Skip to main content Skip to main navigation menu Skip to site footer
Jurnal Keperawatan Indonesia
Articles
VIEWS: 139
10.7454/jki.v22i1.675
Submitted: 2023-03-15
Published: 2019-03-29

An Insight Into Maternal Death Caused by Postpartum Hemorrhage in Western Timor, Indonesia

Faculty of Health Sciences Universitas Kristen Satya Wacana, Salatiga 50711
Faculty of Health Sciences Universitas Kristen Satya Wacana, Salatiga 50711
maternal death postpartum hemorrhage Western Timor

Abstract

Maternal deaths in Timor Island, East Nusa Tenggara Province, are one of the contributors to the overall maternal mortality rate (MMR) of Indonesia. The MMR of Western Timor Island was 150/100,000 live births in 2015. The aim of this qualitative study was to explore the perceived causes of maternal death due to postpartum hemorrhage. Data were obtained from family members, traditional birth attendants, and Posyandu cadres, as well as health providers. Using the retrospective method, this study traced six out of nine postpartum hemorrhage cases in the four sub-districts with the highest maternal death rate in 2010. The research findings showed that most childbirth processes were done at home without any help from health workers. Postpartum hemorrhage happened among women ranging from 24-42 years old; five among them had been pregnant more than four times. Medically, five cases were caused by a prolonged third stage of labor due to a retained placenta. Non-medical factors causing postpartum hemorrhage were poor accessibility, lack of communication devices, and lack of infrastructure.
 
Abstrak

Pengetahuan Tentang Kematian Maternal Karena Perdarahan Postpartum di Timor Barat, Indonesia. Kematian maternal di Pulau Timor, Provinsi Nusa Tenggara Timur, merupakan salah satu penyumbang Angka Kematian Ibu (AKI) di Indonesia. Tahun 2015, AKI di Pulau Timor bagian barat adalah sebesar 150/100.000 kelahiran hidup. Tujuan dari studi kualitatif ini adalah untuk mengeksplorasi persepsi para pihak yang paling mengetahui mengenai penyebab kematian maternal karena perdarahan postpartum. Data diberikan oleh anggota keluarga, dukun bersalin, dan kader Posyandu, serta penyedia layanan. Menggunakan metode retrospektif, penelitian ini menyusur enam dari sembilan kasus perdarahan postpartum yang terjadi di empat kecamatan yang memiliki angka kematian maternal tertinggi pada tahun 2010. Hasil penelitian menunjukkan bahwa sebagian besar prosedur persalinan dilakukan di rumah tanpa bantuan dari tenaga kesehatan. Perdarahan postpartum terjadi di antara wanita dengan rentang umur 24–42 tahun; empat di antara mereka sudah pernah hamil sebanyak lebih dari empat kali. Secara medis, lima kasus disebabkan oleh perpanjangan kala tiga persalinan berhubungan dengan retensi plasenta. Faktor-faktor non medis yang menyebabkan perdarahan posrpartum adalah aksesibilitas yang buruk, ketiadaan piranti komunikasi, dan kurangnya infrastruktur.

