The Influence of Antenatal Yoga on Decreasing Anxiety Levels in

Primigravida Trimester I and II in Malang

Ririn Harini

and Dwi Handayani

Department of Nursing, Faculty of Health Sciences, University of Muhammadiyah Malang, Jalan Bendungan sutami 188A

Malang, Indonesia 65145

RSI Aisyiyah, Jl.Sulawesi no.16, Malang, Indonesia 65117

Keywords: Antenatal Yoga Anxiety Level, Primigravida Trimester I and II.

Abstract: Sunlight consists of ultraviolet (UV) light and based on its wavelength, the UV light could be categorized into

UVA, UVB, and UVC. Organic Ultraviolet (UV) filters can be found in plants and fruits which have orange-

red or pink colors, such as watermelon, tomato, Secang (Caesalpinia sappan), carrot, dragon fruit, faloak

(Sterculia quadrifida R.Br), strawberry, papaya, and rosella. Most of these plants contain active compounds

such as carotenoids and anthocyanin. Determination of the effectiveness of the extracts as potential sunscreen

was carried out by determining the Sun Protecting Factor (SPF) value in vitro by UV spectrophotometry.

Maceration technique was used for the extraction process by using ethanol with a ratio of 4:1. Each of dried

extract (100 mg) was then mixed well in the ethanol (96%, 50 mL) until all the extract was dissolved and then

filtered. The SPF values were determined by the Equation of Mansur. It was observed that all of the red

pigmented extracts showed UV protection capabilities, with Secang extract gave the highest SPF value of

18.490. The Secang extract would have good potential to be developed as one of the ingredients in the

sunscreen cream. Sunscreen cream combination between Secang extract and ZnO showed good quality and

significant SPF value than ZnO and extract Secang sunscreen cream.

1 INTRODUCTION

Pregnancy is a complicated process that begins with

conception or when a healthy sperm cell joins with an

egg followed by fertilization, nidation, and

implantation. A pregnancy usually lasts about 280

days or 40 weeks (9 months and 7 days). Pregnancy

is divided into three quarters: first-quarter pregnancy

(weeks 0 to 12), second-quarter pregnancy (weeks 13

to 28), and third-quarter pregnancy (weeks 28 to 40)

(Sulistyowati, 2012). According to Ida Bagus Gede

Manuaba, pregnancy is a growth and development of

the intrauterine fetus from conception up to early

labor (Sunarsih, 2012).

Physical and psychological changes gradually

during pregnancy from the first trimester to the third

trimester might cause anxiety. According to (Astuti et

al., 2017), the most felt changes that require great

adaptation is in the first trimester of pregnancy:

appetite changes, nausea and vomiting, feeling

exhausted, breast pain and gain weight.

Furthermore, psychological changes in the 1st-

trimester mood swings, anxiety, financial and

miscarriage worries, disappointment, rejection,

depression, and decreased libido. Physiological

changes in 2nd trimester are: leg swelling,

constipation, indigestion/bloating, vulvar

varicosities. Besides, psychological changes in the

2nd trimester are; (1) at the time before fetal

movement felt: changing self-identity from the

affection receiver into the giver, evaluating

interpersonal relationships with her mother, and

preparing to be a mother. (2) at the time when fetal

movements felt: realizing that the fetus is a separate

individual and needs to be cared for, focusing on

pregnancy and fetal well-being, feeling healthier,

being sad that she will leave her natural role and

afraid her husband will not like her body shape.

(Astuti et al., 2017).

Physical and psychological changes in 1st-

trimester pregnant women will have an impact on the

subsequent pregnancy process especially those who

have never experienced pregnancy (primigravida)

(Fauziah, Purwono and Abdurachman, 2016). Factors

Harini, R. and Handayani, D.

The Inﬂuence of Antenatal Yoga on Decreasing Anxiety Levels in Primigravida Trimester I and II in Malang.

DOI: 10.5220/0009122800880091

In Proceedings of the 2nd Health Science International Conference (HSIC 2019), pages 88-91

ISBN: 978-989-758-462-6

that can cause anxiety are age, parity, education,

work, husband support, environmental conditions.

