The Relationship between Prenatal Gentle Yoga and the Level of Anxiety of Primigravid Pregnant Women in the Third Trimester in Facing Childbirth at the Juliana Dalimunthe Clinic

ABSTRACT


INTRODUCTION
The pregnancy period starts from conception until the birth of the fetus.The normal length of pregnancy is 280 days (40 weeks or 9 months calculated from day 1 of the first period final).During pregnancy, things change physically and psychologically.Changes in pregnancy are an adaptation process a mother undergoes during her pregnancy.Condition: This will always give rise to physical inconvenience to the mother pregnant, plus, again, a description of the birth process, how circumstances arise, and the condition of the baby after birth [33].Change: This will keep happening for 9 months of pregnancy.One of change psychology Mother is worry .Anxiety for a pregnant mother will increase along with the more near labor.
According to the World Health Organization (WHO), there are about 10% of women pregnant and 13% of women giving birth who are experiencing world disturbances, mental trauma, and depression [13].Whereas according to research in various countries, such as Malaysia, 23.4% of mothers pregnant experience anxiety, in China, 20.6% of mothers pregnant experience anxiety, and in Central America, Nicaragua 41% of mothers pregnant experience symptoms of anxiety, and Int Jou of PHE  451 57% of mothers pregnant experience worry.Mothers who are pregnant experience depression.Besides that, according to research in Pakistan, 70% of mothers pregnant experience anxiety and depression; in Bangladesh, 18% of mothers pregnant experience depression; 29% of mothers pregnant experience depression or anxiety; and in Indonesia alone, 71.90% experience it.Temporary It was discovered in the city of Cirebon, Indonesia, that pregnant mothers experience a high level of anxiety currently.
Worry is an experience subjective from nervous mental tension as a general reaction and incompetence to face problems or feel safe.Feeling unpleasant This generally give rise to symptom physiological like shaking, sweating, and increase beat heart.Whereas psychological symptoms like panic, tension, confusion, and lack of concentration Stress, consequence, worry, and approaching labor No only It has an impact on the mother, but it also has an impact on the fetus.Mother experienced it stress.A running signal through Hypothalamus, Pituitary, and Adrenal (HPA) can cause release of hormone stress so that happens vasoconstriction systemic, incl.narrowing vasouteroplacental causes disturbed genus blood in the uterus so that deliver oxygen.(O2) to myometrium.Incidents cause the birth process to become longer (prolonged labor), so fetuses can experience terrible fetuses.Besides that, research conducted shows that the impact of anxiety during pregnancy includes depression post-birth, giving birth prematurely, surgery caesarean, disruption worry, separation, and disruption behavior in children.
The role of the nurse as executor of nursing maternity is to give care nursing in antenatal care, care nursing during the postpartum period, care nursing postpartum, and care nursing care for neonates (babies newly born).A nurse must be capable of recognizing symptoms of anxiety and reducing maternal anxiety in pregnant women with explanations about pregnancy, childbirth, anxiety, and the impact of maternal anxiety on pregnancy and the fetus.Besides that, research conducted by [13] shows that the impact of anxiety during pregnancy includes depression postpartum, giving birth prematurely, surgery caesarean, disruption worry, separation, and disruption behavior in children (baby blues).
By general role nurse as executor nursing maternity form care nursing in antenatal care, care nursing during the postpartum period, care nursing during the postpartum period and care nursing care for neonates (babies new born).In case Mother is experiencing pregnancy worry, the role nurse here must be capable of recognizing symptom anxiety and lowering worry.She must also give explanations about pregnancy, childbirth, anxiety, and impact worry to Mother.Mother pregnancy and fetus according to Astria, 2010.Settings about maternal anxiety in pregnant women must be quick done.For help grow feeling quiet, safe, and comfortable so that reduces anxiety, mothers get pregnant and facilitates the birthing process.
