (PkM) was attended by 20 participants. The results from the pre-test to the post-test showed an increase in the average score, from 59 to 81.5. The evaluation of participants' skills indicated an improvement, with 90% in the “good” category and 10% in the “adequate” category. In addition, there was a significant change in participants' blood pressure after receiving therapy. This activity was carried out using lectures and discussions, with PowerPoint presentations, leaflets, and videos demonstrating how to perform progressive muscle relaxation therapy and hydrotherapy. This educational activity showed an increase in knowledge among the elderly in performing progressive muscle relaxation therapy and hydrotherapy to reduce hypertension.

The Caesarean Section (C-Section) procedure is one of the most common surgical methods for childbirth, performed through an incision in the abdominal wall (laparotomy) and the uterine wall (hysterotomy). Despite its effectiveness in ensuring maternal and fetal safety, one of the major postoperative complaints reported by patients is pain. Pain itself is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, which is subjective and can only be described by the person experiencing it. Unmanaged pain may negatively affect postoperative recovery, emotional well-being, mobility, and breastfeeding initiation. Therefore, appropriate nursing care interventions are essential to help patients achieve comfort and recovery. This scientific paper explores the implementation of sacral plexus therapy as part of nursing interventions to address pain problems in post-C-section patients. The study employed a case study approach that applied the nursing care process, which includes comprehensive assessment, formulation of nursing diagnoses, planning, implementation of interventions, and evaluation. Nursing care was carried out over a period of 72 hours (3x24 hours), with pain intensity and patient comfort levels monitored throughout the process. The evaluation results showed that all nursing diagnoses related to pain were successfully resolved within the given timeframe. Specifically, the application of sacral plexus therapy proved effective in reducing the intensity of postoperative pain and improving overall comfort, enabling patients to gradually regain mobility and adapt to their postpartum condition. In conclusion, sacral plexus therapy can serve as a complementary and non-pharmacological intervention within nursing care to effectively manage pain in post-C-section patients. These findings highlight the importance of innovative and holistic approaches in nursing practice to improve patient recovery and quality of care after surgical childbirth.

Nausea and vomiting are common complaints experienced by pregnant women in the first trimester. If left unmanaged, these symptoms may develop into hyperemesis gravidarum, which poses risks to both mother and fetus. One non-pharmacological alternative is the use of ginger (Zingiber officinale) as a complementary therapy. This community service activity aimed to improve the knowledge and attitudes of pregnant women regarding the benefits of ginger decoction in reducing nausea and vomiting. The method included health education, hands-on practice in preparing ginger decoction, and pre-test and post-test evaluations. The activity was conducted at Pratama Madina Clinic, involving 45 first-trimester pregnant women. Results indicated a significant increase in knowledge, with pre-test scores averaging 4.53 and post-test scores rising to 8.33. The activity also led to positive behavioral changes and increased awareness of the safe use of herbal therapies during pregnancy. Ginger education proved to be an effective initiative for fostering social transformation within the pregnant women's community.

Sleep disturbances are a common complaint among postpartum mothers, and this condition can affect the physical and psychological recovery process after childbirth. Untreated sleep disturbances can lead to various problems, such as fatigue, decreased quality of life, and even the risk of mental health disorders such as postpartum depression. One non-pharmacological approach that can be used to address these sleep disturbances is lavender aromatherapy. Lavender aromatherapy is known to have a calming effect that can help improve sleep quality. This community service activity aims to increase postpartum mothers' knowledge about the use of lavender aromatherapy as a complementary therapy to address their sleep problems. The activity was conducted in June 2025 at the Lismarini Independent Midwife Practice (PMB), using methods that included education, discussion, and distribution of informative leaflets. A total of 15 postpartum mothers participated in this activity, and to measure their knowledge, pre- and post-tests were conducted before and after the education session. The evaluation results showed a significant increase in participants' knowledge levels after participating in the education about lavender aromatherapy. Education about the use of lavender aromatherapy has been proven effective in increasing postpartum mothers' understanding of the benefits and how to use this therapy. Thus, lavender aromatherapy can be a beneficial health promotion strategy to support postpartum recovery. Through this activity, it is hoped that postpartum mothers can apply the knowledge gained to independently improve their sleep quality, thereby supporting their physical and mental health during the recovery period. This activity also contributes to efforts to improve overall public health and provides new insights for healthcare workers in educating postpartum mothers about safe and effective alternative therapies.

Free association among adolescents is a social problem that is increasingly worrying, especially in the current era of globalization. Adolescents' lack of understanding regarding behavioral boundaries in social interactions can have various negative impacts, both physically, psychologically, and socially. To address this, this community service activity was conducted with the aim of providing education about the dangers of free association to students of MA Mathla'ul Anwar Pandeglang. A total of 25 students participated in this activity. The media used was a snakes and ladders game that had been educationally modified to suit the material presented. The implementation method included interactive lectures, educational games, group discussions, and learning evaluations through pre- and post-tests. The results of the activity showed a 34% increase in students' understanding of the dangers of free association after participating in the entire series of activities. In addition, the snakes and ladders game media proved effective as a fun learning tool and was able to increase active student participation. This game also helped students more easily understand and remember the material presented. With this creative and participatory approach, it is hoped that education about healthy associations and adolescent character can be better accepted and implemented in everyday life. This activity is expected to become an alternative model for character education in schools and can be implemented sustainably in various educational institutions.