However, 52% of pregnant women experience

anxiety or depression during pregnancy (Anxiety and

Depression Association of America, 2016).

The impact of anxiety is harmful for pregnant

women. It can affect the health of the fetus and the

mother. Around 33% of mothers have depression or

anxiety during pregnancy. It will affect the baby, such

as low birth weight, premature birth (before 37

weeks), low infant health level after delivered, poor

adaptation to extrauterine life and respiratory

problems. Thus, the risks experienced by mothers are

suicide, depression or postpartum anxiety, alcohol or

drug abuse, insufficient physical activity,

preeclampsia, preterm labor, and cesarean delivery,

Astuti, et al. (2017). Meanwhile, according to (Buss

et al., 2010) anxiety around pregnancy are prenatal

maternal anxiety is related to distinctive patterns of

structural brain development. Therefore the results

suggest that addressing mothers’ pregnancy-related

concerns and anxiety as a focus for intervention.

UNICEF Indonesia's study in 2014 Indonesian

Public Health book states that one woman dies during

childbirth or due to pregnancy every one hour.

(Wibowo and team (2014) in (Astuti et al., 2017). In

2017, there were 5,113 pregnant women had been

checked at Aisyiyah Hospital (Aisyiah, 2017). 4,573

of them went to the Gynecology Obstetrician and 540

to the KIA clinic. Pregnancy complications consist of

41 women miscarriage/abortion, 16 women

pregnancy with preeclampsia, 17 women pregnancy

bleeding, 24 babies born with premature conditions,

56 babies born weighing less than 2500 gram, and

351 labor with cesarean (Aisyiah, 2017).

According to the data above, the researchers

provide a solution for pregnant women to maintain

their physical and mental health using physical

training, antenatal yoga. Yoga is an ancient practice

that focuses on strength, flexibility, and respiration to

improve physical and mental health. The main

components of yoga are posture and breath. Yoga

originated in India around 5,000 years ago and has

been adapted in other countries in various ways.

The results showed yoga is a safe and effective

way to increase physical activity, especially strength,

flexibility, and balance. Some evidence shows regular

yoga practice is beneficial for people who have high

blood pressure, heart disease, aches and pains such as

lower back pain, depression, and stress (Astuti et al.,

2017). According to (Field et al., 2013; Mediarti et

al., 2014; Fauziah, Purwono and Abdurachman,

2016; Ashari, Pongsibidang and Mikhrunnisai, 2019)

doing prenatal yoga regularly might reduce anxiety or

stress of pregnant women and reviews of prenatal

yoga on reducing maternal discomfort during

pregnancy and anxiety/stress. It will make pregnant

women feel relaxed, both breathing and muscle.

Antenatal Yoga influences the anxiety level of

pregnant women in the third quarter of childbirth

(Aswitami, 2017). Also, research related to yoga

conducted on 94 pregnant women in Taipei shows the

effect of reducing stress during pregnancy and

boosting immunity (Chen et al., 2017).

Based on phenomena in the yoga community,

pregnant women can do exercise in second-trimester.

Besides, based on "Mother's Care in Pregnancy"

(Astuti et al., 2017), women may do yoga in the first-

trimester with only mild movements, by choosing the

most comfortable posture. From the researcher's

preliminary study result, from 10 primigravida

pregnant women, 100% of them didn't know they may

do antenatal yoga in the first quarter of pregnancy. 23

pregnant women who check their pregnancies at

Aisyiyah Hospital Malang stated: 10 first trimester

primigravida pregnant women (38.46%) felt anxiety

caused by complaints of nausea, vomiting, and

dizziness. Whereas out of 10 primigravida pregnant

women in the second trimester, 7 pregnant women

(26.92%) felt anxiety due to worries caused by

complaints of lower back pain, insomnia, legs

cramps, swollen feet, constipation, and 3 pregnant

women (11.53 %) felt anxiety towards the condition

of the baby (Aisyiah, 2017).

