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"Tujuan penelitian ini adalah untuk mengeksplorasi secara mendalam pengalaman hubungan seksual perempuan paska melahirkan dengan seksio sesarea. Penelitian kualitatif ini menggunakan pendekatan fenomenologi. Sampel dalam penelitian ini sebanyak 6 partisipan dengan karakteristik berbeda. Perempuan yang menjadi partisipan sudah diidentifikasi mempunyai pengalaman hubungan seksual paska seksio sesarea dan mampu menceritakan pengalamannya. Pengumpulan data dengan tehnik wawancara mendalam.Metoda yang digunakan untuk analisa data yaitu metoda Colaizzi's. Setelah data dianalisa, peneliti mendapatkan 5 thema: (1) persepsi adanya perubahan hubungan seksual sesudah seksio sesarea, hubungan seksual sebagai kewajiban dan hal penting, (2) pengalaman perempuan memulai hubungan seksual setelah 7 minggu sampai 4 bulan paska seksio sesarea, atas inisiatif suami, dan respon seksualnya berbeda-beda (3) perasaan sakit dan takut saat hubungan seksual merupakan masalah yang dialami partisipan (4) perempuan mengharapkan hubungan seksual dilakukan apabila luka operasi sembuh, dilakukan dengan tenang dan perlahan (5) partisipan membutuhkan informasi atau penyuluhan dari perawat, diharapkan lebih tanggap terhadap permasalahannya.Kesimpulan penelitian ini bahwa pengalaman hubungan seksual paska seksio sesarea dari keenam partisipan didominasi oleh perasaan takut. Rekomendasi berupa: pengembangan program disharge teaching, pemberian pendidikan kesehatan yang efektif, membentuk layanan konseling, penelitian lebih lanjut dan masukan untuk program keperawatan maternitas.

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The purpose of this research was to explore deeply an experience the woman's sexual activity who delivered with caesarean section. A qualitative research used phenomenological approach. Sample in this research was six participants with different characteristics. The women who became participants were identified that they had an experience of sexual activity post caesarean section and capable to explain their experiences. Data collection utilized in-depth interviews.

Colaizzi's method was used for data analysis, so researcher found five themes: (1) perceptions of presence changing after caesarean section in sexual activity, it was as duty and important (2) women's experiences initiated intercourse after 7 weeks until 4 months post caesarean section because of their husband's initiative, and their sexual response were different (3) Feeling of pain and fear were participants problem when they were making love (4) Women's hope that intercourse should be done if the wound repaired, with calmly and slowly (5) the participants needed information or health education from nursing and they hope that nurse could bit, well aware of their problem.

Conclusion of this research, the experience of each participant was dominated with fear. Recommendations were: to develop discharge teaching program, to provide effective health education, available counseling program, continuing research and input for maternity nursing program."

