MANUSCRIPT Perbedaan Kualitas Hidup Ibu Postpartum Dengan Operasi Saesaria Dan Kelahiran Pervaginam Di Rsud Dr. Moewardi Surakarta.
DIFFERENCES QUALITY OF LIFE POSTPARTUM WITH OPERATION
CAESAREAN AND VAGINAL DELIVERY IN THE HOSPITAL
RSUD SURAKARTA
MANUSCRIPT
Submitted as a Partial Fulfillment of the Requirements
For Getting Bachelor Degree of Nursing
By :
Rosanee Pawae
J210.112.009
HEALTH SCIENCE FACULTY
UNIVERSITAS MUHAMMADIYAH SURAKARTA
2015
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
1
RESEARCH
DIFFERENCES QUALITY OF LIFE POSTPARTUM WITH OPERATION
CAESAREAN AND VAGINAL DELIVERY IN HOSPITAL
RSUD SURAKARTA
Abstraction
The postpartum period significantly affects physical and mental health of
the mother and may affect the quality of life usually with life changes such as
sleep deprivation, irregular food intake, and dehydration. Delivery methods have
differences between operation cesarean and vaginal delivery. Differences
physical, psychological and economic the impact on quality of life for postpartum.
The purpose of this study was to analyze whether there are differences in quality
of life between postpartum with operation cesarean and vaginal delivery in
hospital Surakarta. This study is a comparative study with cross sectional design.
Sample were 40 maternal postpartum in hospital Surakarta comprising 20
postpartum operastion cesarean and 20 postpartum vaginal delivery. Data
processing technique using the technique of Mann Whitney Test. Based on the
results of research and discussion, the conclusions of this study are: (1) quality of
life of postpartum operation cesarean mostly well (100%), (2) quality of life for
postpartum with vagina delivery are mostly good (70%) and excellent (30%), and
(3) there are differences in the quality of life postpartum with opertion cesarean
and vagina delivery (p-value 0.038), where mothers with vaginal delivery have a
better quality of life than postpartum operation (75, 25> 70.55).
Keywords : quality of life, postpartum , vaginal delivery, operation cesarean
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
PENDAHULUAN
The postpartum period is a
critical transition for women, which
significantly affect the physical and
mental health of women after
childbirth
and
psychological
problems postpartum may interfere
with the mother's ability to care for
her baby and may affect the quality
of life usually with various life
changes such as lack of sleep, food
intake is not regularly, and
dehydration. This period ranging
from 6 hours to 42 days postpartum
(Aktas, Demet & Terzioglu, Fusun,
2013).
Results of data from Riskesdas
(2013), the number of women giving
birth to normal (Vigina delivery) in
Indonesia amounted to 89.2 %. In
urban areas it amounted to 79.2 %
lower than in Central Java that is
equal to 88.2 %. Figures cesarean
birth mother to the operation in
Indonesia amounted to 9.8 %.
Daerahi in urban areas it was 19.9 %
higher than in Java Tengh 10.1 %
(health profile, 2013). Figures
maternity / childbirth in Indonesia
amounted to 4,492,618 persons, 525
527 people in Central Java.
Results of preliminary studies in
Surakarta Hospital (2014), gave birth
to normal incidence (Vigina delivery)
in Surakarta hospitals by 59 %, while
the cesarean operation by 41 %. For
postpartum patients with cesarean
surgery and birth vaginally need for
sleep problems is very important for
not only the recovery of the patient's
body but to maximize patient care
and in the care of baby at the
hospital.
Mothers who give birth vaginally
usually gives a certain satisfaction
from
the
psychological
than
cesarean delivery operations. In
terms of the economy as a vaginal
delivery is more economical than
delivery by surgery or cesarean
3
sektio because it sektio cesarean
delivery tools that require more
complicated (Zohreh, et al., 2013).
Surgical delivery by cesarean
mothers because there are factors
that affect maternal and fetal factors,
fetal
abnormalities,
abnormal
location of the baby is too big,
umbilical cord abnormalities and
twins. Maternal factors consist of
pelvic circumstances, age, abnormal
uterine
contractions,
premature
rupture
of
membranes
and
preeclamsia (Hutabalian, 2011).
Cesarean operation will cause
pain. The pain experienced by the
mother postpartum wounds are
derived from abdominal surgery.
Complained of pain due to scar fault.
This complaint is actually reasonable
because the body wound healing
and poses no perfect (Christina,
2012). Vaginal birth would cause
pain such as cesarean operation but
will
sumbuhnya
quickly
from
cesarean surgery. Birth canal
laceration or injury usually mild edge
sometimes there is also a wide
wound so as to causing any bleeding
that can be life memebahyakan
mother (Kritcharoen, et al., 2010).