2 METHODS

This research applies cross-sectional design which is

a type of research to study the dynamics of the

correlation between risk factors and effects, through

observation or data collection at a time ( point time

approach ) (Notoatmodjo, 2012). This study was

conducted in a group (One Group Pretest Posttest), to

find out the effect of antenatal yoga on decreasing

anxiety levels in primigravida pregnant women. Data

were taken using a pre and post questionnaire carried

out antenatal yoga to obtain significant data.

3 RESULTS AND DISCUSSION

The results of the influence of antenatal yoga on

decreasing anxiety levels in trimester I and II

primigravida at RSI Aisyiyah Malang measured using

questionnaire sheets. The results of anxiety level

The Inﬂuence of Antenatal Yoga on Decreasing Anxiety Levels in Primigravida Trimester I and II in Malang

before doing antenatal yoga can be seen in Table 5.2

below:

Based on the results, it was found that most

respondents had a severe anxiety level of 11

respondents or 68.75%, moderate anxiety level of 5

respondents or 31.25% of the total respondents and

respondents who have mild levels of anxiety as many

as 0 respondents.

Table 1: Respondents Characteristics in RSI Aisyiyah

Malang from 4th to 26th June 2018.

Characteristics

(%)

Min

Max

Age (years)

Level of

education

-Elememtary

- Junior high

- Senior high

- University

Occupation

- Private

- Public

93,75

6,25

Table 2: Distribution of Anxiety Levels in Primigravida

Trimester I and II Before doing Antenatal Yoga at RSI

Aisyiyah Malang from 4th to 26th June 2018.

Anxiety

Level in

Primigravida

Trimester I and II

Frequency

Percentage (%)

Severe

68,75

Moderate

31,25

Mild

Amount

100

The Wilcoxon Test analysis results using the

SPSS program, it is stated that Z value = -3,530 with

a significance level of 0,000 (p <0.05), Sig value (2-

tailed) ≤ real level (α / 2). It means that H

rejected.

Thus it can be concluded "Antenatal Yoga Influence

Anxiety Levels in Primigravida Trimester I and II at

Aisiyah Hospital Malang". The Wilcoxon test results

can be seen in Table 5.4 below.

Table 3: Distribution of Anxiety Levels in Primigravida

Trimester I and II After Doing Antenatal Yoga at RSI

Aisyiyah Malang on 4th to 26th June 2018.

Anxiety Level in

Primigravida

Trimester I and

Trimester II

Frequency

Percentage (%)

Severe

Moderate

12,5

Mild

87,5

Amount

100

Picture 1: The Influence of Antenatal Yoga on Decreasing

Anxiety Levels in Primigravida Trimester I and II at RSI

Aisyiyah Malang.

Table 4: The Influence of Antenatal Yoga on Decreasing

Levels of Anxiety in Primigravida Trimester I and II at RSI

Aisyiyah Malang from 4 to 26 June 2018.

Variable

Mean

Value

Anxiety level

before doing

antenatal yoga

27,25

3.550

0,000

0.05

Anxiety level

after doing

antenatal yoga

12,75

1.238

The mean score of anxiety levels in primigravida

trimester I and II before doing antenatal yoga is 27.25,

the standard deviation is 3.550, and the minimum and

maximum scores are 20 and 32. Whereas the mean of

primigravida trimester I and II anxiety levels after

doing antenatal yoga is 12.75, the standard deviation

is 1.238, and the minimum and maximum scores are

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Pretest dan Postest

pretest postest

HSIC 2019 - The Health Science International Conference

10 and 15. Probability value = 0,000 and α value 0.05

so the P. value <α and Sig value (0,000) <0.05. The

H1 conclusion is accepted. Therefore, “Antenatal

yoga influence on decreasing anxiety levels in

primigravida trimester I and II in RSI Aisyiyah

Malang”.

