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Anxiety during pregnancy is one of the most common psychological problems experienced by pregnant women, particularly during the third trimester when they face childbirth preparation as well as various physical and emotional changes. If not properly managed, anxiety may adversely affect both maternal and fetal health. This study aimed to describe the level of anxiety among third-trimester pregnant women at Mlati II Public Health Center in 2026. This research employed a descriptive quantitative design with a cross-sectional approach. The study involved 40 third-trimester pregnant women selected using a total sampling technique. Data were collected using the Hamilton Anxiety Rating Scale (HARS) questionnaire and analyzed through univariate analysis in the form of frequency and percentage distributions. The results showed that most respondents were of healthy reproductive age (20–35 years) (92.5%), primigravida (67.5%), had a secondary level of education (70%), and were unemployed (70%). The respondents' anxiety levels were categorized as no anxiety (47.5%), mild anxiety (47.5%), and moderate anxiety (5%), while no cases of severe anxiety or panic were identified. The most dominant anxiety indicators were anxious feelings, tension, respiratory symptoms, and sleep disturbances. These findings indicate that some third-trimester pregnant women still experience anxiety, highlighting the need for early detection, health education, and psychological support through antenatal care services to promote maternal mental well-being during pregnancy.

Background: Breastfeeding is a valuable experience for both mother and infant, enhancing cognitive development, immunity, and emotional bonding. However, exclusive breastfeeding coverage remains suboptimal, partly due to inadequate breastfeeding technique skills among mothers. Objective: This study aims to analyze the differences in breastfeeding technique skills among pregnant women before and after a video-based educational intervention at the Gema Santi Nusa Penida Regional General Hospital, Klungkung Regency. Methods: This study utilized a pre-experimental design with a one-group pretest-posttest approach. The population consisted of 160 pregnant women visiting the Gema Santi Nusa Penida Regional General Hospital from March to April 2025. A sample of 32 pregnant women was determined using a comparative analysis sample size formula and selected via purposive sampling. Primary data were collected through observation using a validated and reliable breastfeeding technique skill checklist (calculated $r = 0.411 - 0.758 > 0.349$; Cronbach's alpha $= 0.757 > 0.6$). Results: The Shapiro-Wilk test indicated that the data were normally distributed, with values of 0.325 (pre-test) and 0.127 (post-test) $> 0.05$. The mean score for breastfeeding technique skills was 42.28 before the intervention and increased to 70.46 afterwards. The paired t-test demonstrated a significant difference in breastfeeding technique skills before and after the educational intervention ($p = 0.000 < 0.05$). Conclusion: Video media is highly effective in improving breastfeeding technique skills. Future initiatives should focus on developing more comprehensive video content to further enhance educational efficacy.

Background: Cesarean section (CS) is a mode of delivery frequently used in women with high-risk pregnancies. Over the past two decades, the rate of CS has increased significantly worldwide. Although CS can be a life-saving intervention when performed based on appropriate medical indications, it may also result in adverse outcomes for both mothers and infants and increase the clinical and economic burden on healthcare systems. Limiting CS rates can be achieved through the control of modifiable risk factors. Purpose: This study aimed to describe the factors contributing to the occurrence of cesarean section. Method: This study employed a descriptive cross-sectional design and was conducted at Singasana Regional General Hospital, Tabanan Regency, from February to May 2025. The study sample consisted of 259 women who underwent cesarean delivery during the period 2020–2024. Data were collected through a review of medical records using a checklist instrument. Univariate analysis was performed to describe maternal characteristics and indications for cesarean section. Result: Most cesarean deliveries occurred in women aged 20–35 years (77.99%) and in multiparous women (48.65%). The most dominant maternal factor was a previous cesarean section (37.6%), while the most common fetal factor was fetal distress (42.7%). Conclusion: Maternal age of 20–35 years, multiparity, a history of previous cesarean section, and fetal distress were the dominant factors associated with cesarean delivery. These findings highlight the importance of early antenatal risk screening and optimal labor management to reduce unnecessary cesarean sections and improve maternal and neonatal safety.