The pain is caused Activity of Daily
Living disturbed, bonding attachment
(bonds of affection) and Early
Initiation of Breastfeeding is not
fulfilled due to an increase in pain
intensity if the mother moves (Fabris,
2011).
Women in this period needs
help and emotional support social
support is important to the health of
women, especially satelah childbirth,
and their role as mothers create
stout teatangan for the mother and
can greatly affect their ability to
enjoy
the
baby
care
(Kongsuriyanavin, et al., 2010).
Quality of life of mothers during
the postpartum period to give effect
to the change in the role of a new
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
partner as a parent. This period is
characterized by an intensive period
and demands for caring for the baby
and breastfeeding. problems often
arise for postpartum maternal
including pain, discomfort in the
breast, constipation, regulate the
activity of homework, coping with
emotional distress, sibling jealousy
and kelelah. (Sadat, et al., 2010).
Results of observation of
researchers to 5 postpartum patients
with cesarean surgery in primiparous
third day after birth, showing all the
patients have not been able to
perform with maximum care in
infants, this condition is caused
patients still experience pain in the
surgical
incision.
Baby
care
performed by family members of
patients perawata ata. Interviews
researchers to 5 patients were
obtained keterngan that 3 people
had not dared to do baby care
because of fear to wound conditions
dialakukan some movement, for
example, feeding the baby while
sleeping mindless and was told by
her parents and had seen other
family members ever do so.
Furthermore, the observation of
the researchers of the 5 patients with
vaginal birth postpartum primiparous
third day after birth, showed that
most patients had activity baby care.
4 patients had been feeding her
baby with sleeping position and a
sitting position and had to change
diapers or clothes for her newborn.
While the others have not been
biased breastfeeding in a sitting
position and not taking care of the
baby on their own due to the large
baby delivery process so that
mothers receive enough stitches
bannyak and cause pain.
This study aims to determine
differences in quality of life between
postpartum mothers with cesarean
surgery and vaginal birth.
4
The Methods of Research
Design of Research
This type of research is
descriptive comparative research to
find a comparison of two samples or
two tests on the object of study. To
determine differences in quality of
life between postpartum mothers
with vaginal births and cesarean
surgery (Suyanto & Salama, 2009).
Using a cross sectional study design
is
research
conducted
measurements at the same time /
moment.
This
research
is
quantitative research. Quantitative
research is demanding the use of
numbers,
ranging
from
data
collection, interpretation of these
data, as well as the appearance of
the results (Hidayat, 2007).
Populasi dan Sampel
The study population was
patients were primiparous cesarean
operation 20 people and vaginal
births are primiparity 20 people in
hospitals Surakarta.
The sample in this study was 40
people who were divided into 2
groups: 20 people as a group of
mothers
giving
birth
to
operasisesariadan 20 people as a
group of mothers giving birth
vaginally with the determination of
sample accidental sampling.
The Measurement
This study uses a questionnaire
measuring instrument
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
The data analysis
Analysis of the data in this
study is univariate and bivariate.
5
quality of life than patients
postpartum cesarean surgery
Discussions
THE RESULT AND
DISCUSSIONS
Univariate analysis
Distribution frequency of quality
life
Table 1 Distribusi Frekuensi
Kualitas Hidup
Quality of life
Very not good
Not good
Good
Very good
Total
Sesaria
F
%
0
0%
0
0%
20
100%
0
0%
20
100%
Pervaginam
F
%
0
0%
0
0%
14
70%
6
30%
20
100%
A. Quality of life postpartum
mother
1. Quality of life postpartum
mother with sesaria
The results showed that of
the 20 respondents, the
quality of life of postpartum
maternal surgery cesarean
all have good quality of life
100 % because the mother
was in the hospital for health
workers in the phase of
taking hold is kesepatan
good to provide various
counseling
and
health
education
are
required
postpartum mothers.
Biviariate analysis
Table 2. Mann Whitney Test
Means of quality life score
Sesaria
Pervaginam
70,55
75,25
p-value
0.038
Mann Whitney Test results of
the analysis of differences in the
quality of life of patients with post
partum cesarean surgery and
vaginal births significance value (p value) 0.038 less than 0.05 (0.038 <
0.05) so that H0 is rejected and
concluded there is a difference in the
quality of life of patients with
postpartum by operation cesarean
and vaginal birth.
Furthermore, based on the
average score of the quality of life
shows that the average score of the
quality of life of patients postpartum
pervagiman birth higher
than
cesarean
surgery
postpartum
patients (75.25 > 70.55). Based on
the average value of quality of life
scores is concluded that vaginal birth
postpartum patients have a better
2. Quality of life postpartum
mother with vaginal
The results showed that out
of 20 respondents quality of
life of both the mother
postpartum vaginal birth as
much as 14 respondents (70
%) and 6 respondents (30 %)
is very good because one of
the factors that cause the
quality of life of respondents
postpartum maternal vaginal
birth, namely the support of
the family.
