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"[ABSTRAKLatar belakang: Persalinan prematur sekarang ini menjadi tantangan dibidangobstetri. Ini terlihat dari tingginya angka prematur di dunia. Dua hal yang harusdiperhatikan dalam kehamilan prematur yaitu kontraksi dan pemberian kortikosteroiduntuk pematangan paru, maka dibutuhkan suatu penanganan dengan menggunakanobat tokolitik. Saat ini telah banyak digunakan terbutalin sulfat yang merupakangolongan agonis beta dan juga nifedipine yang merupakan golongan penyekat kanalkalsium. Namun penggunaan agonis beta menyebabkan efek yang kurang baik padaibu seperti takikardi, dispnoe dan ansietas sehingga penggunaannya sekarang mulaiterbatas. Tujuan: Tesis ini bertujuan mengetahui perbandingan efektifitas nifedipineoral dibandingkan dengan terbutalin sulfat sebagai tokolitik dalam kehamilanprematur. Metode: Penelitian ini merupakan uji klinis randomisasi tanpa penyamaranpada ibu hamil prematur di kurang dari 34 minggu di RSUPN Cipto mangunkusumo.Hasil: dari 60 subyek yang diikutsertakan dengan consecutive sampling, didapatkan56 subyek (93,3%) hilang kontraksi dengan rincian 27 subyek (90,0%) padakelompok nifedipin dan 29 subyek (96,7%) pada kelompok terbutalin (p=0,61).Kelompok yang diberikan nifedipin hilang kontraksi dengan median waktu 1,25(0,67-2,00) jam sementara kelompok yang diberikan terbutalin hilang kontraksi lebihcepat dengan median waktu 0,50 (0,50-1,50) jam (p<0,001). Tidak ada perbedaan efek samping yang ditemukan pada kedua kelompok. Simpulan: Nifedipin dan terbutalin memiliki efektifitas yang sama pada kehamilan prematur.

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ABSTRACTBackground: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ;Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ;Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. , Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ]"

"Bayi prematur menghadapi banyak tantangan ketidakseimbangan cairan untuk bertahan di lingkungan ekstrauterin, sehingga membutuhkan pendekatan asuhan keperawatan yang komprehensif. Studi kasus ini menggambarkan proses keperawatan menggunakan model Konservasi Levine untuk merawat lima bayi prematur dengan ancaman keseimbangan cairan. Pengkajian mengidentifikasi triphocognosis meliputi risiko kekurangan volume cairan dan masalah cairan lainnya. Perawat anak merawat sesuai kompetensi, seperti pemantauan kesesuaian cairan masuk dan kebutuhan, pengurangan jumlah insensible water loss, blood management, dan peningkatan kemampuan minum melalui mulut. Intervensi membantu bayi prematur dan keluarga berhasil beradaptasi untuk mencapai wholeness. Penerapan model ini menyediakan pengalaman asuhan keperawatan yang komprehensif sebagai referensi untuk kasus serupa selanjutnya.

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Preterm infants faces many challenges of fluid imbalance for survive in the extrauterine environment. It needs comprehensive nursing care approach. This study describes a nursing process using Levine’s Conservation model to care five preterm infants with threat to fluids imbalance. The assessments identified triphocognosis including risk of deficient fluid volume and other related problems. Pediatric nurse care according to competencies, such as monitoring the suitability of fluid intake and requirement, reducing the amount of insensible water loss, blood management, and increased oral feeding ability. The interventions helped the preterm infant and family adapt successfully to achieve wholeness. This application of model provides a comprehensive nursing care experience as reference for future similar cases."