One of the non-pharmacological techniques that a nurse can use to reduce maternal anxiety during pregnancy is prenatal yoga.Prenatal yoga is one of them methods to overcome worry in the third trimester of pregnancy.Urgency anxiety that must be handled approaching labor, namely so that mother does not experience worry excess, which becomes a stressor of difficulty in giving birth, because that's the most important thing in the process of giving birth is the presence of a psychological mother in dealing with the birthing process.Prenatal yoga delivers a positive effect for a pregnant mother, that is, reducing stress, anxiety, and pain during pregnancy.I don't think so comfortable, and reducing painful labor, according to [30].Apart from that, one of the other benefits of yoga practice for pregnancy is that it reduces anxiety and prepares the mother mentally to give birth.Yoga exercises emphasize exercise basics in posture and technique (respiratory).
According to [30], it is stated that yoga can help calm thoughts because it can be used as stress coping.This matters because yoga can help somebody make an effort to solve the problems he faces (a planful problem solver) in a given condition.This is to minimize complaints, consequences, and reactions.For example, just like relieving pain in some parts of the body, regulating rhythm Respiratory For reach circumstances, relax, organize rhythm in the heart, and improve quality sleep.Apart from that, the technique of respiration can give a mother the ability to manage her emotions and thoughts to be more focused on the current conditions and situations Int Jou of PHE  452 she faces.This matter enter to in management self (self-control), a person do effort arrangement self-Good in a way emotional nor in action.
From the background behind the writer's initiative to discuss the effect of prenatal yoga on declining maternal anxiety in the third trimester of pregnancy, we can make a recommendation as an intervention to lower maternal anxiety in the third trimester of pregnancy.The purpose of writing This is to know the effect of prenatal yoga on declining maternal anxiety in the third trimester of pregnancy.Based on a number of findings, studies say that yoga is effective for overcoming maternal anxiety in pregnant women who will be giving birth.However, however every study has its own variants of movements and times for prenatal yoga interventions.The purpose of writing This is to know the effect of prenatal yoga on declining maternal anxiety in the third trimester of pregnancy and to know movement and duration in the implementation of prenatal yoga.

RESEARCH METHODS
The research methods used are descriptive-qualitative, with studies References or literature that becomes a benchmark for the review narrative The approach taken in the search article This using PICO (Population Mother third trimester pregnancy, prenatal yoga interventions, comparison, and results decline maternal anxiety third trimester of pregnancy) with using Google Scholar, PubMed, Science Direct, EBSCO, and the National Library of Indonesia databases.The keywords used in search are an Indonesian word (Pregnant Women, Anxiety, Prenatal, Gymnastics, Third Trimester, Yoga) and an English word (Anxiety, Gymnastics, Pregnant Women, Prenatal, Third Trimester, Yoga).Search article starting on February 24, 2021.Findings from various sources are limited by criteria of inclusion and exclusion.Criteria inclusion study This is a range-year publication at the latest (2016-2021), third trimester pregnancy, primigravida/multigravida, full-text, outcome of decline anxiety, and prenatal yoga interventions.Whereas criteria, the exclusion is compared with intervention otherwise, mother pregnant with abnormality, no relevant topics, and articles, theses, or reviews.

RESEARCH RESULTS & DISCUSSION
Based on review results from 8 journals, everything speaks Indonesian.From 8 journals, there are 4 journals that explain that duration.Effective prenatal yoga exercises is 2 times a week, 1 journal mention 3 times a week, and 3 journals No mention duration effective.As for types of movement, 4 journals mention that effective movement is technique stretching muscle body, meditation breathing, and increasing health and spiritual growth. 1

journal mentions 5 effective core techniques like technique mastery body (asanas), technique mastery breath (pranayama), technique locking energy (bandha), technique control energy (mudra), and technique cleaning body (kriya).
According to a study from [02], that is a yoga exercise intervention carried out on pregnant mothers.Prenatal stages matter to the level of maternal anxiety in a pregnant woman who is entering the third trimester.Study This serves the objective of knowing the influence of prenatal yoga on lower worry.Mother in the third trimester of pregnancy in Indonesia.There are weaknesses and advantages to studying this.For its advantages is Amount respondents who complied minimum research requirements quasi experiment.Temporary its weakness is No mentioned instrument which anxiety to use.Unclear how long will it take For do intervention.
