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BPJS Health has incurred losses exceeding 200 billion rupiah over a two-year period due to the payment of contributions that were discontinued by participants who had utilized maternity services. Data show that 64.7% of mothers registered as BPJS Health participants only one month prior to childbirth, after which 43% either withdrew their membership or failed to continue paying contributions following delivery. The highest proportion of this behavior was observed among independent participants or non-wage recipients (PBPU). In Jambi Province, the highest level of contribution non-compliance occurs in Jambi City. In 2023, there were 77,489 participants with contribution arrears, resulting in financial losses amounting to 60.1 billion rupiah. Contribution non-compliance is influenced by various factors. This study aims to analyze the factors contributing to non-compliance among independent participants in paying BPJS Health contributions after utilizing childbirth services in Jambi City. The findings revealed that 33.3% of independent participants were non-compliant in paying BPJS Health contributions after using maternity services. Significant associations were found between contribution non-compliance and the number of family members (p = 0.001), level of knowledge (p = 0.000), illness perception (p = 0.001), clinical assessment (p = 0.000), and willingness to pay (WTP). Based on these findings, it is recommended that BPJS Health consider implementing a waiting period policy for participants intending to utilize maternity services. In addition, the Jambi City Government should strengthen promotive efforts to educate the public and raise awareness of the importance of health insurance in safeguarding household financial security.  

Labor pain is a significant challenge faced by in-partum mothers, with a prevalence of 70% in Indonesia, and 40% of women reporting severe pain (Central Statistics Agency, 2022). Conventional pharmacological methods often do not provide optimal results and can cause side effects. As a non-pharmacological alternative, oxytocin massage has shown promise in reducing labor pain intensity by stimulating the endogenous production of oxytocin, a natural analgesic hormone. This study aimed to assess the effect of oxytocin massage on labor pain intensity in in-partum mothers at Manado Medical Center Hospital. A pre-experimental design with a one-group pre-test post-test approach was used. The sample consisted of 30 in-partum mothers who met the inclusion criteria. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after a 30-minute oxytocin massage administered by trained health workers. Data were analyzed using a paired t-test. The results showed a significant reduction in pain intensity from an average of 7.23 (SD=1.08) before the massage to 4.63 (SD=1.11) afterward, with a decrease of 2.6 points. The proportion of mothers experiencing severe pain decreased from 50% to 20%, while mild pain increased from 16.7% to 46.7%. The paired t-test revealed a highly significant difference with t=10.274 (df=29), p=0.000 (p<0.05). In conclusion, oxytocin massage is an effective non-pharmacological intervention that can significantly reduce labor pain and improve the birth experience. It can be incorporated into standard maternity nursing protocols to enhance maternal care.

Continuity of Care (CoC) is a midwifery care model that provides continuous care from pregnancy, childbirth, the postpartum period, and newborn care to family planning services. This approach aims to improve the quality of care, enable early detection of complications, and enhance maternal and neonatal health outcomes. This study aimed to describe the implementation of Continuity of Care midwifery services for Mrs. D, aged 25 years, at PMB Siti Nur Azizah, Wonoayu, Sidoarjo, East Java.This study employed a descriptive method with a case study approach. The subject was Mrs. D, a primigravida woman who received midwifery care from the first trimester of pregnancy through the postpartum period, newborn care, and family planning services. Data were collected through interviews, observation, physical examinations, and medical record review.The results showed that throughout pregnancy, both maternal and fetal conditions remained within physiological limits with routine monitoring and adequate health education. Labor occurred spontaneously and normally with the application of respectful maternity care and interventions based on clinical indications. The postpartum period progressed normally with good uterine involution and adequate breast milk production. The newborn demonstrated optimal physiological adaptation and received essential neonatal care. In the family planning phase, Mrs. D chose a three-month injectable contraceptive, which was appropriate for her breastfeeding condition and pregnancy spacing needs.