Preeclampsia is a pregnancy complication that significantly contributes to maternal and neonatal morbidity and mortality worldwide. Globally, it affects approximately 3–8% of pregnancies and causes more than 70,000 maternal deaths each year. In Indonesia, preeclampsia accounts for around 30% of the 4,151 maternal deaths reported in 2024. In Padang City, there were 254 cases in 2023 and 129 cases in 2024, with Puskesmas Bungus having the highest prevalence (7.2% and 3.77%). This study aimed to analyze the association between body mass index (BMI), history of hypertension, and history of preeclampsia with the incidence of preeclampsia among pregnant women at Puskesmas Bungus, Padang. This study used a quantitative case-control design involving 50 cases and 50 controls. Data were analyzed using chi-square and logistic regression tests. The results showed significant associations between obesity (p=0.031; OR=2.897), history of preeclampsia (p=0.006; OR=13.821), and history of hypertension (p=0.002; OR=17.216) with the incidence of preeclampsia. Multivariate analysis identified history of hypertension as the most dominant factor associated with preeclampsia. This study concludes that obesity, history of hypertension, and history of preeclampsia are significant risk factors for preeclampsia among pregnant women. Strengthening early detection and routine antenatal care for high-risk pregnancies is necessary to reduce maternal complications associated with preeclampsia.

The physiological changes that occur during pregnancy, both physically and mentally, may be rather uncomfortable, particularly in the second and third trimesters. Pregnant women often report back discomfort, muscular aches, trouble sleeping, excessive exhaustion, and irregular sleep patterns. Mothers' physical and mental health as well as the health of their unborn children may be significantly impacted by inadequate sleep quality during pregnancy. To enhance comfort and the quality of sleep during pregnancy, one non-pharmacological technique is to use an aromatherapy maternity pillow. An ergonomic and ecologically sustainable invention to enhance mother comfort during pregnancy was the goal of this research, which intended to produce a Pregnancy Pillow Therapy product with pineapple leaf fiber and aromatherapy. A descriptive research design using a prototype creation technique was used in this study. The stages of the research included problem identification, literature review, product design, material selection, prototype manufacturing, and product evaluation. Data were collected through literature studies and observations related to sleep discomfort in pregnancy, maternity pillow utilization, aromatherapy therapy, and pineapple leaf fiber characteristics. The developed product was designed ergonomically to support the back, abdomen, waist, and legs of pregnant women. The addition of aromatherapy was intended to provide a relaxing effect and improve sleep quality. The use of pineapple leaf fiber also supports environmentally friendly product innovation through agricultural waste utilization. The results indicate that Pregnancy Pillow Therapy has the potential to become a supportive product for improving comfort and sleep quality among pregnant women. Further studies are recommended to evaluate product effectiveness directly among pregnant women.

Anemia pada ibu hamil merupakan masalah kesehatan yang sering terjadi dan berisiko terhadap kesehatan ibu dan janin. Rendahnya pengetahuan serta kepatuhan dalam mengonsumsi tablet Fe menjadi salah satu penyebab tingginya kasus anemia selama kehamilan. Kegiatan pengabdian masyarakat ini bertujuan meningkatkan pengetahuan dan kesadaran ibu hamil tentang pentingnya konsumsi tablet Fe sebagai upaya pencegahan anemia. Metode yang digunakan berupa pemeriksaan kadar hb, penyuluhan melalui ceramah, diskusi. Kegiatan dilaksanakan pada 31 Januari 2026 di PMB Bidan Irma dengan peserta 13 ibu hamil. Hasil kegiatan menemukan 1 peserta ibu hamil yang terkena anemia, pentingnya peningkatan pengetahuan dan kesadaran ibu hamil mengenai bahaya anemia dan pentingnya konsumsi tablet Fe secara rutin. Peserta memberikan respons positif dan berharap kegiatan serupa dapat dilakukan secara berkelanjutan. Edukasi ini diharapkan mampu meningkatkan kepatuhan konsumsi tablet Fe serta mencegah komplikasi selama kehamilan, persalinan, dan masa nifas.