"Karya ilmiah akhir ini memberikan gambaran penerapan Model Konservasi Levine pada asuhan keperawatan pada bayi dengan risiko kerusakan integritas kulit dan pencapaian kompetensi sebagai spesialis keperawatan anak. Trophicognosis risiko kerusakan integritas kulit menurut Levine merupakan gangguan pada integritas struktur. Intervensi keperawatan dilakukan untuk mengatasi masalah integritas struktur tersebut dengan memperhatikan pula konservasi energi, konservasi integritas personal dan konservasi integritas sosial. Intervensi dilakukan dengan menerapkan aspek perawatan kulit dan cara memposisikan yang benar. Evaluasi yang dilakukan dengan mengkaji respon organismik bayi, menunjukkan bahwa belum semua bayi mampu mencapai wholeness yang ditandai dengan cedera pada nares, namun sudah mengalami perbaikan. Perawat memegang peranan yang sangat penting dalam pencegahan cedera pada nares yaitu pemilihan alat yang tepat, pemantauan dan pemenuhan kenyamanan bayi sehingga bayi tidak banyak bergerak dan mempercepat proses penyapihan continuous positive airway pressure (CPAP).

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This Final Assignment gave an overview about the application of Levine's Conservation Model in nursing care of baby with risk of skin integrity breakdown and competency achievement as a pediatric nurse specialist. According to Levine, trophicognosis of skin integrity breakdown was the structure integrity impaiment. Nursing interventions was undertaken to solve structure integrity problem, and also energy conservation, personal conservation and social conservation. Nursing interventions applied the skin care aspetcs and positioning. Evaluation had been done by evaluate the organismic responses of the baby, showed that not all the baby got wholenes, was marked by nares injury, but getting better. Nurse had the crucial role to prevent nares injury, that to choise the appropriate tool, monitored ang gave baby’s comfort so the baby did not much to move and weaned the continuous positive airway pressure (CPAP) as soon as possible."

"Penulisan karya ilmiah akhir ini bertujuan untuk memberikan gambaran penerapan teori Model Konservasi pada bayi dengan kebutuhan asuhan perkembangan. Bayi berat lahir rendah (BBLR) membutuhkan adaptasi yang luar biasa agar dapat mempertahankan kelansungan hidupnya, oleh sebab itu dibutuhkan perawatan NICU. Namun ternyata dampak dari perawatan NICU yang lama mengakibatkan tingginya angka kesakitan dan disabilitas pada BBLR kedepannya. Oleh sebab itu intervensi dini harus sudah diberikan sejak awal bayi mulai dirawat melalui asuhan perkembangan. Asuhan perkembangan adalah segala upaya yang dilakukan dalam rangka memberikan dukungan fisik, psiko dan sosial kepada bayi berat lahir rendah dengan cara memodifikasi lingkungan agar dapat mempromosikan pertumbuhan dan perkembangannya. Salah satu intervensi dini yang dapat memperbaiki kekurangan stimulasi yang membangun untuk meningkatkan pertumbuhan dan perkembangan adalah stimulasi taktil kinestetik yang dilakukan oleh ibu.

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This scientific final assignment is intended to describe the application of the theory of Conservation Model in infants with developmental care needs. Low birth weight infants needs a great effort to adapt and survive, therefore need neonatal intensive care unit (NICU). But it turns out the impac to fthe old NICU care resulting in high morbidity and disability. Therefore,early intervention should have been given since the beginning of the baby was admitted through developmental care. Developmental care is all the efforts made in order to facilitate and support the physical, social and psycho of low birth weight infant through modifications to the environment to be able to promote the growth and development of low birth weight infant. One of the early intervention that can correct the lack of stimulation to promote growth and development is a tactile kinestetic stimulation by the mother."

"Bayi kurang bulan yang dirawat di rumah sakit seringkali mengalami nyeri yang disebabkan oleh prosedur diagnostik dan terapeutik. Tujuan dari studi kasus ini adalah memberikan gambaran aplikasi Model Konservasi Levine pada bayi kurang bulan dengan masalah nyeri. Model Konservasi Levine berfokus pada peningkatan adaptasi melalui prinsip konservasi untuk mencapai wholeness. Metode penelitian ini adalah studi kasus. Lima bayi kurang bulan yang mengalami masalah nyeri akut dirawat dengan pendekatan proses keperawatan berdasarkan teori Model Konservasi Levine. Masalah keperawatan lain yang ditemukan adalah pemenuhan nutrisi kurang dari keutuhan tubuh, risiko volume cairan kurang dari kebutuhan tubuh, risiko infeksi, ikterik neonaturum, gangguan pertumbuhan dan perkembangan risiko gangguan perlekatan orang tua dan bayi. Masalah-masalah tersebut dapat memperberat rasa nyeri dan menghambat proses adaptasi bayi kurang bulan dalam mencapai integritas diri.