"Latar Belakang : Hipotensi adalah komplikasi yang paling sering terjadi pada analgesia spinal. khususnya pada pasien obstetrik. Hipotensi terjadi karena blok simpatis. Salab satu cara untuk menurunkan insiden hipotensi adalah dengan menurunkan dosis obat analgetika lokal dan kombinasi dengan opioid untuk analgesia infra dan postoperatif. Fentanil intratekal memiliki rnula kerja yang lebih cepat dibanding morfin dan memberikan analgesia postoperatif yang cukup singkat. Intratekal fentanil menurunkan ketidaknyarnanan ibu intraoperatif saat penarikan peritonium atau manipulasi uterus.Metode : 86 ibu hamil yang akan menjalani operasi bedah sesar elektif maupun darurat dibagi secara random dalam 2 kelompok. Kelompok I diberikan 10 mg bupivakain 0.5;o hiperbarik plus 12,5 gig fentanil dan Kelompok 11 diberikan 12,5 mg bupivakain 0.5% hiperbarik. Tinggi hambatan maksimal, masa kerja dan masa pulih sensori diuji menggunakan uji pin-prick. Mula kerja, mass kerja dan masa pulih motorik dinilai dengan skala Modifikasi Bromage. Tekanan darah, frekuensi denyut nadi dan frekuensi nafas dicatat setiap 2 menit dalam 20 menit pertama. Insiden hipotensi. mual muntah_ pruritus dan depresi nafas dicatat.Hasi1 : Data demografik dan data dasar tidak berbeda bermakna. Insiden hipotensi tidak berbeda bermakna antara kelompok fentanil dan kontrol (39,5% banding 48.8%;p>0.05). Median tinggi maksimal blok sensori tidak berbeda bermakna antara kedua kelompok (T5: p>0.05). Masa kerja dan masa pulih hambatan sensori Iebih lama pada kelompok fentanil dibanding kontrol (104,21±29,199 vs 72,60±19,538 menit; 153.21±30.671 vs 124,88±21,001 menu ; p<0.05). Masa kerja dan masa pulih hambatan motorik lebih singkat pada kelompok fentanil dibanding kontrol (99.44120.466 vs 65.95=17.845 menit ; 49.60±18.611 vs 114.14±11.823 menit : p<0,05). Insiden muai muntah tidak berbeda bermakna antara kedua kelompok. Tidak ada pasien pada kedua kelompok mengalami insiden depresi nafas. Insiden pruritus berbeda bermakna (p>0,05).Kesimpulan : Insiden hipotensi tidak berbeda bermakna antara kedua kelompok. Dosis bupivakain yang lebih rendah akan menyebabkan masa kerja blok motorik lebih singkat tanpa berpengaruh pada blok sensori. Penambahan fentanil- intratekai _akan memperpanjang masa kerja hambatan sensori. Insiden pruritus berbeda bermakna pada kelompok fentanil jika dibandingkan dengan kelompok bupivakain.

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Backgrounds : Hypotension was the most common complication ,franc spinal analgesia. especially in obstetric patients. Hypotension developed because of svmpatlretic blockade. One method to reduced hi pnten.vwn incidence in caesarean .section was two reduced the doses of local atutlge& drugs and combined with opioul for infra and post operative analgesia. hrtratltecal lipophilic opioid had faster onset of sensory blockade than nrorfne and produced a brief post operative analgesia. Intrathecal feuitanvl decreased maternal discomfort intraoperatively when peritoneum pulled or uterus exrerioration.

Methods : 86 parturients undergoing elective or emergency cesarean section were randomized into one of 2 groups. In group I, spinal analgesia bras performed with 111 mg 0,5% hyperbaric hupivacaine plus /2,5 pg fenianyl and in Group 11 with 12,5 mg 0,5% hyperbaric hupiracain. the max/man season. blockade, duration of analgesia and recovery time were test using pin-prick test. Onset, duration and recovery of motor block were assessed using modified 1lromage scale. Blood pressure. heart rate and respiration rare were recorded even' 2 minute in f rst 20 minutes. The incidence of hypotension, nausea vomiting. pruritus and respiratory depression were recorded.

Results : "There were no significant differences in demographic and baseline value. Incidence of hypotension did not significantly different between fentanyl group and control (39,5% versus 48,8%: p-° 0.115). Tire median maximum block height did not significantly different between two groups (75 ; p 0.05). Duration of analgesia and sensory recovery time was significantly longer in fentonvl group compared to control (104,21-29.199 vs 72.60=19,538 minute 153,21=30.67I vs 124,88=21,001 minute : p<0,05). Onset of motor blockade did not significantly different between two groups. Duration and recovery time of motor blockade was more, shorter in fentanyl group compared to control (99,44=20,466 vs 65,95=17,845 minute ; 49,60,18,611 vs 114,14 -11.823 minute p<0,05). Incidence of nausea and vomiting did not significantly different between two groups. None of the patient in hnt11 groups had respiratory depression episode. Pruritus incidence significantly different (p. (1,05).

Conclusion : Incidence of hypotension did not significantly different between two groups. Smaller doses of bupivacaine results--more shorter time of-motor-blockade with no effect on sensory block. Adding fenianyl intrathecally will prolong the duration of analgesia. Pruritus incidence signifcanl/y different with intrathecal fentanyl when compared with bupivacaine alone."