Pregnancy complications remain a leading cause of maternal morbidity and mortality in Indonesia. Pregnant women's limited knowledge of pregnancy danger signs and suboptimal participation in antenatal care (ANC) services can increase the risk of delayed detection and management of pregnancy complications. The Kinovaro Community Health Center (Puskesmas) in Sigi Regency is one of the areas requiring maternal health information and activities that can increase pregnant women's participation in health education activities. This community service activity aims to improve pregnant women's knowledge and preparedness in preventing pregnancy complications through mentoring based on Pregnant Women's Classes. The activity involved eight pregnant women in their second and third trimesters. The methods used included health education, interactive discussions, simple pregnancy check-ups, pregnancy exercise demonstrations, and evaluation using pre- and post-tests. The results showed that all participants actively participated in the activity and had a good level of knowledge after participating. The average knowledge score increased from 77.5 to 80.0, an increase of 3.2%. In addition, participants were able to identify pregnancy danger signs, understand the importance of standard ANC visits, and practice pregnancy exercise movements independently. This activity demonstrates that mentoring through the Pregnant Women's Class can strengthen maternal health literacy, increase pregnant women's preparedness in recognizing pregnancy complications, and support the strengthening of maternal health services at the community level.

Hyperemesis gravidarum is excessive nausea and vomiting in pregnant women to the point of interfering with daily activities. Hyperemesis gravidarum affects the mother's physiological condition. Continuous nausea and vomiting can cause carbohydrate and fat reserves to be used up for hormonal needs, resulting in activity intolerance, and imperfect fat oxidation, resulting in ketosis. This case study aims to explain Nursing Care for Patient Mrs. B with Hyperemesis Gravidarum Case in Providing Ginger Water Decoction to Reduce Nausea and Vomiting in Pregnant Women in Arafah Room 3 RSUDZA Banda Aceh. This design is a case study with a nursing process approach, the results of the case study found three nursing diagnoses, namely nausea related to pregnancy, the risk of nutritional deficits related to psychological factors (reluctance to eat) and anxiety related to lack of exposure to information. The nursing actions given are providing non-pharmacological therapy: ginger decoction, encouraging patients to eat little but often and providing information about physiological symptoms in pregnant women in the first trimester, including nausea and vomiting. The results of the evaluation after 5 visits for the nursing diagnosis of Nausea related to pregnancy were obtained at the fifth visit. The subjective data evaluation of the client said that nausea was still felt occasionally, the client said that vomiting was no longer present, the client said that appetite had started to improve

Meeting the nutritional needs of pregnant women requires innovative strategies through the provision of healthy snacks with balanced nutritional value. Donuts are popular snack foods; however, they are generally made from wheat flour and have limited nutritional content. This study aimed to analyze the nutritional content and acceptability of donuts enriched with red bean flour and Banggai yam flour as a healthy snack for pregnant women. This experimental study employed a Completely Randomized Design (CRD) consisting of three formulations: F1 (35% red bean flour : 15% Banggai yam flour), F2 (40% : 10%), and F3 (45% : 5%), with two replications. Nutritional analysis included protein using the Kjeldahl method, fat using the Soxhlet method, and carbohydrate using UV-Vis spectrophotometry. Acceptability was evaluated using a hedonic test. Data were analyzed using ANOVA and the Kruskal–Wallis test. The results showed significant differences in protein, fat, and carbohydrate contents among formulations (p<0.05). The highest protein content was found in F3, the highest fat content in F2, and the highest carbohydrate content in F1. Acceptability did not differ significantly among formulations (p>0.05); however, F1 obtained the highest preference score. Donuts enriched with red bean flour and Banggai yam flour have the potential to be developed as a healthy local food–based snack for pregnant women.

Gestational hypertension is one of the leading causes of maternal mortality in Indonesia. Non-pharmacological interventions such as lavender aromatherapy have gained attention as complementary therapies due to their natural properties and minimal side effects. This study aims to evaluate the effect of lavender aromatherapy on blood pressure among pregnant women with gestational hypertension. The research employed a quasi-experimental design using a one-group pretest-posttest approach. A total of 15 participants meeting the inclusion criteria received an intervention consisting of lavender aromatherapy inhalation for 10–15 minutes. The results showed a decrease in mean systolic blood pressure from 141.53 mmHg before the intervention to 139.27 mmHg after the intervention. However, the mean diastolic blood pressure slightly increased from 90.20 mmHg to 90.27 mmHg. The reduction in systolic pressure indicates a potential relaxation effect of lavender, likely mediated through parasympathetic nervous system stimulation. Although the change in diastolic pressure was minimal and not clinically significant, these findings support the use of lavender aromatherapy as a supportive approach in managing blood pressure in pregnant women with gestational hypertension. This complementary therapy is expected to enhance maternal healthcare, particularly in improving comfort and reducing stress during pregnancy.

