MIDWIFERY JOURNAL (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.
Education On Consumption of Fe Tablets Increases Hemoglobin Levels Index In Pregnant Women Sabilla Ratu Cetrin1.
Evi Wahyuntari 2.
Nuli Nuryanti Zulala 3 Faculty of Health Sciences, 'Aisyiyah University of Yogyakarta Email: sabillaratu.
cetrin2506@gmail.
com1, evi.
wahyuntari@unisayogya.
zulala@unisayogya.
ABSTRACT
Anemia is a global public health problem that can increase morbidity and mortality rates among mothers and infant.
Education about anemia in pregnant women will get good results when using appropriate media.
One of the health promotion methods with persuasive visual messaging is through the use of leaflets.
The purpose of this study is to determine the effect of education on Fe tablet consumption on the increase of Hb levels index in pregnant women in the Mlati I Public Health Center region.
The research method is a quantitative pre-experimental design with a one group pretest posttest design.
The population consists of 149 pregnant women with anemia.
The sample is 22 individuals selected using non-probability sampling, specifically purposive sampling.
The results of data analysis using wilcoxon test obtains with an asymp.
-taile.
value of 0.
001 < 0.
There is a significant effect ofeducation using leaflets and supervision of taking Fe tablets using observation sheets that are followed up 3x a week on the consumption of Fe tablets with an increase in hemoglobin levels index.
This indicates that there is an influence of education on consuming Fe tablets with an increase Hb levels in pregnant women after intervention 4 weeks.
Keywords: Pregnant Women.
Anemia.
Education.
Fe Tablets.
Hemoglobin Levels index A2025 Sabilla Ratu Cetrin.
Evi Wahyuntari.
Nuli Nuryanti Zulala Under the license CC BY-SA 4.
*Sabilla Ratu Cetrin.
Faculty of Health Sciences, 'Aisyiyah University of Yogyakarta.
Jl.
Siliwangi No.
63 Area Sawah.
Ngotirto Kecamatan Gamping Kabupaten Sleman Daerah Istimewa Yogyakarta, 55292.
Indonesia, sabillaratu.
cetrin2506@gmail.
Sabilla Ratu Cetrin1.
Evi Wahyuntari2.
Nuli Nuryanti Zulala3 / Journal of Midwifery Vol.
No.
2, 2025 .
Visits, parity, age, and husband's suppor.
INTRODUCTION World Health Organization (WHO) indirect factors .
attern of iron tablet defines anemia in pregnancy if the consumption, infectious diseases, and hemoglobin level in pregnant women is bleedin.
(Harna et al.
, 2.
less than 11 gr (WHO, 2.
Anemia is a The impact of anemia on pregnant women global public health problem that can is abortion, premature labor, prolonged labor, postpartum hemorrhage, shock, mothers and infant.
Anemia in pregnant intrapartum/postpartum infection, besides women is called "potential danger to that the impact of anemia on pregnant mother and child", pregnant women who women can be observed from the large suffer from anemia have a chance of experiencing bleeding during childbirth mortality, increased fetal morbidity and which can result in death, therefore anemia mortality, and increased risk of low birth requires attention from all parties involved weight (Utami et al.
, 2.
Anemia not in health services (Satriani, 2.
only affects the mother, but also the baby SKI 2023 shows that anemia in pregnant who is born.
problems that can occur in women is still a public health problem in babies if the mother suffers from anemia Indonesia, with a prevalence of 27.
are low birth weight (LBW).
IUGR (Lestari et al.
, 2.
Data from the (Intrauterine Sleman Regency Health Office, .
the premature birth, fetal death and neonatal prevalence of anemia in pregnant women death (Astuti et al.
, 2.
(Farhan & K1 in Sleman Regency in 2023 was Dhanny, 2.
78%, while the prevalence of anemia at Efforts to prevent and overcome anemia the Mlati I Health Center was 18.
have been carried out by the government (Sleman Regency Health Office, 2.
and have been standardized through the The main causes of anemia during Regulation of the Minister of Health of the pregnancy are iron deficiency, folate Republic of Indonesia No.
88 of 2014 concerning the standard for iron tablets for conditions such as sickle cell anemia and women of childbearing age and pregnant thalassemia (Kuma et al.
, 2.
Factors women (Syari et al.
, 2.