Hypertension is a condition in which Systolic Blood Pressure (SBP) is greater than 140 mm Hg and Diastolic Blood Pressure (DBP) is greater than 90 mm Hg. This disease is one of the most common chronic diseases and can affect anyone, both young and old. Hypertension is often called a silent killer because it has no major symptoms, so sufferers are often unaware that they have high blood pressure until serious complications occur. This study aims to determine the relationship between medication adherence and the use of complementary therapies in hypertensive patients at Mitra Medika Amplas Hospital. The research design used an analytical survey method with a cross-sectional approach. The population in this study were all hypertensive patients who received treatment at the internal polyclinic of Mitra Medika Amplas Hospital, with a total population of 1,398 people. The sampling technique used was purposive sampling with the Slovin formula, resulting in 94 respondents. Based on the results of the analysis using the chi-square statistical test, the P-Value was obtained at 0.685 or P-Value > 0.005, which indicates that the alternative hypothesis (Ha) is rejected and the null hypothesis (Ho) is accepted. Thus, it can be concluded that there is no significant relationship between medication adherence and the use of complementary therapy in hypertensive patients at Mitra Medika Amplas Hospital. The conclusion of this study shows statistically that there is no relationship between medication adherence and the use of complementary therapy at Mitra Medika Amplas Hospital this year, which indicates the need for more attention in improving patient adherence to recommended treatment. The conclusion of this study statistically shows that there is no relationship of medication adherence in the use of complementary therapy at Mitra Medika Amplas Hospital.

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.

Infant growth and development are crucial issues that require serious attention, particularly during the early childhood phase, which is crucial for a child's future development. The golden age of infants is the most sensitive period to various forms of stimulation that influence their motor, sensory, cognitive, and emotional development. However, not all parents, especially mothers, fully understand the importance of appropriate and safe stimulation in supporting infant growth and development. One form of stimulation that is relatively easy to perform, has no side effects, and can be applied independently at home is gentle touch therapy. Gentle Touch Therapy is a complementary therapy method that involves gentle, affectionate touch on the baby's body, aimed at stimulating the nervous system, strengthening the emotional bond between mother and child, and increasing comfort and relaxation in the baby. Several studies have shown that this gentle touch can improve sleep quality, accelerate weight gain, relieve stress, and encourage infant neuromotor and socio-emotional development. This community service activity was carried out as an effort to increase mothers' awareness and skills in providing stimulation through gentle touch. The activity was carried out at the Andina Independent Midwife Practice (PMB), Palembang City, in June 2025. The main target of this activity was mothers with babies aged 0–12 months. The implementation method included providing education through interactive lectures, demonstrations of touch therapy techniques by health professionals, and direct practice by mothers accompanied by facilitators. The results of the activity showed a significant increase in mothers' understanding of the importance of growth and development stimulation, especially through gentle touch therapy. The participants showed high enthusiasm in participating in the activity and were able to practice gentle touch techniques correctly and confidently.

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.

Anemia is a common health problem among adolescent girls, especially in developing countries like Indonesia. This condition is generally caused by insufficient iron intake, an unbalanced diet, and increased iron requirements during growth. Anemia not only impacts physical health but also affects concentration, productivity, and quality of life. Therefore, interventions based on nutrition education and the utilization of local food sources are crucial in sustainable anemia prevention efforts. One potential complementary therapy alternative is the consumption of herbal drinks based on moringa leaves (Moringa oleifera). Moringa leaves are known to be rich in iron, vitamin A, and antioxidants that play a role in red blood cell formation. This community service activity aims to increase the knowledge and skills of adolescent girls in utilizing moringa leaves as a natural source of iron. The target group is grade 10 and 11 female students at SMA Sejahtera Palembang, which was held in June 2025. The activity methods included a nutrition lecture on anemia and the importance of iron, an interactive discussion on the benefits of moringa leaves, and hands-on practice in making herbal moringa drinks (such as moringa leaf tea and moringa juice). The material was delivered using a communicative and participatory approach to actively engage participants. The results of the activity showed an increase in participants' understanding of the causes of anemia, the benefits of moringa leaves, and their willingness to consume herbal drinks as a preventative measure. Most participants also expressed interest in trying to make their own moringa herbal drink at home. This activity is expected to become part of school-based promotional and preventive efforts to address anemia in adolescent girls.