Hypertension in pregnant women and Women of Reproductive Age remains a significant health problem in West Java Province. The prevalence of hypertension among pregnant women in West Java is approximately 10.57%, higher than the national rate of 6.18%, while the prevalence among WRA ranges from 25% to 30%. This study employed a pretest–posttest design with health counseling provided to 25 pregnant women and Women of Reproductive Age in RW 05, Kertamaya Subdistrict, Bogor City. Data were collected using knowledge and attitude questionnaires before and after the counseling and analyzed using the Paired Sample T-test. The results showed a significant increase in participants’ average knowledge and attitude scores after the educational intervention (p < 0.05). Based on the Paired T-test, the intervention yielded a p-value of 0.000, indicating a statistically significant improvement in both knowledge and attitudes. These findings demonstrate that health education is effective in increasing knowledge and fostering positive attitudes regarding hypertension among pregnant women and Women of Reproductive Age.

Background: The prevalence of Chronic Energy Deficiency (SEZ) of pregnant women nationally is still 16.9%, and anemia reaches 27.7%, so the development of local food-based Supplementary Feeding (PMT) is needed. Brownies with the substitution of red spinach as a source of iron and purple sweet potato flour as an energy source have the potential to be developed as an alternative to PMT. This study aims to determine the acceptability and nutritional content of red spinach brownies with the addition of purple sweet potato flour as an interlude food for pregnant women. Method: Design using the Complete Random Design (RAL) method. The formulation of making brownies consists of three treatments with a comparison between (red spinach pureee and purple sweet potato flour) as follows: F1 (50:50), F2 (60:40), and F3 (40:60). The acceptance test was conducted using a hedonic test of color, aroma, taste, and texture on 30 semi-trained panelists. Analysis of nutritional content includes moisture content (thermogravimetry), ash content (dry ashing), protein (Kjeldahl), fat (Soxhlet), carbohydrates (by difference), and Fe (Atomic Absorption Spectrophotometry). The data were analyzed using the Kruskal-Wallis test. Research Results: The acceptability test showed that there was no significant difference between the formulations. The F3 formulation with a ratio of 40% red spinach pureee and 60% purple sweet potato flour obtained the highest preference value and was determined as the best formulation. The nutritional content of the F3 formulation includes protein 10.447%, fat 8.047%, carbohydrates 1.5579%, Fe 0.0005%, moisture content 20.68%, and ash content 1.4875%. Conclusion: There was no significant effect of each formulation on the acceptability of Brownis Suggestion: It is hoped that the next researcher can improve product formulation and processing processes to maintain and increase iron (Fe) levels in brownies.

Iron deficiency anemia remains a major public health problem among pregnant women in Indonesia, with a national prevalence of 37.1% and higher rates in regions such as Brebes Regency. Adequate nutritional knowledge and sufficient iron intake are expected to prevent decreases in hemoglobin (Hb) levels during the third trimester. This study aimed to analyze the relationship between nutritional knowledge, iron intake adequacy, and Hb levels among third-trimester pregnant women at Puskesmas Brebes. An analytic observational study with a cross-sectional design was conducted on 62 respondents using total sampling. Data were collected through a nutritional knowledge questionnaire, a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to assess iron intake based on the Recommended Dietary Allowance of 27 mg/day, and Hb measurement using a digital device. The prevalence of anemia was 32.3%, with a mean Hb level of 11.25 ± 1.74 g/dL. Most respondents had high nutritional knowledge (72.6%), but 79.0% had inadequate iron intake. Chi-Square analysis showed no significant relationship between nutritional knowledge and Hb levels (p=0.109) or between iron intake adequacy and Hb levels (p=0.426). Other factors, including iron absorption inhibitors, compliance with iron supplementation, nutritional status, and limited sample size, may have influenced the results.