"[Penelitian ini bertujuan untuk membuktikan efektivitas mengunyah permen karet dan intervensi mobilisasi dini. Sebuah penelitian time series, 46 wanita pasca bedah sesar elektif dengan anestesi spinal dibagi ke dalam dua kelompok. Uji man-whitney dan chi-square digunakan untuk analisis statistik. Frekuensi bising usus (7 ± 5-10 dibanding 6 ± 1-8,). Waktu pertama kali flatus (7 ± 6-10 dibanding16 ± 11-20), secara signifikan lebih cepat muncul pada kelompok mengunyah permen karet dan intervensi mobilisasi dini dibandingkan dengan yang intervensi mobilisasi dini. Nilai masing-masing p=0,00 dan p=0,00. Mengunyah permen karet dan intervensi mobilisasi dini efektif dalam mempercepat pengembalian motilitas usus pasca bedah sesar dan dapat digunakan sebagai manajemen protokol pasca operasi;The aim of study was to prove the effectiveness of gum‑chewing and early mobilization intervention. A time series study with fourty-six women for elective caesarean section under spinal anaesthesia were divided into two groups. The Student’s man-whitney and chi‑square test were used for statistical analysis. The frequency of bowel sounds (7 ± 5-10 vs 6 ± 1-8). The first passage of flatus (7 ±6-10 vs 16 ± 11-20), were significantly reduced in patients that chewed gum and early mobilization intervention compared with early mobilization intervention. p=0,00 and p=0,00, respectively. Gum‑chewing and early mobilization intervention have a beneficial effect on early return of bowel function following cesarean section and should be included in the postoperative management protocol., The aim of study was to prove the effectiveness of gum‑chewing and earlymobilization intervention. A time series study with fourty-six women for electivecaesarean section under spinal anaesthesia were divided into two groups. TheStudent’s man-whitney and chi‑square test were used for statistical analysis. Thefrequency of bowel sounds (7 ± 5-10 vs 6 ± 1-8). The first passage of flatus (7 ±6-10 vs 16 ± 11-20), were significantly reduced in patients that chewed gum andearly mobilization intervention compared with early mobilization intervention.p=0,00 and p=0,00, respectively. Gum‑chewing and early mobilizationintervention have a beneficial effect on early return of bowel function followingcesarean section and should be included in the postoperative managementprotocol.]"

"Bayi 0-6 bulan memerlukan ASI eksklusif untuk pertumbuhan dan perkembangannya. Akan tetapi berbagai kendala dirasakan ibu untuk menyusui eksklusif terutama pada ibu paska bedah sesar. Penelitian ini bertujuan mengetahui prediktor pengambilan keputusan untuk menyusui eksklusif pada ibu paska bedah sesar. Desain yang digunakan adalah potong lintang, dengan 97 responden, dan analisis data dengan regresi logistik berganda. Hasil penelitian menunjukkan 53.6% responden memutuskan untuk menyusui eksklusif. Prediktor pengambilan keputusan untuk menyusui eksklusif adalah paparan informasi, pengetahuan, sikap tentang menyusui eksklusif, dukungan keluarga, dan dukungan petugas kesehatan, sedangkan yang tidak berhubungan adalah umur, pendidikan, paritas, dan nyeri. Prediktor paling dominan yang mempengaruhi pengambilan keputusan untuk menyusui eksklusif adalah sikap yang baik tentang menyusui eksklusif. Penelitian ini merekomendasikan agar mempertimbangkan sikap tentang menyusui eksklusif, pengetahuan tentang menyusui eksklusif, dukungan keluarga, dukungan petugas kesehatan dan penyebaran informasi tentang menyusui untuk mensukseskan program menyusui eksklusif.Predictors of Decision Making to Exclusive Breastfeeding of Post Cesarean Section Mother. The baby aged 0-6 month needs exclusive breastfeeding for growth and development. However, the constraints were found by the mother to exclusive breastfeeding, especially for mother after cesarean section. This study aimed to identify the predicting factors related to the exclusive breastfeeding decision-making of mothers post caesarean section. This study applied cross sectional design with 97 respondents. The data are analyzed using multiple logistic regressions. The result showed that 53.6% of respondents decided to provide exclusive breastfeeding. Factors related to exclusive breastfeeding decision-making were attitudes about exclusive breastfeeding, knowledge, family support, and health professionals? support, while unrelated factors were age, pain history, parity, and education. The most dominant factor associated with exclusive breastfeeding decision-making was attitude about exclusive breastfeeding. It is recommended to consider the attitudes, knowledge, family support, health professionals? support, and providing information about breastfeeding to succeess the exclusive breastfeeding programs."

