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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.

Maternal hypertension remains one of the major contributors to maternal morbidity and mortality in Indonesia and globally. This study aimed to analyze the prevalence, mortality trends, and geographical disparities of maternal hypertension in Indonesia during the 2022–2023 period. The research employed a descriptive design using secondary data obtained from official reports of the Indonesian Ministry of Health, national health surveys, and Maternal Perinatal Death Notification (MPDN) data. Data analysis was conducted descriptively by examining prevalence rates, maternal mortality due to hypertension, regional distribution, and temporal trends across provinces in Indonesia. The findings showed a slight but consistent decline in both the prevalence and mortality rates of maternal hypertension from 2022 to 2023 in most provinces. However, significant regional disparities remained evident. Provinces in eastern Indonesia, including Papua Barat, Nusa Tenggara Timur, Maluku, and several provinces in Sulawesi and Kalimantan, consistently recorded higher prevalence and mortality rates compared to provinces in Java and Bali. Meanwhile, provinces with better healthcare infrastructure and maternal referral systems demonstrated lower mortality outcomes. The study also revealed a strong association between high prevalence and increased maternal mortality, indicating the importance of healthcare accessibility, antenatal care quality, and emergency obstetric services in reducing maternal health burdens. These findings emphasize the need for region-specific maternal health interventions, improved healthcare distribution, early detection programs, and strengthened referral systems to reduce maternal hypertension disparities and improve maternal health outcomes in Indonesia.

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

Bariatric surgery is effective in treating obesity and type 2 diabetes mellitus (T2DM); however, pregnancy occurring within 12–24 months after surgery carries significant risks. This report presents a complex pregnancy case in a patient with a history of sleeve gastrectomy, post-hemithyroidectomy hypothyroidism, and T2DM. A 29-year-old primigravida conceived 2 months after undergoing sleeve gastrectomy, which successfully induced T2DM remission, with HbA1c decreasing from 11% to 5.5%. Although glycemic control and euthyroid status were maintained throughout pregnancy, the patient developed severe preeclampsia at 35–36 weeks of gestation, complicated by intrauterine growth restriction (IUGR) and oligohydramnios. An emergency cesarean section delivered a male infant weighing 2000 grams with Apgar scores of 8 and 9 at the first and fifth minutes, respectively. The neonate required 14 days of NICU care due to respiratory distress syndrome, respiratory failure, and hyperbilirubinemia. Maternal gestational weight gain was suboptimal at only 4 kg, below the recommended range for pregnant women with obesity. This case highlights the importance of adhering to the recommended surgery-to-conception interval following bariatric surgery. Early pregnancy after surgery, combined with multiple metabolic comorbidities, may contribute to adverse maternal and neonatal outcomes. Multidisciplinary management, comprehensive nutritional monitoring, and optimization of comorbidities before conception are essential to improve pregnancy outcomes in this population.

Low Birth Weight (LBW) refers to infants born with a birth weight of less than 2,500 grams and remains an important issue in neonatal health due to its association with increased neonatal morbidity and mortality. To analyze the determinants of LBW based on primary studies published from 2021 to 2026. A literature review was conducted using the PRISMA approach. Article searches were performed through PubMed, Google Scholar, Scopus, ScienceDirect, and ProQuest using the keywords low birth weight, determinant factors, risk factors, BBLR, and faktor risiko with Boolean operators AND/OR. The inclusion criteria were primary studies, full-text availability, publication in Indonesian or English, and publication years from 2021 to 2026. A total of 20 articles were included, consisting of 15 international articles and 5 national sources. The review showed that LBW is influenced by interrelated maternal, nutritional, obstetric, and sociodemographic factors during pregnancy. The most dominant factors included multiple pregnancy with an adjusted OR of 21.74, maternal food insecurity with an AOR of 6.85, maternal hemoglobin level <11 g/dL with an AOR of 5.21, lack of iron-folic acid supplementation with an AOR of 4.17, maternal age ≤20 years with an AOR of 3.42, pregnancy interval <1 year with an adjusted OR of 2.92, missed antenatal care visits with an AOR of 2.74, smoking during pregnancy with an OR of 2.18, and maternal hypertension with an AOR of 1.94. LBW is influenced by multiple interrelated factors; therefore, efforts to reduce its incidence should focus on evidence-based interventions, particularly through optimizing antenatal care services, improving maternal nutritional status, and early detection of pregnancy.

