ABSTRAKLatar  belakang : Penyebab langsung kematian ibu antara lain komplikasi pada kehamilan, persalinan, dan nifas yaitu perdarahan (30-35%), eklamsi (28,76%), infeksi (20-25%), gestosis (15-17%) (Sarwono Prawiroraharjo.2008) Perdarahan dan eklamsi merupakan kasus kegawatdaruratan yang memerlukan tindakan bidan secara cepat dan tanggap. Masalah muncul ketika tindakan yang diambil memiliki risiko yang cukup besar, sehingga mengharuskan bidan untuk meminta persetujuan tindakan medis (informed consent). Tujuan : Mengeksplorasi persepsi bidan tentang peran dan fungsi bidan sebagai pelaksana, pengelola, pendidik dan peneliti  pada tindakan kegawatdaruratan. Metode Penelitian : Penelitian ini menggunakan metode kualitatif. Teknik pengumpulan data dengan wawancara mendalam. Jumlah informan adalah 3 Bidan yang bekerja di Puskesmas wilayah Dinas Kesehatan Kota Semarang. Hasil: Hasil wawancara mendalam pada informan didapatkan informasi tentang Persepsi bidan dalam pengertian informed consent yaitu persetujuan dalam melakukan tindakan kegawatdaruratan, peran dan fungsi bidan sebagai pelaksana khusunya melaksanakan tugas mandiri, peran dan fungsi bidan sebagai pengelola dalam mengembangkan pelayanan kesehatan ibu dan anak, peran dan fungsi bidan sebagai pendidik dengan mewujudkan sebagai role model untuk anak didik, peran dan fungsi bidan sebagai peneliti baik secara langsung atau tidak langsung melalui identifikasi. Saran :  untuk bidan agar memahami peran dan dan fungsinya sebagai  bidan di puskesmas, bagi puskesmas memaksimalkan tenaga kesehatannya khusunya bidan. Kata kunci : informed consent, peran dan fungsi bidanDaftar Pustaka: 24  (2008-2015) ROLE AND FUNCTION OF THE MIDWIFE IN THE IMPLEMENTATION OF THE INFORMED CONSENT IN HEALTH EMERGENCIES OBSTETRIC COMMUNITY HEALTH CENTERS ABSTRACTBackground: The immediate causes of maternal mortality include complications in pregnancy, childbirth, and puerperal bleeding (30-35%), eclampsy (28.76%), infection (20-25%), gestosis (15-17%). (Sarwono Prawiroraharjo.2008) Bleeding and eclampsia is an emergency case that requires fast and responsive midwife action. Problems arise when actions taken have substantial risks, requiring the midwife to seek informed consent. Objective: To explore midwives' perceptions of the role and function of midwives as implementers, managers, educators and researchers on emergency measures. Research Method: This research uses qualitative method. Data collection techniques with in-depth interviews. Number of informants is 3 Midwives who work in PUskesmas area Health Department of Semarang City. Result: The result of in-depth interview on informant obtained information about midwives perception in the sense of informed consent that is approval in performing emergency action, role and function of midwife as executor especially carry out independent duty, role and function of midwife as manager in developing mother and child health service, function of midwife as educator by realizing as role model for student, role and function of midwife as researcher either directly or indirectly through identification. Suggestion: for midwife to understand role and function as midwife in puskesmas, for community Health centers maximize health worker especially midwife.Keywords: informed consent, role and function of midwife

The birth process is to help and encourage safe and healthy births for mothers and babies, so that the roles and responsibilities of health workers are needed to anticipate and overcome the complications that occur in labor. Prolong labor is one of the factors that influence maternal mortality. The result of the Survey on 2015 is Maternal Mortality Rate (MMR) is 305 per 100,000 live births in Indonesia. The rebozo technique is a non-pharmacological method that makes the muscles of the pelvis more relaxed and gives the pelvic space more space and  open so that it helps accelerate the opening of the cervix and help descending of the fetal head, so that can help shorten the time of delivery. The aim of the study was determined the differences in the effectiveness of the