CHAPTER 1

INTRODUCTION

1.1 Background

Pregnancy is since the beginning of conception until the birth of a normal pregnancy the

fetal length is 280 days (40 weeks or 9 months 7 days) (Prawirohardjo, 2002: 89).

Pregnancy as a physiological state can be followed by a pathological process that

threatens the state of the mother and fetus. Health workers should be able to recognize

changes that may occur, so there is disorder that can be recognized early. For example

the changes that occur are lower limb edema in the last trimester may be physiological.

But when accompanied by edema of the upper body like the face and arms, especially

when followed by an increase in blood pressure is suspected pre-eclampsia. Bleeding in

the first trimester can be a sign of physiological processes nidasi Hartman is a result of

blastocysts to the endometrium that causes the surface of the bleeding lasts for a while,

a little and did not endanger the pregnancy but can be a pathological case of abortion,

ectopic pregnancy or hydatidiform mole (Mansjor, et al, 2001: 252 ). Humans are

basically always want to know is right. to satisfy this curiosity, of mankind since time

immemorial have tried to gather knowledge. Knowledge is basically composed of a

number of facts and theories that allow a person to be able to solve his problems. Such

knowledge is obtained either from direct experience or through other people's

experiences (SoekidjoNotoatmodjo, 2005:10). Mortality and mordibitas in pregnant

women is a major problem in developing countries. In poor countries around 25-50%.

Childbearing age woman's death caused by something related to pregnancy. Death

during childbirth is usually a major factor in mortality of young women during the

height of its productivity. In 1996, WHO estimates that more than 585,000 women die

1
annually during pregnancy or maternity is actually more than 50% of deaths in

developing countries (Prawirohardjo, 2002: 3).

Pregnant women in the countries of Africa and South Asia face the risk of death during

pregnancy and childbirth around 200 times greater than the risk faced by women in

developed countries. Because fertility rates in developing countries is higher then the

range of risk among African I 6000. each year there are 150 million pregnant women in

developing countries. About 500,000 of them will die from causes pregnancy, and 50

million others suffer because of her pregnancy had complications (Widyastuti, 2003: 1).

Putting efforts to reduce maternal mortality as a priority program direct cause of

maternal death in Indonesia as well as in other countries are bleeding, infection and

eclampsia in bleeding and infection as a cause of death, actually included are deaths

caused by infected abortion and parturition time. Only about 50% of maternal deaths

caused by disease which deteriorated due to pregnancy, such as heart disease and

chronic infections. Circumstances since the pre-pregnant mothers can affect on her

pregnancy, the indirect cause of maternal mortality, these include the Amenia, chronic

lack of energy (KEK) and the state "4 is too" young / old, often and many

(Prawirohardjo, 2003: 6).

According to demographic and health survey of Indonesia (IDHS) 2002/2003 MMR in

Indonesia ranges 307/100.000 live births and infant mortality rate (IMR) 35/1.000 live

births, while infant mortality newborn (neonatal) around 20/1.000 live births ( MOH,

2004)

At the 2005 annual report Department of Health Tuban number of new high-risk

pregnancy as much as up to 4088 people, ie as many as 798 people at the health center,

health center aides in as many as 258 people, in Polindes many as 2145 people, in IHC

as many as 378 people and as many as 509 people at Home .

2
The number of pregnant women in yellow Polindes Tasikmadu in 2005 as many as 64

people, belonging to high risk as many as 20 people (45.6%). While that is not classified

as high risk as many as 44 people (54.4%).

From the results of the survey on the researchers wanted to find out how knowledge of

pregnant women about high-risk pregnancy, to the researchers conducted the study.

1.2 Problem formulation

Problem formulation is How the knowledge of high risk pregnant women about

.pregnancy?

1.3 Research Objectives

1.3.1. General Purpose

Knowing the knowledge of high-risk pregnant women about pregnancy

1.3.2. Specific Objectives.

1.3.2.1.Mengidentifikasi maternal characteristics including age, education and

V employment.