Quality of life is a
picture of the condition of
postpartum
maternal
postpartum maternal domain
in terms of child care,
physical
health,
and
psychology. The better the
quality of life of postpartum
mother, then the mother's
ability to care for the child is
good, there is no interruption
in the physical health of the
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
mother and child, as well as
the psychology of the child
and the mother accepted the
presence of the child 's
presence makes a mother
happier.
Quality of life in postpartum
vaginal
and
cesarean
respondents showed most
have a good quality of life.
One of the factors that lead
to postpartum quality of life of
respondents in this study is
the support of the family. In
the process of maternity care
in hospitals Surakarta, birth
mother after childbirth wards
can directly occupy space
and can interact directly with
other family members. Family
interaction with post partum
mothers have an impact on
the help of family members in
care of postpartum mothers
and
babies.
Assistance
obtained from the family will
improve the quality of life of
both the mother post partum
cesarean or vaginal.
Bahadoran (2007) revealed
that one of the factors
associated with postpartum
mother's quality of life is
family and husband. The
family and the husband is the
most effective factor to take
exercise
during
after
kehamillan. Because the
husband and family support
to decision making physical
exercise, mental, social as
different aspects of quality of
life for postpartum mothers.
It is as stated in the research
Hastuti (2014) about the
relationship with the family
support maternal quality of
life. This study suggests that
6
family support related quality
of life of maternal, where the
higher the family support, the
better the quality of life of
mothers giving birth because
family
support
is
very
important for mothers giving
birth to aid activities that are
not
biased
mom
feel
someone accompany not
alone.
B. Differences in Quality of Life
Among
Mothers
With
Postpartum Birth vaginal and
cesarean surgery
Mann
Whitney
Test
results of the analysis of
differences in the quality of life of
patients with postpartum by
cesarean surgery and vaginal
births significance value (p value) 0.038 less than 0.05
(0.038 < 0.05) that concluded
there is a difference in the quality
of life of patients with postpartum
by cesarean surgery and vaginal
births.
Furthermore, based on
the average score of the quality
of life shows that the average
score of the quality of life of
patients postpartum pervagiman
birth higher than cesarean
surgery postpartum patients
(75.25 > 70.55). Based on the
average value of quality of life
scores is concluded that vaginal
birth postpartum patients have a
better quality of life than patients
postpartum cesarean surgery.
This study shows that
there are differences in the
quality of life of patients with post
partum
vaginal
birth
and
cesarean surgery, where the
patient postpartum vaginal birth
have a better quality of life than
patients postpartum cesarean
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
surgery. The results support the
results of research Andrew
(2014) about the comparison of
the incidence of postpartum
blues in postpartum mothers with
normal deliveries and caesarean
operation. The study concluded
that postpartum mothers with
cesarean surgery have a higher
incidence of postpartum blues as
compared
with
postpartum
mothers with normal deliveries
because of some medical
technology (the use of tools such
as opersai obstetric cesarean,
episiotomy) in aid delivery could
trigger
postpartum
blues.
Delivery by cesarean surgery is
a medical intervention that may
cause emotional reactions are
not expected.
The
research
also
showed that of the three
domains of quality of life, there
are two domains, namely child
care and physical health were
shown to have a significant
difference between maternal
postpartum by cesarean and
vaginal. While the psychological
domain showed no significant
difference.
Mothers who give birth by
cesarean surgery has limitations
physically higher than vaginal
birth mother. Because they care
cuts due to cesarean surgery
requires a recovery time, so that
the physical ability of mothers
giving birth by cesarean to be
blocked for some time. The big
difference in the physical ability
to have an impact on the
differences in the treatment of
children, physical functioning,
and psychological functioning
(Majzoobi, 2014).
Comparison
between
maternal postpartum physical
abilities by cesarean and vaginal
7
in this study have an impact on
the difference in quality of life for
child care domain. But the
results of this study are not
supported by previous studies,
the research Zahra (2015), which
examines the quality of life
between maternal postpartum by
cesarean method, vaginal, and
gave birth in the water (water
birth). This study concluded that
there
were
no
significant
differences in physical abilities
postpartum
mothers
with
cesarean method, vaginal, and
water birth. This study suggests
the development of better
treatment process, causing the
healing process faster cesarean
postpartum mothers, so the
physical limitations of the lower
cesarean postpartum mothers
and do not disturb the physical
ability of the mother in the care
of babies.