rebozo technique on cervical dilatation and descend of the fetal head in active phase of first stage in labor mothers. Methodology of this study was Quasy experimental design. It take pre-post test on one group design. Population and sample were 20 primigravidas mothers in active phase of the first stage of labor. Sampling technique used accidental sampling. The result of this study that there was effectiveness of rebozo technique on opening of the cervix during the active phase with p-value 0.012. Conclusion is there was an effectiveness of the rebozo technique for descending of fetal head in the active phase of the first stage of maternal delivery with p-value 0.028

ABSTRAKRuptur perineum merupakan robekan pada perineum yang terjadi pada saat bayi lahir secara spontan maupun menggunakan alat atau tindakan. Ruptur perineum pada primipara terjadi karena kondisi perineum kaku, jalan lahir belum pernah dilewati oleh bayi. Upaya pencegahan ruptur perineum bisa dilakukan dengan cara pijat perineum dan supercrowning. Tujuan Penelitian untuk mengetahui perbedaan efektifitas pijat perineum dan supercrowning terhadap derajat ruptur perineum . Jenis penelitian adalah quasi experiment, desain penelitian menggunakan post-test only control group. Populasi Penelitian ini adalah ibu bersalin primipara di UPT Puskesmas Kragan II sebanyak 59 ibu bersalin. Sampel Penelitian ini adalah ibu bersalin primipara sebanyak 36 ibu bersalin dengan accidental sampling. Analisa data menggunakan Mann Whitney untuk melihat adanya perbedaan efektifitas pijat perineum dan supercrowning terhadap derajat ruptur perineum  pada ibu bersalin primipara. Hasil penelitian nilai mean rank pada kelompok yang diberikan perlakuan pijat perineum 12,33 dan pada kelompok yang diberikan perlakuan supercrowning 24,67 dan nilai p-value=0,000 (<0,05). Ada perbedaan efektifitas pijat perineum dan supercrowning terhadap derajat ruptur perineum  pada ibu bersalin primipara. Pijat perineum lebih efektif mencegah derajat ruptur perineum  pada ibu bersalin primipara.Kata kunci: pijat perineum; supercrowning; ruptur perineum. EFFECTIVENESS  DISTICNTION OF PERINEUM MASSAGE AND SUPERCROWNING TOWARDS DEGREE OF PERINEUM RUPTURES IN PRIMIPARA MOTHERS ABSTRACTPerineal rupture is a tear in the perineum that occurs when a baby is born spontaneously or uses tools or actions. Perineal ruptur in primipara occurs because of a rigid perineum, the birth canal has never been passed by the baby causing ruptur of the perineum. The efforts to prevent perineal rupture can be done by massaging the perineum and supercrowning. The purpose of this study was to determine the differences in the effectiveness of perineal massage and supercrowning on the level of perineal rupture. The type of research used is quasi experiment. The design of this study used a post-test only control group. The population of this research was 59 primiparous mothers in Kragan II Health Center. The sample of this research was 36 primiparous mothers. Sampling technique in this study used accidental sampling. Data analysis used Mann Whitney to see differences in the effectivness of perineum massage and supercrowning on the level of perineal ruptur in primiparaous mothers. Mean rank in the interventionof perineal massage is 12,33, while in supercrowning group  is 24.67 and p-value = 0,000 (<0.05). There is a difference in the effectiveness of perineum massage and supercrowning on the level of perineal rupture in primiparous mothers. From the results of this study the perineum massage is more effective in preventing the level of perineal rupture in primiparous maternal  Keywords: perineum massage; supercrowning; perineum rupture