The employee leave application information system is a digital solution designed to simplify the process of submitting, approving, and managing leave within an institution. This internship project resulted in the development of a system called SiCuti, which was built using the Laravel framework with a MySQL database. The system provides two main roles: employees and administrators/supervisors. Employees can apply for leave according to their entitlements, such as annual leave with a maximum of 12 working days, maternity leave for 3 months, pilgrimage leave (Hajj) which can be taken once during their service period, as well as special leave for important reasons such as marriage or the death of an immediate family member, typically lasting 1–3 days. When applying, employees may also upload supporting documents and monitor the status of their applications through the leave status menu.Administrators or supervisors have broader authority, including reviewing the list of leave requests, approving or rejecting applications, and managing employee leave quotas to ensure compliance with regulations. In addition, administrators can track the complete leave history of employees through an integrated dashboard. This feature supports faster, more transparent, and accountable decision-making processes.The results of local testing indicate that SiCuti has the potential to increase efficiency in administrative leave processes that were previously carried out manually, making them faster, more transparent, and more structured. The interactive dashboard design also facilitates monitoring from both employees and administrators. With the implementation of SiCuti, it is expected that the leave management process can reduce the risk of human error, ensure data accuracy, and support transparency and accountability in human resource management once the system is fully deployed within the institution.

The aim of this research is to describe the social and health movements carried out by Muhammadiyah as one of the leading Islamic organizations in Indonesia. This research uses a qualitative methodology with a library approach. The research results show that Muhammadiyah's contribution to the field of social and health services is very large with the birth of various Muhammadiyah Charity Businesses such as hospitals, maternity homes, polyclinics, orphanages, nursing homes, and lazismu.  

BPJS Health experienced losses due to stopped payment of contributions for participants who had utilized delivery services of more than 200 billion in a period of 2 years. It was recorded that 64.7% of mothers who were about to give birth registered as participants a month before giving birth and then stopped (43%) or behaved in adverse selection in payments after delivery. The largest percentage comes from independent participants or Non-Wage Recipient Participants (PBPU). In Jambi Province, non-compliance in paying BPJS Health contributions is highest in Jambi City. It was recorded that 77,489 participants were in arrears in 2021, resulting in losses of 60.1 billion. Non-compliance with paying contributions is adverse selection behavior. The aim of this study is to analyze the factors causing adverse selection behavior among independent participants in paying post-natal JKN contributions in Jambi City.  Quantitative study approach with a cross-sectional design carried out in Jambi City. Respondents totaling 96 people were selected based on accidental sampling technique. The study instrument is a questionnaire. Data analysis consists of univariate analysis stages and bivariate analysis using the chi-square test. The study results found that as many as 33.3% of independent participants behaved in adverse selection when paying JKN contributions after giving birth. There is a significant relationship between the factors number of family members (p=0.001), knowledge (0.000), perception of illness (p=0.001), clinical assessment (p=0.000), and willingness to pay (WTP) with adverse selection behavior in independent JKN participants postpartum. It is recommended that BPJS Health consider implementing a waiting period method for participants who will utilize maternity services. As well as increasing promotive activities for the Jambi City Government in educating and increasing public awareness about the importance of health insurance in protecting household finances.

The rate of deliveries by cesarean section (CS) continues to increase globally and is projected to reach 29% by 2030. Although CS is medically effective in ensuring maternal and neonatal safety, the procedure often results in moderate to severe postoperative pain, which may hinder early mobilization, slow recovery, and reduce the mother’s overall quality of life. Effective pain management is therefore crucial. Non-pharmacological therapies such as endorphin massage and lavender aromatherapy have been recognized as complementary approaches that stimulate the release of relaxation hormones, provide natural analgesic effects, and help reduce anxiety. This study aimed to analyze the effect of combining endorphin massage and lavender aromatherapy on reducing pain levels in post-cesarean section mothers. A quasi-experimental design with a pre–posttest control group was employed. A total of 34 respondents were selected using purposive sampling and divided into intervention and control groups. The study was conducted in the maternity ward of SMC Telogorejo Hospital from March to April 2025. The intervention group received endorphin massage combined with lavender aromatherapy for 10–30 minutes, while the control group was given deep breathing relaxation only. Pain levels were measured before and after the intervention using the Numeric Rating Scale (NRS). Data were collected through questionnaires and medical records, and analyzed using univariate and bivariate techniques with the Mann–Whitney test. Results showed a p-value of 0.000 and Z = -3.774, indicating a significant effect of the intervention. These findings suggest that endorphin massage combined with lavender aromatherapy is effective in reducing postoperative pain. Further studies with larger samples are recommended to explore the optimal duration and frequency of therapy.