Exclusive breastfeeding is a crucial step in improving infant health, yet it remains under-practiced in Indonesia. This is primarily due to a lack of knowledge and positive attitudes among mothers. Health education using leaflets has become a popular strategy in community-based nursing due to its simplicity and ease of understanding. The purpose of this study was to evaluate the effectiveness of leaflets in improving maternal knowledge, attitudes, and practices regarding exclusive breastfeeding. A systematic literature search was conducted using the PRISMA methodology. Data were collected from scientific articles published between 2020 and 2025 that met the inclusion criteria for intervention studies using information leaflets with pregnant, breastfeeding, and postpartum women. Twenty original articles meeting these criteria were analyzed. The results showed that most studies found a significant increase in maternal knowledge after distribution of information leaflets (p < 0.005). Furthermore, improvements in attitudes toward exclusive breastfeeding were observed, although practices varied. Many studies have shown that audiovisual materials are more effective than leaflets, although leaflets are easier to use and distribute. Factors such as social support and infrastructure influence the success of exclusive breastfeeding. This study concluded that leaflets were effective in improving mothers' knowledge and attitudes toward exclusive breastfeeding and remained valuable inhome care, especially when combined with other educational methods

Exclusive breastfeeding is a crucial step in improving infant health, yet it remains under-practiced in Indonesia. This is primarily due to a lack of knowledge and positive attitudes among mothers. Health education using leaflets has become a popular strategy in community-based nursing due to its simplicity and ease of understanding. The purpose of this study was to evaluate the effectiveness of leaflets in improving maternal knowledge, attitudes, and practices regarding exclusive breastfeeding. A systematic literature search was conducted using the PRISMA methodology. Data were collected from scientific articles published between 2020 and 2025 that met the inclusion criteria for intervention studies using information leaflets with pregnant, breastfeeding, and postpartum women. Twenty original articles meeting these criteria were analyzed. The results showed that most studies found a significant increase in maternal knowledge after distribution of information leaflets (p < 0.005). Furthermore, improvements in attitudes toward exclusive breastfeeding were observed, although practices varied. Many studies have shown that audiovisual materials are more effective than leaflets, although leaflets are easier to use and distribute. Factors such as social support and infrastructure influence the success of exclusive breastfeeding. This study concluded that leaflets were effective in improving mothers' knowledge and attitudes toward exclusive breastfeeding and remained valuable inhome care, especially when combined with other educational methods

The postpartum period is a vulnerable phase often accompanied by lactation problems, particularly ineffective breastfeeding and discomfort due to breast engorgement. These conditions may reduce maternal comfort, inhibit the let-down reflex, and increase the risk of failure in exclusive breastfeeding. Therefore, safe, practical, and comprehensive non-pharmacological nursing interventions are needed. This Final Nursing Project aims to describe the implementation of cabbage leaf compresses combined with breastfeeding education to improve maternal comfort and enhance breast milk flow in postpartum mothers. This study employed a case study method using a nursing care approach involving two postpartum mothers who experienced ineffective breastfeeding and discomfort due to breast engorgement. The interventions were provided for three days and included cabbage leaf compresses and education on breastfeeding techniques. Evaluation focused on breastfeeding ability, pain level, breast condition, maternal comfort, and milk production. The results showed improvement in breastfeeding ability, indicated by the mothers’ ability to correctly demonstrate proper positioning and latch-on techniques. Infants appeared calmer during feeding, and the duration of breastfeeding increased to approximately 10 minutes per breast. Pain scores decreased from 5 to 0–3, breast tension was reduced, and maternal comfort improved. It can be concluded that the application of cabbage leaf compresses combined with breastfeeding education is effective in improving breast milk flow and maternal comfort in postpartum mothers and can be recommended as an independent nursing intervention in maternity practice.

The postpartum period is a critical phase in which mothers experience physiological and psychological recovery. Bengkung, a traditional abdominal binding cloth, is commonly used by Indonesian postpartum mothers, but inappropriate application may cause discomfort and may not support recovery optimally. This community service program aimed to improve postpartum mothers' knowledge and skills regarding safe and appropriate bengkung use. The activity was conducted through counseling, demonstration, guided practice, and evaluation using a one-group pre-test and post-test approach involving 30 postpartum mothers at a community-based maternal health service setting. The educational content covered postpartum physiological changes, indications and contraindications, safe binding principles, hygiene, duration of use, warning signs, and when to seek professional care. The evaluation showed an increase in good knowledge from 26.7% before education to 86.7% after education, and correct practice skills increased from 20.0% to 83.3%. Participants also reported better understanding of avoiding overly tight binding, maintaining breathing comfort, and discontinuing use when pain, shortness of breath, excessive bleeding, or wound problems occur. This activity indicates that structured education and demonstration can strengthen postpartum self-care and support safer integration of traditional practices into maternal health services.

