Improving Mother’s Knowledge in Early Detection of Pregnancy and Childbirth Complication

detection and treatment of birth complications can threaten the lives of the mother and fetus. Childbirth complications consist of bleeding (25%), infection (14%), hypertensive disorders in pregnancy (13%), complications of unsafe abortion (13%), and the consequences of prolonged labor or dystocia (7%)(Yuniarti et al., 2022). Hemorrhage is the main cause of death, most of which is caused by retention of the placenta Abstract Pregnancy and childbirth complications and high risks, which are estimated to occur in 15–20% of pregnant women, are not all detected early. For those detected, not all of them have been handled in a timely and adequate manner. In one of the provinces in Indonesia, namely Lampung, there are still many women giving birth at home. Research results in the form of population-based information about birth complications in mothers must rely on reporting about mothers' experiences through interviews. The Community Health Center has carried out health promotion activities both periodically and incidentally about the health of mothers and babies. However, it is very unfortunate that people do not really understand the danger signs and how to detect early labor, so treatment is still too late. The targets for this activity were 30 pregnant and breastfeeding mothers who came to Posyandu. The types of activities carried out include providing education about recognizing the danger signs of pregnancy and childbirth and using the IKA-LIN booklet as an instrument for detecting childbirth complications. All community service participants were given a pre-test, followed by a presentation regarding the danger signs of pregnancy, after which booklets were given to all participants, and the final stage was the post-test. The final session also included questions and answers regarding the mother's experience during childbirth. There was an increase in mothers' knowledge based on the results of the pre-test and post-test.


A. Introduction
Every woman must know and be aware of the danger signs during pregnancy because complications in pregnancy are sometimes unpredictable (Isdiaty & Ungsianik, 2013).These danger signs include vaginal bleeding, severe headaches, visual disturbances, high fever, edema on the face and limbs, and decreased fetal movement, which can lead to complications in pregnancy, childbirth, and postpartum.Pregnant women's knowledge of these danger signs will help them make the right decision to seek help from a health facility quickly.The act of asking for help appropriately will reduce maternal morbidity and mortality (Pamungkas et al., 2020).
Pregnancy and childbirth complications and high risks, which are estimated to occur in 15-20% of pregnant women, are not all detected early (Bayuana et al., 2023;Retnaningtyas et al., 2022;Yunita et al., 2017).For those detected, not all of them have been handled in a timely and adequate manner.Delay in the detection and treatment of birth complications can threaten the lives of the mother and fetus.Childbirth complications consist of bleeding (25%), infection (14%), hypertensive disorders in pregnancy (13%), complications of unsafe abortion (13%), and the consequences of prolonged labor or dystocia (7%) (Yuniarti et al., 2022).Hemorrhage is the main cause of death, most of which is caused by retention of the placenta

Abstract
Pregnancy and childbirth complications and high risks, which are estimated to occur in 15-20% of pregnant women, are not all detected early.For those detected, not all of them have been handled in a timely and adequate manner.In one of the provinces in Indonesia, namely Lampung, there are still many women giving birth at home.Research results in the form of populationbased information about birth complications in mothers must rely on reporting about mothers' experiences through interviews.The Community Health Center has carried out health promotion activities both periodically and incidentally about the health of mothers and babies.However, it is very unfortunate that people do not really understand the danger signs and how to detect early labor, so treatment is still too late.The targets for this activity were 30 pregnant and breastfeeding mothers who came to Posyandu.The types of activities carried out include providing education about recognizing the danger signs of pregnancy and childbirth and using the IKA-LIN booklet as an instrument for detecting childbirth complications.All community service participants were given a pre-test, followed by a presentation regarding the danger signs of pregnancy, after which booklets were given to all participants, and the final stage was the posttest.The final session also included questions and answers regarding the mother's experience during childbirth.There was an increase in mothers' knowledge based on the results of the pre-test and post-test.(Kurniasih et al., 2021;Kristianingsih et al., 2019;Umrah & Dahlan, 2020).Other than that, maternal depression can lead to serious pregnancy complication such as pre-eklampsia (Hilinti et al., 2021).
In one of the provinces in Indonesia, namely Lampung, there are still many women giving birth at home (Arisandi et al., 2016).Research results in the form of population-based information about birth complications in mothers must rely on reporting about mothers' experiences through interviews.Assessing the validity of maternal reporting of birth complications is critical.Especially in Lampung, where many people live in rural areas and are not exposed to much information about the danger signs of birth complications, which can make information about mothers' experiences inaccurate (Ida & Afriani, 2021).Mothers' reports of their birth experiences may differ from the clinical diagnosis established by physicians as the gold standard.Therefore, the IKA-LIN instrument was developed as a tool for early detection of labor complications.This instrument has been tested and obtained quite high reliability and validity values (Elmeida, 2021).
Village Which There is in the region subdistrict Coral New that's Way Huwi, Dawn New, Jatimulyo, Coral Anyar, Rejo Mulyo, Clan Great, Clan Rich, and Karang Sari.Way Huwi Village, Jati Agung District, is within the working area of Puskesmas Karang Anyar.Health data up to the month In May 2023, the number of pregnant women in Way Huwi Village was 17 pregnant women.This village is the closest to a health service, namely the Karang Anyar Health Center.Apart from that, there are also health clinics that provide maternal and child health services.Apart from that, posyandu activities are also running well, as seen by the number of posyandu visits each month.There are 10 posyandu in the village, namely: white stem posyandu, jasmine 1, jasmine 2, dahlia, ylang ylang, hope mother, flamboyant, rose, jewel, and sekar sari.The number of cadres is 50; each posyandu contains 5 cadres.Apart from the posyandu, there is also a mothers' group, the PKK, and farmer groups as vehicles, as well as the public.
The Community Health Center has carried out health promotion activities both periodically and periodically incidental about health Mother And baby.Activity promotion No only carried out inside the building but also outside the building.However, it is very unfortunate that people do not really understand the danger signs and how to detect early labor so treatment is still too late.