"Inisiasi menyusu dini (IMD) adalah meletakkan bayi di dada ibu segera setelah bayi lahir dan dibersihkan untuk melakukan kontak kulit antara dada ibu dan bayi, membiarkan bayi menemukan puting ibu untuk menyusu. Proporsi IMD di Dunia sebesar 42% ; ASIA Timur 32% ; ASIA Selatan 40%; dan di Indonesia 56,5%. Penundaan IMD biasanya disebabkan karena bayi lahir dengan dengan sectio cesarea (SC) karena perawatan pasca operasi yang lama sehingga menunda kontak ibu-bayi dan kemungkinan dilakukannya IMD menjadi kecil. Penelitian ini dilakukan untuk mengetahui pengaruh persalinan Caesar terhadap upaya pelaksanaan IMD, menggunakan data individu Survei Demografi dan Kesehatan Indonesia (SDKI) Tahun 2017 dengan desain cross-sectional. Sampel dibagi menjadi dua kelompok yaitu ibu dengan bayi yang melakukan IMD (n=8418) dan ibu dengan bayi yang tidak melakukan IMD (n=4238). Data bersifat kategorik dan dianalisis dengan uji regresi logistik ganda. Persalinan dengan SC berisiko 2,7 kali untuk tidak melakukan IMD setelah dikontrol oleh variabel paritas; kunjungan ANC; berat lahir; interaksi antara persalinan Caesar dengan pekerjaan suami; interaksi antara persalinan Caesar dengan pendidikan ibu; dan interaksi antara persalinan Caesar dengan kunjungan ANC. Diharapkan agar dilakukan penapisan secara ketat agar persalinan tanpa indikasi tidak dilakukan tindakan SC, sehingga menurukan angka persalinan SC. Dibuatnya undang-undang mengenai upaya pelaksanaan IMD segera setelah bayi lahir baik bayi yang lahir dengan pervaginam maupun SC.

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Early initiation of breastfeeding (EIBF) is placing the baby on the mother's chest as soon as the baby is born and clean to make sure skin-to-skin contact between the mother's chest and the baby, letting the baby find the mother's nipple. The proportion of EIBF in the world was 42%; East ASIA 32%; South ASIA 40%; and in Indonesia 56.5%. Delayed of initiation of breastfeeding was usually caused by the baby was born by cesarean section (CS) because prolonged postoperative care, delaying mother-infant contact, making EIBF less likely. This study was conducted to determine the effect of the CS delivery on the implementation of early initiation of breastfeeding using the 2017 Indonesian Demographic and Health Survey (IDHS) data with a cross-sectional design. The sample of this study were grouped into two groups, baby-mothers who did EIBF (n=8418) and baby-mothers who did not EIBF (n=4238). Data were categorical and analyzed by multiple logistic regression tests. Delivery with c-section had a 2.7 times risk of not getting EIBF after being controlled by the parity variable; ANC visit; birth weight; the interaction between the type of delivery and the work of the husband; the interaction between the type of delivery and the mother's education; and the interaction between the type of delivery and the ANC visit. It is hoped that a strict screening will be carried out so that deliveries without indications will not be performed by c-section, thereby reducing the number of CS deliveries. The drafting of a law regarding the implementation of EIBF immediately after the baby is born, either babies born with vaginal or CS."

