EFFECTIVENESS OF THE AoKELAS IBU HAMILAo MOBILE APPLICATION IN IMPROVING DELIVERY PREPAREDNESS: A QUASI-EXPERIMENTAL
STUDY AMONG PREGNANT WOMEN IN MOJOKERTO
Asirotul MaAorifah.
SST.
Bd.
Kes 1 Bachelor's Degree Program in Midwifery.
UNIVERSITAS BINA SEHAT PPNI
MOJOKERTO
Corresponding Email: asirotul.
marifah@gmail.
ABSTRACT
Adequate delivery preparedness is essential to reduce maternal and neonatal Digital maternal classes have emerged as an alternative to conventional education, yet empirical evidence on their structured and sustained effectiveness remains limited.
This study aimed to evaluate the effectiveness of the mobile application AuKelas Ibu HamilAy in improving delivery preparedness among pregnant women.
A quasi-experimental study with a control group was conducted among 40 pregnant women receiving antenatal care at Tambak Agung Auxiliary Health Center.
Mojokerto.
Participants were selected using total sampling and divided into an intervention group .
= .
using the Kelas Ibu Hamil application and a control group .
= .
receiving routine education.
Delivery preparedness was measured weekly for four weeks using a validated questionnaire.
Data were analyzed using paired and independent sample t-tests.
Ethical approval was obtained prior to data collection.
The intervention group showed a significant increase in mean delivery preparedness scores from baseline to week four .
ean difference = 1.
p < 0.
, while the control group demonstrated minimal and inconsistent changes.
Weekly comparisons revealed consistently greater improvements in the intervention group compared to controls.
The Kelas Ibu Hamil mobile application is effective in improving delivery preparedness among pregnant women and may serve as a complementary digital strategy for antenatal education.
Keywords Delivery International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025
INTRODUCTION
Maternal mortality and morbidity remain critical public health challenges in Indonesia.
One of the key strategies to reduce maternal and neonatal complications womenAos preparedness for childbirth through effective antenatal education.
Traditional maternal classes have been shown to improve knowledge, psychological readiness, and confidence prior to delivery.
access to face-to-face education remains limited in some settings due to time, (Rahmawati.
Advances information and communication technology have facilitated the development of digital maternal classes, allowing pregnant women to access educational content flexibly through mobile applications.
Several studies have reported positive outcomes of digital improvements in knowledge, attitudes, and childbirth readiness.
Nevertheless, most existing studies assess outcomes at a single post-intervention point and do not evaluate changes in readiness over time.
(Savitri et , 2.
This study is guided by the Health Belief Model (HBM), which posits that health-related behavior is influenced by perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action.
Delivery preparedness is shaped by mothersAo perceptions of childbirth risks and the benefits of preparation.
The Kelas Ibu Hamil application functions as a cue to action by providing continuous education, reminders, and access to professional consultation.
In addition.
BanduraAos Self-Efficacy Theory supports this study by explaining how repeated exposure to educational content and direct communication with midwives through the application enhances mothersAo confidence in managing childbirth preparation ( Sukawati & Futriani 2.
Previous studies on digital maternal classes have not adequately examined weekto-week changes in delivery preparedness, particularly in semi-rural primary healthcare settings where face-to-face education is This study is novel in that it evaluates weekly changes in delivery preparedness over a four-week period using a mobile application integrated with midwife consultation and compares its effectiveness with routine maternal Therefore, this study aimed to examine the effectiveness of the AuKelas Ibu HamilAy mobile application in improving delivery preparedness among pregnant women attending antenatal care at Tambak Agung Auxiliary Health Center.
Mojokerto.
METHOD
This study employed a quantitative quasi-experimental design with a control group to evaluate the effectiveness of the Kelas Ibu Hamil mobile application on delivery preparedness among pregnant The study was conducted at Tambak Agung Auxiliary Health Center.
Puri.
Mojokerto, in October 2025.
The study population consisted of all pregnant women receiving antenatal care (ANC) services at the health center during the study period.
total sampling technique was applied, yielding 40 eligible participants.
These participants were allocated into two groups:
an intervention group .
= .
that used the Kelas Ibu Hamil mobile application and a control group .
= .
that received routine maternal education.
