149Ulfa, Andestia, The Effectiveness of Counseling to the Ability of... 149 THE EFFECTIVENESS OF COUNSELING TO THE ABILITY OF CARING OF THE UMBILICAL CORD OF POST PARTUM PRIMI- GRAVIDA MOTHER Maria ulfa, Andestia D3 Kebidanan STIKes Patria Husada Blitar email: ulfamaria845@gmail.com Abstract: The high infant mortality rate due to improper umbilical cord caring is increasing. Improper umbilical cord caring behavior is still found in postpartum primigravida, so it is necessary to increase the knowledge of the importance of treating the umbilical cord in the right way to prevent infection. This study design was Quasy-experimental one group Pre-post-test-design. The population of this study was Primigravida Postpartum Mother on 2-7 days in BPM NihayaturRohmah. The sample in this study was 15 respondents by using total sampling. The data analysis used Wilcoxon test. The results of the study on the ability of postpartum primigravida mother in caring for the correct umbilical cord before counsel- ing was 6,7% in the able category and after getting counseling there was a 93,3% increase that is 100% in the category of capable. Based on the results of the study was expected to respondents more active in increasing information about caring for the correct umbilical cord to prevent the occurrence of infec- tion. . Keywords: Counseling, Caring for The Umbilical Cord The data of Indonesian Demographic and Health Survey (SDKI) of newborn mortality rate is 25 per 1000 live birth, the cause of death can be prevented with adequate treatment (MOH RI, 2009). Case of Fatality Rate (CFR) is very high in case of untreated tetanus neonaturum is close to 100 percent, especially those with an incubation period of less than seven days. The mortality rate of neonaturum tetanus cases caused by unsterile umbilical cord care, which is hospitalized in Indonesia varies between 10.8-55 percent (Sarwono, 2009, p.370). In this modern day, it is expected that Indonesia can create the quality of human resources, one of them is in the field of infant and child health, so that the role of mother in the care for the baby is needed. Most of the community is lack of knowledge in newborn car e, especially the umbilical cord. Particularly it occured in the remote areas that still used traditional way of caring for their babies and had low educational and socio-economic. It is also influenced by the lack of knowledge of mother about the importance of neonatal service or newborn (DepKes RI, 2009). The postpartum period is the important thing to look for in order to bring down maternal mortality and infant in Indonesia, postpartum period is theperiod after the  partus is  finished  and  the returning of body function as before getting pregnant. The length of the period of postpartum is a ppr oxima tely 6-8 of the week (Ma nsyur, 2014, p. 4). The time of postpartum in the phase of taking hold taking place between 3-10 days after giving birth, which make the mother will worry the inability of and a sense of responsibility in taking care of a baby especially at primigravida mother. This phase is a good opportunity for the health workers to provide a variety of counseling and health education needed by postpartum period such as how to care for a baby, especially in the caring for the umbilical cord (Walyani 2015, p. 79). Based on a survey conducted by researchers on February 7, 2017 at BPM NihayaturRohmah, SST of KarangsonoKanigoro Village, Blitar, the number of postpartum during January 2016 until January 2017 was 44 people, born in midwife as ACER Typewritten text Jurnal Ners dan Kebidanan, Volume 4, No. 2, Agustus 2017 DOI: 10.26699/jnk.v4i2.ART.p149-152 IT Typewritten text © 2017 Jurnal Ners dan Kebidanan IT Typewritten text This is an Open Access article under the CC BY-SA license (http://creativecommons.org/licenses/by-sa/4.0/) https://creativecommons.org/licenses/by-sa/4.0/ 150 Jurnal Ners dan Kebidanan, Volume 4, Nomor 2, Agustus 2017, hlm. 149–152 many as 31 people and the rest of was born in hospital. From the midwife data, it was found that there was no primigravida postpartum mother who did not care for umbilical cord as much as 19 people. From the data of postpartum primigravida month of january 2016 until January 2017 there were 50% of the umbilical cord infant had infection. Based on that problem, the researcher was interested in doing research about the effevtiveness of counseling to the ability of caring of umbilical cord in postpartum primigravida mother in BPM NihayaturRohamahKarangsono Village Kanigoro Sub-district, Blitar. The general objective of the research was to know the effectiveness of counseling on the ability of ca r ing for umbilica l cor d in postpa rtum primigravida mother. The specific objectives were (1) Identifyingthe primary pregnancy mothers in the care of their umbilical cord before counseling (2) Identify postpartum primigravida in treating the baby’s umbilical cord after counseling (3) Analyze the effectiveness of counseling ma y help primigravida postpartum in treating the