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Preterm infants who is hospitalized, experience pain frequently that caused by diagnostic and procedure treatment. This study aim to describe the application of Levine’s Conservation Model in preterm infants who experienced pain. Levine's Conservation Model focuses on improving adaptation through conservation principles to achieve wholeness. This research method is case study with nursing process approach. Levine’s Conservation Model applied in five selected cases that have problem acute pain. The other nursing problems are nutrition less than body requirements, risk for deficient fluid volume, risk of infection, neonaturum icteric, impaired growth and development, risk of attachment disorder between parents and babies. All of the problems can aggravate pain and inhibit the process of adaptation in preterm infant to reaches wholeness."

"Prematuritas merupakan salah satu penyebab terbesar morbiditas dan mortalitas bayi termasuk kematian neonatal. Penelitian ini bertujuan mengetahui besar hubungan prematuritas dengan kematian neonatal di Indonesia setelah seluruh variabel confounding (umur ibu, urutan kelahiran, jarak kelahiran, komplikasi kehamilan, komplikasi persalinan, tingkat pendidikan ibu, pekerjaan ibu, status ekonomi ibu, frekuensi ANC, komponen ANC 5T plus, penolong persalinan, tempat persalinan, jenis persalinan, dan wilayah tempat tinggal ibu) dikendalikan dan mengetahui besar PAR (Population Attributtable Risk) prematuritas terhadap kematian neonatal di Indonesia tahun 2010. Desain studi penelitian ini adalah kasus kontrol (1:4) dengan analisis multivariat regresi logistik ganda menggunakan data sekunder Riskesdas 2010. Jumlah sampel dalam penelitian ini adalah 120 kasus dan 480 kontrol. Hasil penelitian menunjukkan bahwa besar hubungan prematuritas dengan kematian neonatal setelah dikendalikan variabel confounding (komplikasi kehamilan, komplikasi persalinan, frekuensi ANC) yaitu OR sebesar 9,31 (95% CI : 4,63-18,70) dan PAR sebesar 19,96%. Untuk menurunkan kematian neonatal, diharapkan pemerintah dan masyarakat dapat berperan aktif dalam penurunan dan penanggulangan prematuritas sedini mungkin dengan peningkatan pelayanan antenatal.

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Prematurity is one of the biggest main cause of morbidity and mortality of infant including the neonatal death. Aims of this research are to know how big the relationship between prematurity and neonatal death in Indonesia after all variables of confounding (age of mother, turn of birth, gap of birth, complication of pregnancy, complication of labor, mother’s education level, mother's job, mother's economic status, frequency of ANC, component of ANC 5T plus, labor helper, place of labor, kind of labor and mother’s region) have been controlled and to know how big the PAR (Population Attributtable Risk) of prematurity and neonatal death in Indonesia on 2010. The design of this research is case control (1:4) with multiple logistic regression to multivariate analysis using secondary data of Riskesdas 2010. The number of sample in this research is 120 cases and 480 controls. The result of this research shows the strong relation between prematurity and neonatal death after controlled by variables of confounding (complication of pregnancy, complication of labor, frequency of ANC) is OR as 9,31 (95% CI : 4,63-18,70) and PAR as 19,66%. To decrease the neonatal death, hopefully the government and public will actively support in decreasing and preventing the prematurity by improving the effectiveness of ANC."

"Respon anak yang dirawat terhadap hospitalisasi berbeda-beda. Untuk mengurangidampak hospitalisasi yang timbul pada anak yang dirawat, peneliti mencoba memberikan terapi bermain pada anak yang dirawat. Penelitian ini bertujuan untuk mengetahui gambaran respon balita yang rnengalami hospitalisasi sebelum dan sesudah terapi bermain, rnengetahui sejauhrnana peran perawat pemberi terapi bermain berdasarkan tanggapan orang tua, memberikan gambaran jenis terapi bemain pada balita berdasarkan isi dan karakter sosialnya, mengukur efektifitas terapi bermain terhadap hospitalisasi. Penelitian deskriptif korelasi dengan 35 responden ini menggunakan alat ukur lembar observasi dan kuisioner."