This effort not that can influence the incidence of anemia only includes the provision of iron tablets in pregnant women are basic factors during pregnancy or a minimum of 90 .
ocioeconomic, knowledge, education, and cultur.
, direct factors (Antenatal Care importance of counseling, information and Growth Restrictio.
Sabilla Ratu Cetrin1.
Evi Wahyuntari2.
Nuli Nuryanti Zulala3 / Journal of Midwifery Vol.
No.
2, 2025 .
(Ekayanthi & Purnamasari, 2.
can increase compliance in taking iron tablets (Wakwoya et al.
, 2.
One effort to overcome the incidence of anemia is to provide health education.
METHOD
Health education is a very important factor Quantitative and will be successful depending on the experimental design, namely one group design, the right method and the use of pretest posttest design.
The location of the appropriate theory (Sang et al.
, 2.
study was at the Mlati I Health Center.
The Education about anemia in pregnant research time was March-May 2025.
The women will get good results if using the population was 149 pregnant women with method of health The sample was 22 people with the sampling technique using purposive message delivery is education using sampling with inclusion criteria: pregnant leaflets (Ekayanthi & Purnamasari, 2.
women in the first and third trimesters Media leaflets are effective because they with Hb levels <11gr / dl, pregnant women have the advantage of being a health in the second trimester with Hb levels promotion medium that contains material <10.
5gr / dl, mothers do not have chronic accompanied by images that serve to diseases, mothers are willing to be explain the content presented by the Exclusion criteria: pregnant speaker (Aliva et al.
, 2.
This is reinforced by research Ermitha & Yuniarti, women who consume drugs that affect .
that shows the influence of health hemoglobin levels, pregnant women who education through media leaflets and enter aterm pregnancy (Ou 37 week.
, and WhatsApp pregnant women who plan to move Media leaflets are effective because, as a domicile and health facilities.
The time of health promotion tool, they contain images this study began in March to May 2025.
that can explain the content of the material Calibrated easy touch blood Hb level presented by the presenter, can be stored Pregnant women will be checked for a long time, and can remind people of for pretest and posttest Hb levels.
Before the material that has been presented by the the examination, to ensure that the pregnant woman has anemia, medical knowledge and hemoglobin levels in records and KIA books are used to see pregnant women with anemia because it hemoglobin levels.
then the mother is media, one Education Sabilla Ratu Cetrin1.
Evi Wahyuntari2.
Nuli Nuryanti Zulala3 / Journal of Midwifery Vol.
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Wilk and the pretest results were 0.
identity data.
After that, pregnant women and posttest 0.
052, these data were not will be checked for pretest Hb levels, normally distributed because p <0.
pregnant women will be given education Because the data was not normally using leaflets door to door and supervision distributed, the data analysis used the of taking Fe tablets using observation Wilcoxon test.
This research has obtained sheets that are followed up 3x a week.
ethical permission from the health research After 4 weeks, pregnant women will be ethics committee of 'Aisyiyah University checked for Hb levels.
Data analysis used the data normality test, namely Saphiro 2034/KEP-UNISA/II/2025.
Yogyakarta
RESULTS AND DISCUSSIONS
Results Table 1.
Frequency Distribution of Characteristics of Pregnant Women at Mlati I Health Center Variables Category Amount Presentation Age 20-35 years > 35 years Education Junior High School Senior High School Bachelor Work Work Doesn't work Parity Primigravida Multigravida Grand multigravida Gestational Age Trimester I Trimester II Trimester i Source: primary data Table 2.
Analysis of the influence of education on consuming iron tablets on increasing Hb levels in pregnant women at the Mlati I Health Center.
Hb levels Median (Minimum-Maximu.
Mean A SD P-value Pre-test 4 .
Post-test 2 .
Source: Primary data Discussion mostly aged 20-35 years .
8%), high Based on table 1, the results show that the school education .
5%), unemployed characteristics of the respondents were .
6%),
%),
Sabilla Ratu Cetrin1.
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second trimester gestational age .
5%).
pregnancy at the age of <20 years and>35 The age of pregnant women has a years will increase the risk of pregnancy significant relationship with the incidence including anemia (Tampubolon et al.
of anemia and hemoglobin levels during 2.
Anemia in pregnant women is Pregnant women who are in caused by physiological changes in the the risky age category, either too young cardiovascular system which result in <20 years or too old> 35 years, tend to hemodilution or blood thinning.
In this have a higher chance of experiencing condition, the body of a pregnant woman anemia (Sari et al.