The intervention group was given access to the Kelas Ibu Hamil mobile application for four consecutive weeks.
The application provides structured educational International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 materials on pregnancy care, birth planning, recognition of danger signs, and preparation for childbirth and the postpartum period.
Participants were encouraged to access the application independently for approximately 20Ae30 minutes per week and were able to communicate directly with a midwife through an in-application messaging feature.
Application engagement were monitored weekly by the The control group received routine antenatal education, including standard counseling during ANC visits and the use of the Maternal and Child Health (KIA) handbook, without exposure to the digital application.
Delivery preparedness was measured using a structured psychological, and informational readiness for childbirth.
The instrument was tested for validity and reliability prior to data collection and demonstrated acceptable internal consistency, with a CronbachAos alpha coefficient greater than 0.
Data were collected weekly over a four-week period using a pre-test and posttest design.
Normality of the data was assessed using the ShapiroAewilk test.
Within-group differences were analyzed using paired sample t-tests, while betweengroup differences were examined using independent sample t-tests.
Effect sizes were calculated using CohenAos d to determine the magnitude of the intervention effect.
address the significant difference in family income between groups, family income was treated as a covariate during analysis and further acknowledged as a study limitation.
A p-value of less than 0.
05 was considered statistically significant.
Ethical approval for the study was obtained from the institutional ethics committee, and written informed consent was secured from all participants before participation.
RESULTS
Table 1.
Respondent Characteristics Based on Age.
Education.
Parity, and Family Income.
Interventio Group Control Group Age .
<20 or>35 Total Low Middle / High Total Family Income Low Middle / High Total Variable Parity Primiparous Multiparous/Grand Total Education Based on Table 1, the majority of respondents in the intervention group were 20Ae35 years old, with 14 people .
%).
the control group, most respondents were also 20Ae35 years old, with 17 people .
%).
For parity, most respondents in the intervention group were multiparous or grand multiparous, totaling 11 people .
%).
In the control group, the majority were also multiparous or grand multiparous, with 16 people .
%).
For education, most respondents in the intervention group had middle or higher education, totaling 15 people .
%).
In the control group, the majority also had middle or higher education, with 13 people .
%).
For family income, the intervention group had an equal International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 distribution: 10 respondents .
%) with low income and 10 respondents .
%) with middle or high income.
In the control group, most respondents had middle or high income, totaling 18 people .
%).
Table 2.
Difference Test of Respondent Characteristics between the Intervention and Control Groups.
Variable Age .
<20 or>35 Total Total Total Family Income Low Middle / High Total Post-test Post-test Week 3 Pre-test Middle / High Week 1 Pre-test Contro Group Week 2 Pre-test Post-test Week 4 Pre-test Education Low Interventio n Group Interventi Group Parity Primiparous Multiparous/Gr Table 3.
Pre-test and Post-test Results of the Intervention Group.
Based on Table 2, the demographic characteristics of participants showed that the intervention and control groups were comparable in terms of age, parity, and educational level .
> 0.
A statistically significant difference was identified in family income between groups .
= 0.
Post-test Std.
Deviatio Mea Based on Table 3, the data on childbirth readiness before and after the intervention was first tested using the ShapiroAeWilk normality test.
All data showed a normal distribution, so the analysis proceeded with the Paired Sample T-Test for the intervention group.
The results showed a meaningful increase at every weekly In the first week, the p-value 003, indicating a significant difference between the pre-test and post-test The second week also showed a significant change with a p-value of 0.
In the third week, the increase remained significant with a p-value of 0.
002, and the fourth week continued to show significance with a p-value of 0.
Overall, these findings confirm that the AuKelas Ibu HamilAy application significantly improved childbirth readiness across all weeks of observation.
The improvement remained consistent from week one through week four, showing that International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 the intervention had a positive and sustained impact on the readiness of pregnant women.
Table 4.
Pre-test and Post-test Results of the Control Group.
Control Group Std.
Deviation Mean Week 1 Pre-test Post-test Week 2 Pre-test Post-test Week 3 Pre-test Post-test Week 4 Pre-test Post-test Based on Table 4, the pre-test and post-test data for the control group were also tested for normality using the ShapiroAeWilk test, and all results showed a normal Therefore, the preAepost comparison was analyzed using the Paired Sample T-Test.
