JOURNAL MIDWIFERY (JM)
Jurnal Jurusan Kebidanan.
Poltekkes Kemenkes Gorontalo P-ISSN .
E-ISSN .
8-523X)
http://jurnal.
id/index.
php/JM/index DOI: http://dx.
org/10.
52365/jm.
Analysis Determinants Of Anxiety In Pregnancy Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3
1,2,3
Bachelor of Midwifery Programmee.
Faculty of Nursing and Health Sciences.
Universitas Muhammadiyah Banjarmasin.
Indonesia.
Email: Alyaa.
nuurafifah11@gmail.
Darmadatika@gmail.
Fattimaharifin80@umbjm.
ABSTRACT
Pregnancy is a natural process that is accompanied by physical and psychological changes.
These changes can trigger mental disorders such as anxiety, especially if they are not properly managed.
These conditions may affect both maternal and fetal health.
The purpose of this study is to determine how common anxiety is among pregnant women in Banjarmasin and to examine how age, parity, education, income, and employment relate to anxiety during This research applies a quantitative method with a cross-sectional design.
total of 33 pregnant women were chosen using a purposive sampling method.
Anxiety during pregnancy was measured using the Perinatal Anxiety Screening Scale (PASS).
The relationships between the studied variables were analyzed using the Spearman Rank test.
The study found that 11 respondents .
3%) were asymptomatic, while 22 respondents .
7%) experienced anxiety during pregnancy.
Moreover, significant correlations were found between age, parity, education level, income, and employment status with the level of anxiety experienced.
These findings emphasize the importance of integrating antenatal care (ANC) with routine anxiety screening and counseling programs, so that mental health problems can be detected and managed early during pregnancy.
Keywords: Prenatal Anxiety Screening Scale (PASS).
Anxiety.
Pregnancy A2025 Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3 Under the licence CC BY-SA 4.
* Ramadhana Alya Nuur Afifah.
Bachelor of Midwifery Programmee.
Faculty of Nursing and Health Sciences.
Universitas Muhammadiyah Banjarmasin.
Indonesia.
Email: Alyaa.
nuurafifah11@gmail.
Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
INTRODUCTION
during pregnancy can trigger various Pregnancy is a normal and biological complications, both for the mother and the process experienced by women with a This situation may increase the healthy reproductive system.
This process likelihood of premature delivery, low starts from sexual intercourse that results in fertilization, followed by implantation of the embryo in the uterus, and lasts for hypertension, preeclampsia, & postpartum approximately 280 days or 40 weeks complication (Halil & Puspitasari, 2.
pproximately 9 months and 7 day.
, until Mental the appearance of signs of Labor (Fadillah, important, has not been implemented Although pregnancy is a normal Currently, only responsive occurrence, each phase in this process steps are taken, such as handling patients requires great attention and understanding with real mental health complaints (Asih et in order to ensure maternal and fetal , 2.
During pregnancy, the mother will primarily influenced by elevated hormone progesterone (Anggraeni et al.
, 2.
increase in this hormone can cause various discomforts, such as nausea, fatigue, to emotional disorders, which in turn can trigger stress in pregnant women.
Without proper treatment, this condition can trigger anxiety, sleep disorders, to antenatal (Hasanah Psychological disorders such as anxiety in World Health Organization (WHO) .
reported that anxiety is experienced by 810% of women during pregnancy, and increases to 13% towards childbirth.
Based countries, it was found that pregnant women and mothers after childbirth have a high risk of developing psychological (Cahyani Meanwhile, in Indonesia, about 71.
9% of pregnant women are known to experience (Astuti et al.
, 2.
pregnant women can have a major impact Mental on various aspects, from pregnancy care, women can trigger stress or depression, fetal development in the womb, to the and in severe conditions can increase the delivery process and the puerperium risk of death in both mother and baby.
(Adyani et al.
, 2.
Mental health Anxiety during pregnancy has also been problems that are not treated optimally linked with obstetric complications such as Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
preterm birth, which are recognized as mortality rate (MMR) (Ahmad et al.
and postpartum women (Suksesty & Budiono, 2.
This research aims to determine the incidence of anxiety during pregnancy in the city of Banjarmasin and to analyze According to data from the Indonesian whether there is a correlation between Ministry of Health, the MMR in Indonesia sociodemographic factorsAinamely age, in 2023 was 4,129 cases, with 84 cases reported in South Kalimantan in 2024.
The occupationAiand the degree of anxiety experienced by pregnant women.
The including depression and anxiety, is also novelty of this study lies in the use of the evident in urban areas.
