The Correlation Number Of Parity On Third Trimester Of Pregnancy To Anxiety In Confronting Birth Labour

Anxiety is a condition that experiencing anxious, fear that followed by somatic symptoms to inform there was hyperactivity in autonomy neural system. Number of parity is one of factor that emerge anxiety in pregnancy. The aim of this study to find out the correlation number of parity on third trimester of pregnancy to anxiety in confronting birth labor phase in BPM Walladatun Islah A.MKeb Batu Aji. The design of this study was used cross sectional which is independent variable and dependent variable was taken in the same time. The population of samples are 71 pregnancy mothers (read: respondents) in their third trimester in working area of BPM Walladatun Islah A.MKeb Batu Aji, and method of sampling was simple random sampling. The instrument of this study was using questionnaire that was spread around August to September 2019. The data analyze was using Personal Chi Square. The result is 50 pregnancy mother with primigravid, there is 1 respondent with no anxiety symptom (2,0%), 20 respondents (40,0%) with mild anxiety, and 10 respondents (20,0%) with moderate anxiety, 16 respondents (32,0%) severe anxiety, and 3 respondents (6.0%) very severe anxiety. Whereas 21 respondents with multigravida , which is one respondent with no anxiety at all (4,8%), 16 respondents ( 76,2%) with mild anxiety, and 2 respondents (9,5%) with moderate anxiety, one respondent (4,8%) with severe anxiety, and one respondent (4,8%) with very severe anxiety. The analyze of Chi Square was shown of p-value 0,44 (p<0,05). The conclusion there is a correlation number of parity on third trimester to anxiety in confronting birth labor in BPM Walladatun Islah A.MKeb Batam City in 2019.


INTRODUCTION
Pregnancy is period of transition form, life time before having baby and after that baby born. The changing of status was considering as crisis time due to endure normal birth labor and the peak was when the baby is born. 1 Pregnancy is divided into three trimester, 1 st trimester, 2 nd trimester, 3 rd trimester. Each trimester in pregnancy, mother will experiencing physical changes. These changes will cause anxiety. 2 Anxiety is one of psychological changes in mother who entering third trimester. Anxiety is affective disorder that signs with intensify fear and worry persistently with no disturbance in assessing reality( Reality Testing Ability), and intact personality( no splitting of personality), with behavior changes but still in normal boundaries. 3 Anxiety in pregnancy is a emotional condition which is look like general anxiety but this happen in pregnancy due to baby prosperity, like the process of delivering baby, all treatment during pregnancy and changing status to become parent. 3 Anxiety can caused bad impact to pregnancy such as hamper the process of delivery the baby, like irregular contraction begin of uterus, and the passage is become rigid, and hard to open, and the baby may not come out 4 .
prevalence of anxiety levels in pregnant women in portugal (18.2%), Hongkong (54%), and Pakistan (70%), even in Bangladesh 18 % mothers suffering depression and 29% experiencing anxiety 5 . Meanwhile, in poor countries, around 25-50% of deaths of women of childbearing age are caused by problems related to pregnancy, childbirth and childbirth, World Health Organization, 2014, the maternal mortality rate (MMR) reached 289,000.
More than 90% women in UK have psychological disorders during pregnancy. Whereas in French about 7,9% mothers with primigravida suffering anxiety during pregnancy, and 11, 8% mother suffering depression during pregnancy, and 13,2 % suffering depression and anxiety in same time 4 Indonesia has 373,000,000 pregnant women, and those who experience anxiety in the face of childbirth are 107,000,000 people (28.7%). Research conducted by Field states that women who are about to give birth experience anxiety, 10% of women are calm in the face of childbirth and more than 60% of pregnant women experience depression 6 Based on research that been done in Center of Public Health (Puskesmas) Jetis, Yogyakarta City, there 42 respondents (54,4%) with mild anxiety in confronting birth labor, while 31 respondents (40,3%) with moderate anxiety, and 4 respondents with severe anxiety (5,2%). Due to big amount of mothers in experiencing anxiety with primigravida it can caused all the experiences that never been felt before in their lifetime before pregnant, and become worrying about things that must be prepared for birth labor and after it 3 Factors that influenced in third trimester pregnancy to birth labor phase such as, ages, number of parity, education, family support. 7 . Women less than 20 years old or more than 35 years old gave impact in feel fear and worry toward birth labor phase due to high risks pregnancy. The closer time of labor phase the more worry and anxiety that mother will experiencing especially in their first labor.
Whereas in multigravida pregnancies unpleasant feeling happen because they will remind about the pain, nervous in their past birth labor 8 By looking this background, this study was aim to knowing about the correlation number of parity on third trimester of pregnancy to anxiety in confronting birth labour in BPM Walladatun Islah, A.MKeb, Batam City, Batu Aji.

METHOD
The design of this study is using Cross Sectional.

DISCUSSION
In this study that can be found is 50 respondents with low of number parity (70,4%). Parity is number of pregnancy that produce fetus who can have ability life outside the uterus (28 weeks). 9 . Parity is life born baby that belongs to woman. Rochajati cited Manuaba ( 2010), parity is one of factor that influence to the conception. Uterus that produced more than one children tend to inefficiently to all period in labor.
Primigravida and multigravida (more than 3) are higher risk to maternal death. The higher number of parity, the more higher to maternal death. In Primigravida risk can maintain by obstetrically, while risks in multigravida can reduce or prevent with family planning since most of the pregnancy were not planned Mothers with primigravida tend to healthier condition than mother with multigravida, and some of diseases associate to multigravida 10 . According to 11 , multiparity 2-3 was considerate safe from maternal death.
Based on this study the level of the anxiety in confronting labor phase on their third trimester pregnancy in BPM Walladatun Islah Am.Keb, most of respondents experiencing moderate anxiety 36 prespondents (50,7%) dan 17 respondents with severe anxiety. This anxiety happens due to their first pregnancy (primigravida). This is due to the experience of the first pregnancy that the respondent has never felt before so that the respondent becomes anxious because they do not know what to prepare.
From the results of this study, there were 2 people who did not experience anxietystates, in general, individuals cannot be separated from stressors and experiences of anxiety, where the emergence of anxiety for each individual varies according to its level. The difference is because each individual has experience in using coping mechanisms 12 According, 13 , Fitriana Ikhtiariniwati Fajrin (2017), stated most of respondents feeling moderate anxiety. Different to Kallo,etc (2014), it stated that their respondents feel panic.
This research is in line with the research of 13 , 14 , which states that the majority of respondents experience moderate anxiety. In contrast to the research results of 15 , which stated that the majority of respondents experienced panic anxiety. Approaching the delivery process, not a few expectant mothers experience anxiety during childbirth Anxiety cannot be avoided from the individual's life in maintaining balance and this anxiety usually accompanies fear. Anxiety is a disturbance in feelings characterized by deep and continuous feelings of fear or worry, no disturbance in assessing reality, personality is still intact, behavior can be disturbed but still within normal limits 16 . According to 17  The results showed that the majority of primigravida mothers experienced mild and severe anxiety, while the majority of multigravida mothers experienced moderate anxiety. This shows that the mother who is going to give birth is experiencing moderate and severe anxiety. During the period of