Healthcare is an integral part of health development in Indonesia, which aims to optimally improve public health. Hospitals, as healthcare facilities, are required to provide quality, safe, and patient-centered services. Service quality is a key indicator of service success, as good service impacts patient satisfaction. One of the most important services in hospitals is obstetrics, which directly relates to maternal and infant health, making patient satisfaction a crucial aspect. Midwives, as professional healthcare workers, play a strategic role in providing comprehensive, sustainable, and patient-centered midwifery care. This study aims to analyze the influence of healthcare facilities and midwife performance on patient satisfaction through service quality. The method used is a quantitative study with an analytical approach and a cross-sectional design. The results of the multiple linear regression test indicate that midwife performance has a more dominant influence on service quality than healthcare facilities. Meanwhile, regarding patient satisfaction, service quality is the most dominant factor, followed by midwife performance and healthcare facilities. The conclusion of this study is that service quality reflects the overall patient experience and is a key factor in improving patient satisfaction.

Preeclampsia remains a major contributor to maternal morbidity and mortality, particularly in developing countries such as Indonesia. Early detection and integrated management at the primary healthcare level are essential to prevent disease progression and improve maternal outcomes.  Modifiable risk factors such as maternal obesity, inadequate calcium intake, and poor clinical management contribute significantly to disease progression (WHO, 2021; Zhang et al., 2020). This study aimed to evaluate the effectiveness of an Integrated Maternal Health Model (IMHM) combining risk assessment, nutritional intervention, and clinical management for early prevention and control of preeclampsia in primary healthcare settings. A quasi-experimental cohort study was conducted among 104 pregnant women, consisting of 52 preeclamptic and 52 normotensive participants in community health centers in Medan, Indonesia. Data were collected across four antenatal visits, including blood pressure measurements, proteinuria (dipstick), calcium intake, supplementation adherence, and antihypertensive therapy. Statistical analyses included bivariate and longitudinal tests. The results showed that maternal obesity, history of preeclampsia, and hypertension were significant risk factors. Adequate calcium intake demonstrated a protective effect against preeclampsia (p < 0.05), consistent with recent evidence indicating that calcium supplementation can reduce the risk of preeclampsia by up to 49%. However, calcium supplementation did not significantly influence blood pressure among normotensive pregnant women. Antihypertensive therapy, particularly intensive nifedipine regimens, showed significant differences in blood pressure patterns across visits (p < 0.05). In addition, proteinuria levels significantly decreased over time (p < 0.001), indicating improvement in renal function. In conclusion, the IMHM is effective in improving maternal outcomes through a multi-component approach integrating clinical, nutritional, and monitoring strategies. This model provides a practical and scalable framework for early prevention and management of preeclampsia in primary healthcare settings.

Immunization is one of the most cost-effective efforts to improve maternal and child health. The proper use of Buku Kesehatan Ibu dan Anak (KIA) – Mother and Children Health Manual can server as an indicator of the quality of care provided to children in health center services. This study aims to determine the correlation between the use of KIA towards basic immunization compliance in Ulee Kareng Publich Health Center, Banda Aceh. This study employed a quantitative research design using a cross-sectional approach. The population consisted of 521 mothers with babies. The sample was 84 respondents chosen using the probability cluster sampling technique. This study was conducted in Ulee Kareng Publich Health Center from May 27 to June 24, 2025. The data were analyzed using the Chi-Square test.The results showed a correlation between the use of KIA and basic immunization compliance, with a p-value of 0.008 (P<0.05) at Ulee Kareng Public Health Center, Banda Aceh. These results indicated that mothers who used the KIA books had a better understanding of the importance of basic immunization compliance, compared to those who did not utilize them properly. It can be concluded that there is a correlation between the use of KIA books and basic immunization compliance. This study suggests that health workers provide information on the importance of the KIA books and advise mothers to use it properly.