This
study
showed
differences in the quality of life of
physical health domain between
cesarean
and
vaginal
postpartum mothers, where the
physical health of the mother
postpartum vaginal better than
cesarean. The results are
consistent with the results of
Benhaz (2009) which states that
the results of a study of 100
respondents by cesarean and
vaginal
delivery
(normal)
acquired
75
%
did
not
experience physical disturbance
after 3 days of delivery. Because
of advances physical health
experienced by mothers due to
give birth in hospital care better
so as to accelerate improvement
in the physical health of the
mother giving birth. While the
physical health of the mother
postpartum Cesarean lower than
postpartum vaginal surgery due
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
to the cesarean so long healing
process.
Other
appropriate
research by Ramona (2006),
which examines differences in
quality of life of mothers
postpartum
cesarean
and
vaginal. This study shows that
there are differences in the
quality of life postpartum mothers
with cesarean and vaginal. This
study shows that cesarean
delivery are at risk of physical
disruption higher than vaginal
delivery. As it gets the possibility
of a surgical wound infections,
limited movement of his body
because of the surgical wound
so that the wound healing
process and discharge Atua dirty
blood clot from the womb
affected.
This study showed no
difference in the quality of life
domain of psychology between
postpartum maternal cesarean
and vaginal. Results of this study
showed postpartum mothers are
not impaired by psikoligis among
others feel happy with his
presence, no regrets after giving
birth to a child, the joy of being a
mother and others.
Results of this study did
not fit Majzoobi study (2014),
which examines the health and
quality of life of mothers of
postpartum
normal
and
caesarean. This study concludes
that the quality of life of maternal
psychological decline, with the
onset of the baby blues and
maternal depression in child
care. The study was conducted
with the observation period of 2
months, 4 months, 6 months and
12 months.
The big difference in the
results is due to researchers with
previous research on this study,
8
researchers
conducted
observation or testing the quality
of life of mothers postpartum day
3 after birth, where the mother is
still in hospital and get help
maternal and infant care from
nurses. The existence of such
aid cause the mother has not
experienced any problems or
interruptions in the nursing child,
so that the mother has not been
feeling troublesome or child care
problems if the mother alone to
care for her child.
Conclussions and Suggestions
Conclussions
1. Quality of life postpartum mothers
with cesarean surgery are mostly
well (100 %).
2. Quality of life postpartum mothers
with
vaginal
births
are
predominantly good (70 %) and
excellent (30 %).
3. There is a difference in quality of
life for postpartum mothers with
cesarean and birth opersai
pervagiman
(p-value
0.038),
where mothers with vaginal
delivery have a better quality of
life than mothers with postpartum
Suggestions
1. For Mother Postpartum
Postpartum
mothers
should
increase their understanding of
the condition after postpartum. By
understanding these conditions,
postpartum mothers are able to
manage
their
lives
after
postpartum
condition
both
physically and mentally, so the
quality of life of postpartum
mothers can occur well.
2. For the Community
9
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
Postpartum
mother
is
an
individual
who
has
limited
physically and mentally while on
the other hand have a high
responsibility for the baby's
development. Support from family
and society to postpartum
mothers is needed, so that the
health of mothers and infants
postpartum better.
3. For further Researcher
Researchers can further improve
the subject of research by
increasing the number of samples
of research or study area, as well
as adding other variables are
variables related to the quality of
life of post partum mothers, in
order to know the factors that
DAFTAR PUSTAKA
AKTAŞ1&
Füsun
TERZİOĞLU.
2013.
Occurrence
of
depression
during
the
postpartum period and risk
factors. Turkish Journal of
Medical Sciences, 843-850.
Andrew. U.M. 2014. Perbandingan
Kejadian Postpartum Blues
Pada
Ibu
Postpartum
Dengan Persalinan Normal
Dan Operasi Sesaria. Jurnal
Penelitian. Riau: Program
Studi
Ilmu
Keperawatan
Universitas Riau.
B. Torkan, S. P. 2007. Comparative
Analysis of Life Quality in
Mothers
after
Cesarean
Section and Normal Vaginal
Delivery.
Bahadoran, P. 2007. Evaluating the
effect of exercise on the
postpartum quality. Iranian of
Nursing
and
Midwifery
Research.
Christina, S., & Kristanti, E. E. 2012.
Early
Mobilization
in
Connection with Improved
konsep,proses,& praktik
Jakerta: EGC.
7th
ed,
Hastuti,
P.
2014.
Dukungan
Keluarga terjadap Kemajuan
Persalinan.
Jurnal
Keperawatan. Volume V,
Nomor 1, April 2014.
Hidayat, A. Aziz Alimul. 2007.
Metode Penelitian Kebidanan
& Teknik Analisis Data. Edisi
1. Jakarta : Salemba Medika.
Hutabalian,D. 2011. Pengaruh Umur
Terhadap
Persalianan
Sektio.
Kongsuriyanavin,
W.,
Kunrattanaporn,
B.,
&
Techatraisak, K. (88-99).
2010.