"This research explain investigated the correlation between utilization birth attendant and knowledge, attitude and practice among Baduy tribe..."

"Keberadaan seorang ibu merupakan tonggak utama tercapainya keluarga yang sejahtera karena ibu mempunyai nilai strategis dalam pembangunan sumber daya manusia yang sekaligus merupakan kelompok rawan karena resiko kesakitan dan kematian. Angka kematian ibu (AM) dijadikan salah satu indikator nasional yang digunakan dalam menilai tingkat kesejahteraan ibu dan derajat kesehatan. Dibandingkan dengan negara ASEAN lainnya, angka kematian ibu di Indonesia masih relatif tinggi. Pemanfaatan penolong persalinan adalah satu mata rantai dalam upaya penurunan angka kematian ibu dan bayi. Tujuan penelitian adalah untuk memperoleh informasi tentang hubungan pemeriksaan kehamilan dengan pemanfaatan penolong persalinan. Penelitian ini menggunakan data sekunder dari data Survei Kesehatan Ibu dan Anak Indonesia tahun 2001 dengan desain cross sectional. Sampel adalah wanita yang sudah menikah, berumur 15-45 tahun dan pernah melahirkan anak, baik lahir hidup maupun lahir mati dalam satu tahun terakhir. Hasil penelitian menunjukkan bahwa pemeriksaan kehamilan oleh tenaga kesehatan sebesar 94,3%, akan tetapi yang memanfaatkan tenaga kesehatan sebagai penolong persalinan hanya 62,6%. Hasil uji regresi logistik menunjukkan bahwa ibu yang tidak memeriksakan kehamilan ke tenaga kesehatan (tidak ANC) mempunyai peluang 5,09 kali memanfaatkan bukan tenaga kesehatan sebagai penolong persalinan setelah dikontrol variabel pendidikan dan pengetahuan ibu. Selain itu akses terhadap media informasi dan status ekonomi keluarga juga berhubungan secara independen dan bermakna dengan pemanfaatan penolong persalinan. Upaya yang dapat dilakukan untuk meningkatkan pemanfaatan tenaga kesehatan dalam pelayanan kesehatan ibu hamil dan bersalin di Propinsi Jawa Barat adalah dengan meningkatkan ketrampilan tenaga kesehatan dalam konseling-komunikasi interpersonal, memberikan layanan antenatal yang lebih berkualitas, pemantapan sistem rujukan yang komprehensif dari keluarga, masyarakat, puskesmas sampai rumah sakit serta mengupayakan kesinambungan pembiayaan kesehatan bagi keluarga miskin khususnya pelayanan kesehatan ibu hamil/bersalin serta rujukan melalui APBD propinsi dan kabupaten/kota setelah program JPS-BK berakhir.

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Relationship between Antenatal Care History and Birth Delivery Assistant Utilization in the Province of West Java 2001 (Secondary Data Analysis: Indonesia Mother and Child Survey, 2001)The existence of a mother is the main pillar to attempt a welfare family due to it has a strategic value in human resource development. Also, the mother is classified as vulnerable group because of having morbidity and mortality risk. Maternal Mortality Rate (MMR) is one of national indicators assessing the level of well-being mother and health status. In comparison with other ASEAN countries, MMR in Indonesia is relatively high. So, in order to decrease MMR and Infant Mortality Rate (IMR), delivery assistant utilization is an important chain.

The objective of the study was to obtain the information about relationship between antenatal care and birth delivery assistant utilization. This study used secondary data from Indonesia Mother and Child Survey 2001 as well as a cross sectional design, The sample of this study was married women aged 15-45 years and having given birth history, both alive or stillbirth in the last one year.

