E:\2021\NERS AGUSTUS\3--jurnal 161Monica, Ulfa, The Correlation of Mothers’ Satisfaction on Antenatal Care Service by ... The Correlation of Mothers’ Satisfaction on Antenatal Care Service by Midwife and Motivation to Do Antenatal Care Laily Prima Monica1, Maria Ulfa2 1,2Midwifery Department, STIKes Patria Husada Blitar, Indonesia JURNAL NERS DAN KEBIDANAN (JOURNAL OF NERS AND MIDWIFERY) http://jnk.phb.ac.id/index.php/jnk JNK History Article: Received, 03/06/2021 Accepted, 19/07/2021 Published, 05/08/2021 Keywords: satisfaction, motivation, antenatal care Article Information Abstract The problem of maternal mortality and morbidity in Indonesia is still become a big problem. In fact, the maternal mortality rate in Indonesia is still the highest in Asean. The factors above are the direct causes of maternal mortal- ity. The causes of this death can be minimized by antenatal care which moni- tors the condition of the mother’s pregnancy regularly to predict the risks that may arise so that preventive measures can be taken. The design used correlational research with a cross-sectional approach. The population in this research was all pregnant women aged 20-35 years who did antenatal care at Polindes Jatinom Kecamatan Kanigoro Kabupaten Blitar as many as 12 pregnant women. The sampling technique used accidental sampling. The sample was some of the pregnant women aged 20-35 years who did antenatal care at the time of the research as many as 12 pregnant women. Results: The result showed 67% was in the category of very satisfied and 75% of preg- nant women had high motivation towards antenatal care. There was a corre- lation between the satisfaction of pregnant women on antenatal care ser- vices by midwife and motivation to do antenatal care proven by the results of the Spearman Rank statistical test which showed the value of sig = 0,000. Midwives are expected to maintain and keep the quality of service, espe- cially in providing antenatal care to pregnant women so that the needs of mothers during antenatal care are always satisfied. © 2021 Journal of Ners and Midwifery 161 Correspondence Address: STIKes Patria Husada Blitar – East Java, Indonesia P-ISSN : 2355-052X Email: lailyprima07@gmail.com E-ISSN : 2548-3811 DOI: 10.26699/jnk.v8i2.ART.p161–165 This is an Open Access article under the CC BY-SA license (http://creativecommons.org/licenses/by-sa/4.0/) https://doi.org/10.26699/jnk.v8i2.ART.p161-165 https://crossmark.crossref.org/dialog/?doi=10.26699/jnk.v8i2.ART.p161-165&domain=pdf&date_stamp=2021-08-15 162 Jurnal Ners dan Kebidanan, Volume 8, Issue 2, August 2021, page 161–165 INTRODUCTION The problem of maternal mortality and mor- bidity is still a big problem in Indonesia. The fact, the maternal mortality rate in Indonesia is still the highest in Asean. The latest data of BPS is 253 per 100 thousand live births in 2006, while the Human Development Report 2000 states that the maternal mortality rate in Malaysia is far below Indonesia, namely 41 per 100 thousand live births, Philippines 170 per 100 thousand live births, Vietnam 160 thou- sand per 100 thousand live births. Bleeding is the main cause of maternal death in Indonesia and the second cause is eclampsia and infection. All of these are responsible for nearly 70% of maternal deaths which are direct causes. The risk of maternal death is also exacerbated by the presence of diseases that pregnant women may suffer, such as tuberculosis, HIV / AIDS, anemia and malaria. The Ministry of Health states that the preva- lence of anemia in pregnant women is still very high which reach 50%. The factors above are the direct causes of maternal death, but the causes of death can be minimized by antenatal care, which moni- tors the condition of the mother’s pregnancy regu- larly, to predict the risks that may arise so that pre- ventive measures can be taken. Health monitoring during pregnancy for both normal and emergency situations as well as delivery assistance by trained health personnel play an important role in reducing maternal mortality. The using of service facilities for health checks during pregnancy revealed that more than 83 per- cent of women had their health check-ups during pregnancy at health care facilities, both public and private. This figure is still lower than the antenatal care coverage target set. (Fahrozy, 2017) Patient satisfaction is often seen as an impor- tant component of health care. Hospitality and en- joyment related to health services that are not di- rectly related to clinical can affect patient satisfac- tion and their availability to return to the health fa- cility for further services. Generally, government health service facilities are not used by the com- munity. One of the reasons is that in general the quality of health services provided by government health care facilities is still not or does not meet the expectations of patients and / or the community. One of the most important aspects of antena- tal care is fostering a trusting relationship with the mother and her family. If a mother trusts a mid- wife, she is more likely to return to the same mid- wife for delivery and delivery of her baby. Based on the phenomenon above, the writer wanted to know whether there was a correlation between the satisfaction of pregnant women in antenatal care services by midwives with the motivation to do an- tenatal care in these midwives. From the problems and survey results, the researchers were interested in conducting a research entitled “The Correlation of Pregnant Women Satisfaction in Antenatal Care Services by Midwives and Motivation to Do Ante- natal Care”. The resear ch objective was to determine whether there was a correlation between the satis- faction of pregnant women in antenatal care ser- vices by midwives and the motivation to do antena- tal care. The benefits of the research were research- ers could use this as an explanation and evaluation of the satisfaction of pregnant women with antena- tal care by midwives so that they could train to think and work scientifically on a problem. METHODS This research used a cross sectional correla- tion research design. The population was 12 preg- nant women aged 20-35 years who did antenatal care at the Jatinom Polindes, Kanigoro District, Blitar Regency. The sampling technique used Ac- cidental Sampling. The sample of the research was part of pregnant women aged 20-35 years who did antenatal care, obtained 12 pregnant women. The independent variable in this research was the satisfaction of pregnant women during antena- tal care. The dependent variable in this research was mother’s motivation to do antenatal care. The instrument used a questionnaire. The data process- ing methods were editing, coding, tabulating then analyzed with the Spearman Rank statistical test. RESULT General data Table 1. Age Distribution of Respondent No Age (Years) f % 1 18 – 22 5 41,7 2 23 – 27 4 33,3 3 28 – 32 3 25 Total 12 100 163Monica, Ulfa, The Correlation of Mothers’ Satisfaction on Antenatal Care Service by ... Specific Data The result of attitude analysis from Spearman Rank test with p value 0,0000. This meant that there was a correlation between the mothers’ satisfac- tion in antenatal care services by midwives and the motivation to do antenatal care. DISCUSSION Mothers’ Satisfaction of Antenatal Care Ser- vices by Midwives The calculation results of all respondents’ an- swers showed that from 12 respondents, there were 8 respondents (67%) who were very satisfied with the antenatal care services provided by midwives, and 4 respondents (33%) were satisfied. Satisfaction is a level of patient feeling that arises as a result of the performance of health ser- vices obtained after the patient compares it with what he expects. There are 3 levels of satisfaction, if the appearance is less than expected, the cus- tomer is not satisfied. When the appearance is up to expectations, the customer is satisfied. If the appearance exceeds expectations, the customer is very satisfied / happy. Besides, satisfaction is also influenced by aspects including: The attitude of the staff or health workers approach to patients, the quality of service received by patients, administra- tive procedures and the facilities provided.(Susilo, 2014) From the 12 respondents who answered the questionnaire, it could be seen that 8 mothers an- swered very satisfied, this meant that the perfor- mance of midwife in providing services was very satisfying or exceeding expectations. This feeling of very satisfied was influenced by the feeling of pregnant women when they first came to the ser- vice provider, the attitude of the staff / health work- ers when they met, for example smiling and greet- ing in a friendly manner. Pregnant women felt com- Table 2. Numbers of Pregnancy Distribution of Respon- dent No Number of pregnancy f % 1 Gravida 1 7 58,3 2 Gravida 2 4 33,4 3 Gravida > 2 1 8,3 Total 12 100 Table 3. Educational Background Distribution of Re- spondent No Last Education f % 1 Elementary School 1 8,3 2 Junior High School 2 16,7 3 Senior High School 7 58,3 4 University 2 16,7 Total 12 100 Table 4. Occupation Distribution of Respondent No Occupation f % 1 Housewife 9 75 2 Entrepreneur 3 25 Total 12 100 Table 5. Mothers’ Satisfaction on Antenatal Care Ser- vice by Midwives No Satisfaction f % 1 Very Satisfied 8 67 2 Satisfied 4 33 Total 12 100 Table 6. Mothers’ Motivation to do Antenatal Care No Motivation f % 1 High 9 75 2 Fair 3 25 3 Low 0 0 Total 12 100 Table 7. The Frequency Distribution of Mothers’ Satis- faction and Motivation Category % Very Satisfied % Satisfied Highly Motivated 20 80 Fairly Motivated 80 20 Spearman rank test: p = 0,000 164 Jurnal Ners dan Kebidanan, Volume 8, Issue 2, August 2021, page 161–165 fortable with the hospitality given. This also needed to be supported by good quality service, what mid- wives did to the patients related to the healing pro- cess or reduced the complaints felt by pregnant women. It was also important that the facilities pro- vided included the availability of a pleasant waiting area, a comfortable examination area, could main- tain patient privacy, so that mothers could freely express their complaints without being disturbed by other patients, midwives’ explanations in providing counseling used language which easy to understand, listened carefully to every complaint uttered by the mother. Meanwhile, 4 other respondents answered sat- isfied, which meant that the midwife’s performance was comparable to or equal to what the expecta- tion of pregnant women was. With good service and in accordance with standards, pregnant women would be satisfied. If the mothers’ was satisfied and would continue to buy and use products or ser- vices for the future, mothers would share their feel- ings and experiences with other customers. An as- sessment process which was given by mothers could be positive or negative based on the experience they had received. Mother’s motivation to do Antenatal Care From the