Zeitschriftenartikel zum Thema „Involution de Kato“

The involution process during postpartum is a crucial physiological mechanism to avoid postpartum complications. One effort to support uterine involution is with oxytocin massage. There has been a lot of research on oxytocin massage but its effectiveness has not been studied in a wider environment. This study aims to examine articles on the effect of oxytocin massage on uterine involution in postpartum mothers. Researchers used three databases, namely Google Scholar, PubMed and Scopus. Full text, free articles published in the 2014-2024 range with keywords. The keywords used are “pijat oksitosin”, “involusi uterus”, “ibu nifas” in Indonesian. The keywords used in English are "oxytocin massage", "uterine involution", "postpartum". The author uses the PRISMA method and the quality of the articles uses JBI for later review. The results showed that 17 articles met the criteria and were included in the literature review. A total of 14 articles showed results supporting oxytocin massage as having a positive effect on uterine involution compared to controls. Meanwhile, 3 other articles stated there was no difference compared to the control. Measurement of uterine involution using uterine palpation. It can be concluded that oxytocin massage has a significant effect on uterine involution. It is recommended for health workers to teach families in oxytocin massage. Abstrak Proses involusi pada postpartum merupakan mekanisme fisiologi krusial untuk menghindari komplikasi post partum. Salah satu upaya untuk mendukung involusi uteri adalah dengan pijat oksitosin. Telah banyak dilakukan penelitian pijat oksitosin namun belum dikaji tentang efektivitasnya pada lingkungan yang lebih luas. Penelitian ini bertujuan mengkaji artikel pengaruh pijat oksitosin terhadap involusi uterus pada ibu postpartum. Peneliti menggunakan tiga database yaitu google scholar, pubmed dan scopus. Artikel full teks, gratis yang terbit dalam rentang 2014-2024 dengan kata kunci Kata kunci yang digunakan adalah “pijat oksitosin”, “involusi uterus”, “ibu nifas” dalam Bahasa Indonesia. Kata kunci yang digunakan dalam Bahasa inggris adalah “oxytocin massage”, “uterine involution”, “postpartum”. Penulis menggunakan metode PRISMA dan kualitas artikel menggunakan JBI untuk kemudian di tinjau. Hasil didapatkan 17 artikel yang memenuhi kriteria dan dimasukkan dalam review literatur. Sebanyak 14 artikel yang menunjukkan hasil mendukung pijat oksitosin memberikan efek positif terhadap involusi uterus dibandingkan kontrol. Sedangkan 3artikel lainnya menyatakan tidak ada perbedaan dibandingkan dengan kontrolnya. Pengukuran involusi uteri menggunakan palpasi uterus. Dapat disimpulkan bahwa pijat oksitosin berpengaruh signifikan terhadap involusi uterus. Disarankan bagi tenaga kesehatan untuk mengajarkan keluarga dalam pijat oksitosin.

ABSTRACT Background Failed process involution uterus puerperal can cause bleeding. Back Massage and postpartum gymnastics can stimulate hormone oxytocin causes uterine contractions.Purpose identify Comparison of Back Massage and Postpartum Gymnastics on Involuntary Uterine in Post Partum. Method research design used quasi experimental with post test only non equivalent control group design. Samplings using quota sampling 90 respondents divided into 3 groups. Bivariable analysis using repeated measurement with clinical significance used mean 95% interval with P<0.05, multivariable analysis using linear regression. Result shows a significant difference of uterine involution in each group, overall mean -1.700 (95% CI:-2,26 - (-1,37) with P<0.05, back massage group using Clary-sage essential oil compared to gymnastics postpartum group. Back massage group using Clary-sage essential oil (salvia sclarea) showed faster processes of uterine involution than post-partum gymnastics group. Multivariable analysis showed value of P<0.05 with regression coefficient of back massage 0.835 (CI-0.799-1.091), suggesting significantly greater association of uterine involution in back massage intervention group after controlled by parity variables and maternal age, with adjusted values R2 0.621, it means reduction in fundal uteri level 62,1% in a day.Conclusion is mothers who received back massage using Clary-sage essential oil experienced faster uterine involutions compared with other groups of postpartum Suggestion Further research is needed in order to identify the effect of back using Clary sage essential oil on uterine involution of oxytocin hormone levels through venous blood tests before and after intervention, so as to identify with certainty the effect of back massage using Clary sage essential oil accurately in increasing hormone concentrations. oxytocin in the blood. Keywords : Back Massage, Postpartum Gymnastics, Involution uterus ABSTRAK Latar Belakang Involusi uteri masa nifas gagal mengakibatkan perdarahan. Back Massage dan senam nifas merangsang hormon oksitosin memicu kontraksi uterus. Tujuan mengidentifikasi Perbandingan Back Massage dan Senam Nifas terhadap Involusi Uteri.Metode penelitian menggunakan quasi eksperimental with post test only non equivalent control group design, pengambilan sampel dengan quota sampling sampel sebanyak 90 responden dibagi 3 kelompok. Analisis bivariabel menggunakan repeated measurement dengan kemaknaan klinis mean dan cofidence interval 95% dengan nilai P<0,05, analisis multivariabel menggunakan regresi linier. Analisis bivariabel menunjukkan terdapat perbedaaan involusi uteri pada masing-masing kelompok, Δoverall mean -1.700(95% CI:-2,26-(-1,37) dengan nilai p<0.05 yakni kelompok back massage menggunakan minyak esensial Clary sage menunjukkan involusi uteri lebih cepat dibandingkan dengan kelompok senam nifas secara signifikan.Hasil analisis multivariabel menunjukkan nilai p<0,05 dengan koefisien regresi pijat punggung sebesar 0,835 (CI-0,799-1,091). Adanya hubungan yang bermakna bahwa involusi uteri lebih cepat pada kelompok intervensi pijat punggung setelah dikontrol dengan variabel paritas dan umur ibu, dengan nilai adjusted R2 sebesar 0,621, yakni penurunan tinggi fundus uteri mencapai 62,1% perhari.Kesimpulan dari penelitian ini Ibu yang mendapatkan intervensi pijat punggung menggunakan minyak esensial Clary sage mengalami involusi uteri lebih cepat dibandingkan dengan kelompok lain.Saran Perlu dilakukan penelitian lanjutan agar dapat mengidentifikasi pengaruh back menggunakan minyak esensial Clary sage terhadap involusi uteri terhadap kadar hormon oksitosin melalui pemeriksaan darah vena sebelum dan sesudah dilakukan intervensi, sehingga dapat mengidentifikasi secara pasti pengaruh pijat punggung menggunakan minyak esensial Clary sage secara akurat dalam meningkatkan kosentrasi hormon oksitosin dalam darah. Kata kunci : Back Massage, Senam Nifas, Involusi uterus

ABSTRAKLatar Belakang : Involusi uterus adalah suatu proses dimana uterus kembali ke kondisi sebelum hamil. Proses ini dimulai segera plasenta lahir akibat kontraksi otot-otot polos uterus (Ambarwati, 2009). Senam nifas adalah latihan jasmani yang dilakukan setelah melahirkan, dimana fungsinya adalah untuk mengembalikan kondisi kesehatan, untuk mempercepat penyembuhan, mencegah timbulnya komplikasi, memulihkan dan memperbaiki regangan pada otot – otot setelah kehamilan (Ervinasby, 2008). Tujuan : Penelitian ini bertujuan untuk Mengetahui Pengaruh senam nifas terhadap involusi uterus pada ibu post partum Di Puskesmas Mariana Kabupaten Banyuasin tahun 2020. Metodologi : Penelitian ini Merupakan penelitian Kuantitatif dengan pendekatan quasi eksperimen dengan rancangan pretest posttest dengan kelompok kontrol (pretest-posttest with control group). Hasil : Hasil Penelitian menunjukan bahwa rerata involusi uterus pada kelompok Kontrol (Tidak melakukan senam Nifas) adalah 5,30+0,67 cm, rerata kelompok perlakuan (melakukan Senam Nifas) adalah 3,00+1,05 cm. Analisis kemaknaan dengan uji Mann Withney menunjukkan bahwa nilai p = 0,000. Hal ini berarti bahwa kedua kelompok sesudah diberikan perlakuan, rerata Involusi Uterus berbeda secara bermakna (p<0,05). Kesimpulan : Involusi uterus kelompok kontrol (Tidak melakukan senam) sesudah/Pengukuran ke dua terjadi penurunan involusi uterus dan Involusi uterus kelompok Perlakuan (melakukan senam nifas) sesudah senam nifas terjadi penurunan involusi uterus secara signifikan. Berdasarkan hasil tersebut, dapat disimpulkan bahwa Ada pengaruh senam nifas terhadap involusi uteri. Kata kunci : senam nifas, involusi uterusTHE EFFECT OF PUERPERAL GYMNASTICS ON UTERINE INVOLUTION IN POST PARTUM MOTHERS AT MARIANA PUBLIC HEALTH CENTER BANYUASIN DISTRICT IN 2020 ABSTRACTBackground : Uterine involution, a process by which the uterus returns to its pre-pregnancy. This process begins as soon as the placenta is born as a result of contraction of the smooth muscles of the uterus (Ambarwati, 2009). Postpartum gymnastics is a physical exercise performed by mothers after childbirth, where its function is to restore health, to accelerate healing, prevent complications, restore and improve stretch in the muscles after pregnancy (Ervinasby, 2008). Purpose : This study aims to determine the effect of postpartum exercise on uterine involution in post partum mothers at the Mariana Health Center, Banyuasin Regency in 2020. Methods : This research is a quantitative research with a quasi-experimental approach with a pretest-posttest design with a control group (pretest-posttest with control group). Results : The results showed that the mean uterine involution in the Control group (not doing postpartum exercise) was 5.30 + 0.67 cm, the mean for the treatment group (doing postpartum exercise) was 3.00 + 1.05 cm. The analysis of significance using the Mann Withney test showed that the value of p = 0.000. This means that after being given treatment, the mean Uterine Involution was significantly different (p <0.05). Uterine involution in the control group (did not do exercise) after / The second measurement there was a decrease in uterine involution and uterine involution in the Treatment group (doing puerperal exercise) after the puerperal exercise decreased uterine involution significantly. Based on these results, it can be concluded that there is an effect of postpartum exercise on uterine involution. Keywords : puerperal gymnastics, uterine involution