The temporary study from [13] has an objective to know the influence of prenatal gentle yoga on lower-level worry in the third trimester of pregnancy, Study This serve Gentle yoga's prenatal effects show mothers experiencing a third trimester pregnancy worry moment pregnant experience a decline worry moment pregnant after doing prenatal gentle yoga 3 meetings prenatal gentle yoga class.There are advantages and disadvantages to the research conducted by [13].For its advantages is amount respondents who complied minimum research requirements quasi experiment.Temporary Its weakness is that it is an unexplained instrument that causes anxiety to use, and it is also not explained about yoga movements performed and duration every time I do yoga for pregnant mothers.
A study from [24] mentioned that there is a significant influence before and after prenatal gentle yoga with a sig value (-2 tailed) of 0.000, so 0.000 < 0.05, which indicates that there is an effect of prenatal gentle yoga on level of worry.Mother 3rd trimester pregnant primigravida faces labor.Study This objective is to know the effect of prenatal yoga on level of decline anxiety in pregnant mothers.The type of training used is exercise respiratory and also the Hamilton Rating Scale for Anxiety (HRS-A), with modifications to the research data analysis.Superiority in study This article uses a sample of as many as 30 people, fulfilling the standard minimum sample for good research.Enjoy its weakness.No one mentioned the duration (in minutes) of doing yoga.
Study from [17] has objectively known influence yoga practice against level worry.In research, this served results and conclusions, which is the analysis level worry with Mark Asymp.Sig.(2-tailed) is 0.000, so it can be concluded that yoga exercises have an effect on the level of worry about face delivery in primigravida mothers.Superiority in study This means we used a sample of as many as 33 people, which fulfilled the standard minimum sample for good research.Then there are the weaknesses: No mentioned duration How many minutes do pregnant moms spend doing yoga?
Temporary research conducted [9] is mentioned to determine if there is an influence of antenatal yoga on the level of worry a mother is facing in facing the birthing process and if there is a difference in level of worry before and after giving antenatal yoga to a mother in the third trimester of pregnancy.Study This uses the pre-experiment method of one-group pre-test and posttest design.There are advantages and disadvantages to studying this.For its advantages, this study used a sample of as many as 35 people.Temporary, its weakness is the not-mentioned technique for taking the sample.
Research [25] presents results.There is an influence of prenatal yoga on worry in face delivery in the third trimester of primigravida due to the fact that mothers who are pregnant experience a decline in worry after receiving a prenatal yoga intervention.Superiority from the study This study uses a sample of more than 30 people, namely 55 people.Whereas its weakness is no There is a specification instrument used in research conducted.
Then, research conducted by [15] presents research data showing that level of worry for pregnant primi gravidarum third trimesters who get more prenatal yoga is low compared to pregnant third trimester primi gravidarum, who does not get prenatal yoga.There are advantages to studying This is the number of respondents who complied with the minimum research requirements pre-experiment using group control.Whereas its weakness is technique, taking sample No. 1, and also the duration and type of intervention movement No. 1.
The study from [31] presents results; the study exists.The influence of yoga exercise on pregnant mothers who will face labor is such that there is a difference in maternal anxiety between pregnant women before and after yoga exercises.Superiority in study This is the number of respondents who complied with the minimum study requirements, quasi-experiment samples, and instruments explained in a detailed way.Based on 8 articles that have been reviewed, the researcher will explain the results of intervention, duration, type of exercise or movement, and mechanism of decline worry.Intervention results from all over the article show that effective prenatal yoga exercise intervention lowers maternal anxiety in the third trimester of pregnancy with pv < 0.05.In research [01], it was stated that intervention prenatal yoga exercises are performed with five core techniques: technique mastery body (asana), technique mastery breath (pranayama), locking energy.technique (bandha), control energy (mudra), and technique cleaning body (kriya) without explaining the duration carried out by the researcher.Then, power in the article is the number of respondents who complied with the minimum study requirements in quasi-experiments, and weaknesses in the article are No mentioned instrument which anxiety to use and It is not clear how long will it take For do intervention.
