The process of childbirth is a crucial moment in a mother’s life that affects both the long-term health of the mother and the baby. A negative childbirth experience can lead to adverse effects such as postpartum depression and Post-Traumatic Stress Disorder (PTSD), as well as reduce a mother’s confidence in the healthcare system. One solution to address this issue is by improving the quality of antenatal services, including encouraging physical activity during pregnancy. The WHO recommends that pregnant women without contraindications engage in at least 150 minutes of exercise per week to reduce the risk of complications during childbirth and improve the health of both mother and baby. Various healthcare facilities in Indonesia have implemented pregnancy exercise programs as a form of physical activity for pregnant women, but the implementation still requires improvement.
Roikhatul Jannah, a doctoral student in Public Health Science at FPH UI, conducted research to develop models of Intensive Antenatal Physiotherapy (FA) for Safe-Healthy Labor (IKHA) fitness that integrates aerobic movements, strengthening, and stretching according to WHO guidelines, titled “Strategic Model of Antenatal Physiotherapy Services for Positive Birth”. This research was defended during her doctoral promotion session on Tuesday, July 9, 2024, in the Doctoral Promotion Room, Building G, Faculty of Public Health (FPH) at the University of Indonesia (UI).
The issue of traumatic childbirth affecting the safety and health of mothers and newborns requires a contextual antenatal physiotherapy service strategy in a sedentary culture. Therefore, it is crucial to have a strategic model for positive childbirth, which refers to quality, safe childbirth with a healthy mother and baby, exceeding expectations. Roikhatul’s research contributes to maintaining and enhancing physical fitness during pregnancy through the “Music Motion” Intensive Antenatal Physiotherapy (FA) for Safe-Healthy Labor (IKHA) service model. This program is an exercise regimen for pregnant women that combines aerobic movements, stretching, and strengthening into a structured movement series. Through her dissertation, the aim was to assess the effectiveness and feasibility of the FA IKHA service model for positive childbirth. This dissertation research involved pregnant women and midwife health providers as participants, with 48 pregnant women selected through purposive sampling for the effectiveness stage. Data collection was conducted by implementing the FA IKHA intervention on pregnant women with 22 weeks of gestation, followed by the completion of a modified birth satisfaction questionnaire from the Birth Satisfaction Scale (BSS) and Childbirth Experience Questionnaire (CEQ) one week postpartum.
The results showed that in the effectiveness phase, the proportion of positive births was higher in the treatment group (67%) compared to the control group (40.4%) with a p-value of 0.014. Other components of childbirth quality that showed statistically significant differences between the treatment and control groups were the method of delivery, labor pain, perineal laceration, bleeding, duration of stage II, use of forceps, induction processes, and the use of pain-relieving medication. In the feasibility phase, the FA IKHA model was enthusiastically accepted due to the benefits perceived by the pregnant women and midwives, as it was safe and enjoyable. Therefore, it can be concluded that the FA IKHA service model is a strategic approach for positive childbirth, considering the effectiveness and feasibility experienced by both mothers and providers from pregnancy to delivery.
The implementation of this model aims to improve the quality of childbirth and maternal health in Indonesia. In its implementation, the FA IKHA model is expected to be practiced independently with the aid of video instructions and carried out in groups to obtain positive support from fellow pregnant women. By integrating the FA IKHA model as part of a more comprehensive antenatal care service at primary healthcare facilities, more mothers can achieve positive births. Regarding the program’s implementation, the researcher has also proposed the FA IKHA as an integrated policy for antenatal services in collaboration with Indonesia’s Ministry of Health (Kemenkes RI).
Based on the results of her dissertation, with a “Very Satisfactory” grade and a GPA of 3.83, Roikhatul Jannah successfully graduated with a Doctorate in Public Health Science, making her the 37th graduate of the Public Health Doctoral Program in 2024, the 333rd graduate of the Public Health Science Doctoral Program at FPH UI, and the 428th graduate of FPH UI’s doctoral program.
The session was led by Prof. Dr. dr. Sudarto Ronoatmodjo, S.K.M., M.Sc., as the head of the examination committee. The promoter was Prof. dr. Budi Utomo, M.P.H., Ph.D., and the co-promoters were Ir. Ahmad Syafiq, M.Sc., Ph.D., and Wahyuddin, S.ST., M.Sc., Ph.D. The examination committee included Prof. Dr. dr. Sudarto Ronoatmodjo, S.K.M., M.Sc.; Prof. dr. Endang L. Achadi, M.P.H., Dr.PH.; Dr. Or. Bambang Trisnowiyanto, S.Pd., S.K.M., S.Tr.Kes., M.Or.; and Dr. Indra Supradewi, M.K.M. (DFD)