1.3.2.2.Mengidentifikasi knowledge of pregnant women about the meaning,

signs and all kinds of high risk pregnancies.

1.4 Benefits of Research

1.4.1. For Researchers

Adds new insight into prenatal care, pregnant women in particular knowledge

.about high-risk pregnancy.

1.4.2. For Educational Institutions

For reading and reference materials in the manufacture of research grade

.younger then.

1.4.3. For Professionals

3
 Expected to provide input for the midwives in providing midwifery care to

..pregnant women in particular counseling on knowledge of high-risk pregnancy.

1.4.4. Community

Can add insight and knowledge of pregnant women about high-risk pregnancy.

4
 CHAPTER 2

REVIEW REFERENCES

In this chapter we will discuss about knowledge, basic concepts of pregnancy and high

risk pregnancies.

2.1 Knowledge

2.1.1 Definition

Knowledge is the result of "know" and it occurs after the person doing the

sensing of a particular object. Sensing occurs through the human senses,

.namely: the senses of sight, hearing, smell, taste and touch. Much of human

.knowledge gained through the eyes and ears (Notoatmodjo, 2003: 126).

...Knowledge or cognitive domain is very important to the formation of one's

...actions. Because of that experience and the research was based on the

.knowledge of the behavior will be more lasting than the behaviors that are not

.based on knowledge (Notoatmodjo, 2003: 127).

2.1.2 Levels of Knowledge.

Knowledge covered in the cognitive domain has six levels, namely:

2.1.2.1 Know (Know)

.5Tahu interpreted as remembering a previously learned material. Included

.in this level is knowledge recall (recall) to a specific weight of all materials

.studied or stimuli that have been received. Therefore, "Know" is a low-level

.knowledge, to measure that people know about what is learned among

.other things: mention, describe, define, declare and so on.

5
..2.1.2.2 Understanding (Compresiension)

.Understanding is defined as an ability to explain the truth about objects

.that are known and can correctly interpret the material. People who have

.better understanding on the object or material must be able to explain, cite

.the example, it concluded, predicting and forth to the object being studied.

.For example, can explain why you should eat nutritious food.

2.1.2.3 Application (Application)

Application is defined as the ability to use a material that has been studied

in a situation or condition of the real (actual). The application here can be

..interpreted application or use of the laws, formulas, methods, principles and

..so in the context or other situations, for example, can use statistical

formulas in the calculations the results of research, can use the principles of

...problem-solving cycle (cycle Problem Solving ) in solving health problems of

a given case.

2.1.2.4 Analysis (Analysis)

Analysis is an ability to describe the material or an object into components,

...but still within an organizational structure, and still have something to do

with one another. The ability of this analysis can be seen from the use of

verbs: to describe (make a chart), distinguishing, separating, grouping and so

on.

..2.1.2.5 Synthesis (Synthesisi)

. Synthesis refers to the ability to place or connect the parts in a whole new

form. In other words, the synthesis is an ability to develop new formulations

..of existing formulations. For example: to prepare, to plan, to summarize, can

..adjust and forth against a theory or formulas that already exist.

6
.2.1.2.6 Evaluation (Evaluation)

.. This evaluation relates to the ability to conduct an assessment of the

..justification or a material or object. Assessments were based on a self-defined

..criteria, or using criteria that already exist. For example: to compare children

..who are well nourished with children who are malnourished, can interpret the

..causes of the mothers did not want to join KB and so on.

..Measurement of knowledge can be done with interviews or questionnaires

..that ask about the content material to be measured from the research

..subjects or respondents. The depth of knowledge we want to know or we can

measure we adjust the levels mentioned above (Notoatmodjo, 2003: 128).

2.1.3 How to Acquire Knowledge

2.1.3.1 Traditional Ways to Acquire Knowledge

This method is used to acquire the knowledge of truth, before the

.discovery of scientific method or methods of the invention systematically

.and logically. The way this knowledge discovery, among others:

a. Trial-and-wrong way (Trial and Error)

This method has been used in people before the culture, perhaps even before the

.existence of civilization. At that time a person when facing issues or problems, the

.solution effort is done by using the possibility to solve the problem, and if that

.possibility does not work, try another possibility. If this second possibility also failed,

.then tried again with the possibility of a third and so on, until the problem can be

.solved. That is why the way is called the method of trial (try) and error (failed or

.wrong) or the method of trial-and-one / trial and error.