, 2.
This age factor requires a supply of iron to meet the is related to the physiological condition of nutritional needs of the fetus, mother and Meanwhile, the younger and Younger pregnant women may not have an older the age of a pregnant mother, the optimal diet or experience hormonal more it will affect the nutritional needs (Yunida Meanwhile, older pregnant women are at Reproductive age .
years-35 year.
is risk of experiencing health complications the best age to get pregnant and give birth that can worsen anemia (Ririn Riyani et (Tri Aksari & Didik Nur Imanah, 2.
, 2.
Pregnant women at a young The level of education of pregnant women age (<20 year.
need a lot of additional is related to the incidence of anemia and nutrition because in addition to being used for their own growth and development.
Higher education is often associated with a they also have to share it with the fetus better understanding of health, including they are carrying and for older women the importance of adequate iron and over 35 years of age, they also need a lot of energy because the function of the (Bachtiar et al.
, 2.
Pregnant women organs is getting weaker and is required to with low levels of education are at higher work optimally, so they need sufficient risk of anemia due to lack of knowledge additional energy to support the ongoing about healthy eating patterns and access to pregnancy (Yunida et al.
, 2.
health information.
Education is closely Age related to the ability to receive information pregnancy are ages that are more or less related to health, especially in pregnant than healthy reproductive age.
It is better if women with anemia, such as knowledge of the age of pregnancy is not too young (<20 anemia, selection of foods high in iron and year.
and too old (>35 years, because iron intake (Muliani et al.
, 2.
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Education irregular eating patterns and limited access knowledge of mothers in undergoing to nutritious food (Ariani et al.
, 2.
pregnancy and childbirth (Wahyuntari.
This is in line with previous research that 2.
The level of education affects there is a relationship between work and knowledge because a person's ability to the incidence of anemia in pregnant women in the second trimester, the results determined by their level of education.
The of the study explained that 14 respondents level of education also greatly affects the of working pregnant women experienced ability to receive nutritional information, determining or influencing how easy it is for someone to receive knowledge, the higher the education, the easier it is for someone to receive nutritional information respondents did not experience anemia (Sasono et al.
, 2.
In addition, the (Desi Haryani Aulia & Purwati, 2.
Excessive Meanwhile, information capture by someone who has a women to get less rest, which results in red higher education is clearly superior to blood cell production not being formed someone who has a lower education optimally and can result in the mother (Qomarasari et al.
, 2.
being anemic or known as anemia (Desi The Haryani Aulia & Purwati, 2.
women is related to the incidence of Parity is a factor in the occurrence of anemia which is closely related to Employment status is related to the pregnancy spacing that is too close <2 economic status and burden experienced years, mothers with high parity .
any by the mother during pregnancy.
Pregnant women with good economic status tend to experiencing anemia because consecutive be able to access more adequate health pregnancies can deplete their body's iron information, one of which is about the reserves, especially if they do not get need for pregnant women to consume Fe enough recovery between pregnancies tablets, so they are more likely to improve (Afini et al.
, 2.
Parity> 4 has a greater their health during pregnancy (Fajarwati & risk of experiencing anemia in pregnancy.
Ama, 2.
Pregnant women who do not if they do not pay attention to nutritional work or have jobs with high stress levels needs during pregnancy (Elisa Safitri & are at higher risk of anemia due to Rahmika, 2.
Mothers who lack Sabilla Ratu Cetrin1.
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nutrients, especially Fe, will be at risk of the risk of developing anemia is greater if causing the mother to experience anemia it is not balanced with a balanced diet and childbirth (Qomarasari et al.
, 2.
(Qomarasari et al.
, 2.
Mothers with high parity (>.
need In the third trimester of pregnancy, iron counseling to pay more attention to their is very much needed by the fetus for fetal nutritional intake during pregnancy and to growth and development as well as routinely carry out pregnancy checks so supplies after birth, this condition causes that any complications that occur can be pregnant women to be more easily detected as early as possible (Sari et al.
exposed to agents so that they are at risk of 2.
Mothers with too close birth spacing do not provide the mother with the elements of pregnant women are related to opportunity to restore the function of the the need for iron (F.
, folic acid, and vitamin B12.