Factors
Affecting
Postpartum Women’s Mental
Health. Thai Journal of
Nursing Council.
Kritcharoen, S., Chuntharapat, S.-p.,
Phol-In, K., & Pongpaiboon,
P. 2010. Knowledge and
expected services about
natural childbirth of midwives.
Songkla Med J, 169-178.
Riset Kesehatan Dasar (Riskesdas).
(2013). Badan Penelitian dan
Pengembangan Kesehatan
RI.
Ramona, A. 2012.
Vaginal or
Cesarian Birth: What Is at
Stake for Women and
Babies?.
New
York:
Childbirth Connection.
Suyanto.& Salamah, Ummi. 2009.
Riset Kebidanan Metodologi
& Aplikasi. Yogjakarta: Mitra
Cendikia Press.
Sadat, Z., Taebi, M., Saberi, F., &
Kalarhoudi, M. A. 2013. The
relationship between mode of
delivery and postpartum
physical and mental health
related quality of life. PMCID:
PMC, 499-504.
Majzoobi, MM. 2014. Comparing
Quality of Life in Woman
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
after Vaginal Delivery and
Cesarean
Section.
J.Midwifery Reprod Health.
2(4): 207 – 214. Iran:
Hamadan
University
of
Medical Science.
Zahra K. 2014. A Comparison of
Mother’s Quality of Life after
Normal Vaginal, Cesarean,
and Water Birth Deliveries.
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*Rosanee Pawae: Mahasiswa S1
Keperawatan FIK UMS. Jln A Yani
Tromol Post 1 Kartasura
**Siti Arifah, S.Kep., M.Kes: Dosen
Kepera-watan FIK UMS. Jln A Yani
Tromol Post 1 Kartasura.
***Dewi Suyandari S.Kep: Dosen
Keperawatan FIK UMS. Jln A Yani
Tromol Post 1 Kartasura
10
CAESAREAN AND VAGINAL DELIVERY IN THE HOSPITAL
RSUD SURAKARTA
MANUSCRIPT
Submitted as a Partial Fulfillment of the Requirements
For Getting Bachelor Degree of Nursing
By :
Rosanee Pawae
J210.112.009
HEALTH SCIENCE FACULTY
UNIVERSITAS MUHAMMADIYAH SURAKARTA
2015
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
1
RESEARCH
DIFFERENCES QUALITY OF LIFE POSTPARTUM WITH OPERATION
CAESAREAN AND VAGINAL DELIVERY IN HOSPITAL
RSUD SURAKARTA
Abstraction
The postpartum period significantly affects physical and mental health of
the mother and may affect the quality of life usually with life changes such as
sleep deprivation, irregular food intake, and dehydration. Delivery methods have
differences between operation cesarean and vaginal delivery. Differences
physical, psychological and economic the impact on quality of life for postpartum.
The purpose of this study was to analyze whether there are differences in quality
of life between postpartum with operation cesarean and vaginal delivery in
hospital Surakarta. This study is a comparative study with cross sectional design.
Sample were 40 maternal postpartum in hospital Surakarta comprising 20
postpartum operastion cesarean and 20 postpartum vaginal delivery. Data
processing technique using the technique of Mann Whitney Test. Based on the
results of research and discussion, the conclusions of this study are: (1) quality of
life of postpartum operation cesarean mostly well (100%), (2) quality of life for
postpartum with vagina delivery are mostly good (70%) and excellent (30%), and
(3) there are differences in the quality of life postpartum with opertion cesarean
and vagina delivery (p-value 0.038), where mothers with vaginal delivery have a
better quality of life than postpartum operation (75, 25> 70.55).
Keywords : quality of life, postpartum , vaginal delivery, operation cesarean
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
PENDAHULUAN
The postpartum period is a
critical transition for women, which
significantly affect the physical and
mental health of women after
childbirth
and
psychological
problems postpartum may interfere
with the mother's ability to care for
her baby and may affect the quality
of life usually with various life
changes such as lack of sleep, food
intake is not regularly, and
dehydration. This period ranging
from 6 hours to 42 days postpartum
(Aktas, Demet & Terzioglu, Fusun,
2013).
Results of data from Riskesdas
(2013), the number of women giving
birth to normal (Vigina delivery) in
Indonesia amounted to 89.2 %. In
urban areas it amounted to 79.2 %
lower than in Central Java that is
equal to 88.2 %. Figures cesarean
birth mother to the operation in
Indonesia amounted to 9.8 %.
Daerahi in urban areas it was 19.9 %
higher than in Java Tengh 10.1 %
(health profile, 2013). Figures
maternity / childbirth in Indonesia
amounted to 4,492,618 persons, 525
527 people in Central Java.