7
b. How to Power or Authority

SZ In everyday human life, so many customs and traditions are carried by people,

without going VVthrough the reasoning is done is good or not. For example, why do

mothers who are SSbreastfeeding should drink herbal medicine. From history we know

and we learn that the XXancient royal power is absolute, so anything that comes out of

the mouth of the king is the absolute truth and must be accepted by society or its

people.

M These habits as if received from the source as the absolute truth. The source of such

knowledge may be community leaders in both formal and informal, religious scholars,

holders of government and so on. In other words knowledge is obtained based on the

authority or power, both tradition, government authorities, the authority or power of

science experts.

c. Based on Personal Experience

Experience is a good teacher, so the saying goes. This proverb contains mean that the

Caexperience was a source of knowledge, or experience it is a way to gain knowledge of

.truth. ccTherefore, personal experience was used as a means of gaining

.knowledge.This is done by repeating the experience gained in solving the problems

.encountered, then the other to solve.the same problem, people can also use this

.way.

d. Through Shortcut

ddIn line with the cultural development of mankind. Go the way of thinking evolved

.human being. From this man has been able to use reasoning in acquiring knowledge,

.either through induction or deduction.

ss.Induction and deduction is basically a way of thinking gave birth indirectly through

.the statements put forward, then sought to do so can be made a conclusion that the
8
.specific statements to which the public is called induction. While deduction is a

.conclusion of making public statements to the particular. (Notoatmodjo 2002:8).

2.1.3.2 Simplified Method of Obtaining Knowledge

dd..New or modern ways of acquiring knowledge in today's more systematic, logical

and scientific. This method is called "method of scientific research" or more popularly

called the ss.research methodology.This method was originally developed by Francis

Balloon (1561-1626).He is a character who developed a method of inductive thinking.

At first he held a direct observation of natural phenomena or social observations are

then collected and clarified, and finally the general conclusions drawn. Then the

method of inductive thinking that was developed by the balloon followed by Deobold

Van Dollen. He said that in the conclusion made by conducting direct observation, and

make the recording-recording of all the facts in relation to the object observed. This

recording includes three main points, namely:

a. Everything that is positive, ie, specific symptoms that appear at the time of

..observation.

b. Everything that is negative, ie, certain symptoms that do not appear during

..observation.

c. Symptoms that appear in gravity, ie symptoms that vary in certain conditions

vvv.(Notoatmodjo, 2002: 10)

2.1.4 Characteristics of Pregnant Women.

2.1.4.1 Age

Is the age of individuals starting at birth until a few years. The more

..sufficient age and maturity level of a person's strength will be more mature

..in thinking and working in terms of public confidence in older adults will

9
..have more confidence,than in people not yet high enough maturity. This

.was as a result of the experience of the soul (Nursalam, 2001).

According to the Hanafi (2002) ages are divided into:

a. Age <> 30 years to stop or terminate the pregnancy.

2.1.4.2 Education

Mean educational level of assistance provided by a person against the

,development of other people toward a certain goal. (Sarwono, 1992,

.quoted Nursalam, 2001). Education is one effort to develop the personality

and abilities in and outside of school and lasts a lifetime. (Notoatmodjo,

1993). Education affects the learning process, according to Marta IB (1997),

the higher one's education the easier person to receive the information.

Education is classified into:

1) Higher education: Colleges / PT

2) Education is: Junior / Senior High School

3) Low education: primary school / no school

With higher education then the person will tend to get good information

..from others or from the media. In contrast levels of education and less will

..hinder the development of a person's attitude towards the values of the

..newly introduced (Koentjaraningrat, 1997, quoted Nursalam, 2001).