Life in urban Perinatal Anxiety Screening Scale (PASS), which, despite being a valid and reliable challenges may burden pregnant women, instrument internationally, has not yet thereby increasing their vulnerability to been widely applied in maternal health psychological distress (Sulistyorini et al.
research in Banjarmasin.
The study was These conditions can potentially be conducted at Puskesmas S.
Parman, found in the city of Banjarmasin.
Based on Banjarmasin, from April to June 2025, to 2023 data.
Banjarmasin City had a provide locally relevant evidence that can population of 679,637 people, with 12,752 strengthen antenatal care services through pregnant women recorded as receiving the integration of routine mental health antenatal services that year.
However, no precise data are available regarding the prevalence of anxiety among pregnant women in the city.
For this reason, instruments capable of assessing anxiety while considering cultural aspects and demonstrating good validity and reliability are needed.
One such tool is the Perinatal Anxiety Screening Scale (PASS), which has been widely used in various countries to detect anxiety symptoms in pregnant
METHOD
This study applied a cross-sectional design using a quantitative method.
The research was conducted in Banjarmasin City.
South Kalimantan Province.
Puskesmas S.
Parman, from April to June The study population consisted of all pregnant women visiting Puskesmas S.
Parman during the research period.
A total of 33 pregnant women were recruited using a purposive sampling technique, in Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
accordance with the inclusion criteria.
The inclusion criteria were: .
pregnant independent and dependent variables, with women in the first, second, or third a significance level of = 0.
A p-value trimester, .
willing to participate as < 0.
05 indicated a statistically significant respondents, and .
able to read the questionnaire well.
The exclusion criteria were pregnant women experiencing severe RESULTS AND DISCUSSIONS medical or psychiatric disorders that could Result Study findings revealed that the PASS The number of samples was identified anxiety in 22 pregnant women, limited to 33 respondents, which was 7% of participants.
The determined based on the availability of demographic characteristics of respondents pregnant women during the study period were analyzed based on age variables, rather than using a formal sample size number of children .
, education formula, and this is acknowledged as one level, income, and occupation.
accuracy of of the studyAos limitations.
According to Table 1, from a total of 33 respondents of pregnant women in the city The instrument used was the Perinatal of Banjarmasin, it is known that most are Anxiety Screening Scale (PASS), which in the at-risk age group (<20 years or >35 consists of 31 items.
A reliability test year.
, which is as many as 18 people conducted in this study produced a .
4%).
A total of 20 respondents CronbachAos alpha coefficient of 0.
6%) had parity at risk .
irst child or exceeding the r-table value of 0.
more than three childre.
Related to indicating that all items were consistent income, the majority of respondents 22 and the instrument was reliable.
Data people .
7%) have income ranging from analysis included univariate and bivariate < Rp1,500,000 to Rp3,500,000.
Based on Univariate analysis described education level, 14 people .
2%) only the characteristics of each variable, both attended elementaryAejunior high school, and 21 people .
6%) did not have a job.
ge, education, occupation, and incom.
nxiety pregnant wome.
Results were presented in tables and figures.
Bivariate analysis used the SpearmanAos rank correlation test Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
Table 1.
Univariate Analysis Related to Age.
Parity.
Income.
Education.
Occupation.
To Anxiety During Pregnancy Variables Age Parity Education Income Occupation Anxiety Category <20, >35 years old 20-35 years old Number Of Children 1, > 3 Number Of Children 2-3 Low education High education <Rp.
000,-Rp.
>Rp.
No Occupation Occupation Asymptomatic Anxiety Total Source: Primary Data, 2025 Table 2.
Bivariate Analysis Related to Age.
Parity.
Income.
Education.
Occupation.
To Anxiety During Pregnancy Anxiety Levels During Pregnancy Total Variables Category Not Anxious Anxious Value CI .
%) <20, >35 years old
0,175
Age
20-35 years old
0,026
,035-0,.
Total
1, > 3
0,016
Parity 0,001 .
,001-0,.
Total Low education 0,185 Education High education 0,048 .
,032-1,.
Total <Rp.
Rp.
0,005
Income
0,001
>Rp.
,000-0,.
Total No Occupation 0,010 Occupation Occupation 0,001 .
,001-0,.
Total Source: Primary Data, 2025 According to Table 2, of the 33 pregnant greater chance of experiencing anxiety women studied, 18 were classified as than mothers aged 20-35 years.
being in the high-risk age group, of whom For the parity factor, 19 out of 20 expectant mothers .
0%) who had either 1 child or more than 3 children were found pregnant women aged 20Ae35 years, 7 to experience anxiety.
While out of 13 .
7%) reported experiencing anxiety.
pregnant women with 2-3 children, only 3 The value of the odds ratio (OR) of 0.
