International Journal of Engineering Business
and Social Science
Vol. 1 No. 03, January-February 2023, pages: 241 -247
e-ISSN: 2980-4108, p-ISSN: 2980-4272
https://ijebss.ph/index.php/ijebss
241
The Effect of Rebozo Reaction on the Length of Labor in Primiparous
Mothers at PMB Deli Serdang in 2021
Suryani
1
, Tri Marini
2
, Julietta Hutabarat
3
, Nur Afi Darti
4
, Mamik
5
1,2,3,4
Midwifery Study Program, Ministry of Health Polytechnic, Medan, Indonesia
5
Midwifery Study Program, Ministry of Health Polytechnic Surabaya, Indonesia
*Corresponding Author: suryanimkes12@gmail.com
Submitted: 08-02-2023 Revised: 12-02-2023, Publication: 20-02-2023
Keywords
Abstract
Rebozo, Stage I, Length
of Labor
Prolonged parturition can result in an emergency for both mother and baby. In
mothers, it can cause bleeding, shock, and death, while in infants it can cause fetal
distress, asphyxia, and caput. One of the efforts to prevent prolonged labor is to use
the Rebozo Relaxation Technique which supports labor so that it can run
physiologically. The purpose of this study was to determine the effect of rebozo
relaxation on the length of labor in Primiparous mothers. This type of research uses
a Quasi-Experimental Design research design with a Non-Equivalent Control Group
research design. The sample in this study was 40 respondents divided into 20 people
in the control group and 20 in the experimental group. Data collection using T-Test
and Mann-Whitney Test. The results of the study obtained a p-value (0.00) <α
(0.005). With a frequency of 4-8 times and a duration of 20-45 minutes with an
intensity of 85%-95%, the total length of labor in the experimental group averaged
334.50 minutes (5.57 hours) and the non-experimental group averaged 478, 75
minutes (7.79 hours). Suggestion for applying Rebozo Relaxation to Mothers of
Inpartum Primigravida Stage I Active Phase to prevent prolonged labor and reduce
oxytocin injection for primigravida.
1. Introduction
Maternal Mortality Rate (MMR) is a measure of health status in a country which from time to time can
provide an overview of the development of public health status and as an indicator in assessing the success of health
services and other health development programs. Maternal mortality and morbidity. Maternal and postpartum
mothers are still a big problem, especially in developing countries, including Indonesia (Achadi, 2010; Sukfitrianty
et al., 2016; Widoyo, 2017; Batubara, Mahayani, & Al Faiq Agma, 2019).
World Health Organization (WHO) states that the death of a mother is the death of a woman while pregnant or
within 40 days after the termination of pregnancy due to any cause, regardless of the age of the pregnancy and the
actions taken to terminate the pregnancy (Qudus & Regariana, 2019; Munafiah, Astuti, Parada, & Demu, 2020).
According to a data report from WHO (2015) noted that every day in 2015 there were 830 mothers who died due to
complications of pregnancy and childbirth. WHO also noted that the MMR in Indonesia (2015) was 126/100,000 live
births. This figure is still quite high when compared to neighboring countries in the ASEAN region (Batubara et al.,
2019).
According to the Ministry of Health (2017) stated that there were 1,712 cases of maternal death during
childbirth that occurred until the first semester of 2017. This figure is still far from achieving the 2030 Sustainable
Development Goals (SDG's) target agenda, which is 70/100,000 live births.
IJEBSS e-ISSN: 2980-4108 p-ISSN: 2980-4272 242
IJEBSS Vol. 1 No.03, January-February 2023, pages: 241 -247
The MMR reported in North Sumatra in 2012 was 106/100,000 live births and in 2014 the maternal mortality
rate was 187 out of 228,947 live births (North Sumatra Health Office). According to the Health Profile of Deli
Serdang Regency (2017), it states that the number of MMR is 15 cases/44,656 live births. If converted to 100,000,
then in Deli Serdang district in 2017 it was reported that there were 33-34 maternal deaths per 100,000 live births
with a percentage of 50% in maternity mothers.
There are two factors that cause maternal death, namely direct and indirect factors. The direct factor of a
mother's death is the result of pregnancy, childbirth, or the puerperium and any intervention or inappropriate
handling of complications suffered by the mother, such as bleeding, sepsis, hypertension in pregnancy, obstructed
labor, complications of unsafe abortion and other causes. other. While the indirect death of a mother is the result of a
pre-existing disease or disease that arose during pregnancy that could affect her pregnancy, such as malaria, anemia,
HIV/AIDS, and cardiovascular disease. (Citaningtyas & Bukhori, 2015;Kurniati et al, 2016; Nur & Arifuddin, 2017;
Rahman et al,. 2017; (Hardianti & Mairo, 2018).
During labor, if there is weakness in uterine contractions, there will be an elongated cervical dilatation. The
prolonged cervical dilatation phase is caused by the weakness of the uterine muscles to contract. In addition, the
elongated cervical opening is also caused by the strength of the mother's pushing, fetal factors, birth canal factors,
maternal psychological factors, namely the level of anxiety and fear in facing childbirth. And if there is an elongated
cervical opening, it will result in an extension of time in the first stage, which is called the elongated first stage. This
incident is a contributor to maternal and infant mortality.
According to the 2012 IDHS, it was noted that 38.2% prolonged labor was the main cause of maternal and
perinatal death, followed by bleeding 35.26% and eclampsia 16.44%. The survey results obtained stated that
prolonged parturition could result in an emergency for both mother and baby. In the mother it can cause bleeding,
shock and death, while in the baby it can cause fetal distress, asphyxia and caput.
