The effectiveness of lavender and jasmine aroma therapy towards pain levels

Background: The maternal mortality rate in Southeast Asian countries is Indonesia 190 per 100,000 live


INTRODUCTION
According to BKKBN data, the incidence of prolonged labor in Indonesia is 35%, the incidence of premature rupture of membranes is more than 16 hours as much as 15%, bleeding during labor 8%, fever at delivery 8% data contraction. Stress on the mother will also have an impact on fetal distress which can result in fetal death. Maternal Mortality Rate (MMR) as a measure of the success of a health. The highest maternal mortality is in the African region (1).
Labor pain, which is one of the most severe pains experienced, can vary widely in terms of intensity and location . In some cultures, women prefer cesarean delivery to avoid pain (5).
Efforts to reduce pain in maternity with pharmacological and non-pharmacological methods so that pain can be controlled.
Pharmacological methods, namely by using analgesia and anesthesia, which are mostly medical procedures, tend to be more expensive and have side effects on the mother and baby. Labor pain relief methods are divided into non-pharmacological (psychoprophylactic, hypnotic, acupuncture, touch healing therapy, relaxation exercises, massage therapy, music therapy) and pharmacological (systemic drugs, inhalation anesthetics, general anesthesia, regional anesthesia) (7). The use of nonpharmacological pain techniques helps progress labor and shortens the duration. Inhaling aromatherapy can promote emotional health, tranquility, relaxation or rejuvenation of the human body. Aromatherapy provides relaxation and increases the mother's ability to cope with labor pain (8).
The next non-pharmacological method is aromatherapy. Aromatherapy is one of the non-pharmacological methods to reduce pain.
Aromatherapy / pleasant smells and provide a sense of comfort and relaxation to the mother's body and mind, pain and anxiety will be reduced so that pain will decrease during the first stage of the active phase of labor ( 6).
Lavender aromatherapy has advantages in anxiety and pain levels, a study conducted by the Institute in Japan showed that the anti-anxiety and anti-pain effects(Sulakso, 2013). Lavender aromatherapy can increase alpha waves in the brain and these waves help create a relaxed state.

Characteristics of Respondents
Frequency distribution of respondents' characteristics in this studyas follows : with primigravida (G1), which were 33 people (82.5%) and respondents with multigravida were 7 (17.5%). Most of the respondents had high school education as many as 20 people (50.0%).

The level of labor pain in the first stage before and after the lavender aromatherapy intervention period
The description of the research results obtained from the respondents' answers before and after the lavender aromatherapy intervention was given as follows:  Table 2 shows that in the intervention group, before being given lavender aromatherapy, the majority of severe pain intensity was 20 people (100%), and after being given lavender aromatherapy, the moderate pain category was 2 people (10.0%) and the severe category was 18 people (90 people). ,0%).
The level of labor pain in the first stage before and after the jasmine aromatherapy intervention period.

The description of the research results
obtained from the respondents' answers before and after the jasmine aromatherapy intervention was given as follows:  Table 3 shows that in the intervention group, before being given jasmine aromatherapy, the majority of severe pain intensity was 16 people (80.0%), and after being given jasmine aromatherapy, the moderate pain category was 17 people (85.0%) and the severe category was 3 people (15.0%).

Differences in the effectiveness of lavender
and jasmine aromatherapy.
The results of the first stage of labor pain before and after the lavender and jasmine aromatherapy intervention period can be seen in the table 4. Table 4 shows that the mean rank value  Table 4 shows that the mean rank value at the time of the pretest was 9.50 while the posttest was 0.00.The Z_Wilcoxon value was obtained at -4.001 and a significant value of 0.000 (p<0.000), there was a significant difference in the results of the first stage of labor pain before and after the jasmine aromatherapy intervention period.
Based on these results, it shows that jasmine aromatherapy is more effective in reducing pain levels in first stage labor than lavender aromatherapy at the Bina Sehat Clinic.

Bina Sehat Clinic
The results of the effect of lavender and jasmine aromatherapy on pain levels in the first stage of labor at the Bina Sehat Clinic can be seen in the table below:  Table 5 shows that the value ofB in logistic regression was obtained at -4.143 and a significant value of 0.000 (p<0.000), there was a significant effect of the results of the first stage of labor pain before and after the lavender and jasmine aromatherapy intervention period.
The results before being given lavender aromatherapy intervention showed that respondents who had labor pain in the first stage were 20 respondents in the severe category and the results after being given lavender aromatherapy intervention showed as many as 18 respondents in the severe category and 2 respondents in the moderate category. These results have a large difference compared to before the lavender aromatherapy intervention was given.