"Latar Belakang : Hipotensi adalah komplikasi yang paling sering terjadi pads analgesia spinal, khususnya pada pasien obstetrik. Hipotensi terjadi karena blok simpatis. Salah satu cara untuk menurunkan insiden hipotensi adalah dengan menurunkan dosis obat analgetika lokal dan kombinasi dengan opioid untuk analgesia intra dan postoperatif. Fentanil intratekal memiliki mule kerja yang lebih cepat dibanding morfin dan memberikan analgesia postoperatif yang cukup singkat. Intratekal fentanii menurunkan ketidaknyamanan ibu intraoperatif saat penarikan peritonium atau manipulasi uterus.Metode : 86 ibu hamil yang akan menjalani operasi bedah sesar elektif maupun darurat dibagi secara random dalam 2 kelompok. Kelompok I diberikan 10 mg bupivakain 0,5% hiperbarik plus 12,5 µg fentanil dan Kelompok II diberikan 12,5 mg bupivakain 0,5% hiperbarik. Tinggi hambatan maksimal, masa kerja dan masa pulih sensori diuji menggunakan uji pin-prick. Mula kerja, masa kera dan masa pulih motorik dinilai dengan skala Modifikasi Bromage. Tekanan darah, frekuensi denyut nadi dan frekuensi nafas dicatat setiap 2 menit dalam 20 menit pertama. Insiden hipotensi, mual muntah, pruritus dan depresi nafas dicatat.Hasil : Data demografik dan data dasar tidak berbeda bermakna. Insiden hipotensi tidak berbeda bermakna antara kelompok fentanil dan kontrol (39,5% banding 48,8%;p0,05). Median tinggi maksimal blok sensori tidak berbeda bermakna antara kedua kelompok (T5 ; pp0,05). Masa kerja dan mesa pulih hambatan sensori lebih lama pada kelompok fentanil dibanding kontrol (104,21129,199 vs 72,60+19,538 merit ; 153,21+30,671 vs 124,88+21,001 menit ; p<0,05). Mula kerja, masa kerja dan masa pulih lebih singkat pada kelompok fentanil dibanding kontrol (99,44+20,466 vs 65,95+17,845 minute ; 49,60+18,611 vs 114,14+11,823 minute ; p<0,05). Insiden mual muntah tidak berbeda bermakna antara kedua kelompok. Tidak ada pasien pada kedua kelompok mengalami insiden depresi nafas. Insiden pruritus berbeda bermakna (p0,05).Kesimpulan : Insiden hipotensi tidak berbeda bermakna antara kedua kelompok. Dosis bupivakain yang lebih rendah akan menyebabkan masa kerja blok motorik lebih singkat tanpa berpengaruh pada blok sensori. Penambahan fentanil intratekal akan memperpanjang masa kerja hambatan sensori. Insiden pruritus berbeda bermakna pada kelompok fentanil jika dibandingkan dengan kelompok bupivakain.

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Backgrounds : Hypotension was the most common complication from spinal analgesia, especially in obstetric patients. Hypotension developed because of sympathetic blockade. One method to reduced hypotension incidence in caesarean section was to reduced the doses of local analgesic drugs and combined with opioid for intro and post operative analgesia. Intrathecal Iipophilic opioid had faster onset of sensory blockade than morfine and produced a brief post operative analgesia. Intrathecal fentanyl decreased maternal discomfort intraoperatively when peritoneum pulled or uterus exteriozation.

Methods : 86 parturients undergoing elective or emergency cesarean section were randomized into one of 2 groups. In Group I, spinal analgesia was performed with 10 mg 0,5% hyperbaric bupivacaine plus 12,5 pg fentanyl and in Group II with 12,5 mg 0,5% hyperbaric bupivacain. The maximum sensory blockade, duration of analgesia and recovery time were test using pin prick test. Onset, duration and recovery of motor block were assessed using modified Bromage scale. Blood pressure, heart rate and respiration rate were recorded every 2 minute in first 20 minutes. The incidence of hypotension, nausea vomitting, pruritus and respiratory depresion were recorded

Results : There were no significant differences in demographic and baseline value. Incidence of hypotension did not significantly different between fentanyl group and control (39,5% versus 48,8%;p>0,05). The median maximum block height did not significantly different between two groups (5 ; p>0,05). Duration of analgesia and sensory recovery time was significantly longer in fentanyl group compared to control (104,211_29,199 vs 72,60119,538 minute ; 153,21130,671 vs 124,88±21,001 minute , p<0,05). Onset of motor blockade did not significantly different between two groups. Duration and recovery time of motor blockade was more shorter in fentanyl group compared to control (99,44+_20,466 vs 65,95±17,845 minute ; 49,60±18,611 vs 114,14111, 1,823 minute ; p<0,05). Incidence of nausea and vomitting did not significantly different between two groups. None of the patient in both groups had respiratory depresion episode. Pruritus was significantly different (p<0, 05).