ABSTRAKLatar Belakang Masalah. Kegagalan involusi uterus untuk kembali pada keadaan tidak hamil akan menyebabkan sub involusi yang menyebabkan perdarahan masa postpartum. Angka Kematian Ibu karena perdarahan post partum mempunyai peringkat tertinggi dimana salah satu penyebab perdarahannya adalah subinvolusi uteri. Swedish Massage Therapy (SMT) mempertahankan kesehatan dan menambah baiknya fungsi tubuh, merangsang pengeluaran hormone endorphin yang melancarkan reflek let down untuk mengeluarkan hormon oksitosin. Tujuan penelitian untuk mengetahui pengaruh Swedish Massage Therapy (SMT) pada ibu pospartum sebagai upaya penatalaksanaan involusi uteri di wilayah Cilacap Kota. Metode: Studi eksperimental dengan Posttest Only Control Group Design. Alat yang digunakan dalam penelitian berupa metline. Diberikan perlakuan SMT pada kelompok intervensi dan tidak diberi perlakuan SMT pada kelompok kontrol, kemudian dilakukan pengukuran tinggi fundus uteri hari ke-3 dan hari ke-5. Pengambilan sampel menggunakan teknik incidental sampling sebesar 30 responden. Data dianalisis dengan uji Mann Whitney melalui program SPSS 20. Hasil penelitian. Terdapat perbedaan yang signifikan penurunan tinggi fundus uteri antara kedua kelompok pada hari ke-3 (p=0,31) dan hari ke 5 (p=0,33). Dari hasil penelitian dapat disimpulkan bahwa Swedish Massage Therapy (SMT) berpengaruh pada ibu postpartum sebagai upaya percepatan involusi uteri di wilayah Cilacap Kota. Kata Kunci: SMT, Involusi, Pospartum SWEDISH MASSAGE THERAPY ATTEMPTS TO ACCELERATE INVOLUTION OF UTERI IN THE POSPARTUM MOTHER REGION IN CILACAP CITYABSTRACTBackground problem. Failure of the involution of the uterus to return to the Unexpectant state will cause a sub involution that causes the bleeding of postpartum period. The maternal mortality rate of post-partum hemorrhage has the highest ranking in which one of the causes of the land is the uterine atony or the involution of utero. Swedish Massage Therapy (SMT) maintains health and augments body function, stimulating the production of endorphin hormone that launches a quick reflec let down to secrete oxytocin hormones. The research aims to determine the effect of the Swedish Massage Therapy (SMT) on the Pospartum mother as an effort to manage utero involution in Cilacap Kota. Methods: Experimental studies with Posttest Only Control Group Design. The tools used in the study of the Metline. Administered SMT treatment in the intervention group and was not given SMT treatment in the control group, then carried out the high measurement of Fundus utero Day 3 and day-5. Sampling using the incidental sampling technique of 30 respondents. The Data is analyzed by Mann Whitney test statistic through the SPSS 20 program. Research results. There is a significant difference in the high decline of utero fundus between the two groups on day 3 (P = 0.31) and day 5 (P = 0.33). From the results of the study can be concluded that the Swedish Massage Therapy (SMT) has an effect on the mother postpartum as an attempt to accelerate utero involution in the area of Cilacap Kota. Keywords: SMT, Involusi, Pospartum

Latar Belakang: Masa nifas merupakan masa krusial bagi petugas kesehatan untuk memantau kondisi ibu. Pada masa ini, organ reproduksi mengalami involusi dan kembali ke kondisi sebelum hamil. Namun jika proses involusi uterus gagal maka dapat terjadi subinvolusi uterus. Kegagalan ini dapat disebabkan oleh tertahannya fragmen plasenta, infeksi, atau pendarahan yang terus menerus. Beberapa faktor seperti usia, paritas, senam nifas, inisiasi menyusui dini (IMD), mobilisasi dini, nutrisi, dan penggunaan stagen dapat mempengaruhi dan mempercepat proses involusi. Stagen mengacu pada cara tradisional yang digunakan masyarakat Jawa untuk merawat penampilan fisik wanita pasca melahirkan. Penggunaan stagen selama 40 hari diyakini efektif mengencangkan perut dan membantu involusi rahim.Tujuan: Penelitian ini dilakukan untuk menilai efektivitas penggunaan stagen terhadap involusi uterus pada ibu nifas di TPMB Ponirah Kota Metro Lampung Tahun 2023.Metode: Penelitian dilakukan dengan menggunakan desain penelitian quasi eksperimen dengan pendekatan dua kelompok dan jumlah responden sebanyak 30 orang, yang terbagi menjadi 15 kelompok kontrol dan 15 kelompok intervensi. Analisis data meliputi analisis univariat, bivariat, dan multivariat.Hasil: Hasil penelitian menunjukkan efektivitas penggunaan stagen terhadap involusi uterus pada ibu nifas di TPMB Ponirah Kota Metro tahun 2023 dengan nilai P value sebesar 0,014.Kesimpulan: Terdapat pengaruh penggunaan stagen terhadap tinggi fundus uteri ibu nifasSaran : Wanita pasca melahirkan disarankan menggunakan stagen untuk mempercepat proses pemulihan di masa nifas. Kata Kunci: Stagen, Involusi Uterus, Masa Nifas, Wanita Nifas ABSTRACT Background: The postpartum period is a crucial time for health workers to monitor the mother's condition. During this time, the reproductive organs go through involution, returning to their pre-pregnancy state. However, if the uterine involution process fails, it can lead to uterine subinvolution. This failure can be caused by retained placental fragments, infection, or continued bleeding. Several factors, such as age, parity, postpartum exercises, early breastfeeding initiation (IMD), early mobilization, nutrition, and the use of stagen can influence and accelerate the process of involution. Stagen refers to traditional methods used by the Javanese community to care for postpartum women' physical appearance. The use of stagen for 40 days is believed to be effective in firming the abdomen and aiding in uterine involution.Aim: This study was conducted to assess the effectiveness of stagen use on uterine involution in postpartum women at TPMB Ponirah Metro City, Lampung in 2023.Methods: The research was conducted using a quasi-experimental research design with a two-group approach and a total of 30 respondents, split into 15 control group and 15 intervention group. Data analysis involved univariate, bivariate, and multivariate analysis.Results: The results showed the effectiveness of using stagen for uterine involution in postpartum women at TPMB Ponirah Metro City in 2023, with a P value of 0.014.Conclusion: There is an effect of stagen use on the uterine fundal height of postpartum womenSuggestion: Postpartum women are advised to use stagen to accelerate the recovery process during the postpartum period. Keywords: Stagen, Uterine involution, Postpartum period, Postpartum women

Abstrak: Masa nifas dapat diartikan masa dimana dimulainya dari plasenta telah keluar dan selesai saat alat-alat kandungan kembali seperti keadaan semula atau seperti sebelum hamil, masa ini terjadi sekitar 6 minggu. Tujuan pada penelitian kali ini untuk mengetahui hubungan senam nifas otaria dengan involusi uteridi PMB Juwarti Amd. Keb Desa Tanon Kecamatan Papar Kabupaten Kediri. Jenis penelitian yang digunakan adalah penelitian kuantitatif analitik dengan metode One group pre-post test design yang dilakukan pada bulan Juni hingga Juli 2021 dengan total jumlah populasi sejumlah 27 orang. Sampel semua ibu nifas di PMB Juwarti Amd. Keb Desa Tanon Kecamatan Papar Kabupaten Kedirisejumlah 15 orang. Hasil uji analisa menunjukkan hubungan yang bermakna tentang frekuensi senam nifas otaria terhadap resiko mengalami involusi uteri selama masa nifas. diperoleh hasil nilai signifikan < α yaitu 0.002, sehingga dapat disimpulkan bahwa frekuensi senam nifas otari yang lebih sering menurunkan faktor ibu nifas mengalami involusi uteri selama masa nifas.Kesimpulan pada penelitian ini adalah hasil nilai signifikan < α yaitu 0.002, sehingga dapat disimpulkan bahwa frekuensi senam nifas otari yang lebih sering menurunkan faktor ibu nifas mengalami involusi uteri selama masa nifas. Bagi Bidan diharapkan agar mempertahankan pelayanan senam nifas otaria sehingga dapat mempercepat terjadi uterus ke bentuk normal serta kondisi ibu nifas cepat pulih seperti sebelum hamil. Kata Kunci :Senam Nifas Otaria, Involusi Uteri Abstract : The puerperium can interpreted as the period that begins after the placenta comes out and ends when the uterine organs return to their original state (before pregnancy), the puerperium periode lasts about 6 weeks. The purpose of this study was to determine the relationship between postpartum otaria exercise and uterine involution at PMB Juwarti Amd. Keb, Tanon Village, Papar District, Kediri Regency. This research is a quantitative research in analytical from using the One group pre-post test design method and was carried out from June to July 2021 with a population of 27 people. Based on a sample of all postpartum mothers at PMB Juwarti Amd. Keb, Tanon Village, Papar District, Kediri Regency. There are 15 people in the PMB Juwarti Amd. Keb, Tanon Village, Papar District, Kediri Regency. The results of the analysis test showed a significant relationship about the frequency of otarial puerperal exercise to the risk of experiencing uterine involution during the puerperium period. The results obtained a significant value < α 0.002, so it can be concluded that the frequency of otaria puerperal exercise which is more frequent decreases the postpartum mother’s factor. Uterine involution during the puerperium. The conclusion in this study is the result of a significant value < α which is 0.002, so it can be concluded that the frequency of otaria puerperal exercise which is more frequent reduces the factor that postpartum women experience uterine involution during the postpartum period. Midwives are expected to maintain otaria puerperal gymnastics services so that it can accelerate the occurrence of the uterus to a normal shape and the condition of the postpartum mother recovers quickly as before pregnancy. Keywords : Otaria Postpartum Gymnastics, Uterine Involution