Results of preliminary studies in
Surakarta Hospital (2014), gave birth
to normal incidence (Vigina delivery)
in Surakarta hospitals by 59 %, while
the cesarean operation by 41 %. For
postpartum patients with cesarean
surgery and birth vaginally need for
sleep problems is very important for
not only the recovery of the patient's
body but to maximize patient care
and in the care of baby at the
hospital.
Mothers who give birth vaginally
usually gives a certain satisfaction
from
the
psychological
than
cesarean delivery operations. In
terms of the economy as a vaginal
delivery is more economical than
delivery by surgery or cesarean
3
sektio because it sektio cesarean
delivery tools that require more
complicated (Zohreh, et al., 2013).
Surgical delivery by cesarean
mothers because there are factors
that affect maternal and fetal factors,
fetal
abnormalities,
abnormal
location of the baby is too big,
umbilical cord abnormalities and
twins. Maternal factors consist of
pelvic circumstances, age, abnormal
uterine
contractions,
premature
rupture
of
membranes
and
preeclamsia (Hutabalian, 2011).
Cesarean operation will cause
pain. The pain experienced by the
mother postpartum wounds are
derived from abdominal surgery.
Complained of pain due to scar fault.
This complaint is actually reasonable
because the body wound healing
and poses no perfect (Christina,
2012). Vaginal birth would cause
pain such as cesarean operation but
will
sumbuhnya
quickly
from
cesarean surgery. Birth canal
laceration or injury usually mild edge
sometimes there is also a wide
wound so as to causing any bleeding
that can be life memebahyakan
mother (Kritcharoen, et al., 2010).
The pain is caused Activity of Daily
Living disturbed, bonding attachment
(bonds of affection) and Early
Initiation of Breastfeeding is not
fulfilled due to an increase in pain
intensity if the mother moves (Fabris,
2011).
Women in this period needs
help and emotional support social
support is important to the health of
women, especially satelah childbirth,
and their role as mothers create
stout teatangan for the mother and
can greatly affect their ability to
enjoy
the
baby
care
(Kongsuriyanavin, et al., 2010).
Quality of life of mothers during
the postpartum period to give effect
to the change in the role of a new
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
partner as a parent. This period is
characterized by an intensive period
and demands for caring for the baby
and breastfeeding. problems often
arise for postpartum maternal
including pain, discomfort in the
breast, constipation, regulate the
activity of homework, coping with
emotional distress, sibling jealousy
and kelelah. (Sadat, et al., 2010).
Results of observation of
researchers to 5 postpartum patients
with cesarean surgery in primiparous
third day after birth, showing all the
patients have not been able to
perform with maximum care in
infants, this condition is caused
patients still experience pain in the
surgical
incision.
Baby
care
performed by family members of
patients perawata ata. Interviews
researchers to 5 patients were
obtained keterngan that 3 people
had not dared to do baby care
because of fear to wound conditions
dialakukan some movement, for
example, feeding the baby while
sleeping mindless and was told by
her parents and had seen other
family members ever do so.
Furthermore, the observation of
the researchers of the 5 patients with
vaginal birth postpartum primiparous
third day after birth, showed that
most patients had activity baby care.
4 patients had been feeding her
baby with sleeping position and a
sitting position and had to change
diapers or clothes for her newborn.
While the others have not been
biased breastfeeding in a sitting
position and not taking care of the
baby on their own due to the large
baby delivery process so that
mothers receive enough stitches
bannyak and cause pain.
This study aims to determine
differences in quality of life between
postpartum mothers with cesarean
surgery and vaginal birth.
4
The Methods of Research
Design of Research
This type of research is
descriptive comparative research to
find a comparison of two samples or
two tests on the object of study. To
determine differences in quality of
life between postpartum mothers
with vaginal births and cesarean
surgery (Suyanto & Salama, 2009).
Using a cross sectional study design
is
research
conducted
measurements at the same time /
moment.
This
research
is
quantitative research. Quantitative
research is demanding the use of
numbers,
ranging
from
data
collection, interpretation of these
data, as well as the appearance of
the results (Hidayat, 2007).
Populasi dan Sampel
The study population was
patients were primiparous cesarean
operation 20 people and vaginal
births are primiparity 20 people in
hospitals Surakarta.
The sample in this study was 40
people who were divided into 2
groups: 20 people as a group of
mothers
giving
birth
to
operasisesariadan 20 people as a
group of mothers giving birth
vaginally with the determination of
sample accidental sampling.
The Measurement
This study uses a questionnaire
measuring instrument
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
The data analysis
Analysis of the data in this
study is univariate and bivariate.