results of the research, mothers’ motivation to do antenatal care that has been imple- mented, from 12 respondents showed that 9 respon- dents were in the category of high motivation (75%) and 3 respondents (25%) were in fair motivation. Basically, humans have unique characteristics so that motivating one another does not have to be the same. This is what causes differences in the level of motivation with one another. (Imbalo, 2016) Types of motivation are divided into two, first is intrinsic motivation; motivation that comes from within humans that is driven by satisfaction and curiosity factors; and the second is extrinsic moti- vation; namely motivation that comes from outside which is the influence of other people or the envi- ronment. Extrinsic motivation can be stimulated in the form of praise, gifts. From the results of the research, the motiva- tion that encourages pregnant women to do ante- natal care was mostly based on intrinsic motiva- tion, which rose from within the mother herself. Mother felt that antenatal care was a need that must be met. Pregnant women wanted to give the best for the fetus they were carried, so that mother and the fetus were in good health until the time of deliv- ery arrived. The results of the research above was corroborated by the theory of Goal - Setting Theory proposed by John Locke (1968) that a person’s behavior is basically influenced by his efforts to achieve a goal. According to him, a specific and difficult goa l ca n lea d to high motiva tion (Supartiningsih, 2017) There was a goal that each mother wants to achieve, such as provided the best for the fetus, this was the cause why mothers had high motiva- tion to do antenatal care. The Correlation of Mothers’ Satisfaction on Antenatal Care Service by Midwife and Moti- vation to Do Antenatal Care From the results of research and data analysis as in table 4.1 and the results of calculations with the Rho Spearman formula, it is found that ñ count 0.67 is then compared to the Rho Spearman criti- cism price table with a sample size (N) of 12 re- spondents and a 95% confidence interval. The results of the Spearman rank statistical test showed the value of sig = 0,000. This meant that there was a correlation between the mothers’ sat- isfaction in antenatal care services by midwives and the motivation to do antenatal care. A pure motivation is motivation that is really aware of the importance of a behavior and is felt as a need. Each individual has a hierarchy of needs that determines his actions, once the most basic needs are satisfied, the individual will be motivated to achieve the next need. (Susilo, 2014) Research showed that mothers who felt satis- fied / satisfied beyond what was expected would be motivated to do antenatal care. Motivation itself is influenced by the urge to act which is based on the needs they feel; the desires and needs of the individual motivate individuals to fulfill them. The need for antenatal care will foster a motivation for mothers because they are aware that this is a need for the fetus that must be fulfilled. If the most basic needs of pregnant women are properly fulfilled and satisfied, then automatically there will be motiva- tion to meet their needs again, namely to visit ante- natal care centers. The result above is in line with the reinforce- ment theory which states that individual behavior will lead to motivation if there are consequences of that behavior. Behavior that gives rise to satisfac- tion will strengthen this behavior so that it tends to 165Monica, Ulfa, The Correlation of Mothers’ Satisfaction on Antenatal Care Service by ... be repeated, on the other hand, behavior that causes dissatisfaction will weaken the behavior so that it tends to be abandoned. CONCLUSION From the results and data analysis that had been done, the following results were obtained:The sat- isfaction level of mothers at antenatal care services provided by midwives was in the category of very satisfied with a total of 67%, Mothers had high motivation to do antenatal care with a total of 75%, There was a correlation between mothers’ satis- faction at antenatal care services provided by mid- wives and motivation to do antenatal care. Based on the results of the Spearman Rank statistical test, it showed the value of sig = 0,000. SUGGESTION The suggestions of this research are: Midwives are expected to maintain and maintain the quality of service, especially in providing antenatal care to pregnant women so that the needs of mothers for antenatal care are always satisfied and Mothers are expected to be able to provide an assessment of the services provided by health workers which can be used as an evaluation of the performance of health workers, especially midwives in an effort to maintain and improve the quality of midwifery ser- vices. REFERENCES Fahrozy, A. (2017). Hubungan Kualitas Pelayanan Rumah Sakit Dengan Kepuasan Pasien Pengguna BPJS Kesehatan Di Rumah Sakit Abdul Wahab Sjahranie Samarinda. 1–2. Imbalo, S. . (2016). Jaminan Mutu Layanan Kesehatan/ : Dasar - Dasar Pengertian dan Penerapan (2nd ed.). Penerbit Buku Kedokteran - EGC. Supartiningsih, S. (2017). Kualitas Pelayanan an Kepuasan Pasien Rumah Sakit: Kasus Pada Pasien Rawa t Jala n. Jurnal Medicoe ticol egal Dan Manajemen Rumah Sakit 10.18196/Jmmr.2016, 6(1), 9–15. https://doi.org/10.18196/jmmr.6122 Susilo, C. (2014). Hubungan Pasien Rawat Inap Berstatus BPJS Dengan Tingkat Kepuasan Pasien di Puskesmas Sumbersari Kabupaten Jember. 34.