DISCUSSION
This study was conducted to determine the effect of lavender and jasmine aromatherapy on  Aromatherapy is very effective when used to control pain. Essential oils will be absorbed by the body through the circulation and nervous system, so that the entire body system can be affected. This is an important therapy when done for specific pain therapy (Allard, 2017; Jopke, 2017; Halcon, 2014 in (12). Aromatherapy channels stimuli through the olfactory glands, causing the release of serotonin, endorphins and non-adrenaline hormones (12). Touches and deep fragrances affect the soul and emotional level of a person. The organs of touch and smell in the human body system not only function sexually but also function sensually so that they can regulate and correct hormonal imbalances in the body. So that the pain or pain will decrease and make the mother calmer (5).
The level of labor pain in the first stage before and after the jasmine aromatherapy intervention period.
The results before being given jasmine aromatherapy intervention showed that respondents who had labor pain in the first stage were 16 respondents in the severe category and the results after being given jasmine aromatherapy intervention showed as many as 17 respondents in the moderate category.
These results have a large difference compared to before the jasmine aromatherapy intervention was given.
These results are consistent with previous studies which showed that pain scores between the latent phase and the beginning of the active phase and baseline were significantly lower in the aromatherapy group. This means that after the aromatherapy intervention is given, the level of labor pain in the first stage can decrease (7). Education level is also one of the factors that influence a person's perception of being more receptive to new ideas. The higher a person's education, the higher the quality of knowledge and the more mature intellectually so that it is easier to adapt to new changes.

Pain is a condition in the form of an
The mother's level of education will have an effect on responding to things that come from outside. Mothers who are highly educated will give a more rational response to incoming information and will think about the extent to which these ideas can have an effect.
Previous research related to the analysis of the relationship between respondents' education and the intensity of pain in the first stage of labor showed non-significant results, p>0.05, which means that there is no relationship between the pain felt by the mother and education. This shows that labor pain is influenced by many factors and is individual. The possibility of this condition is also caused by pain that is personal. Pain during labor is influenced by physiological factors (uterine contractions, cervical dilatation, pressure of the fetal head on the pelvis, stretching of the birth canal) and psychosocial factors (anxiety, fear, education level, ability to cope with mother, physical environment, culture and ethnicity, and emotional support) (19) .
In addition to education, the majority of This is in accordance with this study which showed that the administration of jasmine aromatherapy could reduce the pain felt by the mother during the first stage of labor.
Jasmine, which contains main compounds such as linalool, has benefits as an antidepressant because of the effect of jasmine which will stimulate the serotonin hormone, which encourages energy and improves mood. In addition, jasmine has a sedative substance on the autonomic nerves and mental states that are calming the body, mind and spirit and create positive energy (21) .

Differences in the effectiveness of lavender
and jasmine aromatherapy.
The results of giving jasmine aromatherapy were more effective in treating labor pain in the first stage when compared to giving lavender aromatherapy. Judging from the pain scale before the intervention, it appears that the lavender group is in the severe category and the jasmine group is in the moderate pain category. After being given the intervention, the pain scale decreased significantly in the jasmine aromatherapy group.
These results are in line with previous research that giving lavender aromatherapy is proven to be an alternative to complementary therapy to reduce pain. This is because a pleasant smell will create a feeling of calm and pleasure so that it can reduce anxiety and make you more relaxed (21). Lavender aromatherapy is effective in reducing labor pain levels (23). Lavender the occurrence of a decrease in pain scale after being given lavender aromatherapy because the scent produced by lavender aromatherapy will stimulate the thalamus to secrete enkephalins which function as pain relievers. The provision of therapy using aromatherapy has been widely given to reduce pain in normal delivery mothers and sectio caesaria (26). This is evidenced by previous research that the administration of lavender therapy can reduce the intensity of pain in laboring mothers (27). Another presentation shows that lavender aromatherapy has a dominant effect on reducing pain scales (28). In this study, jasmine aromatherapy was also proven to be effective in reducing pain in the first stage of labor, seen changes before and after the jasmine aromatherapy intervention experienced a decrease in pain scores. This proves that giving jasmine aromatherapy can help relieve pain experienced by mothers in labor.
In line with previous research that jasmine aromatherapy can reduce pain in the first stage, it was explained that jasmine aromatherapy was given by means of counter pressure massage to the mother's back, because jasmine oil is a uterine tonic that has been used traditionally as an aid in childbirth and jasmine oil has high content of antidepressants, namely linalool(Mukhlis et al., 2018)

CONCLUSION AND RECOMMENDATION
There was a significant effect of the results of the first stage of labor pain before and after the lavender and jasmine aromatherapy intervention period, which was -4.143 and a significant value of 0.000 (p<0.000). Pregnant and maternity mothers can use lavender and jasmine aromatherapy to reduce pain so that the delivery process can run smoothly.Health workers can use lavender and jasmine aromatherapy as a non-pharmacological method that is easy and practical to reduce labor pain. The results of this study are expected to be input for clinics in the management of active phase 1 labor pain with non-pharmacological methods that can be applied in the clinic using lavender and jasmine aromatherapy. This research is expected to be used as a material or reference for further research, besides that it can use a pain measuring