The Relationship of Massage the Perineum

with Ruptur Perineum

Fatimah1, Prasetya Lestari2

1,2
Departement of Midwifery, Faculty of Health Science, Universitas Alma Ata, Jalan Brawijaya No. 99,
Yogyakarta, Indonesia 55183
*Coresponding author: [email protected]

ABSTRACT

Backgrounds: The cause of maternal mortality can directly or indirectly. (1) The number of maternal mortality
in DIY years 2014 (40 mothers) decline compared with the years 2013 (46 mothers). In 2015
maternal mortality very significant a decrease in the number of cases to 29. However in 2016
return to 39 cases and 34 in 2017 (2). The cause of Maternal Mortality is most commonly found in
DIY is because the heart (10 cases), embolism (1 cases), shock (3 cases), sepsis/infection (5 cases),
bleeding (5 cases), eclampsia (1 cases), preeclampsia (3 cases), pneumonia (2 cases), hyperthyroid
(2 cases), a seizure hypoxia (1 cases), unknown (1 cases) (3). Still a lot of cases as bleeding one
of the bleedings is the birth canal mother her apart (3). Based on research from Lestari, 2016
in Yogyakarta 50% happen rips the perineum on the number of spontaneous delivery (4). Rips
the perineum could be problematic because of increased morbidities and mortality postpartum
mother.
Objectives: To influence massage the perineum for pregnant women with the perineum rupture.
Methods: Research methodology true-experiment using posttest only control design in community health
center Yogyakarta city. The sample is pregnant women 37-42 week gestational age.
Results: Research pregnant women IRT the largest 56 people (70%), Education is high school 51 people
(63,8%), had a massage the perineum 56 people (70%) and 42,5 people had not to massage the
perineum.
Conclusions: No relationship massage perineum with rupture perineum.

Keywords: Massage the Perineum, Rupture the Perineum

37 Asia-Pasific Partnership On Health And Nutritional Improvement 2019

INTRODUCTION to performs massage the perineum. This background
of the matter over and found how important this
Pregnancy is a physiological process for a issue be examined with expect to minimalize the risk
woman to breed. Pregnancy to be prepared well the perineum rupture during labor.
before delivery. Preparation labor is very important
as an undesirable occurrence it is possible that at
the time of labor and postpartum. Postpartum can MATERIALS AND METHODS
complications like placenta left behind, the rest of
the placenta, atonia uteri, and rupture perineum. Design of research that is used is identification
Rupture perineum is the birth canal mother ruptures pre-experiment using posttest only a fair
when the issuance of the baby either intentionally as compensation including on the instrument types
well as it not been for the less elastic the birth canal academicians as well as national about massage
mother who has just given. the perineum for pregnant women in the long term
Rupture perineum can happen to all the mother the done posttest for pregnant women performs
in labor, can primipara or a multiparous of degrees I massage the perineum or not. As well as true-
to IV. The factor that affects rupture perineum very experiment by the use of posttest only control
much among others of the mother and fetus. Factor group (6) the data used the primary data was need
the mother of parity, consisting of a distance of the is questionnaire sheets was the implementation of
birth of, a way that does not exactly and mother age. massage the perineum and observation rupture the
A factor of a fetus that consists of weight for newborn perineum. While secondary data from the medical
infants and presentation. Factor labor of extraction record to completeness of the identity of pregnant
forceps, extraction, vacuum tools, and episiotomy, women, gymnastic activities massage the perineum
trauma there the helper labor is the leader of a bad and observation rupture the perineum using the test
(1). and been approved Mann-Whitney and Wilcoxon.
The mortality rate in Indonesia is still very high.
According to WHO years 2015 every day there are
RESULTS AND DISCUSSION
830 cases of maternal mortality. Audit trails maternal
perinatal (AMP) found the cause of maternal mortality
in 2015 was heavy pre-eclampsia (PEB) as much as Result Univariate Test
36% (4 cause), case the bleeding as much as 36% (4 Research is pregnant women more than
cases), case pulmonary tuberculosis 18% ( 2 cases), 36 weeks in the Yogyakarta can be seen several
embolism water 9% (1 case). Case the fallout death characteristic of such as education and work.
maternal was 50% postpartum, at the time one of the Table 1. A frequency distribution of pregnant women in
perinea on number increase morbidity and mortality the city of Yogyakarta
postpartum (3).
Rupture the perineum can be minimize by Job f %
through preventive measures during pregnancy No job 56 70.0
and showed you kindness and the act of massage Corporate 15 18.8
the perineum that could be done by for pregnant Employee 9 11,2
women began to get a bit pregnancy 34 week or of
pregnant women and between the ages of pregnancy Based on table 1. The majority of respondents
37-42 week pregnant mother and not suffered in the as a housewife or not a job with 56 people (70,0%).
genital and perineum. Based on the research from On the households, many spent time in a house so
Demirel and Golbasi in 2015, a decrease episiotomy many spare time to learn, especially the provision of
if do massage the perineum (5). education us to pregnant women about massage the
The number of above high in maternal and perineum.
child health problems because rupture perineum
can improve infection and promote maternal
mortality. The city of Yogyakarta in public health has
a population density and use antenatal for pregnancy
and baby labor so this reason wit researchers
interesting of research education pregnant women