Kata kunci: kematian ibu, perdarahan postpartum, Timor Barat

References

  1. AbouZahr, C. (2003). Safe motherhood: A brief history of the global movement 1947-2002. British Medical Bulletin, 67 (March),13–25. doi: 10.1093/bmb/ldg014.
  2. Astuti, D.P., Hakimi, M., & Prawitasari, S. (2014). Hubungan response time dengan luaran keberhasilan penanganan perdarahn post-partum di RSU Margono Soekardjo Purwokerto. Jurnal Ilmiah Kesehatan, 10 (2), 100–107.
  3. Belton, S., Myers, B., & Ngana, F.R. (2014). Maternal deaths in eastern Indonesia: 20 years and still walking: An ethnographic study. BMC Pregnancy and Childbirth, 14 (1). doi: 10.1186/1471-2393-14-39.
  4. BPS NTT. (2014) Nusa Tenggara Timur dalam angka 2014. Kupang: BPS Provinsi Nusa Tenggara TImur.
  5. Calvert, C., Thomas, S.L., Ronsmans, C., Wagner K.S., Adler, A.J., & Filippi, V. (2012). Identifying regional variation in the prevalence of postpartum haemorrhage: A systematic review and meta-analysis. PLoS ONE, 7 (7), p. e41114. doi: 10.1371/journal.pone.0041114.
  6. Combs, T.V., Sundby, J., & Malata, A. (2012). Piecing Together the Maternal Death Puzzle through Narratives: The Three Delays Model Revisited. PLoS ONE, 7(12), p.e52090. doi: 10.1371/journal.pone.0052090.
  7. Dinkes Kab. TTS. (2016). Profil Dinas Kesehatan Kabupaten Timor Tengah Selatan Tahun 2015. Soe: Dinas Kesehatan Kab. TTS.
  8. Dinkes NTT. (2009). Pedoman Revolusi KIA. Kupang: Dinas Kesehatan Provinsi NTT.
  9. Dinkes NTT. (2013). Profil Kesehatan Nusa Tenggara Timur. Kupang: Dinas Kesehatan Provinsi NTT.
  10. Dinkes NTT. (2015). Profil Kesehatan Provinsi Nusa Tenggara TImur Tahun 2014. Kupang: Dinas Kesehatan Provinsi NTT.
  11. Harvey, S., Lim, E., Gandhi, K.R., Miyamura, J., & Nakagawa, K. (2017). Racial-ethnic disparities in postpartum hemorrhage in Native Hawaiians, Pacific Islanders, and Asians. Hawa’i Journal of Medicine & Public Health, 76(5), 128–132.
  12. Kassebaum, N., Bertozzi-Villa, A., Coggeshall, M.S., Shackelford, K.A., Steiner, C., Heuton K.R., Gonzalez-Medina, D., Barber, R. . . . Lozano, R. (2014). Global, regional, and national levels and causes of maternal mortality during 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet, 384(9947), 980–1004. doi: 10.1016/S0140-6736(14)60696-6.
  13. Khan, R.U., & El-Refaey, H. (2006). Pathophysiology of postpartum hemorrhage and third stage of labor. Postpartum Hemorrhage, 93(3), 243–253.
  14. Larosa, P. (2009). Perbedaan Lama Persalinan antara Primipara dengan Multipara di RSUD Dr. Moewardi Surakarta. Surakarta: Universitas Sebelas Maret Surakarta.
  15. Lowdermilk, D.L. (2012). Postpartum complications. In D.L. Lowdermilk, D.E. Shannon, K. Perry, & K.R.A. Cashion (Eds.), Maternity & women’s health care (10th ed.) (pp. 824-834). New York: Mosby Elsevier.
  16. Lundine, J., Hadikusumah, R.Y., & Sudrajat, T. (2013). Indonesia’s progress on the 2015 Millenium Development Goals. Indonesia 360, 3(3), 54–66.
  17. MMEIG. (2015). Indonesia: Maternal mortality in 1990-2015. WHO, UNICEF, UNFPA, World Bank Group, and United Nations Population Division Maternal Mortality Estimation Inter-Agency Group, pp. 1–5. doi: http://www.who.int/gho/maternal_health/countries/sle.pdf
  18. Myers, B.A., Fisher, R.P., Nelson, N., & Belton, S. (2015). Defining remoteness from health care: Integrated research on accessing emergency maternal care in Indonesia. AIMS Public Health, 2(3), 256–273. doi: 10.3934/publichealth.2015.3.256
  19. Ronsmans, C., Achadi, E., Cohen, S., & Zazri, A. (1997). Women’s recall of obstetric complications in South Kalimantan, Indonesia. Studies in Family Planning, 28(3), 203–214.
  20. Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A.B., Daniels, J., Gülmezoglu, A.M., Temmerman, M., & Alkema, L. (2014). Global causes of maternal death: A WHO systematic analysis. The Lancet Global Health, 2(6), 323–333. doi: 10.1016/S2214-109X(14)70227-X.
  21. Susiloningtyas, I., & Purwanti, Y. (2012). Kajian Pengaruh Manajemen Aktif Kala III Terhadap Pencegahan Perdarahan Postpartum. Majalah Ilmiah Sultan Agung, 50(128), 63–72.
  22. WHO. (2015a). Maternal mortality fact sheet. Geneva: World Health Organization.
  23. WHO. (2015b). Trends in maternal mortality: 1990 to 2015. Geneva: World Health Organization.
  24. WHO, UNICEF, UNFPA. (n.d.). The World Bank and the United Nations Population Divisions, Who/Rhr/15.23. Geneva: World Health Organization.

How to Cite

Tauho, K. D., & Karwur, F. F. (2019). An Insight Into Maternal Death Caused by Postpartum Hemorrhage in Western Timor, Indonesia. Jurnal Keperawatan Indonesia, 22(1), 1–10. https://doi.org/10.7454/jki.v22i1.675