According to Aprilia in Gustyar & Nouyriana, (2017); Rodríguez-Blanque et al,. (2019); (TD, 2019); Baljon et
al., (2020); Siregar et al., (2020); (Hidajatunnikma, Setyawati, & Palin, 2020); (Setyaningsih, 2021); (Dwi Arianti,
2021); (Kamilya Baljon et al., 2022) states that in addition to using a partograph, there are several physiological
efforts that can be made to prevent prolonged labor such as pregnancy exercise and deep breathing techniques. Other
efforts to prevent prolonged labor such as the Rebozo Relaxation Technique which supports labor so that it can run
physiologically. Rebozo helps provide a wider pelvic space for the mother so that it is easier for the baby to descend
the pelvis and the delivery process will be faster ((Chasse, 2016); Munafiah et al., 2020; (Damayanti & Fatimah,
2021). The Rebozo technique is a technique that uses a shawl with a gym ball as an additional tool to support or
perform certain movements ((Cohen & Thomas, 2015); (Morgan, 2021); (Nguyen, Donovan, & Wright, 2022).
The results of research conducted by Munafiah on the Benefits of the Rebozo Technique on the Advancement
of Labor in 2020 were obtained from the results of the Mann-Whitney test that there was a difference in effectiveness
between the intervention group (rebozo technique) and the control group (pelvic rocking). So it was concluded that
the rebozo technique was more effective against cervical dilatation during the first active phase of labor.
Based on the results of a survey conducted at PMB / Jannah Maternity Clinic, from 30 mothers giving birth, 18
of them experienced prolonged labor. So in connection with this problem, researchers are interested in conducting a
study entitled "The Effect of Rebozo Relaxation on the Length of Labor in Primiparous Mothers at PMB Deli
Serdang 2021”. The purpose of this study was to determine the effect of rebozo relaxation on the length of labor in
Primiparous mothers. And applying Rebozo Relaxation to Mothers of Inpartum Primigravida Stage I Active Phase to
prevent prolonged labor and reduce oxytocin injection for primigravida.
2. Materials and Methods
The method of research used Quasi Experiment with a Non-Equivalent Control Group research design where
there was an experimental group, namely the mother group who was given the rebozo relaxation treatment and those
who were not treated as a non-experimental group. The population of the study was all primigravida pregnant
women with gestational age in the third trimester (36-40 weeks) who underwent a pregnancy examination at the Deli
Serdang Independent Midwife Practice (PMB Jannah, PMB Herlina Tanjung, PMB Yatini, PMB Kurnia Ningsih,
PMB Asni Sitio and PMB Linda). The research sample was taken by purposive sampling technique, with inclusion
criteria of maternal age 20-35 years, Body Mass Index before normal pregnancy (18.5-24.9 kg/m2), weight gain
during normal pregnancy (11.5-16 kg), normal fetal heart rate (120-160 beats/minute) and psychological data in the
category of low anxiety level.
243 e-ISSN: 2980-4108 p-ISSN: 2980-4272 IJEBSS
IJEBSS Vol. 1 No.03, January-February 2023, pages: 241 -247
3. Result and Discussion
The variables measured in this study were the duration of the active phase of the first stage of labor, the length
of the second stage and the total length of labor with the unit of time being minutes. The results can be seen in the
table below:
Table 1
of Average, SD, and Range of Research Variables
No
Variable
Experiment
Non
Experiment
Average (SD)
Average
(SD)
Range
1
long time
ago I active
387,75
(43,54)
448,75
(41,64)
390-530
2
long time
ago II
27,75
(9,66)
40,00
(8,27)
25-55
3
Total time
childbirth
334,50
(44,35)
478,75
(82,64)
190-595
Description: SD = Standard deviation
n = 20
From Table 1 it can be seen that the duration of the active phase I in the experimental group averaged 387.75
minutes, the standard deviation was 43.54 with a range of 260 - 400 minutes, while the non-experimental group
averaged 448.75 minutes, standard deviation 41.64 with a range of 390 – 530 minutes. The length of second stage in
the experimental group averaged 27.75 minutes, standard deviation 9.66 with a range of 15-50 minutes, while the
non-experimental group averaged 40.00 minutes, standard deviation 8.27 with a range of 25-55 minutes.
The total length of labor in the experimental group averaged 334.50 minutes, standard deviation 44.32 with a
range of 265 – 450 minutes, while the non-experimental group averaged 478.75 minutes, standard deviation 82.64
with a standard deviation of 190 – 595 minutes.
Research Variable Normality Test
The results of the measurement of the research variables were tested for normality using the Shapiro-Wilk
test. Variables that were tested for normality included the variable length of the first active phase, the length of the
second stage, and the total length of labor.
Table 2
Effect of Rebozo Relaxation Normality Test
From the results of the normality test, it was found that for the first and second stage variables, the p value >
(0.005) both in the experimental group and the non-experimental group, so it can be concluded that the data is
normally distributed so that to determine the effect of Rebozo Relaxation on the length of the first and second stages,
it is carried out analysis with the T-Test test, namely the independent sample T-Test. Meanwhile, for the variable
total length of labor in the non-experimental group, the data were not normally distributed where the p value (0.00) <
(0.005) so that the analysis was carried out using the Mann Whitney.
Test T-Test
To determine the effect of Rebozo relaxation on long time ago I long time ago II delivery, a T-Test test is
carried out as shown in table 3 below:
No
Variable
Shapiro- Wilk value p
Experiment
Non Experiment
1
2
3
long time ago I
long time ago II
Total time
childbirth
0,136
0,069
0,396
0,208
0,325
0,00