Asia-Pasific Partnership On Health And Nutritional Improvement 2019 38

 Table. 2. A frequency distribution education pregnant file with Natami research, most research did not
women the city of Yogyakarta rupture 60% (7).
Education f % The results of the analysis bivariate
Primary School 6 7.5
Table 5. The massage of perineum with ruptur perineum
Junior High School 13 16.3
High School 51 63.8 Level Ruptur perineum
College 10 12.5 Mann-Whitney U 670.000
Wilcoxon W 1265.000
In Table 2. The education in the highest Z -1.373
presents is pregnant women with the education Asymp. Sig. (2-tailed) -0.170
level high schools as many as the 51 people (63.8%). Based on Table 5 result statistic use Mann-
Senior secondary education is the easiest to receive Whitney test is significant result -0.170, it’s mean
information than primary schools or to schools no connection implementation of the massage
junior high school. With college sometimes had perineum with rupture perineum. Reason this
smart and to new receive information. Inline by because researches can’t control pregnancy women
research Anggaeni most high school graduates study to implementation massage perineum or not.
of a number pregnant women. Although was according to the theory massage
Table 3. Frequency distribution in order of pregnant the perineum can improve elasticity perineum and
women or new in the implementation of the massage increase confident mother. This research inconsistent
the perineum with Damirel that massage the perineum this had an
Massage Perineum f % impact on rupture the perineum. From the research
Damirel, etc there are 99 participant was only 13
No massage 24 30
the proportion experienced laceration (4.2%) (4).
Massage 56 70 The result of this research also with the research
Total 80 100 by Dartiwen about massage perineum primigravida
deals with the incident when the town laceration the
perineum time of postpartum (13).
In table 3. Pregnant women who perform
Mother doesn’t massage the perineum risk
massage the perineum through education about
a laceration or rupture as much as 11.2227 times
the perineum highest massage known for pregnant
(95% CI) compared massage perineum. This research
women who performs massage the one as many as
consistent Anggaeni and Martini which is there a
56 people (70%) and perform massage the perineum
connection massage the perineum with rupture
as many as 24 one pregnant women (30%). the reason
the birth canal the research result he declared that
does not perform massage pregnant women because
mother do not a massage the perineum risk 10,280
they felt fear if the perineum massage will happen
times compared with a mother who carried out the
contraction and pain on the perineum massage done
massage during pregnancy (15). In addition, the
by pregnant women own the perineum and tone
research of any impact Natami, etc also massages the
done by her husband from pregnancy more than 36
perineum with level rupture perineum. The research
weeks.
was conducted massage of 10 respondents 6 is the
Table 4. Frequency distribution pregnant women that perineum (60%) to rupture the perineum and there
experienced the perineum immediately after giving
are 3 (30%) to rupture perineum. level 1(10%) where
birth
one respondents who experienced rupture the
Rupture Level f % perineum is level two or two degrees (7). The result
No Rupture 34 42.5 of this research not accordance with Kusuwawati,
Degree I 19 23.8 etc, relationship the antenatal visit with perineal
Degree II 15 18.8 massage for primigravida in labour process and was
Degree III 12 15.0 reduce using tolls as vacuum for easy baby labour.
This research result not accordance with
Karacam (2016), the massage the perineum decrease
Based on table 4. Respondents no highest
the action episiotomy or cutting perineum when
rupture degrees as many as 34 people (42,5%). This
baby will born (12) who supported the research

39 Asia-Pasific Partnership On Health And Nutritional Improvement 2019

from Savitri,etc in years 2015 which the perineum 2015 Jul 26 URL https://www.ncbi.nlm.gov/
a massage for pregnant women who first or pubmed/26410801 di akses 4 April 2017
primigravida leverage with the inscident rupture 7. Machfoedz, I. 2014. Metodologi Penelitian
perineum when will baby born (13). (Kuantitatif & Kualitatif) Bidang Kesehatan,
Keperawatan, Kedidanan, Kedokteran Disertasi
contoh KTI, Skipsi, Tesis. Fitramaya. Yogyakarta.
CONCLUSION AND RECOMMENDATION 8. Natami, Andyna. P, Runiari. N, Mastini. P.
Pengaruh Perineum Massage Terhadap Derajat
The research result from 80 respondents with
Robekan Perineum Pada Ibu Primigravida di BPS
a job as mother biggest not job or in home 56
Widjayati dan BPS Desak Kecamatan Negara.
orang (70%), in terms of education most higt school
SKRIPSI Program Studi Ilmu Keperawatan
education 51 people (63,8) and most ofteb not
Fakultas Kedokteran Universitas Udayana
subjected to rupture the perineum as much massage
http://download.portalgaruda.org/article.
the perineum to rupture the perineum.
php?article=80903&val=956 diakses tanggal
For the health and professional obstetrics is 21 September 2018
emphasized the massage perineum for pregnant
9. Beckmann MM, Stock OM, 2016. Antenatal
women especially in the examination antenatal care
Perineal Massage for Reducing Perineal Trauma,
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Pubmed, https: // www. ncbi. nlm. nih. gov /
cadres.
pubmed / 23633325 diakses 4 April 2017
10. Septianingrum, Y, 2014. Pengaruh Pendidikan
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