The increasing complexity of competition in the healthcare industry requires hospitals to adopt adaptive and strategic management practices to enhance organizational competitiveness. This study aims to analyze the role of strategic management in improving hospital competitiveness through a Systematic Literature Review (SLR) approach. A total of 41 national and international scientific articles published between 2014 and 2025 were reviewed, sourced from Scopus, Web of Science, Google Scholar, and Sinta databases, following the PRISMA guidelines for literature selection. The synthesis of findings indicates that strategic management plays a significant role in strengthening hospital competitiveness through clear strategy formulation, consistent implementation, and continuous performance evaluation. Key factors contributing to competitive advantage include strategic leadership, adaptive organizational culture, effective human resource management, utilization of information technology, and integration between strategic planning and operational processes. The results emphasize that hospitals implementing strategic management comprehensively are better equipped to respond to environmental dynamics, improve service quality, and sustain competitive advantage in the long term. This study highlights the importance of strategic management as a foundational element in modern hospital governance and provides a conceptual basis for future empirical research in healthcare management.

The increasing complexity of competition in the healthcare industry requires hospitals to adopt adaptive and strategic management practices to enhance organizational competitiveness. This study aims to analyze the role of strategic management in improving hospital competitiveness through a Systematic Literature Review (SLR) approach. A total of 41 national and international scientific articles published between 2014 and 2025 were reviewed, sourced from Scopus, Web of Science, Google Scholar, and Sinta databases, following the PRISMA guidelines for literature selection. The synthesis of findings indicates that strategic management plays a significant role in strengthening hospital competitiveness through clear strategy formulation, consistent implementation, and continuous performance evaluation. Key factors contributing to competitive advantage include strategic leadership, adaptive organizational culture, effective human resource management, utilization of information technology, and integration between strategic planning and operational processes. The results emphasize that hospitals implementing strategic management comprehensively are better equipped to respond to environmental dynamics, improve service quality, and sustain competitive advantage in the long term. This study highlights the importance of strategic management as a foundational element in modern hospital governance and provides a conceptual basis for future empirical research in healthcare management.

Background: Pregnancy is a crucial period that requires special attention to the mother's physiological and psychological aspects. Many pregnant women experience poorly understood physical and emotional changes, lack of early detection of high-risk pregnancies, and lack of knowledge about a healthy lifestyle during pregnancy, including physical activity and balanced nutrition. The main problems faced are pregnant women's lack of understanding of normal physiological and psychological changes during pregnancy, lack of knowledge about danger signs and how to detect high-risk pregnancies, low participation of pregnant women in physical activities such as prenatal exercise, lack of knowledge regarding balanced nutrition for pregnant women, and limited comprehensive health education facilities in the community. Objective: This community service activity aims to improve the health of pregnant women by strengthening promotive and preventive pregnancy classes. Methods: This community service activity included screening for high-risk pregnancies, providing materials on physiological and psychological changes in pregnancy, maternal nutrition, and early detection of complications in high-risk pregnancies. A demonstration of prenatal exercise practices was also conducted at the Pondokgebangsari Village Hall, Kuwarasan District, Kebumen Regency. The training, conducted in February 2026, involved 15 pregnant women in their first, second, and third trimesters. Results: This activity demonstrated an increase in mothers' knowledge about physiological, psychological changes, and pregnancy nutrition after education, with 8 receiving good and 7 receiving adequate education. Education on Early Detection and Danger Signs of High-Risk Pregnancy also increased, with 9 receiving good and 6 receiving adequate education. Thus, families are aware of the importance of attending pregnancy classes and see them as essential for a healthy pregnancy. Conclusion: Community service programs to strengthen pregnancy classes through education, high-risk screening, and nutrition counseling support efforts to improve maternal and infant health, and are an investment in the future.