4 CONCLUSIONS

The mean score of anxiety levels in primigravida

trimester I and II before doing antenatal yoga is 27.25,

the standard deviation is 3.550, and the minimum and

maximum scores are 20 and 32. Whereas the mean of

primigravida trimester I and II anxiety levels after

doing antenatal yoga is 12.75, the standard deviation

is 1.238, and the minimum and maximum scores are

10 and 15.

Probability value = 0,000 and α value 0.05 so the

P. value <α and Sig value (0,000) <0.05. The H1

conclusion is accepted. Therefore, “Antenatal yoga

influence on decreasing anxiety levels in

primigravida trimester I and II in RSI Aisyiyah

Malang”.

ACKNOWLEDGEMENTS

The researcher would like to thank all those who have

provided guidance and support for this research.

REFERENCES

Aisyiah, R. (2017) Medical Report Aisyah Hospital.

Anxiety and Depression Association of America (2016)

Pregnancy and Medication | Anxiety and Depression

Association of America, ADAA. Available at:

https://adaa.org/living-with-

anxiety/women/pregnancy-and-medication (Accessed:

4 November 2019).

Ashari, A., Pongsibidang, G. S. and Mikhrunnisai, A.

(2019) ‘Pengaruh Senam Prenatal Yoga terhadap

Penurunan Kecemasan Ibu Hamil Trimester III’, Media

Kesehatan Masyarakat Indonesia, 15(1), p. 55. doi:

10.30597/mkmi.v15i1.5554.

Astuti, S. et al. (2017) Asuhan Ibu dalam Masa Kehamilan.

Jakarta: Erlangga.

Aswitami, N. G. A. P. (2017) ‘Pengaruh Yoga Antenatal

Terhadap Tingkat Kecemasan Pada Ibu Hamil Tw Iii

Dalam Menghadapi Proses Persalinan Di Klinik

Yayasan Bumi Sehat’, Jurnal Kesehatan Terpadu, 1(1).

doi: 10.36002/jkt.v1i1.155.

Buss, C. et al. (2010) ‘High pregnancy anxiety during mid-

gestation is associated with decreased gray matter

density in 6-9 year-old children’,

Psychoneuroendocrinology. NIH Public Access, 35(1),

p. 141. doi: 10.1016/J.PSYNEUEN.2009.07.010.

Chen, P. et al. (2017) ‘Effects of prenatal yoga on women’s

stress and immune function across pregnancy: A

randomized controlled trial.’, Complementary

therapies in medicine, 31, pp. 109–117. doi:

10.1016/J.CTIM.2017.03.003.

Fauziah, L., Purwono, U. and Abdurachman, M. (2016)

Efektivitas Latihan Yoga Prenatal Dalam Menurunkan

Kecemasan Pada Ibu Primigravida Trimester Iii.

Available at: http://pustaka.unpad.ac.id/wp-

content/uploads/2016/09/Lestari-Fauziah-P-S.Psi.pdf.

Field, T. et al. (2013) ‘Tai chi/yoga reduces prenatal

depression, anxiety and sleep disturbances’,

Complementary therapies in clinical practice. NIH

Public Access, 19(1), p. 6. doi:

10.1016/J.CTCP.2012.10.001.

Mediarti, D. et al. (2014) ‘Pengaruh Yoga Antenatal

Terhadap Pengurangan Keluhan Ibu Hamil Trimester

III’, Jurnal Kedokteran dan Kesehatan : Publikasi

Ilmiah Fakultas Kedokteran Universitas Sriwijaya,

1(1), pp. 47–53. Available at:

https://ejournal.unsri.ac.id/index.php/jkk/article/view/

2567 (Accessed: 4 November 2019).

Notoatmodjo (2012) Metodologi Penelitian Kesehatan.

Sulistyowati, A. (2012) Asuhan Kebidanan Pada Masa

Kehamilan. Jakarta: Salemba Medika.

Sunarsih, D. (2012) Asuhan Kehamilan untuk Kebidanan.

Jakarta: Salemba Medika.

The Inﬂuence of Antenatal Yoga on Decreasing Anxiety Levels in Primigravida Trimester I and II in Malang