In research [33], it was stated that for durational implementation, prenatal yoga exercises are done three times a day, three times a month, with type exercise, movement exercise, breathing deep, meditation, and stretching.from muscles in the body.Then, power in the article is that this article uses a sample of as many as 30 people, fulfilling the standard minimum sample for good research, and its weaknesses are that it does not mention the duration (minutes) of doing yoga.
Study [13] duration Prenatal yoga exercise intervention is carried out twice a week for 3 months.This is also supported by research [17], which states its duration is done twice a week, and the kind of exercises used are control muscle, technique breathing, relaxation, and calm thought.Whereas in research [9] and [31] stated that was carried out in the intervention prenatal yoga practice is 3 weeks with duration 2 times a week and type exercises used. is stretching muscles, meditation, breathing, and improving health and spiritual growth.The above is in line with the results of research [17] and research [9] that control muscle, technique, breathing, relaxation, and calm thought.If done routinely, i.e., two times a week during one month, yes, lower maternal anxiety during pregnancy with pv = 0.000 (p<α 0.05).
Based on the evidence and research that has been mentioned above, prenatal yoga practice states that there is a significant relationship between a pregnant mother who does yoga practice and decline anxiety in pregnancy.Statement This is also in line with research conducted by [15], where data obtained showed that there is a difference in worry for mothers who are pregnant before and after doing yoga exercises.This matter is proven with data from 20 respondents.Where anxiety experienced by mothers during a pregnant moment, face labor decreased after doing yoga exercises.Another study conducted by [31] also explains that there is an influence of yoga exercise done twice a week for 3 weeks consecutive to worry Mother pregnant face delivery at the Maternity Home Alfitrah, Paya Perupuk Tanjung Village, Pura District, Regency.Step up in 2018 using the Wilcoxon test, p value = 0.002<0.005.
According to [21], yoga is really needed by pregnant mothers to flex the joints, especially mothers who are approaching labor.Yoga practice consists of the five core techniques, viz., technique mastery body (asana), technique mastery breath (pranayama), technique locking energy (bandha), technique control energy (mudra), and technique cleaning body (kriya), that can be beneficial for the body.pregnancy period long.This technique is expected to lighten up complaints of mothers pregnant during pregnancy, especially frequent cramps and edema that happen at the end of pregnancy, launch genus blood and nutrition in the fetus, help position and movement of the baby, increase energy and passion to eat, create calm and focus, overcome nausea, relieve tension in the neck uterus, relieve anxiety and depression during pregnancy, and stretch muscles.
Int Jou of PHE  457 Facts above show suitability with the theory that prenatal yoga can lower the worry of a mother pregnant.Prenatal yoga practice with techniques such as breathing deeply, stretching muscles, and meditation with a duration of twice a week have a significant influence on lowering maternal anxiety in pregnant women.Apart from that, no found effect side on prenatal yoga and can done Where course, so considered as Effective, safe and easy intervention for done as well as reduce level worry Mother pregnant.

CONCLUSION
Prenatal yoga can be used as a therapy alternative to reduce maternal anxiety in the third trimester of pregnancy because it can help calm the mind and can be used as stress coping.Additionally, prenatal yoga does not give rise to the effects of being effective, safe, and easy to do.This matter is supported by 8 articles that have been reviewed above, and inside the article, it is mentioned that there is a significant influence between the groups before and after intervention with level maternal anxiety in the third trimester of pregnancy, with average values p < 0.000 (p < 0.05).Duration effective for lower maternal anxiety pregnant according to the review results are 2 times in a week and kind exercise or most effective movement used is technique breathing deep, stretching muscle, and meditation.done by a mother experiencing third trimester pregnancy worry.Although there is one article that has a lack that only uses one group intervention, to overcome the lack, the researcher uses the purposive sampling technique to control homogeneity in the sample so that the results can be confirmed as a pure because intervention.No, because variable other.
Temporary weakness from the study This is design research used in quasi-experimental research.Type of exercise performed No mentioned and not explained instrument what to use .