1%) experienced anxiety.
The indicates that pregnant women aged <20 Spearman Rho analysis generated a p- .
Meanwhile, years or >35 years have a 0.
175 times Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
value of 0.
< 0.
, signifying a Spearman Rho test showed a value of p = statistically significant link relating parity 001 .
< 0.
, which indicates a to anxiety during gestation, with an Odds significant relationship between income to Ratio (OR) of 0.
016, indicating that An OR value of 0.
005 indicates women with one child or more than three that mothers with low incomes are 0.
children had a 0.
016-fold likelihood of times more likely to experience anxiety developing anxiety compared to those with than mothers with high incomes.
2-3 children.
In the aspect of employment status, of the Related to the level of education, 12 of 14 21 pregnant women who did not work, as expectant women .
7%) whose formal many as 20 people .
2%) experienced schooling ended at primary or lower- Meanwhile, out of 12 pregnant women who had a job, only 2 people Meanwhile, .
7%) experienced anxiety.
Spearman women with education ranging from senior Rho test results showed a value of p = high school to a bachelorAos degree, 10 001 .
< 0.
, which indicates a .
6%) experienced anxiety.
The results of the Spearman Rho test showed a value employment status and anxiety during of p = 0.
< 0.
, which indicates a significant relationship between the level indicates that non-working mothers are 010 times more likely to experience The OR value of 0.
anxiety than working mothers.
elementaryAejunior high school education The Correlation of Age With Anxiety have a 0.
185 times greater chance of During Pregnancy experiencing anxiety than mothers with This study found that maternal age was higher education.
associated with anxiety during pregnancy.
In variable income, from 22 pregnant These results are comparable to the women with income < Rp1,500,000AeRp3, research of Safitri et al.
, where Chi- 500, 000, as many as 21 people .
Square analysis revealed a p-value of experienced anxiety during pregnancy.
009, confirming a relationship between Meanwhile, out of 11 pregnant women age and anxiety in 3rd trimester pregnant who had an income > Rp3,500,000, only 1 women at RSIA Ananda Makassar .
In that study, women under 20 or over 35 .
Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
years of age were found to have about 2.
affective maturity at this age supports times the risk of experiencing anxiety coping skills in the face of stressors.
compared to women aged 20Ae35 years (OR = 2.
283, 95% CI 0.
862Ae6.
Based The Correlation of Parity With Anxiety on the assumptions of researchers, age is During Pregnancy estimated to can be considered as one of This study confirmed that parity was the factors influencing anxiety levels.
significantly associated with maternal pregnant women.
The results of the study According to Fadillah .
support this assumption, where out of 20 statistical analysis revealed a significant pregnant women who are in the age association between parity and anxiety category at risk (<20 years and >35 year.
, levels among women in their 3rd trimester as many as 15 people .
3%) experience at PMB Rita.
Bukittinggi City.
The These findings corroborate that findings indicated a p-value of 0.
age at risk is related to the psychological which is below the 0.
05 threshold, leading condition of the mother during pregnancy.
to the rejection of the null hypothesis and This statement is reinforced by Lestaluhu .
, who explained that pregnant That is, parity is significantly women aged 20-35 years generally have related to the level of anxiety.
Similarly.
Suryaningsih & Horhoruw .
reported a significant correlation of parity with optimally, in contrast, women under 20 maternal anxiety about childbirth among years old have reproductive organs that are 3rd trimester pregnant women.
With a p- still developing, which may increase anxiety related to childbirth.
On the other relationship is statistically significant.
hand, pregnancies over the age of 35 are line with the results of research Anggraeni categorized as high-risk because they are et al.
, suggested that anxiety in more prone to congenital abnormalities primigravid mothers is generally caused by and complications during childbirth, which shadows or negative perceptions of the can also trigger anxiety.
In line with this, labor process that have never been Herlina et al.
states that at the ideal experienced before.
Mothers who undergo age of 20-35 years, subjective maturity a first pregnancy often feel anxious and occurs which has an effect on maternal worried about things that are not yet The combination of cognitive and known or the risks that may occur during pregnancy until delivery.
Meanwhile, in Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
multigravid mothers, anxiety is more This allows them to respond common due to unpleasant previous more calmly and rationally to various experiences, both during pregnancy and childbirth, causing fears that similar associated with better analytical skills, so that the individual is better prepared to Reinforced by Yanti & Hasrida .
, face problems and less likely to experience explained that women who have given excessive anxiety.
Reinforced by Fadillah birth more than three times are at higher .
, education plays an important role risk for both their own health and that of in determining anxiety levels during their babies.