B. Research Methods
This method of implementing community service activities is divided into several stages.The first stage is preparation, namely preparation materials, equipment activity, and taking care of administration activity.Implementation of community service activities includes providing education on the importance of recognizing the danger signs of pregnancy and childbirth using lecture and question-and-answer methods.The media used were presentations using PowerPoint and IKA-LIN booklets.Reporting is prepared as a result of activities and as activity performance devotion for the public by Civitas Academics Health Polytechnic Tanjungkarang.Activity held in Posyand u Mawar 3 on Jl.Prison, Village Way Huwi Jati Agung District, South Lampung Regency in early June 2023 Target activity Devotion to the Public This covers mothers pregnant and breastfeeding who come to Posyandu Roses with a total of 3 people.Participants were given a pre-test and post-test related to complications during childbirth.

C. Result and Discussion
This community service activity was carried out well on June 10, 2023, at Posyandu Mawar 3 Way Huwi Village, Jati Agung District, which is the working area of the Karanganyar Health Center, South Lampung, while still implementing health protocols.This activity starts at 08.30 until finished.This activity is led by Dr. Ika Fitria Elmeida, S.Si.T., and M.Keb, the chief executive, who gave a speech in the form of opening community service activities.Community service events were carried out with the following structure: 1. Giving pre-test questions 2. Providing material on the danger signs of pregnancy and childbirth 3. Providing the IKA-LIN booklet and explanation 4. Giving post-test questions All community service participants were given a pre-test, followed by a presentation regarding the danger signs of pregnancy, after which booklets were given to all participants, and the final stage was the post-test.The final session also included questions and answers regarding the mother's experience during childbirth.From the answers of some participants, it shows that counseling at Posyandu Mawar 3 has not been carried 92 JENTIK ABDIGERMAS  Elmeida, I. F., Purwaningsih, D., Risneni, R., & Suja, M. D. D.
Jurnal Ilmiah Pengabdian Masyarakat Bidang Kesehatan Vol 1, No 3, pp 97-100 2023 out intensively.Apart from asking questions about mothers' experiences during childbirth, participants also actively participated in a series of activities and enthusiastically asked questions until the end of all activities.The results that can be evaluated directly are increasing knowledge for pregnant women regarding the danger signs of pregnancy, which can be seen in the pre-test and post-test results (Table 1) in the Karanganyar Community Health Center working area, especially participants at Posyandu Mawar 3.This community service activity was accompanied by village officials, namely the village head and village head, as well as Karanganyar Community Health Center health workers, including the coordinator midwife, village midwife, and posyandu cadres.
Mother can increase their knowledge about the danger sign in pregnancy with so many ways, such as attending antenatal care more than six times during the pregnancy (Rini et al., 2023).One of the effective way to improve mother's knowledge about danger sign in pregnancy and childbirth is by giving the mother's education when they come to Posyandu every month (Retnaningtyas et al., 2022).Therefore, mother pregnancy class have a positive impact to improve mother's ability to do early detection of complication in pregnancy (Ida & Afriani, 2021;Komariyah & Abdullah, 2020).In Indonesia there is a program called P4K to prevent complication during pregnancy.Umami ( 2017) study prove that SMS can be a media to increasing mother's knowledge.
Ongoing follow-up activities will be carried out in the form of assisting pregnant, maternity, and breastfeeding mothers in providing exclusive breast milk to support the prevention of complications in birthing mothers (Oktavia, 2018).Apart from that, providing education regarding the danger signs during pregnancy and childbirth so that pregnant women know how to detect early complications in their pregnancy quickly so they can access and get quality health services can reduce the maternal mortality rate (MMR) (Katmini, 2020).

D. Conclusion
This community service activity was carried out well on June 10, 2023, at Posyandu M.Awar 3 Way Huwi Village while still implementing health protocols.The targets for this activity were 30 pregnant and breastfeeding mothers who came to Posyandu.The types of activities carried out include providing education about recognizing the danger signs of pregnancy and childbirth and using the IKA-LIN booklet as an instrument to detect childbirth complications.There is the improvement in mother's knowledge after giving them a short lecturer and booklet.

E. Acknowledgement
We would like to thanks to Karang Anyar Public Health Center and Government of South Lampung for supporting this research activity.

Table 1 .
Pre-test and Post-test Results of Mother's Knowledge about Childbirth Complications