Background: One of the factors that influence uterine involution is early initiation of breastfeeding (IMD). When breastfeeding occurs stimulation and the release of hormones, including oxytocin, which functions in addition to stimulating contraction of the smooth muscles of the breast, also causes uterine muscle contraction and retraction. This will put pressure on the blood vessels resulting in reduced blood supply to the uterus. This process helps to reduce the placenta implantation site or site as well as reduce bleeding. The Maternal Mortality Rate (MMR) in Indonesia is 250 / 100,000 (KH). one of them is caused by bleeding. One of the causes of bleeding is the sub-involution of the uterus. Uterine involution or uterine contraction is a process by which the uterus returns to its pre-pregnancy state.Purpose: To determine the influencing of early initiation of breastfeeding on uterine involution.Methods: The study was carried out by early initiation of breastfeeding and observation and measuring the height of the uterine fundus (TFU) to assess uterine involution. The design of this study used an analytical survey method with a Cohort research design. This study used primary data. The population in this study were all women with normal gestational age at the Independent Practice Midwives (BPM) Choirul Mala and PMB Fauziah Hatta. The sampling technique was non propability sampling with purposive technique. The sample size was n1 = n2 for each group of 48 people. The analysis used univariate and bivariate with Chi Square. The study was conducted at BPM Choirul Mala and BPM Fauziah Hatta from December 2018 to February 2019.Results: The results of data analysis from 96 respondents showed that the proportion of non-initiation of early breastfeeding with abnormal uterine involution was 45.8% smaller than those with early initiation of breastfeeding as much as 0%. The results of the Chi-square statistical test showed that the p value = 0.00 was smaller than 0.05, this indicated that there was an influencing of early initiation of breastfeeding on uterine involution with an OR: 0.083.Conclusion: There was an influencing of early initiation of breastfeeding on uterine involution in BPM Choirul Mala and BPM Fauziah Hatta in 2019 Suggestion: It is expected that midwives, to carry out their role in carrying out midwifery care by providing education to pregnant women about early initiation of breastfeeding and its benefits and consistently doing IMD in maternity mothers for at least 1 hour. Keywords: Early Initiation of Breastfeeding, Uterine Involution ABSTRAK Latar Belakang : Salah satu faktor yang mempengaruhi involusi uterus adalah Inisiasi menyusu Dini (IMD). Saat menyusui terjadi rangsangan dan dikeluarkannya hormon antara lain oksitosin yangberfungsi selain merangsang kontraksi otot-otot polos payudara, juga menyebabkan terjadinya kontraksi dan retraksi otot uterus. Hal ini akan menekan pembuluh darah yang mengakibatkan berkurangnya suplai darah ke uterus. Proses ini membantu untuk mengurangi situs atau tempat implantasi plasenta serta mengurangi perdarahan. Angka Kematian Ibu (AKI) di Indonesia adalah 250/100.000 (KH). salah satunya disebabkan oleh perdarahan. Penyebab perdarahan salah satunya yaitu sub involusi uterus. Involusi uterus atau pengerutan uterus merupakan suatu proses dimana uterus kembali ke kondisi sebelum hamil.Tujuan : Mengetahui pengaruh inisiasi menyusu dini terhadap involusi uterus.Metode : Penellitian dilakukan dengan cara melakukan inisiasi menyusu dini dan observasi serta mengukur Tinggi Fundus Uteri (TFU) untuk menilai involusi uteri. Desain penelitian ini menggunakan metode survey analitik dengan rancangan penelitian Cohort. Penelitian ini menggunakan data primer. Populasi dalam penelitian ini adalah seluruh ibu bersalin normal dengan usia kehamilan aterm di Bidan Praktik Mandiri (BPM) Choirul Mala dan PMB Fauziah Hatta. Tehnik Pengambilan sampel secaranon propability sampling dengan teknik purposive. Besar sampel n1 =n2 masing-masing 48 orang setiap kelompok.Analisa yang digunakan univariat dan bivariat dengan Chi Square. Penelitian dilakukan di BPM Choirul Mala dan BPM Fauziah Hatta pada bulan Desember 2018 sampai dengan Februari 2019.Hasil : Hasil analisis data dari 96 responden, didapatkanproporsi tidak inisiasi menyusu dini dengan involusi uterus tidak normal sebanyak 45,8 % lebih kecil daripada yang inisiasi menyusu dini sebanyak 0 %. Hasil uji statistik Chi-squarediperoleh nilai p value = 0,00 lebih kecil dari 0,05 hal ini menunjukkan bahwa ada pengaruh inisiasi menyusu dini terhadap involusi uterus dengan nilai OR : 0,083.Kesimpulan : Ada pengaruh inisiasi menyusu dini terhadap involusi uterus di BPM Choirul Mala dan BPM Fauziah Hatta tahun 2019Saran : Diharapkan kepada bidan, untuk menjalankan perannya dalam melakukan asuhan kebidanan dengan memberikan edukasi pada pada ibu hamil tentang inisiasi menyusu dini dan manfaatnya serta secara konsisten melakukan IMD pada ibu bersalin mimimal selama 1 jam. Kata Kunci : Inisiasi Menyusu Dini, Involusi Uterus

Kembalinya alat-alat reproduksi seperti sebelum hamil membutuhkan kandungan gizi yang cukup bagi ibu. Makanan yang dikonsumsi ibu nifas harus bermutu, bergizi, dan cukup kalori. Dimana makanan yang dikonsumsi berguna untuk melakukan aktifitas, metabolisme, proses memproduksi ASI, sebagai ASI sendiri yang akan dikonsumsi oleh bayi untuk pertumbuhan dan perkembangan bayi, serta mempertahankan tubuh terhadap infeksi. Tujuan penelitian yaitu untuk mencari pengaruh edukasi berbasis edutainment tentang gizi laktasi, involusio uteri dan lokhea terhadap peningkatan pengetahuan, sikap dan perilaku ibu nifas. Metode Penelitian menggunakan Quasi Eksperimen dengan rancangan Non Equivalent Control Group Design. Di dalam desain ini observasi dilakukan sebanyak 2 kali yaitu sebelum dilakukan perlakuan dan sesudah dilakukan perlakuan. Pada kelompok intervensi dan kelompok kontrol masing-masing dilakukan pretest dan post test. Populasi dalam penelitian ini adalah seluruh ibu Nifas yang berada di RSKDIA Pertiwi dan RSKDIA Siti Fatimah Makassar sebanyak 5843 ibu nifas. Berdasarkan dari hasil perhitungan diatas didapatkan jumlah sampel sebesar 47 orang kelompok intervensi di RSKDIA Pertiwi Makassar dan 47 orang kelompok kontrol di RSKDIA Siti Fatimah Makassar dengan menggunakan teknik Purposive Sampling. Hasil penelitian menunjukkan bahwa terdapat pengaruh signifikan antara pengetahuan dengan edukasi berbasis edutainment tentang gizi laktasi, involusi uteri, dan lochea. Hasil penelitian menunjukkan bahwa terdapat pengaruh signifikan antara sikap dengan edukasi berbasis edutainment tentang gizi laktasi, involusi uteri, dan lochea. Hasil penelitian menunjukkan bahwa terdapat pengaruh signifikan antara perilaku dengan edukasi berbasis edutainment tentang gizi laktasi, involusi uteri, dan lochea. Saran kepada bidan yang bertugas di daerah khususnya di RSKDIA Pertiwi Makassar dan RSKDIA Siti Fatimah Makassar agar lebih meningkatkan kinerja serta perhatiannya dalam memberikan informasi tentang gizi laktasi, involusi uteri, dan lochea Kata Kunci : Edukasi, Gizi Laktasi, Involusio Uteri, Lokhea, Pengetahuan, Sikap dan Perilaku. ABSTRACT The return of reproductive organs before pregnancy requires sufficient nutritional content for the mother. The food consumed by the puerperal mother must be of high quality, nutritious, and sufficiently caloric. Where the food consumed is useful for activities, metabolism, and the process of producing breast milk, as its own milk that will be consumed by the baby for the growth and development of the baby, as well as defending the body against infections. The purpose of this study is to find the influence of edutainment-based education on lactation nutrition, uterine and lochia involution on increasing the knowledge, attitudes and behaviors of puerperal mothers. This study used the Quasi-Experimental design method with a Non-Equivalent Control Group Design. In this design, observations are carried out as many as 2 times, namely before treatment and after treatment. In the intervention group and the control group, pre-test and post-test were carried out, respectively. The population in this study was all Puerperal mothers who were at RSKDIA Pertiwi and RSKDIA Siti Fatimah Makassar as many as 5843 puerperal mothers. Based on the results of the calculations above, the number of samples was obtained by 47 intervention groups at RSKDIA Pertiwi Makassar and 47 control groups at RSKDIA Siti Fatimah Makassar using the Purposive Sampling technique. The results showed that there was a significant influence between knowledge and edutainment-based education about lactation nutrition, uterine involution, and lochia. The results showed that there was a significant influence between attitudes and edutainment-based education about lactation nutrition, uterine involution, and lochia. The results showed that there was a significant influence between behavior and edutainment-based education about lactation nutrition, uterine involution, and lochia. It is recommended to midwives who serve in the regions, especially at RSKDIA Pertiwi Makassar and RSKDIA Siti Fatimah Makassar to further improve their performance and attention in providing information about lactation nutrition, uterine involution, and lochia Key Words: Education, Lactation Nutrition, Uterine Involution, Lochia, Knowledge, Attitudes and Behaviors.