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

Gender equality in the workforce is a fundamental issue closely linked to human rights and sustainable economic development. This study examines the paradox in the implementation of maternity leave rights as part of the legal protection for female workers—where a right intended to provide protection instead becomes a barrier during recruitment processes. The aim of this research is to analyze the relationship between the provisions on maternity leave rights and the principle of legal equality in the workplace, as well as to identify efforts that companies can undertake to protect female workers from discrimination and to promote gender equality. This study employs normative legal research methods with a qualitative approach by analyzing various national and international regulations related to the protection of female workers. Primary data were obtained through an in-depth review of Undang-Undang No. 13 Tahun 2003 tentang Ketenagakerjaan, Undang-Undang Dasar Negara Republik Indonesia Tahun 1945, and their implementing regulations, as well as international conventions such as CEDAW and ILO standards. The analysis was carried out using a deductive approach to identify the gap between legal norms and the reality of their implementation in practice.

Danger signs of pregnancy are signs or symptoms indicating that the mother or fetus is in danger. Knowledge of danger signs of pregnancy is a factor that influences the high Hamilton Anxiety Rating Scale (HARS) score of mothers in labor. This study aims to determine the relationship between mother's knowledge about pregnancy danger signs and HARS scale scores for mothers in childbirth in the Lamasi Health Center Work Area. This is a quantitative study using an observational cross-sectional approach. The population and sample were 32 people using total sampling technique. Data collection used questionnaires and observation sheets. Analysis used chi-square test. The results showed that there was a relationship between the mother's knowledge of pregnancy danger signs and HARS scale scores of mothers in labor in the Lamasi Health Center Work Area with a p value = 0.021 < α value = 0.05. It is hoped that health institutions can increase the knowledge of health workers and the community regarding pregnancy danger signs and the HARS score of mothers in labor.

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

This study uses qualitative methods to analyze the law on menstrual leave and maternity leave rights in the practice of the workplace in Indonesia. This study aims to examine the implementation of Law Number 13 of 2003 concerning Manpower which provides menstrual leave and maternity leave rights for female workers, and examines the obstacles faced in its implementation in various companies. The results of the study indicate that although the legal framework has clearly regulated these rights, their implementation in the field is still not optimal. The main obstacles found include the lack of understanding and awareness of workers and employers, weak government supervision, and the existence of cultural stigma and discrimination related to menstruation and pregnancy. In addition, several companies still implement policies that are not in accordance with regulations, such as salary deductions or restrictions on leave rights. This study recommends increasing the socialization of regulations, strengthening supervision, and enforcing strict sanctions so that legal protection for menstrual leave and maternity leave rights can be realized fairly and effectively, thereby supporting social justice and the protection of female workers in Indonesia.  

Contraception is used to control population growth and ensure the availability of natural resources, thereby maintaining the quality of human life. Contraceptive methods can be categorized into two types: long-term contraceptive methods (LTCMs), such as intrauterine devices (IUDs), implants, female sterilization (tubal ligation or MOW), and male sterilization (vasectomy or MOP); and short-term contraceptive methods (non-LTCMs), such as condoms, injections, and oral contraceptive pills. The aim of this study is to examine and explain the relationship between spousal support and the role of healthcare workers in the selection of long-term contraceptive methods among women of reproductive age in the working area of the Kefa Utara Village Maternity Post, North Central Timor Regency. This research is quantitative with a cross sectional approach. The sampling technique used accidental sampling with a total of 106 WUS respondents. Data analysis using Chi Square test analysis. The results showed that women of reproductive age who did not get husband's support were higher (57.50%) than those who got husband's support (42.50%). Chi-Square test showed a significant relationship between husband's support and the selection of LTCMS (p < 0.05) with an Odds Ratio (OR) value of 2.690. In addition, health workers who played a role in the selection of LTCMS were greater (67.90%) than health workers who did not play a role (32.10%). The Chi Square test results also showed a significant relationship between the role of health workers and the selection of LTCMS (p < 0.05) with an 0R value of 3.733.