Frequent childbirth can cause damage to the uterine blood vessels, education tend to have better access to impairing fetal nutrient supply, which may information and a clearer understanding of hinder proper growth and development of issues related to their pregnancy.
This can the fetus.
motivate the mother to recognize the cause Higher Individuals of anxiety as well as find solutions to The Correlation of Education Level overcome it independently.
Conversely.
With Anxiety During Pregnancy pregnant women with a low level of This study found that education level was education tend to be more easily affected related to maternal anxiety.
These findings by information from their surrounding are consistent with Wahyuni & Hardin environment, which can trigger or worsen .
, which found that out of 29 the anxiety condition experienced.
respondents with a higher level of education, about 20.
7% of participants The experienced moderate anxiety.
Among the Anxiety During Pregnancy 44 respondents who had only primary This study showed that family income was associated with maternal anxiety.
In line The analysis yielded a p-value of with Syabin .
study, which showed 036, indicating a significant relationship that severe anxiety was found in 22 between the level of education of pregnant pregnant women .
%), and of these, 15 women with anxiety in Windari et al.
%) had incomes below UMR.
, suggests that individuals with The higher levels of education tend to have greater access to information, including relationship between family income level about health, life planning, and stress and anxiety in 3rd trimester of pregnancy.
Correlation chi-square Income With Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
with a value of p = 0.
02 ( = 0,.
The help reduce the anxiety of pregnant OR value of 5.
57 indicates that pregnant women towards various needs during and women with income of O UMR have a 5.
after pregnancy, such as the cost of times greater risk of experiencing anxiety pregnancy examination (ANC), fulfillment than those whose income is above UMR.
of nutrition for mothers and fetuses.
With a p value of < , this indicates a maternity clothing, and childbirth costs.
significant link between income and the The Correlation of Occupation With Anxiety During Pregnancy Research by Wulandari & Purwaningrum This study indicated that employment .
also reported a notable correlation status was significantly associated with of economic conditions with the level of anxiety during pregnancy.
These findings anxiety of pregnant women in 3rd are consistent with the research conducted trimester before childbirth.
The test results by Jannah et al.
, which used the showed a value of p = 0.
049 (< 0.
PASS instrument and Chi-Square test which means there is a meaningful correlation between the two variables.
According to Sutriningsih et al.
employment status and her anxiety levels pregnant women who do not have a fixed during pregnancy .
= 0.
, with an OR income or come from low-income families value of 4.
This indicates that non- tend to experience severe anxiety more working pregnant women are 4,129 times often than mothers whose income is A stable family income makes compared to working pregnant women.
mothers more mentally and financially addition, the results of this study are also prepared for pregnancy, this may be reinforced by the findings of Meirany et because working mothers have better .
which states that women who resources and financial stability to support actively work outside the home tend to be more exposed to various experiences and On the contrary, low economic information from the environment and conditions can affect the psychological colleagues, so they have a better ability to state of the mother, so her anxiety level respond and manage stress and anxiety.
This is reinforced by the Conversely, mothers who spend more time findings of Alifah et al.
, which at home tend to have limited access to states that sufficient family income can information, making them more prone to motherAos Ramadhana Alya Nuur Afifah1.
Darmayanti Wulandatika2.
Siti Fatimah3.
Journal Midwifery Vol.
No.
2, 2025 .
experiencing anxiety due to lack of experience or references in dealing with associated with anxiety levels during situations during pregnancy.
Accordingly.
Based on these findings.
Nurlatifah et al.
stated that further researchers are advised to involve a housewives who spend more time at home larger number of respondents and reach tend to have limited access to information more diverse areas, so that the results can and less often discuss directly with health better describe the anxiety condition of workers about the anxiety or worry they pregnant women as a whole.
In addition, it experience during pregnancy.
will be better if the next study not only uses questionnaires, but also adds methods Every research must have its advantages and disadvantages.
Likewise with this study, this study has advantages because it is able to show that mental health checks, especially anxiety in pregnant women, have not been part of routine services in health services.
The findings are expected to encourage routine anxiety screening during pregnancy.
In addition, it is also important that health workers not only do the screening, but also understand the results and be able to provide appropriate such as interviews or group discussions, so that the data obtained are deeper and more recommended that antenatal care services incorporate routine anxiety screening and counseling, so that pregnant women psychological support.
Health workers are encouraged to provide not only physical comprehensive mental health assistance during ANC visits.
accompaniment or assistance to reduce maternal anxiety.
The disadvantage of this study is the limited number of samples and only conducted in one location, so the results have not been able to represent THANK YOU We would like to thank all those who have helped and supported the implementation of this research.
other areas thoroughly.
BIBLIOGRAPHY