Available online on 15.05.2022 at http://jddtonline.info Journal of Drug Delivery and Therapeutics Open Access to Pharmaceutical and Medical Research Copyright © 2011-2022 The Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited Open Access Full Text Article Research Article The Effectiveness of Prenatal Couple Gentle Yoga and Birth Ball on Maternal Mental Readiness and the length of Labor at the Depok Regional Health Center Sri Handayani1, Rasumawati2 1,2Department of Midwifery, Health Polytechnic of Jakarta I, Indonesia Article Info: _____________________________________________ Article History: Received 27 March 2022 Reviewed 29 April 2022 Accepted 10 May 2022 Published 15 May 2022 ___________________________________________________________ Cite this article as: Handayani S, Rasumawati, The Effectiveness of Prenatal Couple Gentle Yoga and Birth Ball on Maternal Mental Readiness and the length of Labor at the Depok Regional Health Centre, Journal of Drug Delivery and Therapeutics. 2022; 12(3):100-102 DOI: http://dx.doi.org/10.22270/jddt.v12i3.5476 Abstract _____________________________________________________________________________________________________________________ There are several ways to prevent pregnancy during pregnancy when the mother and baby are in a healthy condition and the delivery process is normal, including prenatal yoga, a modification of yoga that is adapted to the condition of pregnant women by preparing pregnant women physically, mentally and spiritually for the birth process. The study was conducted at the Depok Regional Health Center which aims to determine the effect of prenatal couple gentle yoga and birth ball on the mental readiness of the mother and the duration of labor, presumably as a confounder variable, namely the mother's age, education, occupation, parity and husband's support, conducted interviews and observations on the implementation of the intervention. in pregnant women and the delivery process. The research design was quasi-experimental with a post-test control group approach, the sample was quota sampling of 35-36 weeks pregnant women as many as 30 respondents in the intervention group and 30 respondents in the control group. The analysis test was carried out by linear regression. It was found that the results of the exercise of Couple gentle yoga and birth ball were significant for the maternal mental readiness of the mother and the length of labor with a P value = 0.0001. Confounding variables are the variables of mother's age, occupation and parity, the determination coefficient R2 (R square) = 0.897, meaning that the other variable implementation of exercises. Keywords: Prenatal couple, gentle yoga, birth ball, maternal mental readiness *Address for Correspondence: Sri Handayani, Department of Midwifery, Health Polytechnic of Jakarta I, Indonesia INTRODUCTION Mortality and Morbidity in pregnant and childbirth women is a big problem in developing countries.1 In general, women who are pregnant are afraid to face childbirth because of the pain that causes fear and anxiety.2 This can cause mental and physical strain which will result in unnatural stiffness of the muscles and joints. At delivery there are physical changes, namely: the mother will feel back pain, stomach ache, feel uncomfortable, tired, lethargic, uncomfortable, unable to sleep well.3 The psychological changes that occur are feeling afraid in relation to oneself, afraid that there will be danger to them during childbirth.4 There are several ways to take precautions during pregnancy so that the mother and fetus are in good health and a normal delivery process will occur, including prenatal yoga is a modification of yoga that is adapted to the condition of pregnant women with the aim of preparing pregnant women physically, mentally and spiritually for childbirth process.5 With careful preparation, the mother will be more confident and gain confidence in going through labor smoothly and comfortably.6 Prenatal couple gentle yoga is done with a partner (husband / family or relatives) which can strengthen the bounding between the mother, father and future baby and can increase the feeling of love for the partner through his movements. While a birth ball using a ball that is large enough with a shape that resembles a gym ball which is useful to help reduce back pain, form good posture so that it makes it easier for pregnant women to move and labor can run smoothly and normally.7 According to Putri's research, yoga which is practiced by pregnant women regularly, has many benefits for both mother and fetus. Among them, increasing the duration of sleep