Abstract Epidemiological data links higher parity and lack of breastfeeding with increased risk of breast cancer, specifically aggressive triple negative breast cancer, and associated higher mortality rate. Long-term breastfeeding and gradual weaning of an infant leads to gradual involution (GI) of the breast, while lack of or abrupt discontinuation of breastfeeding after birth leads to abrupt involution (AI), when rapid and massive cell death takes place. Our studies show several precancerous changes, such as increased collagen deposition, inflammation, and hyperplasia in the mammary gland (MG) of mice after AI1. Recent studies indicate peroxisome proliferator-activated receptor-gamma coactivator 1-apha (PGC1α) as a regulator of involution and energy metabolism. As metabolic reprogramming is a hallmark of cancer, metabolic changes in the MG related to involution warrant investigation. Objective: Our objective was to evaluate the metabolic effects of AI in MG. We hypothesized that AI leads to marked alteration in mammary lipid metabolism, mitochondrial biogenesis, and oxidative stress through elevations of PGC1α, which cause long-term metabolic reprogramming and genomic instability. Methods: FVB/n mice were paired for breeding. At partum, dams were randomized to AI or GI cohort and standardized to 6 pups per dam. AI mice had pups removed on day 7 postpartum (PPM). For GI mice 3 pups each were removed on day 28 and 31ppm. Tissues were harvested on day 28, 56, and 120 PPM. MG were subjected to Affymetrix, Gene Set Enrichment Analysis (GSEA), Seahorse Analysis, and lipidomics. Results were validated by qPCR and Western Blot. Superoxide species were detected by flow cytometry. DNA damage was analyzed via 8-hydroxy-2’-deoxygnuanosine (8-OHdG) ELISA. Results: Day 28 AI glands had significantly higher PGC1α expression than GI glands (p=0.006). Affymetrix and GSEA data showed day 28 AI glands to have enriched pathways related to fatty acid metabolism (p=0.004) and oxidative phosphorylation (p&lt;0.001). Lipidomics showed elevated levels of oxidized sphingolipids and production of prostaglandin J2 (PGJ2) in day 28 AI glands (all p&lt;0.02). Day 56 AI glands had higher levels of mitochondria superoxide species (p&lt;0.0001) and higher PGJ2 synthesis (p=0.01). Day 120 AI MG had upregulation of an oxidized lipid (p=0.0476). Day 120 AI glands had significantly higher 8-OHdG levels (p=0.02), higher reliance of fatty acid substrates for energy (p=0.0185), and elevated extracellular acidification rates (p=0.0194). Conclusion: Although histologically both GI and AI MG return to near pre-pregnancy state within a month, our data shows long-term metabolic reprogramming in the AI MG similar to what is shown in breast cancer cells. These metabolic changes link to early elevations in PGC1α. Addressing the metabolic changes by targeting PGC1α provide a potential option to reduce the risk of developing breast cancer if a woman is unable to breastfeed. PMID6637535 *Fellowship T32CA229114 Citation Format: Kate S Ormiston, Kirti Kaul, Neelam Shinde, Gautam Sarathy, Morgan Bauer, Djawed Bennouna, Rachel Kopec, Ramesh Ganju, Sarmila Majumder, Bhuvaneswari Ramaswamy. Elevated PGC1α during abrupt mammary gland involution leads to long-term metabolic reprogramming and genomic instability; hallmarks of breast cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr A045.

Failure of the uterus to contract after childbearing is one in all the causes of maternal death. Numerous makes an attempts were created to enhanced the power of the uterus to contract. The aim of the study was to compare the effectiveness of postpartum exercise with early mobilization of uterine involution in normal postpartum. This type of research was a quasi-experimental design with a pretest and posttest design group. This research was implemented in midwives practicing independently. The population of this study was all normal postpartum. The sample of the study was 34 normal postpartum, aged 20-35 years, 2-4 parity, baby born healthy, postpartum haemoglobin ≥ 10.5 gr%, exclusively breastfeeding. Early mobilization was carried out after two hours postpartum and postpartum exercise was carried out for six days. Measurement of the postpartum fundal height was performed on days 1st, 3rd and 7th using a caliper pelvimeter. Consecutive sampling was used in this study. The difference between the two groups was analyzed by unpaired t-test and Mann Whitney U-test. There was a difference in the height of the uterine fundus on the third and seventh postpartum days between the two groups. Postpartum exercise was more effective than early mobilization in accelerating uterine involution. Therefore, it is expected that midwives can facilitate mothers to do postpartum exercise from the first day of postpartum. Keywords: postpartum exercise; early mobilization; postpartum; involution; uterus ABSTRAK Salah satu proses penting pada masa nifas adalah pemulihan organ reproduksi yang ditandai dengan penurunan tinggi fundus uteri dan derajat kontraksi uterus. Secara bertahap, uterus yang berkontraksi dengan baik akan berkurang ukurannya sampai tidak dapat dipalpasi lagi di atas simfisis pubis. Diantara faktor yang berperan dalam kontraksi uterus adalah mobilisasi dini dan senam nifas. Tujuan penelitian adalah untuk membandingkan efektifitas mobilisasi dini dan senam nifas terhadap involusi uterus pada ibu postpartum normal. Jenis penelitian adalah desain kuasi eksperimental dengan kelompok pre dan posttest. Responden penelitian adalah 34 orang ibu postpartum, usia 20-35 tahun di Bidan Praktek Mandiri Kota Pematangsiantar, Juni-September 2016. Teknik pengambilan sampel adalah consecutive sampling sesuai dengan kriteria inklusi. Dilakukan senam nifas pada kelompok intervensi dan mobilisasi dini pada kelompok kontrol. Pengukuran tinggi fundus uteri dilakukan sebelum dan setelah perlakuan pada hari ke-1, -3 dan -7. Analisa data menggunakan uji t-tak berpasanagn dan Mann Whitney menggunakan SPSS versi 20.0. Terdapat perbedaan tinggi fundus uteri hari ke-3 dan ke-7 antara senam nifas dan mobilisasi dini. Senam nifas lebih efektif menurunkan tinggi fundus uteri dibandingkan mobilisasi dini. Bidan diharapkan dapat memfasilitasi ibu melakukan senam nifas sejak hari pertama postpartum. Kata kunci: senam nifas; mobilisasi dini; postpartum; involusi; uterus

Failure of the uterus to contract after childbearing is one in all the causes of maternal death. Numerous makes an attempts were created to enhanced the power of the uterus to contract. The aim of the study was to compare the effectiveness of postpartum exercise with early mobilization of uterine involution in normal postpartum. This type of research was a quasi-experimental design with a pretest and posttest design group. This research was implemented in midwives practicing independently. The population of this study was all normal postpartum. The sample of the study was 34 normal postpartum, aged 20-35 years, 2-4 parity, baby born healthy, postpartum haemoglobin ≥ 10.5 gr%, exclusively breastfeeding. Early mobilization was carried out after two hours postpartum and postpartum exercise was carried out for six days. Measurement of the postpartum fundal height was performed on days 1st, 3rd and 7th using a caliper pelvimeter. Consecutive sampling was used in this study. The difference between the two groups was analyzed by unpaired t-test and Mann Whitney U-test. There was a difference in the height of the uterine fundus on the third and seventh postpartum days between the two groups. Postpartum exercise was more effective than early mobilization in accelerating uterine involution. Therefore, it is expected that midwives can facilitate mothers to do postpartum exercise from the first day of postpartum. Keywords: postpartum exercise; early mobilization; postpartum; involution; uterus ABSTRAK Salah satu proses penting pada masa nifas adalah pemulihan organ reproduksi yang ditandai dengan penurunan tinggi fundus uteri dan derajat kontraksi uterus. Secara bertahap, uterus yang berkontraksi dengan baik akan berkurang ukurannya sampai tidak dapat dipalpasi lagi di atas simfisis pubis. Diantara faktor yang berperan dalam kontraksi uterus adalah mobilisasi dini dan senam nifas. Tujuan penelitian adalah untuk membandingkan efektifitas mobilisasi dini dan senam nifas terhadap involusi uterus pada ibu postpartum normal. Jenis penelitian adalah desain kuasi eksperimental dengan kelompok pre dan posttest. Responden penelitian adalah 34 orang ibu postpartum, usia 20-35 tahun di Bidan Praktek Mandiri Kota Pematangsiantar, Juni-September 2016. Teknik pengambilan sampel adalah consecutive sampling sesuai dengan kriteria inklusi. Dilakukan senam nifas pada kelompok intervensi dan mobilisasi dini pada kelompok kontrol. Pengukuran tinggi fundus uteri dilakukan sebelum dan setelah perlakuan pada hari ke-1, -3 dan -7. Analisa data menggunakan uji t-tak berpasanagn dan Mann Whitney menggunakan SPSS versi 20.0. Terdapat perbedaan tinggi fundus uteri hari ke-3 dan ke-7 antara senam nifas dan mobilisasi dini. Senam nifas lebih efektif menurunkan tinggi fundus uteri dibandingkan mobilisasi dini. Bidan diharapkan dapat memfasilitasi ibu melakukan senam nifas sejak hari pertama postpartum. Kata kunci: senam nifas; mobilisasi dini; postpartum; involusi; uterus