Anemia during pregnancy remains a major public health concern with significant implications for maternal and fetal health. One contributing factor to its high prevalence is the limited knowledge among pregnant women regarding early detection. Health education serves as a crucial promotive-preventive strategy to enhance awareness of anemia’s signs, symptoms, and risks. This study aimed to analyze the effectiveness of health education in improving knowledge of early detection of anemia among pregnant women in the Galala Community Health Center working area. A pre-experimental one-group pretest–posttest design with a quantitative approach was employed. The sample consisted of 30 pregnant women selected using total sampling. Respondents received structured health education on early detection of anemia, and their knowledge levels were assessed before and after the intervention using a questionnaire. Data were analyzed using univariate and bivariate methods, with the Wilcoxon signed-rank test applied due to non-normal distribution. Results indicated a significant improvement in knowledge after education (p = 0.000), with most respondents shifting from poor or moderate knowledge to good knowledge. The study concludes that health education effectively increases pregnant women’s knowledge of anemia detection and should be systematically integrated into antenatal care to prevent anemia and improve maternal health outcomes.

This study aims to analyze the marketing strategies of maternal and child healthcare services in hospitals to enhance patient experience, emphasizing a shift from traditional promotional approaches toward the creation of a positive and empathetic patient experience. This research employs a systematic literature review of relevant studies published between 2021 and 2025, with analysis conducted through identification, selection, and thematic synthesis to determine key factors influencing patient satisfaction and loyalty. The findings indicate that the quality of interpersonal interactions and the efficiency of service processes are the primary determinants of patient experience, where factors such as staff empathy, clear communication, reduced waiting times, and well-structured service flows have a greater impact than the technical aspects of medical care. Hospitals should therefore prioritize people- and process-oriented strategies by implementing empathy training, enhancing communication effectiveness, and regularly measuring patient satisfaction, while also integrating digital services, ensuring cost transparency, and developing continuity of care programs to strengthen the patient experience holistically. This study proposes a holistic marketing framework that integrates empathy, efficiency, data-driven personalization, and environmental sustainability, highlighting a shift from a purely clinical orientation to an experiential marketing approach that places human values at the core of a hospital’s competitive advantage.

The postpartum period is a crucial phase for mothers to recover after childbirth. One of the common problems is perineal wounds, caused either by episiotomy or spontaneous rupture, which require proper care to prevent infection and accelerate healing. This case study aimed to provide midwifery care for Mrs. M, 28 years old, P3A0H3, with a second-degree perineal wound at PMB Bd. Silvi Ayu, S.Keb. The SOAP approach was applied through assessment, diagnosis, intervention, implementation, and evaluation over five days (June 12–16, 2025). Interventions included education on perineal hygiene, encouragement of nutritious food intake, light mobilization, and perineal wound care using boiled binahong leaves. The results showed decreased pain, reduced edema, a dry wound, and complete healing on the fifth day, with the REEDA score decreasing from 11 to 0. The discussion emphasized that flavonoids, saponins, and ascorbic acid in binahong leaves contribute to tissue regeneration and faster healing. Limitations of this study included the short monitoring period, limited sample, and reliance on maternal compliance. In conclusion, binahong leaf decoction was found to be effective, practical, and able to enhance maternal independence in wound care. This study is expected to serve as a reference for midwifery practice and as a basis for further research with a wider scope.

Hyperemesis gravidarum is a common complication in early pregnancy characterized by excessive nausea and vomiting that can negatively affect maternal health and quality of life. Although pharmacological management is widely used, concerns regarding medication safety during pregnancy have increased interest in complementary and non-pharmacological interventions. One such approach is aromatherapy, particularly the use of lavender essential oil, which is known for its calming and antiemetic properties. This study aimed to evaluate the effectiveness of lavender aromatherapy in reducing the frequency of hyperemesis gravidarum among pregnant women at RSUD Tikep. This research employed a quantitative quasi-experimental design with a pretest–posttest approach. A total of 30 first-trimester pregnant women experiencing hyperemesis gravidarum were selected using purposive sampling. The intervention involved inhalation of lavender aromatherapy administered for a predetermined duration and frequency. The frequency of nausea and vomiting was measured before and after the intervention using observation sheets and self-reported records. Data were analyzed using SPSS software, including descriptive statistics, normality tests, and paired sample t-tests. The results demonstrated a significant reduction in the mean frequency of hyperemesis gravidarum following the administration of lavender aromatherapy. Statistical analysis revealed a p-value of less than 0.05, indicating a significant difference between pre-intervention and post-intervention measurements. These findings suggest that lavender aromatherapy effectively reduces the frequency of nausea and vomiting in pregnant women. In conclusion, lavender aromatherapy is a safe, low-cost, and effective complementary therapy for managing hyperemesis gravidarum. Its integration into routine antenatal care may enhance maternal comfort and support holistic, patient-centered maternity services, particularly in regional healthcare settings.