ABSTRAKLatar belakang: Survey di PONED Puskesmas Ketanggungan, hasil bulan Maret sampai Nopember 2020, 6 ibu bersalin dari 296 ibu bersalin yang rapid test dinyatakan reaktif. Bidan mempunyai resiko tinggi karena harus kontak langsung dengan pasien. Tujuan : Untuk mengeksplorasi tentang peran bidan dalam menolong persalinan selama pandemi Covid-19 di PONED Puskesmas Ketanggungan Metode: Jenis penelitian kualitatif dengan pendekatan fenomenologis, tehnik analisis deskriptif dilaksanakan dari September 2020 sampai Februari 2021. partisipan 4 orang dan 2 triangulasi sumber. Hasil: bidan sebagai pelaksana yaitu pemeriksaan swab rapid kepada pasien, persalinan menggunakan APD level 2 dan protokol kesehatan sesuai standar. bidan sebagai pengelola adalah  mengelola pelayanan persalinan dan pembagian tugas dalam tim. bidan sebagai pendidik yaitu  memberikan edukasi dan informasi menjaga protokol kesehatan, pemeriksaan swab rapid sebelum dilakukan tindakan, pendamping yang hanya 1 orang persalinan. bidan sebagai peneliti adalah memastikan status pasien terpapar Covid  atau tidak, mendata ibu bersalin terpapar Covid, merencanakan asuhan dan melakukan asuhan, mendokumentasikannya, merencanakan tindak lanjutnya. Kesimpulan : Pelaksanaan peran bidan sebagai pelaksana, pengelola, pendidik dan peneliti berjalan secara maksimal, hambatan bisa diatasi sehingga bisa melaksanakan peran secara mandiri: Saran: masukan kepada bidan untuk mengoptimalkan perannya dalam menolong persalinan selama pandemi Covid-19.Kata kunci: Peran Bidan;  Persalinan; Pandemi Covid 19THE ROLE OF MIDWIVES IN HELPING CHILDBIRTH DURING THE COVID 19 PANDEMIC IN NEONATAL OBSTETRIC SERVICES EMERGENCY BASIC, KETANGGUNGAN COMMUNITY HEALTH CENTER, BREBES DISTRICTABSTRACTBackground: The survey at the PONED of the Keanggungan Health Center, the results from March to November 2020, 6 maternity mothers out of 296 maternity mothers whose rapid tests were declared reactive. Midwives have a high risk because they have direct contact with patients. Objective: To explore the role of midwives in assisting childbirth during the Covid-19 pandemic at PONED Puskesmas Ketanggungan Method: This type of qualitative research with a phenomenological approach, descriptive analysis technique was carried out from September 2020 to February 2021. 4 participants and 2 triangulation of sources. Results: midwives as implementers, namely rapid swab examinations for patients, deliveries using level 2 PPE and health protocols according to standards. the midwife as the manager is managing the delivery service and the division of tasks in the team. midwives as educators, namely providing education and information on maintaining health protocols, rapid swab checks before taking action, only 1 assistant giving birth. The midwife as a researcher is to ensure the patient's status is exposed to Covid or not, to record maternal exposure to Covid, to plan care and provide care, to document it, to plan follow-up actions. Conclusion: Implementation of the role of midwives as implementers, managers, educators and researchers runs optimally, obstacles can be overcome so that they can carry out their roles independently: Suggestion: input to midwives to optimize their role in helping childbirth during the Covid-19 pandemic.Keywords: Role of Midwives; Labor; Covid 19 pandemic

Childbirth is a process of expulsion from the conception (fetus and placenta) which is quite months or can live outside the womb through the birth canal or through other ways, using the assistance or without assistance (strength alone or spontaneous). Pelvic rocking can help the mother in an upright position, staying upright when in labor will allow the uterus to work as efficiently as possible by making the pelvic plane wider and open. Other physiological efforts besides moving pelvic rocking are gym ball exercises. A physical therapy ball that helps with labor and can be used in various positions. The purpose of this study was to determine the differences in the effectiveness of pelvic rocking and gym ball exercise for a long time I. This type of research is a quasi experiment using Post test only nonequivalent control group design, there were 30 respondent categoriezed into an intervention group (n=15) pelvic rocking and birth ball exercise (n=15). There is a difference in the effectiveness of pelvic rocking and gym ball exercise against the length of time I (P-value 0. 023). Pelvic rocking and gym ball exercise can accelerate the duration of labor in the first stage.