ETHE INFLUENCE OF TRADITIONAL BIRTH ATTENDANCE (TBA) AND CULTURE TOWARDS INDEPENDENCE AND SELF-CARING OF THE MOTHER DURING EARLY POSTPARTUM

Abstrak Berdasarkan Profil Kesehatan Jawa Barat pada tahun 2012, diketahui di Kabupaten Bogor sebanyak 23 orang ibu postpartum meninggal, padahal sudah sebanyak 87,4% ibu yang mendapatkan pelayanan postpartum oleh tenaga kesehatan.  Kondisi ini salah satunya dapat terjadi akibat komplikasi postpartum karena kurangnya pengetahuan ibu tentang perawatan diri pada masa postpartum. Padahal bidan harus dapat memberikan pendidikan kesehatan secara supportif-edukatif yang adekuat serta dukungan terhadap ibu postpartum, sehingga ibu merasa mampu merawat dirinyadan mencegah terjadinya masalah kesehatan pada masa postpartum. Kemandirian masa postpartum, dipengaruhi oleh faktor internal yang terdiri dari faktor fisik dan psikis, dan faktor lingkungan (eksternal) yang terdiri dari faktor linfkungan fisik, sosial budaya, ekonomi, dan lain sebagainya. Menurut Bloom faktor lingkungan mempengaruhi perilaku seseorang sampai dengan 45%. Salah satu faktor lingkungan yang cukup dominan pada ibu postpartum di Desa Babakan, Ciseseng, Kabupaten Bogor adalah pendampingan dukun bayi dan adat kebudayaan selama masa postpartum. Penelitian ini merupakan penelitian observasional dengan pendekatan cross sectional, dengan subjek penelitian ibu postpartum dini di Desa Babakan, Ciseeng, Kabuten Bogor. Lokasi tersebut dipilih karena di daerah tersebut, ketergantungan ibu postpartum terhadap dukun bayi dalam perawatan masa postpartum masih cukup tinggi. Penelitian dilakukan pada bulan Maret-Oktober 2018 terhadap 92 responden yang memenuhi kriteria inklusi dan eksklusi. Variabel dependent dalam penelitian yaitu kemandirian perawatan diri ibu selama masa postpartum dini. Sedangkan variabel independentnya adalah faktor lingkungan yang terdiri dari variabel pendampingan dukun bayi dan kebudayaan/ adat selama masa postpartum. Variabel diukur dengan kuesioner. Analisis data menggunakan uji koefisien kontigensi lamda. Hasil: terdapat terdapat hubungan pendampingan dukun bayi terhadap kemandirian dan perawatan diri ibu selama masa postpartum dini, terdapat hubungan budaya terhadap kemandirian dan perawatan diri ibu selama masa postpartum dini. Paritas, pendidikan, dan pekerjaan merupakan perancu yang berhubungan dengan perawatan diri ibu selama masa postpartum dini. Penghasilan dan pendidikan merupakan perancu yang berhubungan dengan kemandirian ibu selama masa postpartum dini. Saran: perlu adanya paket pemberdayaan ibu postpartum untuk meningkatkan pengetahuan ibu, sehingga dapat meningkatkan kemandirian dan juga perawatan diri yang baik bagi ibu postpartum dini. Kata  Kunci: Postpartum, perawatan diri, kemandirian, budaya     Abstract As many as 23 postpartum mothers died in Bogor District, even though 87.4% of mothers had received postpartum services by health workers. One of these conditions can occur due to postpartum complications due to a lack of maternal knowledge about self-care during the postpartum period. Midwives must be able to provide adequate supportive-educative health education as well as support for postpartum mothers, so mothers be able to care for themselves and prevent health problems during the postpartum period. The independence of the postpartum period is influenced by internal factors consisting of physical and psychological factors, and environmental factors (external) consisting of physical, socio-cultural, economic, and so on. According to Bloom environmental factors affect a person's behavior up to 45%. One of the dominant environmental factors in postpartum mothers in Babakan Village, Ciseseng, Bogor District is the assistance of traditional birth attendants and cultural customs during the postpartum period. This study was an observational study with a cross-sectional approach, with the subject of early postpartum maternal research in Babakan Village, Ciseeng, Bogor District. The location was chosen because, in the area, the dependence of postpartum mothers on TBAs in postpartum care was high. The study was conducted in August-October 2018 of 92 respondents who met the inclusion and exclusion criteria. The dependent variable in the study is the independence of maternal self-care during the early postpartum period. Whereas the independent variable is an environmental factor consisting of the variables of assistance for traditional birth attendants and culture during the postpartum period. Variables are measured by questionnaire. Data analysis used the Lamda contingency coefficient test. Results: there is a relationship between the dukun's assistance to the independence and self-care of the mother during the early postpartum period, there is a cultural relationship to the independence and self-care of the mother during the early postpartum period. Parity, education, and employment are confounders related to maternal self-care during the early postpartum period. Income and education are confounders related to maternal independence during the early postpartum. Suggestion: there is a need for a postpartum maternal empowerment package to increase maternal knowledge, increase independence and good self-care for early postpartum mothers. Keyword: postpartum, culture, independence, self-care