5
quality of life than patients
postpartum cesarean surgery
Discussions
THE RESULT AND
DISCUSSIONS
Univariate analysis
Distribution frequency of quality
life
Table 1 Distribusi Frekuensi
Kualitas Hidup
Quality of life
Very not good
Not good
Good
Very good
Total
Sesaria
F
%
0
0%
0
0%
20
100%
0
0%
20
100%
Pervaginam
F
%
0
0%
0
0%
14
70%
6
30%
20
100%
A. Quality of life postpartum
mother
1. Quality of life postpartum
mother with sesaria
The results showed that of
the 20 respondents, the
quality of life of postpartum
maternal surgery cesarean
all have good quality of life
100 % because the mother
was in the hospital for health
workers in the phase of
taking hold is kesepatan
good to provide various
counseling
and
health
education
are
required
postpartum mothers.
Biviariate analysis
Table 2. Mann Whitney Test
Means of quality life score
Sesaria
Pervaginam
70,55
75,25
p-value
0.038
Mann Whitney Test results of
the analysis of differences in the
quality of life of patients with post
partum cesarean surgery and
vaginal births significance value (p value) 0.038 less than 0.05 (0.038 <
0.05) so that H0 is rejected and
concluded there is a difference in the
quality of life of patients with
postpartum by operation cesarean
and vaginal birth.
Furthermore, based on the
average score of the quality of life
shows that the average score of the
quality of life of patients postpartum
pervagiman birth higher
than
cesarean
surgery
postpartum
patients (75.25 > 70.55). Based on
the average value of quality of life
scores is concluded that vaginal birth
postpartum patients have a better
2. Quality of life postpartum
mother with vaginal
The results showed that out
of 20 respondents quality of
life of both the mother
postpartum vaginal birth as
much as 14 respondents (70
%) and 6 respondents (30 %)
is very good because one of
the factors that cause the
quality of life of respondents
postpartum maternal vaginal
birth, namely the support of
the family.
Quality of life is a
picture of the condition of
postpartum
maternal
postpartum maternal domain
in terms of child care,
physical
health,
and
psychology. The better the
quality of life of postpartum
mother, then the mother's
ability to care for the child is
good, there is no interruption
in the physical health of the
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
mother and child, as well as
the psychology of the child
and the mother accepted the
presence of the child 's
presence makes a mother
happier.
Quality of life in postpartum
vaginal
and
cesarean
respondents showed most
have a good quality of life.
One of the factors that lead
to postpartum quality of life of
respondents in this study is
the support of the family. In
the process of maternity care
in hospitals Surakarta, birth
mother after childbirth wards
can directly occupy space
and can interact directly with
other family members. Family
interaction with post partum
mothers have an impact on
the help of family members in
care of postpartum mothers
and
babies.
Assistance
obtained from the family will
improve the quality of life of
both the mother post partum
cesarean or vaginal.
Bahadoran (2007) revealed
that one of the factors
associated with postpartum
mother's quality of life is
family and husband. The
family and the husband is the
most effective factor to take
exercise
during
after
kehamillan. Because the
husband and family support
to decision making physical
exercise, mental, social as
different aspects of quality of
life for postpartum mothers.
It is as stated in the research
Hastuti (2014) about the
relationship with the family
support maternal quality of
life. This study suggests that
6
family support related quality
of life of maternal, where the
higher the family support, the
better the quality of life of
mothers giving birth because
family
support
is
very
important for mothers giving
birth to aid activities that are
not
biased
mom
feel
someone accompany not
alone.
B. Differences in Quality of Life
Among
Mothers
With
Postpartum Birth vaginal and
cesarean surgery
Mann
Whitney
Test
results of the analysis of
differences in the quality of life of
patients with postpartum by
cesarean surgery and vaginal
births significance value (p value) 0.038 less than 0.05
(0.038 < 0.05) that concluded
there is a difference in the quality
of life of patients with postpartum
by cesarean surgery and vaginal
births.
Furthermore, based on
the average score of the quality
of life shows that the average
score of the quality of life of
patients postpartum pervagiman
birth higher than cesarean
surgery postpartum patients
(75.25 > 70.55). Based on the
average value of quality of life
scores is concluded that vaginal
birth postpartum patients have a
better quality of life than patients
postpartum cesarean surgery.
This study shows that
there are differences in the
quality of life of patients with post
partum
vaginal
birth
and
cesarean surgery, where the
patient postpartum vaginal birth
have a better quality of life than
patients postpartum cesarean
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
surgery. The results support the
results of research Andrew
(2014) about the comparison of
the incidence of postpartum
blues in postpartum mothers with
normal deliveries and caesarean
operation. The study concluded
that postpartum mothers with
cesarean surgery have a higher
incidence of postpartum blues as
compared
with
postpartum
mothers with normal deliveries
because of some medical
technology (the use of tools such
as opersai obstetric cesarean,
episiotomy) in aid delivery could
trigger
postpartum
blues.
Delivery by cesarean surgery is
a medical intervention that may
cause emotional reactions are
not expected.