Problems: Based on data from the Batam City Health Office, the 3 Community Health Centers with the highest incidence of anemia include Sei Panas 15.7%, Sambau 10.24%, Nongsa 8.24%. Objective: This study aims to determine the relationship between maternal age and parity with the incidence of anemia in pregnant women in the working area of UPT Puskesmas Sei Panas Batam City in 2024. Methods: This study used a descriptive correlation research design with a cross-sectional research design. The sampling technique used was Non Probability Sampling. Respondents in this study were 66 pregnant women. Results: Based on the Chi- Square test, the age variable obtained a P-value of 0.000 (ρ <0.05) and the parias variable with a P-value of 0.000 (ρ>0.05). This study shows that there is a relationship between age and the incidence of anemia in pregnant women and the relationship between parity and the incidence of anemia in pregnant women in the working area of UPT Puskesmas Sei Panas Batam City in 2024. Conclusion: there is a relationship between age and parity of mothers with the incidence of anemia in pregnant women. Suggestion: It is hoped that prospective mothers understand the ideal safe age and parity in preparing for a healthy pregnancy in order to avoid anemia during pregnancy. And pregnant women must be diligent in consuming Fe tablets and also make 6 ANC visits during pregnancy so that pregnant women's health is monitored, especially their Hb levels.

This study aims to analyze the difference in anxiety levels before and after the administration of Qur’anic murottal therapy among third-trimester pregnant women. The third trimester is often associated with increased physical discomfort and psychological stress, which may lead to higher anxiety levels. This research employed a pre-experimental design using a one-group pretest-posttest approach involving 25 respondents selected through purposive sampling. Anxiety levels were measured using the Perinatal Anxiety Screening Scale (PASS), and the data were analyzed using the Wilcoxon Signed Ranks Test. The findings showed that before the intervention, 48% of respondents experienced moderate anxiety and 52% experienced severe anxiety. After the intervention, 40% experienced mild anxiety, 48% moderate, and only 12% severe anxiety. The statistical test result indicated a Z value of -4.376 with a p-value of 0.000 (p < 0.05), which means there was a significant difference in anxiety levels before and after the intervention. These results suggest that murottal therapy is effective in reducing anxiety among third-trimester pregnant women and can be considered as a safe non-pharmacological intervention.

Pregnancy is a period marked by significant emotional challenges for expectant mothers, with stress and anxiety being common issues that may adversely affect maternal well-being and fetal development. The limited availability of safe treatment options for pregnant women, particularly concerning pharmacological interventions, has prompted the exploration of more natural and non-invasive therapeutic alternatives. One increasingly popular method is aromatherapy, which utilizes essential oils to stimulate the limbic system in the brain, thereby promoting relaxation and reducing anxiety. This study aims to explore the effects of aromatherapy in lowering stress and anxiety among pregnant women through a literature review. The method employed involves collecting and analyzing findings from previous studies regarding the use of aromatherapy in pregnancy. Based on the available evidence, aromatherapy—particularly with lavender essential oil—has been proven effective in lowering levels of stress and anxiety in pregnant women. Several studies report a reduction in anxiety levels of up to 40% following the inhalation of lavender oil. However, factors such as the type of essential oil used, the method of application, and individual sensitivity may influence therapeutic outcomes. Despite its potential benefits, the safety of aromatherapy use remains a concern, particularly regarding essential oils that may be unsafe for use during pregnancy.

Baby blues syndrome can have negative implications both in the short and long term, this has the potential to cause a tendency for passive attitudes in pregnant women, and result in neglect of the baby's needs, including a lack of attention and touch from the mother. This study aims to analyze the relationship between the contribution of husbands and the role of health workers with the level of understanding of pregnant women regarding Baby blues syndrome at the Lueng Bata Community Health Center, Banda Aceh. The study applied an analytical method with a cross-sectional approach, and involved all 73 pregnant women registered at the study location, with a total sampling technique. The data collection tool used was a questionnaire. The study took place from May 3 to 25, 2025. Based on the findings, there was a significant relationship between husband's support and pregnant women's knowledge regarding Baby blues syndrome (p = 0.001), and a significant relationship was also identified between the role of health workers on pregnant women's knowledge regarding the condition (p = 0.003). From the results obtained, it can be concluded that husband's support and the involvement of health workers mutually contribute to increasing pregnant women's understanding regarding Baby blues syndrome in the service area of ​​the Lueng Bata Community Health Center. It is recommended that health workers be more proactive in providing education and counseling regarding this syndrome so that pregnant women's knowledge regarding Baby blues syndrome can be maximized.