for the mother so that it can increase the baby's weight at birth, reduce the incidence of preterm birth and various pregnancy complications. The yoga exercises that are carried out include various relaxation, adjusting postures (yoga asana), breathing and meditation for one hour, routine every day. As a result, 14% of the group who were diligent in yoga gave birth to premature babies, while the group who did not do yoga was 20%. In addition, the yoga group also had lower blood pressure.8 MATERIALS AND METHODS The research design used a quasi-experiment with posttest with control group, with quota sampling technique, in the intervention group as many as 30 respondents and control group 30 respondents with gestational age 35-36 weeks. The study was conducted over 3 months, using questionnaire sheets/observation sheets/partographs on the maternal mental readiness and the length of labor. The intervention begins with 30 minutes of couple’s gentle yoga and ends with 10-minute birth ball, where respondents together with their couples (husband / family) make movements with guidance from the research team. Furthermore, respondents in the intervention group performed prenatal couple gentle yoga and birth ball once a week in the center according to the mother's class schedule until the eve of delivery. The control group was only conducted at the beginning of the meeting. Analysis is done multivariate modeling with linear regression analysis through the Best Subset method.9 RESULT Table 1. Distribution of Respondent Characteristics by Age, Education, Employment and Parity in Intervention Groups and Control Groups Variable Intervention Group Control Group Mean min max SD SE n mean min max SD SE n Mother’s age (year) 29.6 20 41 5.94 0.63 30 29.2 20 41 6.37 0.83 30 Parity 2 1 5 1.26 0.13 30 2 1 5 1.32 0.17 30 Variable Intervention Group Control Group f Percentage n f Percentage n Mother’s work: Work 10 33.3 30 5 16.6 30 Does not work 20 66.7 25 83.3 Husband support: Yes 30 100.0 30 30 100.0 30 No 0 0 0 0 The table shows that the average age of respondents in the case group was 29.6 months and the control group was 29.2 months. The most parity group in the case group and the control group was 2 people. The largest proportion of employment status were non-working mothers in the intervention group at 66.7% and the control group at 83.3%. The husband's support was 100% supportive of both the intervention group and the control group. Table 2. Distribution of Respondent Characteristics Based on Maternal Mental Readiness and The length of labor in Intervention Group and Control Group Variable Intervention Group Control Group f Percentage n f Percentage n Maternal Mental Readiness: 30 30 Score ≤ 6 (No anxiety) 25 83 0 0 Score 7 - 14 (Mild Anxiety) 5 17 6 20 Score 15 - 27 (Moderate Anxiety) 0 0 24 80 Score > 27 (Severe Anxiety) 0 0 80 100 The Length of labor: 30 30 0,5 - 1 hour 19 63 3 10 1,5 - 2 hour 11 37 27 90 From the table above shows that in the intervention group most mothers did not experience anxiety with a score of ≤ 6 as many as 25 people (83%) and the length of labor 0.5-1 hour as many as 19 people (63%), while in the control group most mothers experienced moderate anxiety with a score of 1 5-27 as many as 24 people (80%) and the length of labor 1.5-2 hours as many as 27 people (90%). Table 3. Effects of Prenatal Couple Gentle Yoga and Birth Ball on Maternal Mental Readiness and The length of Labor in Intervention Group and Control Group Variable Intervention Group Control Group mean SD 95%CI P value mean SD 95%CI P value Maternal Mental Readiness: 5.18 3.77 4.21-6.16 0.0001 15.53 1.94 14.81-16.26 0.341 The length of labor: 1.10 0.51 -0.91-(-0.46) 0.0001 1.77 0.34 -0.91-(-0.46) 0.062 The table above shows the difference in the average mental readiness score of mothers in the intervention group with an average score of 5.16 (no anxiety) with SD = 3.77 and 95% CI = 4.21-6.16, compared to the control group with an average score of 15.53 (moderate anxiety) with SD values = 1.54 and 95% CI = 14.81-16.26, the results of the analysis test obtained the results of p value = 0.0001, that the implementation of prenatal couple gentle yoga and birth ball effects on maternal mental readiness and the length of labor. Table 4. Final Model Linear Regression Analysis of Prenatal Couple Gentle Yoga and Birth Ball Influence on Maternal Mental Readiness and Duration of Labor Variable P value Coefficients R Square Constanta Prenatal Couple gentle yoga and birth ball 0.0001 -6.644 0.897 19.991 Mother’s age 0.0001 - 0.162 Maternal Mental Readiness 0.0001 5.326 The length of labor 0.027 -0.889 From the table above, it can be known that the variables of the implementation of gentle yoga and birth ball exercises mean the mental readiness of the mother and the length of labor with a value of P value = 0.0001. Confounding variables are variables of maternal age, occupation and parity, Coefficient of determination R2 (R square) = 0.897, this means that the variables of exercise implementation couple gentle yoga and birth ball can explain the variation on maternal mental readiness and the length of labor by 89.7% and the rest is explained by other variables. DISCUSION Prenatal yoga (yoga during pregnancy) is one type of modification of yoga that is adapted to the condition of pregnant women, with the aim of preparing pregnant women physically, mentally and spiritually for the labor process. With careful preparation, the mother will be more confident and gain confidence in delivering smoothly and comfortably.10 While Prenatal couple gentle yoga is a paired pregnant yoga exercise performed with her partner (husband / family or relatives) that can strengthen bounding between mother, father and prospective baby and can increase love for the partner through his movements.11 While birth ball is gymnastics for pregnant women by using a large enough ball with a shape that resembles a gym ball that is useful to help reduce back pain so that it makes it easier for you to move, increase blood flow to the uterus, form good posture, help reduce muscle tension and enlarge the diameter of the pelvis, to optimize the delivery process so that labor can run smoothly and normally.7 CONCLUSION From the results of the study obtained results that the age of respondents in both groups averaged in the case group was 29.6 months and the control group 29.2 months. The average parity group in both the case group and the control group was 2 people. The largest proportion for employment status in the intervention group was that the mothers did not work as much as 53.3%, and for the whole husband support variable said support 100%. Based on mental readiness and the length of labor showed that in the intervention group most mothers did not experience anxiety with a score of ≤ 6 as many as 25 people (83%) and the length of labor 0.5-1 hour as many as 19 people (63%), while in the control group most mothers experienced moderate anxiety with a score of 1 5-27 as many as 24 people (80%) and the length of labor 1.5-2 hours as many as 27 people (90%). With the value P value = 0.0001. Confounding variables are variables of maternal age, occupation and parity, Coefficient of determination R2 (R square) = 0.897, this means that the variables of exercise implementation couple gentle yoga and birth ball can explain the variation in the mental readiness of the mother and the length of labor by 89.7% and the rest is explained by other variables. The confounding variables in the study were maternal age, maternal occupation, parity and husband support. ACKNOWLEDGEMENTS The authors thank to Poltekkes Kemenkes Jakarta I for funding this research, all participants and research assistants. CONFLICT OF INTEREST The author declared that don’t have conflict of interest REFERENCES 1. Agrawal P. Maternal mortality and morbidity in the United States of America. Vol. 93, Bulletin of the World Health Organization. SciELO Public Health; 2015. p. 135. https://doi.org/10.2471/BLT.14.148627 2. Asri H. Asuhan Persalinan Normal. Cetakan Pe. Yojakarta: Nuha Medika; 2010. 3. Bobak. Buku Ajar Keperawatan Maternitas dan Ginekologi. Jakarta: EGC; 2010. 4. Sarwono P. Ilmu Kebidanan. JAKARTA: EGC; 2012. 5. Nirwan TS, Pendidikan J, Fakultas B, Dan T, Pendidikan J, Fakultas B, et al. Hubungan Antara Kesiapan Mental Dengan. 2016; 4(36):33–51. 6. Fauziah L, Purwono RU, Abdurachman M. Efektivitas Latihan Yoga Prenatal Dalam Menurunkan Kecemasan Pada Ibu Primigravida Trimester III. Magister Psikol Profesi Fak Psikol Univ Padjajaran. 2016; 1–15. 7. Thakur J, Thakur J. Yoga in pregnancy: A boon to motherhood. J Ayurveda Holist Med. 2016; 3(6):121–9. 8. Putri. Perbedaan pemberian senam hamil dan yoga terhadap peningkatan durasi tidur ibu hamil trimester iii naskah publikasi. 2016; 1–15. 9. Arikunto S. Prosedur Penelitian: Suatu Pendekatan Praktik. revisi. Jakarta: Renika Cipta; 2010. 10. Widiawati dkk. Pengaruh Senam Yoga Terhadap Kesiapan fisik dan psikologis terhadap persalinan di BPM. J Kedokt dan Kesehat. 2018; 14(1). https://doi.org/10.24853/jkk.14.1.39-47 11. Rafika R. Efektifitas Prenatal Yoga terhadap Pengurangan Keluhan Fisik pada Ibu Hamil Trimester III. J Kesehat. 2018; 9(1):86. https://doi.org/10.26630/jk.v9i1.763