Abstract Introduction: A meta-analysis of 47 global epidemiological studies highlights a higher breast cancer risk in women who did not breastfeed or breastfed for a short time. Further studies showed this is especially true for triple-negative breast cancer (TNBC) patients. Premenopausal AA women (AAW) have a lower prevalence of breastfeeding and a higher incidence of TNBC and mortality. Our previous study compares short-term breastfeeding, abrupt involution (AI) with prolonged breastfeeding called gradual involution (GI), revealing that AI alone induces ductal hyperplasia four months postpartum. Our current investigation delves into early events during AI versus GI, employing a comprehensive approach encompassing histology, gene expression, and myeloid cell involvement. Methods: Utilizing FVB female mice, we conducted a comparative analysis of AI and GI. AI involved early pup removal, while GI was achieved through staggered weaning. The evaluation included analysis of histomorphology, gene/protein expression, and myeloid cell infiltration. Sequential mammary gland (MG) changes were monitored through H&E staining, TUNEL assay, and DNA damage analysis. 3D-organoid cultures of luminal progenitors (LPs) were employed to assess the impact of AI versus GI. qRT-PCR, IHC, Western blot, and flow cytometry/multiplex imaging were employed for the differential expression analysis of molecular and cellular factors associated with AI/GI. Results: Our research showed that AI had early adipocyte repopulation, rapid cell death, DNA repair, and myeloid cell infiltration, resulting in a chronically inflamed microenvironment. In contrast, the GI triggers a controlled immune response and prolonged cell death, facilitating comprehensive remodeling of the MG. Our flow cytometric or multiplexing imaging analyses revealed that AI-affected glands exhibit an enrichment of CCL9-producing CD206+ M2-like macrophages and CD11b+Gr1+ myeloid-derived suppressor cells. Moreover, exogenous CCL9 treatment on LPs in 3D-organoid culture results in disorganized acinar-type organoids, mirroring morphological differences observed in LPs from AI mammary glands on day56 PPM. Further analysis of CCL9 treated organoids revealed the expansion of Esr1- LPs population in ex-vivo organoid culture which might indicate an increase in the putative cells of origin of TNBC. Conclusion: Our studies comparing AI and GI demonstrate that AI is producing a pro-tumorigenic environment in the breast. It is important to note that prolonged breastfeeding protects the breast, although this cannot be a singular risk factor for TNBC. Therefore, understanding the mechanism will lead to prevention strategies to improve outcomes for all women but, has the potential to have a significant benefit in AAW. Citation Format: Sanjay Mishra, Neelam Shinde, Maria Cuitino, Morgan Bauer, Dinesh Ahirwar, Vijaya Bharti, Kate Ormiston, Resham Mawalkar, Sara Alsammerai, Gautam Sarathy, Xiaoli Zhang, Anna Vilgelm, Ramesh Ganju, Sarmila Majumder, Bhuvaneswari Ramaswamy. Understanding the link between breastfeeding and the risk of breast cancer through comparative analysis of the murine-based model of mammary gland involution [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2138.

Abstract Purpose: Epidemiological data links lack of breastfeeding with increased risk of breast cancer, particularly triple negative breast cancer (TNBC). The involution process is characterized by mammary tissue remodeling, including adipocyte repopulation and re-differentiation fueled by metabolic rewiring. Our mouse model mimicking short-term breast feeding that leads to abrupt involution (AI) revealed a chronic inflammatory state in the mammary gland (MG) (Basree, et al. Breast Cancer Research; 2019). As metabolic dysfunction is linked to increased BC risk, we sought to elucidate the effects of AI and gradual involution (GI) on MG energy metabolism and associated oxidative stress. In addition, we evaluated the impact of AI and GI on whole body glucose metabolism and insulin response/resistance. Methods: FVB/n mice (8week old) were paired for breeding. At partum, dams were randomized to AI or GI cohort and standardized to 6 pups per dam. AI mice had pups removed on postpartum day 7 (d7) to mimic short-term breastfeeding. GI mice had 3 pups removed on day 28 and 31 each to mimic gradual weaning. MGs were harvested on d28, 56, and 120 postpartum. Prior to harvest, mice underwent an echoMRI and insulin tolerance test (ITT). At harvest, mice were fasted for 4 hours, and blood was collected for serum insulin measurement using Ultra-Sensitive Insulin ELISA. Lipid peroxidation (MDA) and DNA adduct formation (8-OHdG), which represent chronic oxidative stress, were measured in MG by ELISA. Whole MG RNA were subjected to affymetrix followed by gene set enrichment analyses (GSEA) and qPCR for target validation. MGs were also subjected to untargeted metabolomics analysis and Mitofuel flex assay to assess substrate dependence by Seahorse Bioanalyzer. Results: GSEA and qPCR revealed enrichment of fatty acid oxidation (FAO) and mitochondrial oxidative phosphorylation (OXPHOS) pathways in AI MGs at d28, further validated by expression of genes (PGC-1α, Cpt-2, Srebp1c, and Chrebp). Metabolites associated with FAO were enriched in AI MGs at d28 and 56. Mitofuel flex assay indicated a significantly higher dependence on FAO in AI MGs. On d56, fasted blood glucose was significantly higher in AI mice with serum insulin and HOMA-IR trending to be higher than in GI mice. Level of 8-OHdG was elevated in AI MGs at d120. AI mice trended to be heavier, have greater body fat, and lower lean mass than GI Mice at d120. Body weight and percent body fat on d120 were positively correlated to MDA concentration in the mammary gland. Conclusion: Our mouse models of AI and GI revealed early MG specific metabolic shift towards increased FAO and OXPHOS that persists over time in AI glands. Similarly, increased oxidative stress and its association with adiposity at d120 indicates continued effect of AI. This change in adiposity, altered systemic glucose metabolism and metabolic shift seen in AI mice may contribute to the higher risk of breast cancer. [K.O. and K.K. are co-first authors.] Citation Format: Kate Ormiston, Kirti Kaul, Neelam Shinde, Allen Zhang, Morgan Bauer, Hee Kyung Kim, Ramesh K. Ganju, Sarmila Majumder, Bhuvaneswari Ramaswamy. Lack of breast feeding may contribute to increased breast cancer risk by altering metabolism [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5814.

Abstract Epidemiological data links higher parity and lack of breastfeeding with increased risk of breast cancer, specifically aggressive triple negative breast cancer (TNBC), and higher mortality rate. Following pregnancy and lactation, breast remodels to near pre-pregnancy stage through apoptotic cell death and adipocyte repopulation process. Long-term breastfeeding and gradual weaning of an infant leads to gradual involution (GI) of the breast, while lack of or abrupt discontinuation of breastfeeding after birth leads to abrupt involution (AI), when rapid and massive cell death takes place. Our studies have shown several precancerous changes, such as increased collagen deposition, inflammation, and hyperplasia in the mammary gland of mice after AI. However, the systemic impact of AI and how this increases risk of breast cancer is yet to be elucidated. Objectives: Our objective is to evaluate the systemic effects that are prompted by the AI mammary gland. We hypothesize that AI leads to marked alteration in lipid metabolism and systemic inflammation that enhances risk for breast cancer. Methods: FVB/n mice (8week old) were paired for breeding. At partum (day 0), dams were randomized to AI or GI cohort and standardized to 6 pups. AI mice had pups removed on day 7 postpartum (ppm) to mimic short-term breastfeeding. For GI mice 3 pups each were removed on day 28 and 31ppm to mimic gradual weaning. Tissues harvested on day 28, 56, and 120 postpartum. Body composition was measured by echo MRI. Glucose tolerance test (GTT) was performed after a 6 hour fast using a 2g/kg glucose intraperitoneal injection. Blood glucose was measured by glucometer. Serum insulin was analyzed by ELISA. HOMA-IR was calculated using blood glucose and serum insulin results. Serum was analyzed using multiplex ELISA by MesoScale Diagnostics. Mammary glands were subjected to untargeted lipidomics. Results: There were no significant differences in body weight, percent body fat or lean mass between AI and GI groups at any time point. However, at day 120 ppm (4 months after partum), we have observed significantly larger amount (1.29-fold increase) of perigonadal adipose tissue (visceral adipose) in AI mice than GI mice (p=0.0112; n=24-38/group). There were no significant differences in blood glucose, serum insulin, HOMA-IR, or GTT results between AI and GI groups at day 120. AI mice had significantly higher levels of cytokines IL-1β (3.1-fold increase, p=0.0417) and KC/GRO (1.5-fold increase, p=0.0196) than GI mice at day 120. At day 28, AI mammary glands had significantly higher amounts of level 3 identified oxidized ceramide containing sphingolipids that were linked to insulin resistance and diabetes. At day 56, GI mammary glands had significantly higher amounts of level 2 and 3 identified metabolites linked to cellular signaling and lipid metabolism. On day 120, there were no significant differences in lipid metabolites between groups. Conclusion: Although histologically GI and AI mammary glands return to near pre-pregnancy state within a month after partum, our data shows specific lipid changes in the AI mammary gland similar to what has been shown in women with TNBC. Furthermore, AI of the mammary gland leads to systemic effects on adiposity and inflammation that could be key to increased breast cancer risk. Further studies along these lines are in progress to understand the whole-body effects of AI and stratify preventive measures for women who cannot breast feed. Significance: Lack of breastfeeding is more prevalent in African American (AA) women and linked to higher risk of developing aggressive TNBC1. Our novel animal models of AI and GI help to link the impact of AI and systemic changes that may enhance breast cancer risk. In particular, we see an increase in visceral adiposity with AI. Understanding this mechanism will help identify strategies to reduce risk in women who are unable or choose not to breastfeed and ultimately help to reduce TNBC and TNBC-related mortality in AA women. Citation Format: Kate Ormiston, Kirti Kaul, Neelam Shinde, Djawed Bennouna, Rachel Kopec, Ramesh Ganju, Sarmila Majumder, Bhuvaneswari Ramaswamy. Abrupt involution of mouse mammary gland leads to inflammatory systemic changes along with mammary specific metabolic shifts that may enhance risk of breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-09-11.