umbilical cord . The benefits of this research were expected to improve the quality of health services for health workers in providing counseling and skills about cord care. METHOD This research used Quasy-experimental with one-group Pre-post-test-design design. The subjects of this study were 15 postpartum mothers took by using total sampling, by doing direct observation on postpartum on day 2 to 7 on how they care for the umbilical cord. The research subjects were located in the working area of a midwife Nihayatur Rohmah Blitar. The independent variable was counseling about the correct umbilical cord care and the dependent variable was the ability to care for the umbilical cord in the primigravida postpartum, the data analysis used the Wilcoxson test. THE RESULT The r esult of the study consisted of the characteristics of postpartum mother and specific data of the ressearch No Characteristics f (%) 1 Age - 20 – 25 6 40 - 26 – 30 5 33,3 - 31 – 35 3 20 - >36 1 6,7 2 Education - SD 2 13,3 - SMP 4 26,7 - SMA 7 46,7 - PT 2 13,3 3 Job - IRT 11 73,3 - Swasta 3 20 - Guru 1 6,7 4 Information of the Care of Umbilical Cord - Yes 11 73,3 - No 4 26,7 5 Information Sources - Never 4 50 - Health Employee 6 50 - Family 2 - Friend 1 - Media 2 6 Postpartum day - 2 – 3 9 60 - 4 – 5 5 33,3 - 6 – 7 1 6,7 Tabel 1 The Frequency Distribution of Respondents Charactericticsof Postpartum Primigravida Mother in the Care of Umbilical Cord on 29 April s/d 11 May 2017 Tabel 2 The Identification of Mothers Ability in the Caring of Umbilical Cord Before the Counsel- ing No Ability f % 1. Good 1 6,7 2. Fair 14 93,3 3. Less 0 0 Total 15 100 Tabel 3 The Identification of Mothers Ability in the Car- ing of Umbilical Cord After the Counseling No Ability f % 1. Good 15 100 2. Fair 0 0 3. Less 0 0 Total 15 100 151Ulfa, Andestia, The Effectiveness of Counseling to the Ability of... DISCUSSION The ability of the primigravida puerperal mother to care for the baby’s umbilical cord before the counseling From the results of the research obtained the results before the counseling about the proper umbilical cord care showed that almost all (93.3%) of respondents were in the category fair. Treatment of the umbilical cord in the newborn is to keep the umbilical cord dry and clean (Sarwono, 2008, p.370). Before the counseling, umbilical cord care was in fair category. Treating the umbilical cord was influenced by several factors: age, pregnancy and occupation. This is in accordance with Table 4.1 which shows that nearly half (40%) postpartum aged 20- 25 years. At that age the maturity of thinking and understanding of an object is still optimal. A person who has matured in a developmental task will perform its role well as it is in society (Notoatmodjo, 2003.p.215). Young age certainly does not have the skills that are born from the mother’s experience in caring for newborns. They tend to leave it to health workers or people who are considered older and respected. Based on the samples taken in the puerperium, a ll of them a r e postpa r tum pr imigr a vida mothers. Experience  is  a  way  to gain  truth  in knowledge and skills (Notoadmojo, 2003.p.2018). In this case mother does not have experience in performing umbilical cord care since this is thir first birthing process, so caring for the umbilical cord is the first experience for them. In this study according to table 4.3 most of the mother (73,3%) worked as housewive.Housewives tend to want to do things themselves such as cleaning the house, washing or preparing food for the family. In this case the family is required to support the mother ’s work during the childbirth period so that mothers can take care of the baby well. The ability to give proper care for the umbilical cord suggests that the mother ha s not fully understood the importance of treating the umbilical cord using the correct procedur e. Sufficient management is also suppor ted by a la ck of understanding of the mother about the procedure of action that is must wash hands before and after doing umbilical cord care on the baby. Based on the results of the study found that most of the mothers performed wrong procedure of action against these two indicators, in addition to the respondents also experienced confusion in the umbilical cord and also give baby powder and baby oil on the baby’s body. There were still many respondents who give baby powder and baby oil before wrapping the umbilical cord of the baby, so that the umbilical cord looks dirty with oil and baby powder. In that case the counseling of umbilical cord car e is ver y important to incr ea se mother ’s knowledge about the correct umbilical cord care So that the mother is able to perform the correct care according to the procedure. The ability of the primigravida puerperal mother to care for the baby’s umbilical cord afterthe counseling It was obtained after the counseling on how to ca re for the r ight umbilical cor d, 100% of respondents were in good category. Counseling is a process of providing objective and complete information aimed at