Problem

Indonesia Health and Demography Survey (SDKI) 2012 stated that maternal mortality rate (AKI) had increased drastically to 359 per 100,000 live birth. Before 2012, AKI could be reduced from 390 per 100,000 live births (1991) to 228 per 100,000 live births (SDKI, 2007). Besides AKI, baby mortality rate (AKB) is still high, 32 per 1,000 live births. This rate is only a slight decreased from AKB SDKI 2007 which was 34 per 1,000 live births. The Millennium Development Goals aims to decrease AKI to 102 per 100,000 live birth and AKB to 23 per 1,000 live births in 2015. Deputy of Health Minister Ali Ghufron Mukti stated that AKI in Indonesia is one of the highest numbers in Asia. According to the province report on mother and child health in 2011, a mother mortality rates was 5,118. The mayor causes were bleeding (32 %), hypertension (25 %), infection (5 %), prolonged labor (5 %), and abortion (1 %). Other causes were 32 % (high enough), including non-obstetric illness. WHO survey in 2007 and 2004 stated that around 23 % of neonatal mortality was caused by asphyxia, in which there was a bigger proportion of death birth. Mothers’ complications, such as prolonged labor, bleeding and preeclampsia, were the mayor causes of asphyxia cases. Many efforts had been done by the government to decrease mother and child mortality rates, but more focuses need to be given on the improvement of service quality with a holistic midwifery approach, which embrace not only physical but also psychological and social aspects. (PUSDIKNAKES, 2003). The success of labor process is strongly influenced by physical and psychological states of the mother and the baby, and also of the helpers of labor process. If there is any incongruence in this triad, there would be problem in labor process, both in the mother and the baby. This is a very important understanding since there are some mother and/or baby mortality cases that were caused by no early detection of this incongruence that in turn, causes a late management. (Asrinah, et al. 2011) Pregnancy is an important event and experience in women’s life. However, as other life transition stages, it can also cause stresses, so the response to pregnancy can be varied from happy to the opposite responses, such as anxiety and disappointment (Pusdiknakes, 2003). Therefore, in midwifery, the mind influences up to 80 even 90 % of diseases and complications. Negative records from birthing process that were kept in mind of a person could then reappears in the next birthing process and causes complications (Elena Tonetty). Hypnobirthing is based on a belief that during pregnancy, labor and post natal, a mother needs physical, mental, and spiritual preparations. Hypnobirthing is not a new method. In Indonesia, this method had been used for ages. As there are now more scientific explanations and proper programming, the results of this method has been optimal. Hypnobirthing is one of the autohypnosis (self hypnosis) techniques, which implanted positives intentions to the soul or subconscious mind during pregnancy and labor preparation. By doing so, pregnant mothers are made possible to experience the joy of pregnancy and a smooth labor process. Hypnobirthing method was developed on a belief that a holistically birthing preparation (body, mind, soul) on mother and her labor partner will contribute to a safe, calm, peaceful, and satisfying labor process, far from fear that can causes tension and pain. When there is a harmony between mind and body, the universe will work in the same way as in all other creatures. Hypnobirthing is an effective approach to neutralize and reprogrammed the negative records into positive program in subconscious mind. In effect, a record that has been kept in subconscious mind and says that labor process is a frightening and painful experience then can be erased and changed into a new belief that labor process is an easy, smooth, comfortable, and deeply spiritual experience. If pain can be enjoyed, then labor process will run smoothly. Hence, safety can be guaranteed. In situation where a mother tenses during pregnancy or labor, her muscles will also tensed and this can cause prolonged expulsive phase in the first and second step of labor that can, in turn, causes hemorrhage post partum (HPP), which is the mayor cause of mother mortality rates. With hypnobirthing, labor process can be well-prepared, relax, and enjoyable so the muscles of the womb would work well accordingly. Some literatures stated that hypnobirthing techniques are not only can decrease complaints during pregnancy, such as hyperemesis gravidarum (Neron, 2007; Tan G, 2006) but also acts as basic formula of pain management. This technique creates safe, comfortable, and relax feelings on mother so that she can eliminates stress, fear, and anxiety before labor (Flanner, 2007) and control pain and aches during labor (Brown, Elkins 2007). Endorphin massage intervention can increase the level of endorphin hormone in the body to reduce pain during uterine contractions and helps maintaining oxygen supply to the baby during labor. Combination of hypnobirthing and endorphin massage can reduce birthing complications, risk of cesarean surgery, and fasten the recovery post partum. In Indonesia, the benefits of hypnobirthing has been researched and published profusely in national and international journals, i.e. hypnobirthing shortens the length of labor duration (Elit P, et all; 2011), lowering blood pressure in pregnant woman with hypertension (Wiwien M, et all; 2012), reducing pain intensity during labor (Elit P, et all; 2013). Endorphin massage reduces asphyxia cases in mothers who receive labor induction (Elit P, Winda; 2015). Hypnobirthing is 100% benefitted to midwives and this fact had been presented in European Midwives Association (EMA) Education Conference 2013 (Wilda N, 2011). Hypnobirthing method significantly influences the length of labor duration and reduces cases of prolonged expulsive phase in the first and second stage of labor that can cause HPP (Haemorragic Post Partum) (Gallagher S, 2001). In this modern era, a natural labor and birth process has started to be forgotten. High technology has crept in (unaware, we even have chosen and wanted it). The number of cesarean surgeries has soared. Mother and baby are instantly separated after birth. Less mothers who can breastfeed and gives exclusive breast milk to their babies. So what is happening? Technology itself was developed to save life and if it used wisely, it will have a remarkable result. It is my concern that technology has been over-used and what once was a normal life event has become a high risk medical procedure. A ritual in which a woman transforms into motherhood has been replaced by drugs, so that our natural hormones are no longer functioning in its remarkable roles. We have lost the opportunity to experience one of the most empowering experiences in our life. Nowadays, more mothers “had failed” to labor naturally. Most of them had to go through various interventions that often created certain traumas in their life. According to midwifery philosophy, pregnancy and labor are natural processes - not diseases - and the goal of midwifery care is to save mother and baby (reduce pain and mortality) through programs that focus on: prevention and holistic health promotion which are given in a creative, flexible, supportive, and caring way; guidance, monitoring, and education that focuses on women; continuous care that based on women’s needs, not authoritarian, and respecting women’s choices. (Permenkes 369, 2007) My goal is to help women to get their positive labor experience back. When a woman is given clear information, involves in option selection and decision making, and feels fully supported, she would feel safe and able to go through labor naturally and instinctively. With positive mental-emotional attitude, every woman is able to give birth in a beautiful way. Beside that, it is my wish that every child who comes to this world would feel peace and greeted joyfully by the people who love and support them. This is the foundation for their future life. A gentle birth with hypnobirthing method; a labor and birth process that soul-friendly, smooth, less trauma for our love ones and future generations.

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