Conclusion : Incidence of hypotension did not significantly derent between two groups. Smaller doses of bupivacaine results more shorter time of motor blockade with no effect on sensory block Adding fentanyl intrathecally will prolong the duration of analgesia. Pruritus incidence significantly derent with intrathecal fentanyl when compared with bupivacaine alone."

"Menurut standar nasional, pelayanan obstetri harus mampu melakukan tindakan bedah sesar emergensi dalam waktu 30 menit dari keputusan dibuat (response time). Evaluasi pada tahun 2012, RSUP dr Kariadi tidak dapat memenuhi standar tersebut.Penelitian ini bertujuan untuk mengetahui angka response tim bedah sesar emergensi dan faktor–faktor yang menyebabkan tidak tercapainya standar tersebut.Dilakukan penelitian kuantitatif untukmencari angka response tim disertai wawancara untuk mengetahui faktor-faktor apa yang mempengaruhi response time tersebut. Sebanyak 207 operasi bedah sesar emergensi dilakukan evaluasi.Didapatkan angka response time 54 menit.Tidak tercapainya standar nasional response tim berkaitan dengan belum adanya standar prosedur operasional tentang persiapan operasi bedah sesar emergensi. Sehingga disarankan untuk segera dibuat standar prosedur operasional yang melibatkan tim multidisiplin.

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According to national standards, obstetric services must be able to perform emergency cesarean section within 30 minutes of the decision made (response time). Evaluation in 2012, Doctor Kariadi General Hospital was unable to meet this standards. This study aims to determine the response time of emergency cesarean section and the factors that lead to failure to achieve this standards. Quantitative research conducted to find the response time and interview to determine what factors affect the response time. A total of 207 emergency cesarean section evaluated during the study. The mean response time was 54 minutes. Failure to achieve the national standard response time is related to the lack of standard operating procedures on the preparation of emergency cesarean section. So it is advisable to immediately create a standard operating procedure that involves a multidisciplinary team."

"[Perempuan pasca melahirkan adalah kelompok yang berisiko mengalami perubahan pada fungsi seksual. Penelitian ini untuk mengetahui perbedaan fungsi seksual ibu postpartum pervaginam dengan atau tanpa episiotomi dan pasca bedah sesar. Penelitian ini merupakan studi deskriptif dengan desain cross sectional. Sampel berjumlah 225 ibu postpartum yang diambil secara consecutive sampling dari bulan April-Mei 2015. Fungsi seksual dinilai dengan Sexual Function Questionnaire (SFQ). Hasil penelitian menunjukkan tidak ada perbedaan yang bermakna antara fungsi seksual pada semua jenis persalinan (p=0,977), begitupun hasrat seksual, gairah seksual, dan orgasme. Penelitian ini dapat digunakan untuk meningkatkan kesehatan seksual ibu pada perawatan postpartum yang berkualitas.;The postpartum women is one of group who experience sexual function changes. The aims of the study is to know the comparation sexual function woman after vaginal delivery without episiotomi and post caesarean section. The study was a descriptive study of cross-sectional design. The sample was 225 womanpostpartum was taken by consecutive sampling from April-May 2015. Sexual function was assessed by the Sexual Function Questionnaire (SFQ) score. The results of this study showed there were no significant differences between sexual function and types of delivery (p=0.977), including sexual desire, sexual arousal and orgasm. The results of the study can be used to increase nurses’s service sexual postpartum women for reach quality postpartum care., The postpartum women is one of group who experience sexual function changes.The aims of the study is to know the comparation sexual function woman aftervaginal delivery without episiotomi and post caesarean section. The study was adescriptive study of cross-sectional design. The sample was 225 womanpostpartum was taken by consecutive sampling from April-May 2015. Sexualfunction was assessed by the Sexual Function Questionnaire (SFQ) score. Theresults of this study showed there were no significant differences between sexualfunction and types of delivery (p=0.977), including sexual desire, sexual arousaland orgasm. The results of the study can be used to increase nurses’s servicesexual postpartum women for reach quality postpartum care.]"