The results showed that the increase in readiness scores in the control group was small and inconsistent.
In the first week, the p-value was 0.
071, meaning the change did not reach statistical significance.
The same pattern appeared in the second week with a p-value of 0.
059, still above the significance threshold.
In the third week, the p-value came closer to significance .
= 0.
, but still did not meet the criteria to be considered Only in the fourth week did the p-value fall just at the threshold .
= 0.
but the confidence interval (CI -0.
83 to 0.
indicated that the change was minimal and did not offer any meaningful practical Overall, the control group, which only received routine education, showed slight increases from week to week, but almost all were insignificant.
This intervention, improvements in childbirth readiness among pregnant women remain minimal and are far weaker compared to the gains seen in the intervention group.
Table 5.
Delta Value of Post-test in Both Groups.
Group Week 1 Interventio n Group AE Control Group Week 2 Kelompok Intervensi Kelompok Kontrol Week 3 Kelompok Intervensi Kelompok Kontrol Week 4 Kelompok Intervensi Kelompok Kontrol Std.
Deviatio Mea nAE Based on Table 5, the same pattern appears consistently each week.
The intervention group always shows a greater increase in readiness compared to the control In the first week, the intervention group reached a mean delta of 1.
15 with p = 041 and a 95% CI of 0.
551Ae1.
749, while the control group increased only 0.
35 and remained non-significant.
The second week shows the same direction of improvement.
International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 The intervention group had a delta of 1.
with p = 0.
074, while the control group 38 and again was not significant.
By the third week, the intervention effect became stronger.
The intervention group recorded a delta of 1.
18 with p = 049, far higher than the control group, which only reached 0.
The fourth week reinforced this trend.
The intervention group maintained stable improvement with a delta 18 and p = 0.
050, while the control group continued to show small and insignificant changes.
Between-group comparisons using independent sample t-tests revealed that post-test mean scores in the intervention group were significantly higher than those in the control group, particularly by the fourth week of observation .
< 0.
The magnitude of the intervention effect indicating a sustained impact of the Kelas Ibu Hamil application on delivery DISCUSSION Demographic respondents .
ge, parity, education, and family incom.
The univariate analysis describes the distribution of respondents based on demographic characteristics .
ge, parity, education, and family incom.
In the intervention group, most respondents .
%) were 20Ae35 years old, most .
%) had multiparous or grand multiparous parity, most .
%) had middle or higher education, and half .
%) had low income while the other half had middle/high income.
In the control group, almost all respondents .
%) were 20Ae35 years old, almost all .
%) had multiparous or grand multiparous parity, most .
%) had middle/high education, and almost all .
%) had middle/high income.
A study by Andriani et al.
reported that as a person gets older, their comprehension and thinking skills develop, which improves the knowledge they acquire.
Their study showed that most respondents .
%) were within the 25Ae29 age range.
This supports the idea that many respondents fall within productive age groups, which strengthens their ability to retain Likewise, in this study, reproductive age, so their memory capacity was still good.
In theory, a personAos knowledge, attitude, and behavior are strongly influenced by their education and past experiences.
In this study, most respondents had multiparous or grand multiparous parity.
Mothers who have given birth before bring prior experience into their current pregnancy, which makes it easier to explain things to them during the study activities.
Still, mothers sometimes forget the essential points they need to pay attention to during pregnancy, childbirth, postpartum care, and childcareAiespecially regarding childbirth Because of this, mothers need reminders through the AuKelas Ibu HamilAy application, which complements the antenatal care handbook.
The app helps improve access to information, knowledge, and communication, including raising awareness of reproductive health issues.
The antenatal care handbook itself is designed to provide information and serve as a health guide for pregnant women.
Tamba et al.
reported a clear link between family income and antenatal Women socioeconomic status attended antenatal care more frequently than those with lower The pattern is predictable: financial capacity shapes access to health services.
this study, the AuKelas Ibu HamilAy app helped cut through those barriers.
The app let Mothers access learning materials, join International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 classes, and consult directly with a midwife through their phone, without having to visit a health facility.
This approach reduces the usual obstacles faced by low-income transportation costs.
As a result, mothers can still receive pregnancy education and ongoing support even when socioeconomic constraints are present.