A common mental health problem affecting millions of women all around is anxiety before pregnancy and after delivery. Untreated, it might cause early deliveries, reduced birth weights, bad infant bonding, and children's long-term developmental difficulties. Many mothers choose natural cures than from drugs for safety worries relating to their children. Recent research on non-drug approaches to lessen anxiety in pregnant women and new mothers is examined in this review. Focusing on multiple non-drug treatments, a comprehensive search was conducted in PubMed and Google Scholar. The results indicate that yoga and mindfulness-based stress reduction measures practically reduce anxiety. For treating anxiety, non-drug treatments are safe choices that healthcare professionals should integrate into maternal care. More research is needed for consistent methods and long-term studies to support clinical practices.

Aim of the study: The study aimed to investigate the causes, risk factors, and incidence of caesarean sections in Diyala province during the research period. Patients and Methods: This prospective study was conducted at Al-Batool Maternity Teaching Hospital between October 2023 and December 2023. The study population consisted of 96 women who attended the labor ward for delivery after 32 weeks of gestation, irrespective of the delivery method. Patients' data were collected using an organized questionnaire. The data were analyzed using the Chi-square test for independence between variables.  Results: Study outcomes revealed that the percentage of cesarean sections increased significantly with age, peaking among women aged 20-35 and those over 35 (67.1% and 77.8%, respectively), in contrast to the group under 20, where most deliveries were vaginal (81.8%). An increasing number of previous deliveries (four or more) led to a higher chance of cesarean sections in subsequent pregnancies (76.9% compared to 58.8%) for those with two to four previous deliveries versus those who were primipara (52.6%). The most common indication for elective cesarean sections among participants was a scarred uterus (62.5%), followed by fetal indications such as malposition, abnormal presentation, post-date, and oligohydramnios (15%). The leading reasons for unplanned cesarean sections included obstructed labor (30%), followed by cephalo-pelvic disproportion (20%), and maternal factors (15%). Conclusion: study finding highlight key risk factors influencing delivery methods, suggesting the need for tailored obstetric care to optimize birth outcomes and reduce unnecessary CS procedures.

This study analyzes the impact of employee welfare on working conditions at PT P, focusing on welfare policies and facilities such as health insurance, employment insurance, on-site clinic services, maternity leave, workload balance, and working hours. Using a qualitative descriptive method, data were collected through interviews and direct observation of several employees. The findings show that company-provided welfare positively influences working conditions. Health facilities and work protection increase employees' sense of security and comfort. In addition, fair working hours, sufficient rest time, and attention to both physical and psychological well-being enhance work motivation and employee loyalty. Employees feel appreciated when the company supports work-life balance, leading to a more productive, harmonious, and low-conflict work environment. The study concludes that employee welfare is a key factor in shaping the quality of the workplace. 

Background : The maternal mortality rate in the world is about 303,000 out of 91.45/100,000 KH (WHO, 2022). In ASEAN, the maternal mortality rate in developing countries is 250 per 100,000 (ASEAN Secretariat, 2022). In Indonesia, the maternal mortality rate in 2022 is 183/100,000 KH (Indonesian Ministry of Health, 2022). In Central Java Province, the maternal mortality rate in 2022 was 76,93/100,000 KH (Central Java Health Office, 2022). In Brebes Regency, the maternal mortality rate in 2022 was around 105 cases (Brebes Health Office, 2022). Kaliwadas Health Center in 2022 recorded 1 case of maternal mortality (Health Profile of Kaliwadas Health Center in 2022). Objective : Provide comprehensive midwifery care for pregnant women, maternity, newborns, postpartum and family planning (KB) using the Varney and SOAP management approaches. Research Methods: The method used in this research is a qualitative descriptive method with a comprehensive case study approach. Results : Pregnancy midwifery care that has been given to Mrs. Y aged 20 years with Chronic Energy Deficiency and CPD has been given management according to the needs of the mother, In labor, newborn, postpartum until family planning Mrs. Y did not have complications and there were no gaps between theory and practice. Conclusion: Comprehensive midwifery care given to Mrs. F with Chronic Energy Deficiency (SEZ) and CPD has been carried out in accordance with Standard Operating Procedures (SOP) with the condition of the mother and baby is good.