AbstrakTujuan: Tinjauan sistematis ini bertujuan untuk mengetahui risiko jangka panjang dari inisiasi menyusui dini pada ibu dan bayi di Asia.Metode: Metode yang digunakan dalam penulisan tinjauan pustaka ini adalah tinjauan sistematis dengan menggunakan kata kunci yaitu “Inisiasi Menyusui Dini”, “Menyusui”, “ASI”, “Asia”, “Risiko”, “Bayi dan Ibu”, “Panjang Jangka Risiko", dan "Manfaat". Pencarian literatur dilakukan dengan menggunakan database Google Scholar, Pubmed dan NCBI.Hasil: Dari hasil penelusuran literatur berdasarkan kata kunci diperoleh 25 jurnal, dimana tujuh jurnal diantaranya memenuhi kriteria risiko jangka panjang IMD bagi ibu dan bayi di Asia. Satu penelitian pada penelitian ini menggunakan sistematik review, lima penelitian menggunakan studi kohort retrospektif, dan satu penelitian menggunakan studi cross sectional. Studi tersebut menemukan banyak risiko positif serta manfaat inisiasi menyusui dini bagi ibu dan bayi dalam jangka panjang di Asia.Kesimpulan: Risiko positif pada bayi antara lain peningkatan imunitas, penurunan risiko kematian, dan pencegahan obesitas. Sedangkan risiko jangka panjang bagi ibu antara lain mempercepat involusi rahim, mencegah kanker payudara, serta menurunkan risiko diabetes dan pradiabetes pada ibu yang pernah mengalami diabetes gestasional.Kata kunci: Menyusui; Asia; Bayi; Ibu; Risiko Jangka Panjang AbstractObjective: This systematic review aims to determine the long-term risks of early initiation of breastfeeding in mothers and babies in Asia.Method: The method used in writing this literature review is systematization using keywords, namely "Early Initiation of Breastfeeding", "Breastfeeding", "ASI", "Asia", "Risk", "Baby and Mother", "Long Term Risk" , and "Benefits".A literature search was conducted using Google Scholar, Pubmed and NCBI databases.Results: From the results of a literature search based on keywords, 25 journals were obtained, of which seven journals met the criteria for long-term risk of IMD for mothers and babies in Asia. One study in this study used a systematic review, five studies used a retrospective cohort study, and one study used a cross-sectional study. The study found many positive risks and benefits of early initiation of breastfeeding for mothers and babies in the long term in Asia.Conclusion: Positive risks for babies include increasing immunity, reducing the risk of death, and preventing obesity. Meanwhile, long-term risks for mothers include accelerating uterine involution, preventing breast cancer, and reducing the risk of diabetes and prediabetes in mothers who have experienced gestational diabetes.

Abstrak : Involusi / pengecilan Rahim adalah suatu proses dari uterus balik dalam keadaan pada sebelum kehamilan. Pada ibu pertama kali persalinan, kekuatan kontraksi pada uteri lebih tinggi dan terasa lebih keras, sedangkan pada ibu melahirkan kedua atau lebih, kontraksi uterus berlangsung lebih lama sebagai akibatnya dapat memberikan efek terhadap proses involusi uterus. Tujuan penelitian mengetahui hubungan paritas terhadap penurunan Fundus Uteri pada ibu setelah melahirkan di Tulungagung. Penelitian dilaksanakan tanggal 16 April-15 Mei 2021. Jenis penelitian observasional, menggunakan cross sectional dan instrument penelitian dengan kuesioner dan observasi. Populasi penelitian adalah semua ibu setelah melahirkan di Tulungagung. Sampel diambil menggunakan purposive sampling sebanyak 30 orang. Variabel independent paritas, variabel dependent penurunan fundus uteri. Data dianalisis menggunakan uji chi square. Hasil penelitian didapatkan sebagian besar dari responden merupakan ibu multipara atau melahirkan dua kali atau lebih yaitu sebanyak 19 orang (63,4%) dan hampir seluruh responden penurunan TFU normal, yaitu sebanyak 28 orang (93,3%). Uji statistik chi square didapatkan P Value = 0,001 < 0,05 sehingga H1 diterima, yang berarti ada hubungan paritas terhadap penurunan Fundus Uteri pada ibu setelah melahirkan di Tulungagung. Ibu yang usianya lebih tua dan sudah beberapa kali melahirkan banyak ditentukan oleh proses perubahan umur dimana mengalami perubahan pada metabolisme dengan terjadi peningkatan jumlah lemak, penurunan otot, penurunan penyerapan lemak, karbohidrat , dan protein dan hal ini akan menghambat penurunan fundus uteri. Resiko yang terjadi pada kehamilan >5 kali seperti kontraksi uterus yang kurang maksimal. Kata Kunci : Paritas, Penurunan Tinggi Fundus Uteri, Post Partum Abstract : Involution / shrinkage of the uterus is a process of the uterus turning back in its pre-pregnancy state. In women who give birth for the first time, the force of contractions in the uterus is higher and feels harder, while in women giving birth to the second or more, uterine contractions last longer as a result can have an effect on the process of uterine involution. The purpose of this study was to determine the relationship between parity and decrease in uterine fundus in mothers after giving birth in Tulungagung.The research was carried out on April 16-15 May 2021. The type of research was observational, using cross sectional and research instruments with questionnaires and observations. The study population was all mothers after giving birth in Tulungagung. Samples were taken using purposive sampling as many as 30 people. The independent variable is parity, the dependent variable is a decrease in the uterine fundus. Data were analyzed using chi square test.The results showed that most of the respondents were multiparous mothers or gave birth twice or more as many as 19 people (63.4%) and almost all of the respondents had a normal TFU decline, as many as 28 people (93.3%). Chi square statistical test obtained P Value = 0.001 < 0.05 so H1 is accepted, which means that there is a parity relationship to the decrease in uterine fundus in mothers after giving birth in Tulungagung.Mothers who are older and have given birth several times are largely determined by the process of changing age where there is a change in metabolism with an increase in the amount of fat, a decrease in muscle, a decrease in the absorption of fat, carbohydrates, and protein and this will inhibit the decline in the uterine fundus. Risks that occur in pregnancy > 5 times such as uterine contractions that are less than optimal. Keywords: Parity, Decreased Uterine Fundal Height, Post Partum

Abstract Early mobilization is one of the treatments in mothers with sectio caesarea. Early mobilization in post-sectio caesarea mothers is beneficial for: launching lochea production, initiating postpartum infections, accelerating involution, launching gastrointestinal function, improving smooth blood circulation, and speeding up breast milk function., this study aims to analyze "Mother's Knowledge Relationship With Early Mobilization Action Post Sectio Caesarea at Herna Medan Hospital". The type of research used is descriptive analytics. The study population was mothers who performed sectio caesarea numbering 450 people, the study sample of 30 people and sampling techniques using accidental sampling techniques. To assess knowledge is done using data collection instruments in the form of questionnaires and to assess the actions of researchers filling out observation sheets. The test used in this analysis is the Chi Square statistical test with a value of α = 0.05. The results showed that the majority of maternal knowledge is quite 50% and active early mobilization measures 60% of maternal knowledge is sufficient to make mothers have early mobilization actions post sectio caesarea active. There is a relationship between maternal knowledge and early post sectio caesarea mobilization (p=0.001). Mothers who have enough knowledge are more active to perform early mobilization actions compared to those who have less knowledge. Advice in particular post sectio cesarea mothers to immediately do early mobilization given the importance of early mobilization post sectio cesarea. Keywords: Knowledge, Action, Early Mobilization, Post Sectio Caesarea Abstrak Mobilisasi dini merupakan salah satu perawatan pada ibu dengan sectio caesarea.. Mobilisasi dini pada ibu pasca sectio caesarea bermanfaat untuk: melancarkan pengeluaran lochea, menguragi infeksi postpartum, mempercepat involusi, melancarkan fungsi alat gastrointestinal, meningkatkan kelancaran peredaran darah, dan mempercepat fungsi ASI., Penelitian ini bertujuan untuk menganalisis “Hubungan Pengetahuan Ibu Dengan Tindakan Mobilisasi Dini Pasca Sectio Caesarea di RSU Herna Medan”. Jenis penelitian yang digunakan adalah deskriptif analitik. Populasi penelitian adalah ibu yang melakukan sectio caesarea berjumlah 450 orang, sampel penelitian ini sebesar 30 orang dan Teknik pengambilan sampel menggunakan teknik Accidental sampling. Untuk menilai pengetahuan dilakukan dengan menggunakan Instrument pengumpulan data berupa kuesioner dan untuk menilai tindakan peneliti mengisi lembar observasi.Uji yang digunakan dalam analisa ini adalah uji statistik Chi Square dengan nilai α=0,05. Hasil penelitian menunjukkan mayoritas pengetahuan ibu cukup 50% dan tindakan mobilisasi dini aktif 60% pengetahuan ibu yang cukup menjadikan ibu memiliki tindakan mobilisasi dini pasca sectio caesarea yang aktif. Ada hubungan antara pengetahuan ibu dengan tindakan mobilisasi dini pasca sectio caesarea (p=0,001). Ibu yang memiliki pengetahuan yang cukup lebih aktif untuk melakukan tindakan mobilisasi dini dibandingkan dengan yang memiliki pengetahuan kurang. Saran khususnya ibu post sectio cesarea untuk segera melakukan mobilisasi dini mengingat pentingnya mobilisasi dini pasca sectio cesarea. Kata kunci : Pengetahuan, Tindakan, Mobilisasi Dini, Pasca Sectio Caesarea