..Ignorance can be caused by low education, people with low education levels

.. would be too difficult to receive messages, and message digesting the

. .information conveyed (Effendi, 1998).

10
2.1.4.3 Employment

Work is something that is done to get a living or livelihood. Communities are

busy with activities or daily work will have less time to obtain information (MOH,

1996)..With the person's job will require a lot of time and need attention. Busy people

who have little time to get information, so that the knowledge they gain may also

be.reduced (Notoatmodjo, 1997).

Jobs are classified into:

1. Work: workers, peasants, private and civil servants

2. Not working

3.Pregnancy

The gestation period begins from conception until birth of the fetus. The duration of

normal pregnancy is 280 days (40 weeks or 9 months 7 days) calculated from the first

day of last menstrual period. Pregnancy is divided into three quarters, namely the first

quarter starting from conception to 3 months, the second quarter from the fourth

month to 6 months, the third quarter from month 7 to 9 months (Prawiroharjo, 2002:

89).

11
 CHAPTER 3

DISCUSSION

3.1 Discussion

In this chapter will discuss the results of studies specifically about the characteristics

of pregnant women include age, education and employment as well as on knowledge of

pregnant women of high risk pregnancies.

3.1.1 Age

From table 5.1 it was found that most pregnant women at reproductive age is

.15 people (75%). Found also pregnant women aged> 30 years as many as 4

.people (20%) while the mother was pregnant at the age <> 30 years that this

.was due to lack of.understanding of reproductive health problems.

3.1.2 Education

.From Table 5.2 it was found that most pregnant women have a high school

.education background as many as 10 people (50%). Pregnant women also

.found that as many as six junior high school educated people (30%) while

.elementary education as much as people (20%). Ignorance can be caused by

.low education (Mochtar, 1998). The.existence of too low levels of education

.will be difficult to digest the message or the information conveyed (Effendy,

.1998) while according to IB Mantra (1997) higher education a person the

.easier person to receive the information. With higher education then the

.person will tend to get good information from others or from the media,

.otherwise the level of education and less will hinder the development of

12
.a.person's attitude towards the values of the newly introduced

(Koentjoroningrat, 1997. Cited Nursalam, 2001).

The results support existing theories. This may be because the respondents

.have extensive experience and insight that he is able to easily receive the

.information whether the information obtained from print media, electronic

.media or information received from health workers.

3.1.3 Employment

From Table 5.3 it was found that most pregnant women do not work or the

................housewife that is 18 people (90%) while the pregnant mother who worked as

many as two people with the percentage of 10%.

................Low level of flexibility that makes her work difficult to adjust to schedule jobs

and tasks in the home office (Horlock, 1997). Work is an activity that takes

..time to work.for mothers will have an influence on family life (Markum, 1991

..cited by Nursalam..and Siti Pariani, 2001). Pregnancy is not an impediment to

..work as long as according.to their ability and not doing activities that may

..endanger pregnancy (Manuaba,.1998). The results support the theory that

..there is because most pregnant women do..not work, so as to have more

..opportunities to berisitirahat of the respondents worked.

6.1.4 Knowledge of Pregnant Women of High-Risk Pregnancy

.From Table 5.4 obtained from 20 pregnant women that most of the 12 people

..(60%) have sufficient knowledge, both knowledgeable as many as 5 people

..(25%) while..having less knowledge of as many as 3 people (15%).

..The knowledge gained after the person doing the sensing of a particular

..object. Sensing occurs through the human senses are senses of sight, hearing,

..smell, taste and touch. Much of human knowledge gained through the eyes
13
..and ears. Knowledge is a very important factor for the formation of a person's

..behavior (Notoatmodjo, 1997) Efforts to change the behavior of people in the

..health field can be done by providing health education (Effendy, 1998).

From the results showed that maternal knowledge about high-risk

..pregnancies is good enough where it is influenced by education and age of

..respondents.