Breast cancer is the second leading cause of cancer-related deaths in women, after cervical cancer. To date, breast cancer treatment still faces various challenges, particularly in terms of effectiveness and therapy-related side effects. Therefore, alternative treatments that are safer and more effective are needed, one of which is through the use of natural ingredients such as soursop leaves (Annona muricata). This review article aims to examine the potential of soursop leaf extract in slowing the growth of breast cancer cells. Several studies have shown that soursop leaf extract contains active compounds such as acetogenin, which are known to inhibit cancer cell proliferation, induce apoptosis, and block the formation of new blood vessels (anti-angiogenesis) in cancer tissues. These bioactive compounds make soursop leaves a promising candidate for natural anticancer agents. Thus, soursop leaf extract may be considered as a complementary therapy in the management of breast cancer.

Bacground : The 0–12 month period is a critical phase in infant development, covering motor, cognitive, and emotional domains. Early stimulation has been proven to prevent developmental delays that may affect later life stages. Complementary therapies such as infant massage and baby gym are widely applied as non-pharmacological, safe, low-cost interventions that can be practiced at home by parents. Objective: To systematically review the scientific evidence regarding the effectiveness of complementary therapies in stimulating the development of infants aged 0–12 months. Methods: This literature study involved a review of articles published between 2018–2024 from PubMed and Google Scholar. Inclusion criteria included experimental and quasi-experimental studies evaluating the effect of complementary therapies (infant massage, baby gym, or others) on infant development. Results: Six relevant studies were identified, including four on baby gym and two on infant massage. All studies reported significant improvements in gross motor development following intervention. Infant massage also showed additional benefits such as increased weight gain and enhanced mother-infant bonding. Conclusion: Complementary therapies such as infant massage and baby gym are effective and practical strategies for stimulating infant development. However, further research with more robust experimental designs is needed to strengthen the evidence base.  

The 0–12 month period is a critical phase in infant development, covering motor, cognitive, and emotional domains. Early stimulation has been proven to prevent developmental delays that may affect later life stages. Complementary therapies such as infant massage and baby gym are widely applied as non-pharmacological, safe, low-cost interventions that can be practiced at home by parents. To systematically review the scientific evidence regarding the effectiveness of complementary therapies in stimulating the development of infants aged 0–12 months. This literature study involved a review of articles published between 2018–2024 from PubMed and Google Scholar. Inclusion criteria included experimental and quasi-experimental studies evaluating the effect of complementary therapies (infant massage, baby gym, or others) on infant development. Six relevant studies were identified, including four on baby gym and two on infant massage. All studies reported significant improvements in gross motor development following intervention. Infant massage also showed additional benefits such as increased weight gain and enhanced mother-infant bonding. Complementary therapies such as infant massage and baby gym are effective and practical strategies for stimulating infant development. However, further research with more robust experimental designs is needed to strengthen the evidence base.

Anemia is a common health issue among adolescent girls, primarily due to increased iron demands during growth and menstruation. This literature study aims to synthesize existing research on complementary therapies for managing anemia in this population. The study employed a literature review design with a systematic search of scientific articles published between 2018 and 2025. Data were collected from multiple electronic databases, including PubMed and Google Scholar, using keywords such as "anemia," "adolescent girls," "complementary therapy," "iron deficiency," "herbal medicine," and "nutritional intervention." Only peer-reviewed articles, clinical trials, systematic reviews, and meta-analyses published in English were included. The review found that natural interventions like Moringa oleifera leaf extract, beetroot juice, dates with lime juice, and educational programs are effective, affordable, and culturally acceptable for improving hemoglobin levels and anemia prevention. However, many studies have limitations such as small sample sizes and short intervention durations. Future research should focus on more rigorous designs with larger samples and longer follow-ups. Combining nutritional supplementation with health education offers a promising holistic approach to managing anemia in adolescent girls.

Anemia during pregnancy remains a significant global health issue, particularly in low- and middle-income countries. Iron (Fe) tablets are the standard treatment, but alternative natural supplements such as pure honey may enhance hemoglobin levels through their nutritional and antioxidant properties. This study aims to  analyze the effectiveness of pure honey combined with Fe tablets on hemoglobin levels among pregnant women with anemia at TPMB Choirul Mala, Palembang. This quasi-experimental study employed a pretest-posttest control group design. A total of 30 pregnant women with anemia were selected through purposive sampling from a population of 66 who attended ANC visits between September and December 2024. Participants were divided equally into intervention and control groups. The intervention group received 2 tablespoons of certified pure honey and one 60 mg Fe tablet daily for 4 weeks, while the control group received only the Fe tablet. Hemoglobin levels were measured before and after the intervention. Data were analyzed using the Wilcoxon and Mann–Whitney tests. The intervention group showed a significant increase in mean hemoglobin level from 9.2 g/dL to 10.8 g/dL (p = 0.002), while the control group increased from 9.0 g/dL to 10.4 g/dL (p = 0.004). The difference in hemoglobin increase between groups was statistically significant (p = 0.041). The combination of pure honey and Fe tablets is more effective in increasing hemoglobin levels than Fe tablets alone. Pure honey may serve as a beneficial complementary therapy in managing anemia during pregnancy.