Abstract Continuity of care is a continuing care related to the quality of service from time to time which require the continuous relationship between patients with health workers in order to improve the health of mothers and babies. In order to decrease maternal mortality and the baby for the achievement of the Millennium Development Goals needs to be done on the mother of midwifery services carefully and thoroughly in accordance with SPM (minimum service standard). Standard Obstetrics Care, Midwives conduct record-keeping are complete, accurate, concise, and clear about the circumstances/events that are found and done in providing midwifery care. The awarding of the care of gynecologist in Ny. N GIIPI000I 35 years of age was conducted starting from gestational age 39-40 Sunday, held April 25, 2017 – 16 June 2017. Examination of the ANC done twice (the first ANC Visits found problems in feet and pain odema. Visit ANC kolostum hasn't been out). The mother gave birth at the age of 40 weeks of pregnancy with pregnancy due to operation of the SC action with IUGR and Oligohidramnion. PNC 4 times (in involution of lactation, and normal lochea). Neonates are born with LOW BIRTH WEIGHT i.e. 2300 grams, but on visits 3 neonatal baby weight 2800 grams there are already gaining weight of 500 grams of birth weight. Mom uses the KB MOW conducted post-operative SC on May 4, 2017 and on 16 June 2017 done visit action MOW and given counselling post MOW. Keyword: Midwifery care, continuity of care AbstrakContinuity of care adalah asuhan yang berkelanjutan berkaitan dengan kualitas pelayanan dari waktu ke waktu yang membutuhkan hubungan terus menerus antara pasien dengan tenaga kesehatan dalam rangka untuk meningkatkan kesehatan ibu dan bayi. Dalam rangka menurunkan angka kematian ibu dan bayi untuk pencapaian Millennium Development Goals perlu dilakukan pelayanan kebidanan pada ibu secara teliti dan menyeluruh sesuai dengan SPM (Standar Pelayanan Minimal). Sesuai Standar Asuhan Kebidanan, Bidan melakukan pencatatan secara lengkap, akurat, singkat, dan jelas mengenai keadaan/kejadian yang ditemukan dan dilakukan dalam memberikan asuhan kebidanan. Pemberian asuhan kebidanan pada Ny. N GIIPI000I usia 35 tahun dilakukan mulai dari usia kehamilan 39-40 minggu, dilaksanakan tanggal 25 April 2017 – 16 Juni 2017. Pemeriksaan ANC dilakukan sebanyak 2 kali (Kunjungan ANC pertama ditemukan masalah odema dan nyeri pada kaki. Kunjungan ANC kolostum belum keluar). Ibu melahirkan pada usia kehamilan 40 minggu dengan tindakan operasi SC dikarenakan kehamilandengan Oligohidramnion dan IUGR. PNC 4 kali (laktasi, involusi dan lochea normal). Neonatus lahir dengan BBLR yaitu 2300 gram, namun pada kunjungan neonatus 3 berat badan bayi 2800 gram sudah ada kenaikan berat badan sebesar 500 gram dari berat lahir. Ibu menggunakan KB MOW yang dilakukan pasca operasi SC pada tanggal 4 Mei 2017 dan pada tanggal 16 Juni 2017 dilakukan kunjungan pasca tindakan MOW dan diberikan konseling pasca MOW. Kata Kunci:Asuhan kebidanan, continuity of care

The abnormal period of nifas causes problems such as the sub-involution of utero and bleeding, when it is not handled quickly can result in maternal mortality. Education is one of the upbringing to improve the knowledge, attitudes and behaviors of mother Nifas. The aim of this research is to know the effect of WhatsApp education on lactation, uteri, and Lochea on the knowledge, attitudes and behavior of puerperium in the working area of Sitti Khadijah I Muhammadiyah Makassar ". Research design that is quasi experiment with one group pre-Test and post-Test design. The research was conducted in Rsia Sitti Khadijah I Muhammadiyah Makassar in January S/d february year 2020. Sample of 39 respondents. Sampling technique using purposive sampling, intervention is given through WhatsApp media about lactation, utero and Lochea for 14 days with 2 times the provision of materials in a day and completed the division of the research material conducting group monitoring if the material is accessed then the name of the respondent is in the field "read by" but if it has not been accessed the name of the respondent is in the field Data was analyzed using Mc Nemar test. Result: Most of the respondents were 20-35 years old as much as 84.6%, the majority of the education of respondents was the college as much as 41.0%, respondents MOSTLY worked as IRT, which was 56.4%, most of the family income was 3-5 million per month as many as 69.2% and most respondents had a total of 2-4 children as much as 43.6%. There was a significant increase in the knowledge of 84.6% and an attitude of 79.5% after the intervention with P-value 0.000. While on the behavioral consumption of proteins, Vit A and vit C respectively at 35.9%, 41% and 59% after administration of the intervention with P value < 0.05. There is an increase in the knowledge, attitudes and behaviors of puerperium mothers in the work area of RSIA Sitti Khadijah I Muhammadiyah Branch of Makassar. And expected to be Pregnant and mother Nifas to make use of social media owned especially Whatsapp and Dipleaseto further researchers in order to develop this research using other social media. Keywords: Education, Social Media Whatsapp, Nutrition, Puerperium The abnormal period of nifas causes problems such as the sub-involution of utero and bleeding, when it is not handled quickly can result in maternal mortality. Education is one of the upbringing to improve the knowledge, attitudes and behaviors of mother Nifas. The aim of this research is to know the effect of WhatsApp education on lactation, uteri, and Lochea on the knowledge, attitudes and behavior of puerperium in the working area of Sitti Khadijah I Muhammadiyah Makassar ". Research design that is quasi experiment with one group pre-Test and post-Test design. The research was conducted in Rsia Sitti Khadijah I Muhammadiyah Makassar in January S/d february year 2020. Sample of 39 respondents. Sampling technique using purposive sampling, intervention is given through WhatsApp media about lactation, utero and Lochea for 14 days with 2 times the provision of materials in a day and completed the division of the research material conducting group monitoring if the material is accessed then the name of the respondent is in the field "read by" but if it has not been accessed the name of the respondent is in the field Data was analyzed using Mc Nemar test. Result: Most of the respondents were 20-35 years old as much as 84.6%, the majority of the education of respondents was the college as much as 41.0%, respondents MOSTLY worked as IRT, which was 56.4%, most of the family income was 3-5 million per month as many as 69.2% and most respondents had a total of 2-4 children as much as 43.6%. There was a significant increase in the knowledge of 84.6% and an attitude of 79.5% after the intervention with P-value 0.000. While on the behavioral consumption of proteins, Vit A and vit C respectively at 35.9%, 41% and 59% after administration of the intervention with P value < 0.05. There is an increase in the knowledge, attitudes and behaviors of puerperium mothers in the work area of RSIA Sitti Khadijah I Muhammadiyah Branch of Makassar. And expected to be Pregnant and mother Nifas to make use of social media owned especially Whatsapp and Dipleaseto further researchers in order to develop this research using other social media. Keywords: Education, Social Media Whatsapp, Nutrition, Puerperium ABSTRAK Masa nifas yang abnormal menyebabkan masalah seperti sub-involusi uteri dan perdarahan, apabila tidak tertangani dengan cepat dapat berakibat pada kematian ibu. Edukasi merupakan salah satu asuhan untuk meningkatkan pengetahuan, sikap dan perilaku ibu nifas. Tujuan penelitian ini adalah untuk Mengetahui efek edukasi whatsapp tentang gizi laktasi, involusi uteri, dan lochea terhadap pengetahuan, sikap dan perilaku ibu nifas di wilayah kerja RSIA Sitti Khadijah I Muhammadiyah Makassar”. Desain Penelitian yaitu quasi experiment dengan one group pre-test dan post-test design. Penelitian dilaksanakan di RSIA Sitti Khadijah I Muhammadiyah Makassar pada bulan Januari s/d Februari tahun 2020. Sampel sebanyak 39 responden. Tekhnik pengambilan sampel menggunakan purposive sampling, intervensi diberikan melalui media whatsapp tentang gizi laktasi, involusi uteri dan lochea selama 14 hari dengan 2 kali pemberian materi dalam sehari dan selesai pembagian materi peneliti melakukan pemantauan group jika materi telah diakses maka nama responden berada pada kolom “Dibaca Oleh” namun jika belum diakses nama responden berada pada kolom “Tersampaikan Ke”. Data dianalisis menggunakan uji Mc Nemar. Sebagian besar responden berumur 20-35 tahun yaitu sebanyak 84.6%, mayoritas pendidikan responden yaitu perguruan tinggi sebanyak 41.0%, responden sebagian besar bekerja sebagai IRT yaitu sebanyak 56.4%, Sebagian besar responden pendapatan keluarganya 3-5 juta perbulan sebanyak 69.2% dan sebagian besar responden memiliki jumlah anak 2-4 yaitu sebanyak 43.6%. Terjadi peningkatan yang signifikan terhadap pengetahuan sebesar 84.6% dan sikap sebesar 79.5% setelah pemberian intervensi dengan p-value 0.000. sedangkan pada perilaku konsumsi protein, VIT A dan VIT C masing-masing sebesar 35.9%, 41% dan 59% setelah pemberian intervensi dengan p value < 0.05. Terdapat peningkatan pengetahuan, sikap dan perilaku ibu nifas di wilayah kerja RSIA Sitti Khadijah I Cabang Muhammadiyah Makassar. Dan diharapkan ibu hamil maupun ibu nifas agar memanfaatkan media sosial yang dimiliki khususnya Whatsapp serta diharapkan peneliti selanjutnya agar bisa mengembangkan penelitian ini dengan menggunakan media sosial yang lainnya. Kata Kunci : Edukasi, Media Sosial Whatsapp, Gizi, Ibu Nifas