6.1.5 Knowledge of Pregnant Women of High-Risk Pregnancy by Age

..From Table 5.5 it can be concluded that most pregnant women are 15 people

..(75%) aged between 20-30 years with sufficient knowledge of as many as 8

..people (40%) are knowledgeable both as many as 4 people (20%) and less

..knowledgeable of 3 people (15%). According to the theory cited Hurlock

..Nursalam and Siti Pariani (2001) is getting quite old person's level of maturity

..and strength will be more mature in thinking and working. This was as a result

...of experience and maturity of his soul, the ability to think creatively peaked

..in their twenties. Because the results of this study found the majority of

..pregnant women with sufficient knowledge in the age of 20-30 years of

..varying levels of knowledge are in addition affected by age, according

..to.Nasrul Effendy (1998) there are also other factors include the experience of

..pregnant.women directly and information obtained from the posters, print

..media including magazines, newsletters, newspapers and electronic media

..through radio, computer or television. From the research results obtained in

..accordance with the theory which is getting quite old person's level of

..maturity and strength will be more mature in thinking.

14
6.1.6 Knowledge of Pregnant Women of High-Risk Pregnancy by Education

.From table 5.6 shows that of 20 pregnant women that there are at most 10

.people (50%) high school educated. From high school education who have

.sufficient knowledge of as many as 6 people (30%) while a good

.knowledgeable as many as 4 people (20%).

This is consistent with the statement patrician Kuncoro (1997) cited Nursalam

...(2001) ie the higher one's education the easier it is to receive information so

...that more knowledge. From the research results obtained in accordance with

.the theory. This may be because the respondents have extensive experience

...and insight that he is able to easily receive the information whether the

.information obtained from print media, electronic media or information

....received from health workers so that knowledge is good enough.

..6.1.7 Knowledge about Pregnancy Pregnancy High-Risk Based Work

.From table 5.7 can be seen that from 20 pregnant women obtained most

.mothers do not work or the housewife that is 18 people (90%) with sufficient

.knowledge of as many as 11 people (55%) and good knowledge of as many as

.5 people (25%) and the have less knowledge as much as 2 people (10%).

.With the person's job will require much time and energy to complete the

.work that is considered important and require attention. Busy people who

have little time to obtain information so that the knowledge they gain may also

be reduced (Notoatmodjo, 1997). From the research results obtained in

accordance with the above theory in which many pregnant women who do not

work so if there is new information obtained by a midwife or health worker can

be delivered easily to the respondent.

15
 CHAPTER 4

CONCLUSIONS AND SUGGESTIONS

4.1 Conclusion

.From the results of research conducted at Desa Kemuning Polindes Tasikmadu

Tuban District Cross with 20 pregnant women respondents obtained the following

conclusions:

4.1.1 Characteristics of Pregnant Women

.Respondents were most numerous in the reproductive age between 20-30

.years of age (productive age) with a background of high school education

.while the views of the work available at most pregnant women as housewives.

...4.1.2 Knowledge of Pregnant Women of High-Risk Pregnancy

.In this study of pregnant women obtained knowledge about the definition of

.high risk pregnancies, sorts and a sign of high risk pregnancy is enough.

4.2 Suggestions

From the results above, the researchers hope to convey is that:

1. 43Ibu pregnant routinely check or control on the midwife or health worker that is at

.least 4 .times during pregnancy in order to get information about the person is at

.risk much higher pregnancy.

2. Pregnant women increase their knowledge to be better again to get information from

.print media, electronic or from health professionals.

16
 REFERENCES

Arikunto, Suharsimi (1998) Research Procedures, A Practice Approach. Rinika reserved.

Jakarta.

Mother And Child Health Book of East Java Province, 2002 Bakti Husada

MOH, (2001) National Strategic Plan.

Effendy, Nasrul (1998). Basics of Public Health Nursing. EGC. Jakarta.

Manuaba. Ida Bagus Gde (1998) Obstetrics and Gynecology Family Planning Education

Midwives. EGC. Jakarta

Manjoer. Arif. Triyanti, Kaspuji et al (2001) Capita Selekta Medicine Volume I

Aesculopius media Jakarta.