helping a person recognize his current condition, the problem at hand and or overcoming the problem (Tyastuti, 2009, p.40). The increased ability of mothers in performing this umbilical cord care was because of respondents gain knowledge and counseling on how to care for the correct umbilical cord that they had not previously have. After the counseling, respondents knew and understoodthe proper way in caring the correct umbilical cord in accordance with the procedure and respondents to understand the importance of caring for the correct umbilical cord. Counseling methods used by researchers was to provide umbilical cord care materials through presentation, giving leaflets and also providing examples or practices in umbilical cord care. The success of a counseling or health education could be influenced by health education factors, goals and processes in health education. Tabel 4 The Analysis of the Effectiveness of Counsel- ing to the Ability of Postpartum Primigravida Mother in the care of the Umbilical Cord No Category % Ability % Ability pre test post test 1. Good 6,7 100 2. Fair 93,3 0 3. Less 0 0 Wilcoxon sign rank test: p = 0,000 152 Jurnal Ners dan Kebidanan, Volume 4, Nomor 2, Agustus 2017, hlm. 149–152 Therefore, it used an effective lecture method in the delivery so that mother could understand the contents of counseling. After being able to properly perform the respondent has a willingness to apply the care of the umbilical cord correctly in accordance with the pr ocedur es tha t ha ve been ta ught. Respondents had a positive response so that the sense of giving proper care of the umbilical cord could be apply. The Effectiveness of Counseling to the Abil- ity of the primigravida PostpartumMother in the care of umbilical cord From the results of the research results obtained before counseling showed 93.3% of mothers have enough ability in treating baby’s umbilical cord and after being given counseling on how to care for the right umbilical cord 100% are in good category. From result of data analysis by using Wilcoxon statistic test, got sig value = 0.000. Thus it meant there was an effect of counseling on the ability of mothers primitive women in the care of baby umbilical cord in BPM NihayaturRohmah Village KarangsonoKanigoro District Blitar regency. Counseling is an interpersonal process, in which one person is assisted by one of the other to improve understanding and ability to find the problem (Indrawati, 2008, p.63). This shows that counseling could improve mother’s ability to give proper care for baby’s umbilical cord to provide health for their baby. There were also several factors that could affect the ability of understanding when counseling, the ability of respondents, concentration at the time of counseling and willingness or awareness of respondents to know about how to care for the correct umbilical cord and the importance of treating the umbilical cord for the health of the baby. It could be concludedthat the care of the umbilical cord might affect the ability of caring for the umbilical cord in the primigravida puerperium and the ability itself was influenced by many aspects, although information and counseling have been given not necessarily the umbilical cord could be perform properly and in accordance with the procedure. With this research counseling could improve the ability of respondents to give proper care of umbilical cord. Respondents should know the importance of treating the umbilical cord and understand how to give proper care of umbilical cord so that the infant could avoid infection. Conclusion and Suggestion Conclusion The results of the study showed that (1) the mother’s ability to care for umbilical cord before the counseling in the category offair 93,3% (14 respondents) (2) mother’s ability in baby umbilical cord care after the counseling was in good category 100% (3) From the analysis with Wilxocon test showed that there was an effect of counseling on how to care for the umbilical cord on the ability of caring for umbilical cord in primigravida nifas mother in BPM NihayaturRokamahKarangsono Village Kanigoro Sub-district, Blitar Regency with p value = 0,000. Suggestion For respondents, especially in BPM Nihayatur Rokamah need to give motivation to the mother to always do baby umbilical cord care so that baby have good health degree and avoid infection. . REFERENCES DepkesRI. 2009. Profil Kesehatan Indonesia. Jakarta: Diaksesdari http://www.depkes.go.id.Tanggal 20 Februari 2017. Indrawati, Tatik. 2008. Komunikasi Kebidanan. Buku Kedokteran: EGC, Jakarta. Notoatmodjo, S. 2003. Pendidikan dan Perilaku Kesehatan. PT Rineka Cipta, Jakarta. Novita, Lia. 2011. Penuntun Praktik Asuhan Neonatus, Bayi, dan Balita: EGC, Jakarta. Saifudin, Abdul Bari. 2009. Ilmu Kebidanan Sarwono Prawirohardjo. PT. Bina Pustaka Sarwono Prawirohardjo, Jakarta. Tyastuti, Siti.2009. Komunikasi dan Konseling Dalam Pelayanan Kebidanan. Fitramaya: Yogyakarta. Walyani, Purwoastuti. 2015. Asuhan Kebidanan Masa Nifas dan Menyusui. PT.Pustaka Baru, Yogya- karta.