ABSTRAK Masa nifas dimulai dari placenta lahir dan berakhir ketika alat-alat kandungan kembali seperti keadaan sebelum hamil. Ibu nifas akan mengalami banyak perubahan fisik maupun psikologis. Senam nifas merupakan salah satu cara membantu ibu segera pulih, bertujuan memperlancar proses involusi uteri, bermanfaat dari segi kecantikan, mengembalikan kondisi kesehatan dan memperbaiki keregangan otot-otot setelah kehamilan. Pelaksanaan senam nifas dipengaruhi oleh faktor internal dan eksternal. Rumusan masalah berupa terbatasnya pengetahuan dan keterampilan tentang senam nifas di wilayah kerja Puskesmas Talagasari Kabupaten Karawang, dikarenakan belum adanya sosialisasi dan bimbingan tentang senam nifas. Tujuan pengabdian untuk meningkatkan pengetahuan dan keterampilan tentang senam nifas pada ibu nifas menggunakan media modul dan vidio sehingga membantu dalam melakukan senam nifas secara mandiri dan sebagai program tambahan pada kelas ibu hamil. Metode pengabdian dalam kegiatan sosialisasi dan bimbingan senam nifas menggunakan ceramah tanya jawab, diskusi, simulasi dan praktek senam nifas, disertai pre test dan post test. Kegiatan dilaksanakan selama tiga bulan di rumah responden sebanyak 185 orang. Hasil kegiatan sosialisasi dan bimbingan senam nifas ini memberikan implikasi berupa peningkatan pengetahuan ibu nifas hingga sebesar 9,28. Kegiatan telah memberikan manfaat berupa peningkatan pengetahuan dan keterampilan tentang senam nifas bagi seluruh responden. Kesimpulannya bahwa kegiatan sosialisasi dan bimbingan senam nifas memberikan implikasi berupa peningkatan pengetahuan dan kemampuan dalam melakukan gerakan-gerakan senam nifas secara mandiri menggunakan modul dan vidio senam nifas. Selanjutnya puskesmas dapat melanjutkan kegiatan senam nifas tersebut ke dalam materi perawatan nifas pada program kelas ibu hamil. Kata Kunci: Sosialisasi, Bimbingan, Senam , Nifas ABSTRACT The puerperium begins when the placenta is born and ends when the uterine organs return to their pre-pregnancy state. Postpartum mothers will experience many physical and psychological changes. Postpartum gymnastics is one way to help the mother recover soon, aims to expedite the process of uterine involution, is beneficial in terms of beauty, restores health and improves muscle tension after pregnancy. Implementation of postpartum exercise is influenced by internal and external factors. The formulation of the problem is in the form of limited knowledge and skills about postpartum exercise in the working area of the Talagasari Health Center, Karawang Regency, due to the absence of socialization and guidance regarding postpartum exercise. The purpose of the service is to increase knowledge and skills about postpartum exercise for postpartum mothers using modules and video media so that it helps in carrying out postpartum exercise independently and as an additional program for pregnant women classes. The service method in the socialization and guidance of postpartum gymnastics uses question-and-answer lectures, discussions, simulations and practice of postpartum gymnastics, accompanied by pre-tests and post-tests. The activity was carried out for three months in the homes of 185 respondents. The results of this socialization activity and postpartum exercise guidance have implications in the form of increasing the knowledge of postpartum mothers up to 9.28. Activities have provided benefits in the form of increased knowledge and skills about postpartum exercise for all respondents. The conclusion is that postpartum exercise socialization and guidance activities have implications in the form of increasing knowledge and ability to carry out postpartum exercise movements independently using postpartum exercise modules and videos. Furthermore, the health center can continue the postpartum exercise activities in the postnatal care material in the class program for pregnant women. Keywords: Socialization, Guidance, Gymnastics, PostpartumAnggarini, I. A. (2020). Pengaruh Senam Nifas Dan Pijat Oksitosin Terhadap Involusi Uteri Pada Ibu Postpartum. Midwifery Journal: Jurnal Kebidanan Um. Mataram, 5(2), 65. Https://Doi.Org/10.31764/Mj.V5i2.1277Anggarini, I. A., Hakim, M., & Hidayat, A. (2017). Pengaruh Senam Nifas Terhadap Perubahan Maternal Depressive Symptoms Di Rumah Sakit Ibu Dan Anak (Rsia) Sakina Idaman Kabupaten Sleman. Jurnal Unisa Yogya.Ayundya Prameswary1, F. K. (2019). Hubungan Inisiasi Menyusu Dini (Imd), Mobilisasi Dini Dan Senam Nifas Dengan Involusi Uteri. Jurnal Ilmiah Kebidanan Indonesia. Https://Doi.Org/10.33221/Jiki.V7i04.442Azhari, T., & Triana, A. (2022). Percepatan Involusi Uterus Pasca Persalinan Melalui Senam Nifas. Jurnal Kebidanan Tekini, 01(1), 45–55.Bi’i, G. R. M., Folamauk, C. L. H., & Telussa, A. S. (2021). Efektivitas Media Video Terhadap Peningkatan Pengetahuan Tentang Social Distancing Dalam Pencegahan Covid-19 Pada Mahasiswa Baru Universitas Nusa Cendana. Cendana Medical Journal (Cmj), 9(2), 231–239. Https://Doi.Org/10.35508/Cmj.V9i2.5975Brier, J., & Lia Dwi Jayanti. (2020). Application Of Gymnastics Nifas To Afterpains Level In Mother Post Partum In Ponek Room Salatiga City Hospital Lutfaturrohmah1priharyanti. 21(1), 1–9. Http://Journal.Um-Surabaya.Ac.Id/Index.Php/Jkm/Article/View/2203Hutabarat, V., Sitepu, S. A., Sitepu, M. S., & Situmorang, R. B. (2020). Hubungan Tingkat Pengetahuan Ibu Nifas Tentang. Jurnal Keperawatan Komprehensif, 2(2), 58–65.Ineke, S H, Murti Ani, S. S. (2016). 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Latar Belakang; Badan Kesehatan Dunia (WHO) menyebutkan pada tahun 2019, angka kematian ibu sangat tinggi, setiap harinya kurang lebih 810 perempuan meninggal karena sebab-sebab yang dapat dicegah terkait kehamilan dan persalinan. Penyebab kematian ibu terbanyak adalah perdarahan postpartum, dimana 14 juta ibu atau 11,4% di seluruh dunia. Di negara berkembang, angka kejadian perdarahan postpartum adalah 60% dari 100 ribu ibu. kematian setiap tahunnya dan disebabkan oleh manajemen persalinan yang buruk terutama pada kala 3 yang dapat menyebabkan kehilangan banyak darah (Ramadhan, 2019).Tujuan; Menganalisis pengaruh senam nifas terhadap involusi uteri ibu post partum di Desa Ketro Karangrayung.Metodologi; Jenis penelitian ini kuantitatif menggunakan Desain pra eksperimen dengan pendekatan pretest posttest. Sampel dalam penelitian ini adalah 24 ibu post partum dari bulan Juni-Juli 2024 sampel yang digunakan total sampling, dengan uji Wilcoxon.Hasil; Perbedaan rerata TFU sebelum dan sesudah senam nifas 8,92 dengan hasil data Uji komparatif menggunakan Wilcoxon dengan bantuan komputerisasi didapatkan hasil dengan nilai p-value sebesar (0.000) < ? (0,05). Dari hasil tersebut dapat di artikan bahwa hipotesis Ho ditolak dan Ha diterima, yang berarti ada Pengaruh senam nifas terhadap involusi uteri pada ibu post partum di Desa Ketro Kecamatan Karangrayung Kabupaten Grobogan.Kesimpulan; Kesimpulan ada pengaruh senam nifas terhadap involusi uteri ibu post partum di Desa Ketro Karangrayung. Kata Kunci; Senam nifas, TFU, Ibu Post Partum

<p>ABSTRACT<br />Abundant rice productivity as a result of the success of the modernization of the system, pattern of production and use of seeds are carried by the Indonesian government in agriculture was not automatically change the level of farmers welfare. Based on studies in meunasah Pinto North Aceh District, this article is going to show that the issue of farmers’ welfare is a complex issue strands. At the empirical level narrow land ownership, capital dependence on the elite village economy, changes in the production system of reciprocity into a wage complex obstacles to change farmers’ welfare.In fact, this modernization not only exposes farmers to the issue of involution wellbeing but also directly contribute to the flourishing of social segregation in society as in Meunasah Pinto, North Aceh. As a result, the social insurance obtained by citizens when agricultural production systems is reciprocity now after changing the wage system of social insurance is gone. The high individuality as a new mode of social life also requires farmers to adapt to the problems of their lives increasingly problematic in the midst of well-being that low.<br />Keywords: Farmers, Welfare, modernization of production systems, Meunasah Pinto, North Aceh</p><p>ABSTRAK<br />Produksi pertanian yang melimpah sebagai konsekuensi dari keberhasilan modernisasi sistim, pola produksi dan penggunaan bibit unggul tidak secara otomatis dapat mengubah tingkat kesejahteraan petani. Berdasarkan studi di Meunasah Pinto Kabupaten Aceh Utara. Artikel ini hendak menunjukkan kompleksitas persoalan kesejahteraan petani. Dalam tataran empiris, sempitnya lahan,, ketergantungan modal pada elite ekonomi desa dan pergeseran sistim reprositas dalam sistim produksi sebagai akibat dari modernisasi sistim pertanian merupakan hambatan-hambatan mendasar terhadap perubahan kesejahteraan petani. Realitasnya, modernisasi sistim pertanian tidak hanya berakhir pada terjadinya involusi kesejahteraan petani tetapi juga berkontribusi langsung pada terjadinya segregasi sosial pada masyarakat petani Meunasah Pinto, Aceh Utara. Implikasinya, asuransi sosial yang terjalin melalui sistim reprositas pada pelbagai aspek kehidupan termasuk pada sistim produksi pertanian kini hilang. Modernisasi yang diikuti dengan rasionalisasi dalam pola hubungan produksi menyebabkan pola hubungan produksi tradisional yang bersifat komunal dan reprositas berubah menjadi serba upah dan individual. Gaya hidup individual ini menghadapkan para petani pada pelbagai persoalan dalam kehidupan mereka.<br />Kata kunci: Kesejahteraan petani, modernisasi sistim produksi, Meunasah Pinto, Aceh Utara</p>