The Effect of the AuKelas Ibu HamilAy Application on Pregnant WomenAos Readiness for Childbirth This study aimed to examine the effect of the digital maternal class on pregnant womenAos readiness for childbirth at Puskesmas Pembantu Tambak Agung.
Puri.
Mojokerto.
The analysis in Table 4.
2 shows that before the intervention using the AuKelas Ibu HamilAy application, the readiness levels for childbirth in both the intervention and control groups were classified as high, moderate, and low.
After conducting a pretest comparison (Table .
, the results indicated that the pretest scores of the intervention and control groups were Analysis using the paired sample t-test showed that the control group did not experience a statistically significant change between pretest and posttest scores in terms of increased physical activity levels.
The researchers interpreted this as a result of the control group only participating in routine maternal classes without the additional intervention of the AuKelas Ibu HamilAy application, which serves to enhance access to pregnancy-related health information.
changes in pretest and posttest scores across all measured components.
Analysis using the independent sample t-test showed no significant difference in pretest scores between the intervention and control groups.
This indicates that at the pretest stage, respondents in both groups had not yet been influenced by the intervention, so their Furthermore.
Table 4 shows significant posttest improvements in both groups, with greater gains in the intervention group.
Table 5 highlights that the delta scores also changed significantly.
The difference in treatments provided to the two groups explains the significant differences observed in posttest scores and delta values.
In other words, the intervention using the AuKelas Ibu HamilAy application had a meaningful impact on improving pregnant womenAos readiness for childbirth.
Similar findings were reported in a previous study, which showed that smartphone-based health promotion using the AuBidan-kuAy application could improve pregnancy care (Savitri et al.
, 2.
In this study, the use of the AuKelas Ibu HamilAy application yielded comparable results.
For the control group, which only used the maternal and child health (KIA) book, no significant differences were observed in knowledge and attitudes, although practice variables did show some change.
This indicates that guided support activities are more effective in enhancing respondentsAo knowledge, attitudes, and practices.
The effectiveness is attributed to the ease of Mothers do not need to visit health facilities or midwives in person for consultations, while midwives can more easily monitor their pregnancies.
The direct communication between mothers and midwives provides a sense of attention and support, which motivates mothers to maintain and improve their health.
Consequently, mothers become more aware and responsive to their health during breastfeeding, and child care.
International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 This study also found a significant effect of the AuKelas Ibu HamilAy application on pregnant womenAos knowledge, attitudes, and practices regarding readiness for childbirth, as indicated by a p-value of 000, which is smaller than the level of 05 at a 95% confidence level.
These findings align with previous research showing that the Android-based AuAyo DedisAy application significantly improved pregnant womenAos knowledge of balanced Similarly.
Android-based applications for early detection and prevention of stunting in pregnant women enhance access to information through mobile devices (Mukodri, 2.
This study demonstrates that the Kelas Ibu Hamil mobile application preparedness among pregnant women compared with routine antenatal education.
The consistent weekly improvement observed in the intervention group indicates that sustained exposure to structured digital education enhances readiness for childbirth.
These findings can be explained using the Health Belief Model, which suggests that health behaviors improve when individuals perceive clear benefits and receive continuous cues to action.
The application functioned as an ongoing cue to action by providing repeated educational content and facilitating communication with midwives.
In addition.
BanduraAos Self-Efficacy Theory supports the observed improvement, as repeated learning opportunities and professional feedback likely increased mothersAo confidence in managing childbirth The digital format also reduced common barriers to antenatal education, particularly among women with lower socioeconomic status, by minimizing transportation costs and time constraints.
This finding aligns with previous studies reporting that mobile health interventions enhance access to maternal health information and promote active engagement in pregnancy care.
The findings suggest that midwives should consider integrating mobile-based maternal education into routine antenatal care services.
Health policymakers may support the development of standardized digital maternal class applications, particularly in semi-rural and resource-limited settings.
Future studies should involve larger samples, longer follow-up periods, and objective measures of application usage to strengthen evidence.
CONCLUSIONS
The AuKelas Ibu HamilAy mobile application is an effective digital intervention for improving delivery preparedness among pregnant women.
Integration of mobilebased maternal education into routine antenatal care is recommended, especially in settings with limited access to face-to-face REFERENCES