The
research
also
showed that of the three
domains of quality of life, there
are two domains, namely child
care and physical health were
shown to have a significant
difference between maternal
postpartum by cesarean and
vaginal. While the psychological
domain showed no significant
difference.
Mothers who give birth by
cesarean surgery has limitations
physically higher than vaginal
birth mother. Because they care
cuts due to cesarean surgery
requires a recovery time, so that
the physical ability of mothers
giving birth by cesarean to be
blocked for some time. The big
difference in the physical ability
to have an impact on the
differences in the treatment of
children, physical functioning,
and psychological functioning
(Majzoobi, 2014).
Comparison
between
maternal postpartum physical
abilities by cesarean and vaginal
7
in this study have an impact on
the difference in quality of life for
child care domain. But the
results of this study are not
supported by previous studies,
the research Zahra (2015), which
examines the quality of life
between maternal postpartum by
cesarean method, vaginal, and
gave birth in the water (water
birth). This study concluded that
there
were
no
significant
differences in physical abilities
postpartum
mothers
with
cesarean method, vaginal, and
water birth. This study suggests
the development of better
treatment process, causing the
healing process faster cesarean
postpartum mothers, so the
physical limitations of the lower
cesarean postpartum mothers
and do not disturb the physical
ability of the mother in the care
of babies.
This
study
showed
differences in the quality of life of
physical health domain between
cesarean
and
vaginal
postpartum mothers, where the
physical health of the mother
postpartum vaginal better than
cesarean. The results are
consistent with the results of
Benhaz (2009) which states that
the results of a study of 100
respondents by cesarean and
vaginal
delivery
(normal)
acquired
75
%
did
not
experience physical disturbance
after 3 days of delivery. Because
of advances physical health
experienced by mothers due to
give birth in hospital care better
so as to accelerate improvement
in the physical health of the
mother giving birth. While the
physical health of the mother
postpartum Cesarean lower than
postpartum vaginal surgery due
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
to the cesarean so long healing
process.
Other
appropriate
research by Ramona (2006),
which examines differences in
quality of life of mothers
postpartum
cesarean
and
vaginal. This study shows that
there are differences in the
quality of life postpartum mothers
with cesarean and vaginal. This
study shows that cesarean
delivery are at risk of physical
disruption higher than vaginal
delivery. As it gets the possibility
of a surgical wound infections,
limited movement of his body
because of the surgical wound
so that the wound healing
process and discharge Atua dirty
blood clot from the womb
affected.
This study showed no
difference in the quality of life
domain of psychology between
postpartum maternal cesarean
and vaginal. Results of this study
showed postpartum mothers are
not impaired by psikoligis among
others feel happy with his
presence, no regrets after giving
birth to a child, the joy of being a
mother and others.
Results of this study did
not fit Majzoobi study (2014),
which examines the health and
quality of life of mothers of
postpartum
normal
and
caesarean. This study concludes
that the quality of life of maternal
psychological decline, with the
onset of the baby blues and
maternal depression in child
care. The study was conducted
with the observation period of 2
months, 4 months, 6 months and
12 months.
The big difference in the
results is due to researchers with
previous research on this study,
8
researchers
conducted
observation or testing the quality
of life of mothers postpartum day
3 after birth, where the mother is
still in hospital and get help
maternal and infant care from
nurses. The existence of such
aid cause the mother has not
experienced any problems or
interruptions in the nursing child,
so that the mother has not been
feeling troublesome or child care
problems if the mother alone to
care for her child.
Conclussions and Suggestions
Conclussions
1. Quality of life postpartum mothers
with cesarean surgery are mostly
well (100 %).
2. Quality of life postpartum mothers
with
vaginal
births
are
predominantly good (70 %) and
excellent (30 %).
3. There is a difference in quality of
life for postpartum mothers with
cesarean and birth opersai
pervagiman
(p-value
0.038),
where mothers with vaginal
delivery have a better quality of
life than mothers with postpartum
Suggestions
1. For Mother Postpartum
Postpartum
mothers
should
increase their understanding of
the condition after postpartum. By
understanding these conditions,
postpartum mothers are able to
manage
their
lives
after
postpartum
condition
both
physically and mentally, so the
quality of life of postpartum
mothers can occur well.
2. For the Community
9
DIFFERENCES
QUALITY
OF LIFE OF OPERATIONS WITH POSTPARTUM
MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA
(ROSANEE PAWAE)
Postpartum
mother
is
an
individual
who
has
limited
physically and mentally while on
the other hand have a high
responsibility for the baby's
development. Support from family
and society to postpartum
mothers is needed, so that the
health of mothers and infants
postpartum better.
3. For further Researcher
Researchers can further improve
the subject of research by
increasing the number of samples
of research or study area, as well
as adding other variables are
variables related to the quality of
life of post partum mothers, in
order to know the factors that
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