Teenage pregnancy remains a reproductive health issue in Indonesia, including in Batam City. According to data from the Batam City Health Office in 2024, there were 18 cases of teenage pregnancy (0.06%) with the Lubuk Baja Health Center being one of the highest areas. Pregnant teenagers are at high risk of complications such as anemia, malnutrition, and low birth weight (LBW), which contribute to high rates of maternal and infant morbidity. This study used a descriptive method with a case study approach on Ny. S, an 18-year-old teenager with a pregnancy in the Lubuk Baja Health Center area of Batam City in 2025. Data collection was conducted through interviews, observations, physical examinations, and SOAP documentation following the 7-step Varney obstetric management. The findings revealed that Ny. S experienced mild complaints such as nausea, reduced appetite, and anxiety about her pregnancy. After three visits, the mother's complaints decreased, appetite improved, anxiety decreased, and nutritional status was within normal limits. Comprehensive midwifery care with a biopsychosocial approach was proven effective in improving both the physical and mental health of pregnant teenagers and preventing pregnancy complications.

This study aims to analyze the relationship between public policy paradoxes, healthcare service quality, access to and continuity of postnatal care, and maternal mortality in Pekalongan Regency. A mixed-methods approach with a sequential explanatory design was employed, involving 30 respondents for quantitative analysis using Spearman correlation tests and 5 key informants for in-depth interviews. The results indicate that policy paradoxes are strongly correlated with service quality and with access and continuity of care. Service quality also shows a robust correlation with access and continuity. All variables are significantly associated with maternal mortality, with access and continuity of care demonstrating the strongest correlation. Qualitative findings reveal implementation gaps in Ministry of Health Regulation No. 21 of 2021, where postnatal visits are often conducted only 2–3 times instead of the mandated four visits, with 10 out of 13 maternal deaths occurring during the postnatal period. The persistence of maternal mortality is attributed to inconsistent implementation of standard operating procedures, high workload, and socio-cultural factors. The study highlights the need to strengthen supervision, enhance human resource capacity, and promote cross-sectoral collaboration to optimize postnatal care services.

This study examines the experience of access to health services and resilience strategies in adolescents with unplanned pregnancies in Makassar, Indonesia. Access to quality reproductive health services is important for adolescents' well-being, but they often face systemic barriers that affect access to health services and outcomes. The study used an Interpretative Phenomenological Analysis (IPA) approach on seventeen adolescent girls aged 15–19 years who had an unplanned pregnancy between June–November 2023. Data were collected through in-depth semi-structured interviews, recorded, verbatim transcribed, and analyzed by a six-stage science process. Two main themes were found: Navigating Closed Doors: Systematic Barriers to Care and Finding Light in Darkness: Resilience and Agency. Participants faced a variety of layered barriers, including a lack of information about health services and rights, geographical and economic constraints, age-based discrimination, parental notification obligations, fear of legal consequences especially related to abortion, family control over decisions, and limitations in adolescent-friendly services. Nonetheless, adolescents show resilience through seeking strategic help, resistance to pressure, spiritual and religious coping, peer support, gradual acceptance of maternal identity, educational sustainability, and positive meaningfulness of difficult experiences. These findings point to the need for a transformation of the health system that not only improves attitudes of health workers, but also addresses structural barriers such as confidentiality, age discrimination, and service availability, while strengthening agency and adolescent coping strategies.

The postpartum period following Sectio Caesarea is often accompanied by acute pain due to surgical incisions, which may interfere with mobilization, breastfeeding, and maternal recovery. Effective pain management is essential to prevent further complications and enhance maternal comfort. In addition to pharmacological therapy, non-pharmacological interventions such as Benson relaxation therapy can be implemented. This study aimed to evaluate the application of Benson relaxation therapy in reducing acute pain among postpartum Sectio Caesarea mothers.This study employed a case study design involving four postpartum Sectio Caesarea patients (Ny. R, Ny. A, Ny. Y, and Ny. S) treated in the Ayyub Ward of RS Roemani Muhammadiyah Semarang in 2026. Data were collected through comprehensive nursing assessments, pain intensity measurement using a numeric rating scale, observation of mobilization ability, and evaluation before and after intervention.The results showed that after regular implementation of Benson relaxation therapy, all patients experienced a gradual decrease in pain intensity (from scale 4–7 to ≤3), improved comfort, better breathing control, and increased ability to perform early mobilization. Consistent nursing education, therapeutic guidance, and family involvement supported the effectiveness of the intervention. It can be concluded that Benson relaxation therapy is an effective, safe, and easily applicable nursing intervention for reducing acute pain in postpartum Sectio Caesarea patients.