Factors Affecting The Primigravida Anxiety During The 3 rd Trimester of Pregnancy Regarding The Upcoming Labor

Pregnant women who experience anxiety experience an emotional reaction associated with the mother's concerns with the well-being of her self and her fetus, the sustainability of pregnancy, childbirth, and effects of pregnancy exercises. This study aims to determine the factors affecting the primigravida anxiety of the 3rd trimester. The type of the research was quantitative with analytic observational method and with cross sectional design. The results show that the factors related to primigravic anxiety of third trimester were physical exercise in the form of pregnancy exercise with p value 0,000 (p <0,05), while maternal age, occupation, education level, and husband support had no effect on primagravida anxiety of the 3rd trimester where p value> 0.05. Conclusion: the factors associated with primigravida anxiety of the 3rd semester is a physical exercise in the form of pregnancy exercise.


INTRODUCTION
Pregnant women who experience anxiety experience an emotional reaction associated with the mother's concerns with the well-being of herself and her fetus, the sustainability of pregnancy, childbirth and effects of pregnancy exercises (1).Pregnant women experience changes in their physiological and psychological functions.The forms of psychic changes in pregnant women are emotional changes, feelings ofjealousy, sensitivity, laziness, seekingmore attention, feelings of discomfort, anxiety, depression, and stress (2).Anxious pregnant women are 3.84 times more likely to develop postpartum depression.
Anxiety and antenatal depression during pregnancy are risk factors for psychiatric or postpartum depression (3).
Impacts of anxiety in the third trimester of pregnant women regarding the labor process can include irregular his, reduced diffculty of birth canal, and baby's misposition.Inhibition of labor due to anxiety can stimulate the release of catecholamine hormones that will inhibit the working of the uterus (4).Other impact of excessive anxiety in pregnant women are causing low apgar score at birth (5), affecting the physical and mental health of the mother and fetus (6), the increased likelihood of mothers experiencing postpartum depression (1), tendancy to have premature infants (7), and low birth weight infants (LBW) (8).
One of the causes of high AKI in Indonesia is prolonged labor.Some factors that contribute to the occurrence of prolonged labor include insuffi cient maternal power or strength during childbirth, infant is too large, incompatibility of pelvic size with infant and psychological head or anxiety of the mother who is not ready for labor (9).
The results of interviews conducted by researchers with 10 people of primigavide 3rd trimester who are checking pregnancy, 5 people claimed to worry about labor, 3 people are afraid not able to withstand pain during labor, and 2 people worry about infant health after birth.This study aims to determine the factors that affect primigavida anxiety during the 3rd trimester.

MATERIALS AND METHODS
The research was a quantitative by using Data analysis in this study using univariate analysis which was useful to identify the description of frequency distribution and bivariate analysis which was useful to identify the relation between independent variable and dependent variable, the test used was independent t-test.

RESULT AND DISCUSSION
In this study, there were 50 subjects of primigravida 3rd trimester.Relaxation in pregnancy exercise is one exercise that can break the cycle of anxiety because relaxation movements can stabilize emotions in a pregnant woman (13).Physical exercise done by someone can reduce anxiety (14).Pregnancy exercise is a physical exercise that can be done by pregnant women, so it can be an attempt to reduce anxiety in primigravida 3rd trimester.Gymnastics pregnancy is part of antenatal care to prepare for delivery at several health care centers, such as hospitals (15).
Pregnancy gymnastics is a form of exercise in pregnant women that is useful for strengthening and maintaining elasticity of the abdominal wall muscles, ligaments, and pelvic fl oor muscles associated with labor (16).The results of research conducted by Newham et al ( 2012 ), showed that techniques of relaxation also had an infl uence in decreasinganxiety for pregnant women (17), This is same with statements from Dipietro et al ( 2012) that relaxation is one of the methods that can reduce stress and negative emotions during pregnancy (18).

CONCLUSIONS AND RECOMMENDATION Conclusion
Factors that affect the primigravida anxiety of 3rd trimester is physical exercise in the form of pregnancy exercise.

Recommendtion
For health services to further enhance the promotion and implementation of pregnancy exercises forall pregnant women, especially primigravida 3rd trimesteI.Future researchers should conduct research related to other factors that have not been studied with a greater number of samples.
observational analytic method.The design in this study was cross sectional.The population in this study were pregnant women of primigavide 3rd trimester who checked the pregnancy which amounted to 125 people.Samples were taken using consecutive sampling with 50 people.The study was conducted from December 2015 to February 2016.The instruments used in this study were questionnaire respondent characteristics (age, occupation, education level, husband support and physical exercise) and modifi cation questionnaires from the anxiety scale Taylor Maniest Anxiety Scale (TMAS) instrument and Hamilton Rating Scale for Anxiety (HRS-A).Validity and reliability tests have been performed on the questionnaire.