"Persalinan melalui seksio cesaria (SC) terus meningkat di berbagai Negara. Persalinan dengan SC bisa menyelamatkan ibu dan bayi pada kasus-kasus tertentu. Meskipun begitu, persalinan dengan SC memiliki resiko lebih besar dibanding persalinan pervaginam terlebih lagi pada ibu primipara. Masalah fisik dan psikososial serta kurangnya pengalaman pada klien post SC primipara menghambat pencapaian peran pasien sebagai ibu. Penerapan teori keperawatan becoming a mother pada lima kasus post SC primipara berhasil meningkatkan kemampuan klien dalam pencapaian peran sebagai ibu sesuai dengan tahapan yang dijelaskan Mercer. Lima klien kelolaan memiliki komitment untuk merawat sendiri anaknya. Mereka memiliki keyakinan dan kepercayaan diri yang tinggi dalam merawat bayinya. Perawat membantu klien post SC menjalankan peran barunya sebagai ibu dengan melibatkan peran suami, keluarga dan lingkungan klien. Suami, keluarga dan lingkungan mendukung klien dalam pencapaian perannya sebagai ibu.

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The cesarean delivery rate continues to rise in many countries. Cesarean delivery can be life-saving for the fetus and the mother in Certain cases. Even so, cesarean delivery has a greater risk than vaginal delivery especially maternal primiparas. Physical and psychosocial problems and a lack of experience on the client post SC primiparas impede the achievement of the patient's role as a mother. Application of nursing theory becoming a mother to five cases of post SC primiparas managed to increase the ability of the client in achieving motherhood in accordance with the steps described Mercer. Five clients have a commitment to care for their own children. They have confidence in the care of her baby. The nurse helps clients post SC run her new role as a mother by involving the role of husband, family and client environments. Husband, family and environments support clients in achieving their role as mothers."

"Bedah sesarea cendrung mengalami kesulitan dalam melakukan inisiasi menyusui dini karena keterbatasan mobilisasi, nyeri pada bekas operasi yang mengakibatkan tingkat keberhasilan menyusui yang rendah di antara wanita dengan operasi sesarea dan tingkat pemberian ASI eksklusif yang lebih rendah dan durasi menyusui lebih singkat. Penatalaksanaan keperawatan pada ibu seksio sesarea dengan memberikan asuhan keperawatan secara holistik menggunakan action research dan penerapan teori keperawatan. Penerapan teori kenyamanan Kolcaba dan becoming a mother Mercer pada lima kasus breastfeeding self- efficacy ibu seksio sesarea dengan membahas permsalahan yang dialami dan menguraikan peran perawat pada kasus tersebut dengan tujuan kebutuhan kenyamanan dan pencapaian perannya sebagai seorang ibu. Kejadian nyeri post operasi dapat diatasi dengan penerapan evidence based nursing practice pemakaian gurita. Penelitian dilakukan pada lima ibu post seksio sesarea yang mengalami nyeri didapatkan bahwa pemakaian gurita mampu mengurangi skala nyeri secara signifikan dan meningkatkan bounding attachment ibu dengan bayi. Ibu dan suami berperan aktif dalam mengikuti manajemen laktasi.

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Mothers who undergo caesarean sections tend to experience difficulties in initiating early breastfeeding due to limited mobilization, postoperative pain which results in a low success rate of breastfeeding among women with caesarean sections and lower rates of exclusive breastfeeding and shorter duration of breastfeeding. Nursing management for cesarean section mothers by providing holistic nursing care using action research and application of nursing theory. The application of Kolcaba's theory of comfort and becoming a mother Mercer to five cases of breastfeeding self- efficacy of women for cesarean section by discussing the problems experienced and describing the role of the nurse in these cases with the aim of needing comfort and achieving her role as a mother. The incidence of postoperative pain can be overcome by applying evidence based nursing practice using octopus. Research conducted on five post-cesarean section mothers who experienced pain found that the use of octopus was able to reduce the pain scale significantly and increase the bonding attachment between mother and baby. Mothers and husbands play an active role in following lactation management."