Nazir, Moh. Ph.D. (2003) Research Methods Gholia Indonesia. Jakarta.

Notoatmodjo, Soekidjo (2002) Health Research Methodology Rineka reserved. Jakarta.

---------- (2003) Education and Health Behavior Rineka Cipta Jakarta

---------- (2003) Community Health Sciences EGC. Jakarta.

Nursalam. (2003) Concept And Implementation Methodology Manual of Nursing

Research Theses And Instruments Nursing Research. Salemba Medika. Jakarta.

Prawirohardjo, Sarwono (2002) Maternal Health Services And Neonotal. Yayasan Bina

Pustaka. Jakarta.

Sugiono. Dr. (1999) Business Research Methods ALFABETA. Bandung.

Widyastuti. Palupi (2003) Mother and Infant Care. EGC. Jakarta.

17
KNOWLEDGE OF PREGNANT WOMEN
HIGH RISK PREGNANCY

By:
EVA YULIANA
NIM:.

HEALTH EDUCATION
ACADEMY MIDWIFERY ADILA

BANDAR LAMPUNG
2011

18
 SUMMARY

Pregnancy as a physiological state can be followed by a pathological process that

threatens the state of the mother and fetus. Health workers should be able to recognize

changes that may occur, so there is disorder that can be recognized early. For example

the changes are edema, lower limb in the last trimester may be physiological but when

accompanied edoma in the upper body like the face and arms, especially when followed

by an increase in blood pressure is suspected pre-eclampsia. The purpose of this study

is to identify characteristics of pregnant women include age, education and jobs in

Myrtle Polindes Cross Village District Tasikmadu Tuban. Identify the knowledge

pregnant women about high-risk pregnancies in Polindes Kemuning Cross Village

Tasikmadu Tuban district, from January to July 2006. This research uses descriptive

method. The population in this study were pregnant women who check in Polindes

Desa Kemuning Tasikmadu Tuban District Cross in January until July 2006. Purposive

sampling technique sampling with a sample size of 20 pregnant women. The research

was conducted in Myrtle Polindes Cross Village District Tasikmadu Tuban district by the

time the study began with the January to July 2006. Analysis of the results of this study

of 20 pregnant women most of the 15 people (75%) aged 20-30 years, an average of 10

high school educated people (10%) and the majority do not work as many as 18 people

(90%). Found also 12 people (60%) knowledgeable enough. Based on the age at most 8

people (40%) aged 20-30 years and the majority of knowledgable enough as many as 11

people (55%) are not knowledgeable enough to work. Conclusions obtained from this

study and most numerous responses in the reproductive age with high school education

background. While the views of most of the work obtained is not working. Knowledge

of pregnant women about high-risk pregnancy is to have enough knowledge. From the

ii19
research results obtained so pregnant women are routinely advised to control and

further enhance their knowledge better.

20
 TABLE OF CONTENTS

OUTSIDE COVER
FOREWORD
LIST

CHAPTER 1 INTRODUCTION
1.1 Background
1.2 Problem formulation
1.3 Research Objectives
1.4 Benefits of Research

CHAPTER 2 OVERVIEW REFERENCES

2.1 Knowledge
2.2 Pregnancy
2.3 Basic Concept of High Risk Pregnancy

CHAPTER 3 DISCUSSION
3.1 Discussion
3.1.1 Age
3.1.2 Education
3.1.3 Employment
3.1.4 Knowledge of Pregnant Women of High Risk Pregnancy
3.1.5 Knowledge of Pregnant Women of High Risk Pregnancy by Age
3.1.6 Knowledge about Pregnancy Pregnancy person is at risk of Appeal by Education
3.1.7 Knowledge of Pregnant Women of High Risk Pregnancy based on the Work

CHAPTER 4 CONCLUSIONS AND RECOMMENDATIONS

4.1 Conclusion
4.1.1 Characteristics of Pregnant Women
4.1.2 Knowledge of Pregnant Women High Risk Pregnancy
4.2 Proposed

REFERENCES

21
iv