The results showed that antenatal care provided by health provider was 94.3% but of those who utilized health provider as birth delivery assistant was 62.6%. Logistic regression test revealed that mothers who did not examine their pregnancy to the health provider had chance 5.09 times to utilize other provider beside health provider as their birth delivery assistant after being controlled by mother's educational and knowledge. Furthermore, the access to information media and economical status in the family related to birth delivery assistant utilization independently and significantly.

It is recommended that some attempt that could be conducted to increase health provider utilization in health care for pregnant women and delivery women in the Province of West Java by increasing the health provider's skill on interpersonal communication and counseling, providing quality antenatal care and comprehensive referral system, as well as trying to give continuous health expenses for the poor family, particularly providing the service for pregnant/delivery women."

"Doula adalah seseorang yang terlatih dan tersertifikasi untuk melakukan pendampingan kepada ibu selama hamil, bersalin dan pasca persalinan. Doula memberikan dukungan kepada ibu dengan tujuan agar ibu siap secara fisik dan psikologis dalam menghadapi kehamilan dan persalinannya kelak. Salah satu manfaat penggunaan jasa doula adalah meningkatkan akses pelayanan kesehatan. Angka bersalin oleh dukun di beberapa wilayah Kota Bogor masih cukup tinggi. Diharapkan dengan adanya adaptasi konsep doula (pendamping persalinan) di Kota Bogor dapat meningkatkan cakupan persalinan oleh tenaga kesehatan. Penelitian ini bertujuan untuk mengetahi dukungan yang doula berikan kepda ibu selama proses pendampingan dan membandingkannya dengan program penyelamatan maternal (motivator KIA) di Kota Bogor. Metode penelitian ini menggunakan pendekatan kualitatif dengan pengumpulan data melalui observasi dan wawancara mendalam. Informan pada penelitian ini adalah doula, penyedia jasa doula, ibu hamil dan suami yang menggunakan jasa doula yang ada di wilayah Jakarta. Kepala Bidang Kesehatan Masyarakat,Kepala Seksi Kesehatan Keluarga Kota Bogor, Bidan Koordinator PONED Puskesmas Cipaku, kader dan dukun bayi (paraji) yang ada di wilayah kerja Puskesmas Cipaku. Hasil penelitian ini menunjukan dukungan yang diberikan doula kepada kliennya meliputi pemberian motivasi, afirmasi (sugesti) positif, pemberian pujian, dukungan jasa, waktu, menyusun brith plan, pemenuhan nutrisi, aktivitas fisik dan melakukan disukusi bersama. Perbedaan antara konsep dukungan doula dengan program penyelamatan ibu (motivator KIA) hanyalah pada segi dukungan secara mental dan psikologis. SDM yang tepat untuk melakukan program pendampingan persalinan di Kota Bogor adalah kader dan dukun paraji, sedangkan uang transport yang diberikan dapat dialokasikan dari APBD dan BOK.

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Doula is a trained and certified person to assist mother during pregnancy, childbirth and postpartum. Doula provides support to the mother with the aim that mothers are physically and psychologically ready in the face of pregnancy and childbirth someday. One of the benefits of using doula services is improving access to health services. Birth rate by shamans (paraji) in some areas of Bogor is still quite high. It is expected that with the adaptation of doula concept (birth attendant) in Bogor City can increase the coverage of delivery by health personnel.

This study aims to find out the support that doula give kepda mother during the mentoring process and compare it with the program of maternal rescue (motivator KIA) in the city of Bogor. This research method using qualitative approach with data collection through observation and in-depth interview. Informants in this study were doula, doula service providers, pregnant women and husbands using doula services in the Jakarta area. Head of Public Health Section, Head of Family Health Section of Bogor, Midwife Coordinator of PONED, cadre and shamans "paraji" in Cipaku Public Health Service.

The results of this study show that the support given by the doula to the client includes motivation, positive affirmation, praise, service support, time, brith plan, nutritional fulfillment, physical activity and joint engagement. The difference between the concept of doula support and the mother's rescue program (maternal and child health motivator) is only in terms of mental and psychological support. The right human resources to conduct mentoring programs in Bogor are cadres and paraji shamans, whereas the given transport money can be allocated from APBD and BOK."