Rupture of the perineum is one of the common complications in vaginal delivery that can increase the risk of postpartum hemorrhage, infection, and maternal death. One of the factors that contribute to the occurrence of perineal rupture is the baby's birth weight. Babies with a birth weight of ≥4000 grams can cause greater pressure on the mother's birth canal, increasing the likelihood of tearing of perineal tissue. In Indonesia, 75% of mothers who give birth vaginally experience perineal lacerations, and postpartum bleeding is still the leading cause of 40% of maternal deaths. This study aims to determine the relationship between infant birth weight and the incidence of perineal rupture in normal childbirth at the Lusi Marbun Independent Midwife Practice, Simalungun Regency in 2022.This study uses an observational analytical design with a case control approach. A sample of 30 maternity mothers was selected using the total sampling method. The data were analyzed using the Chi-square test to determine the relationship between birth weight and perineal rupture. The results showed that the majority of babies had a birth weight of <4000 grams (63.3%) and the majority of mothers experienced a second degree perineal rupture (70%). The results of bivariate analysis showed that there was a significant relationship between birth weight and the incidence of perineal rupture (p-value = 0.000). There is a significant relationship between birth weight and the incidence of perineal rupture. The greater the baby's weight, the higher the risk of perineal rupture in the mother during childbirth. It is important for health workers to carry out early detection of fetal weight, provide nutrition education during pregnancy, and prepare for the delivery process optimally to minimize the risk of complications.

Background: Duration of labor is a key determinant of childbirth outcomes and may influence the mother’s physiological and psychological state. Prolonged labor is often associated with increased maternal fatigue and emotional stress, which can delay the establishment of early maternal-infant bonding during the taking-hold period. Methods: This study employed a cross-sectional design with a quantitative approach. A total of 80 postpartum women who delivered vaginally at hospitals and maternity clinics were recruited through purposive sampling. Data were collected using an observation sheet for labor duration and the Maternal Postnatal Attachment Scale (MPAS). Statistical analysis was performed using Pearson’s correlation test with a significance level of p < 0.05. Results: The findings revealed a significant negative correlation between labor duration and maternal-infant bonding scores (r = -0.432; p = 0.002). Mothers who experienced labor longer than 12 hours demonstrated lower emotional closeness with their infants compared to those with shorter labor (<8 hours). Conclusion: Prolonged labor tends to hinder the development of early maternal-infant bonding. Emotional support and midwifery assistance during the labor process are essential to enhance bonding and psychological well-being in the postpartum period.

Signs of danger in the third trimester of pregnancy are important indicators for preventing obstetric complications that can potentially increase the risk of maternal morbidity and mortality. However, the level of awareness and preparedness of mothers in recognizing signs of danger often depends on access to education and the quality of information received during pregnancy. Maternity classes are one of the educational strategies recommended in antenatal care to improve mothers' attitudes and understanding of pregnancy health. This study aims to analyze the effect of antenatal classes on mothers' attitudes toward danger signs in the third trimester at the Galala Inpatient Health Center. This study used a quantitative analytical design with a post-test only design approach. The study sample consisted of 30 pregnant women in their third trimester who were selected using total sampling technique. Data collection was conducted using a closed-ended questionnaire based on a Likert scale that had been tested for validity and reliability (α = 0.82). Data analysis was performed descriptively because the distribution of respondents' attitude scores was homogeneous. The results showed that all respondents (100%) had a fairly positive attitude towards pregnancy danger signs after attending the pregnancy class. These findings indicate that pregnancy classes play a role in increasing mothers' awareness of health risks during pregnancy, although they have not yet reached the optimal attitude category. The conclusion of this study confirms that pregnancy classes contribute to improving maternal attitudes and need to be improved through a variety of educational methods and increased frequency of meetings to support stronger attitude change.