Gestational age and Hb pregnancy, causing depletion syndrome.
levels in pregnant women in the third Mothers trimester are related to the incidence of pregnancies need approximately 2 years to low birth weight, while complaints of nausea and vomiting in pregnant women in the greater the risk of anemia because the availability of iron in the body of pregnant iron reserves in the body are decreasing women so that pregnant women in the first (Qomarasari et al.
, 2.
trimester are also susceptible to anemia Gestational age has an influence on the (Surtinah et al.
, 2.
The increasing age incidence of anemia and hemoglobin (H.
of pregnancy results in an increase in the levels in pregnant women.
As gestational percentage of anemia.
Physiologically, the age increases, the need for iron increases process of anemia begins in the first to support fetal growth and maternal blood trimester of pregnancy, where there is an If these needs are not met, the increase in the amount of plasma which is risk of anemia will increase (Bria & Nur not proportional to the increase in the Rohmah, 2.
Previous research stated number of blood cells, which peaks at 24- 32 weeks of pregnancy (Kusumastuti, occurrence of maternal anemia during 2.
In pregnancy, the volume of red blood cells increases by 20% to 30%, increasing gestational age in the mother, while the volume of plasma increases by (Wahyuntari, 2.
The higher the parity.
Meanwhile.
Sabilla Ratu Cetrin1.
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45 to 55%.
This disproportionate increase themselves, but also for the growth of their in volume results in a blood thinning The supply of iron from food is still process or what is called hemodilution.
insufficient, so supplements are needed in This also results in a decrease in Hb levels the form of iron/Fe tablets.
This is in pregnant women, resulting in anemia reinforced by research Sudarmi et al.
and a decrease in hematocrit (Tri Aksari & .
which states that providing health Didik Nur Imanah, 2.
Based on table 3, it is known that the Hb reminders has been proven effective in level in pregnant women before the showing a difference in hemoglobin (HB) intervention with a median of 10,432 levels, and there is a significant effect on increased after the intervention in the the level of compliance in consuming Fe fourth week to 11,273.
The minimum Hb tablets among pregnant women in their level before the intervention was 9.
third trimester.
The implementation of increased to 9.
8 after the intervention in health promotion through leaflets and the fourth week.
The maximum Hb level WhatsApp on Fe tablets compliance in before the intervention was 10.
9 increased pregnant women is more effective and 9 after the intervention in the fourth easier to understand, thereby increasing The Standard Deviation (SD) before knowledge and influencing behavioral the intervention was 10,432 and after the changes in pregnant women who were intervention in the 4th week became previously non-compliant and did not 11,273.
The results of the statistical test understand the benefits of taking iron with the Wilcoxon test obtained a P value tablets, becoming more compliant than 001, a value of 0.
001 <0.
05, so it can before, as evidenced by the research be concluded that there is an effect of results with a p-value of 0.
000 (Aliva et education on the consumption of iron , 2.
tablets with an increase in hemoglobin recommends that every pregnant woman levels in pregnant women.
consume at least 90 Fe tablets during Based on the results of the study, the pregnancy with a dose of 60 mg (Fajrin, researcher assumes that by providing 2.
In addition.
WHO recommends interventions in the form of education on iron supplementation of 30-60 mg and consuming iron tablets using leaflets, it folic acid 0.
4 mg daily as part of routine can increase hemoglobin levels in pregnant antenatal care during pregnancy (Kuma et Pregnant women are not only , 2.
The SMS Ministry of Health required to meet their iron needs for Sabilla Ratu Cetrin1.
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Pregnant women with anemia have an consuming Fe tablets.
This will have an increased risk of preeclampsia, the risk of impact on the behavior and attitude of bleeding complications and an increased mothers to consume Fe tablets regularly risk of giving birth by cesarean section and maintain their lifestyle.
So that (SC) (Hidayanti & Rahfiludin, 2.
The pregnant women who are obedient in impact of anemia on babies born includes consuming Fe tablets can increase Hb an increased risk of LBW .
ow birth levels in pregnant women (Shafriani et al.
and SGA .
mall for gestational 2.
Educational media that is delivered ag.
, increased premature birth, neonatal and packaged in an attractive manner has death, decreased APGAR scores, and been proven to be able to increase the decreased mental and motor development knowledge and awareness of pregnant of children (Armynia Subratha, 2.
women in consuming routine Fe tablets, so Pregnant that there is an increase in Hb levels in associated with the incidence of anemia in pregnant women.
This is in line with babies born (Risca Fauzia et al.
, 2.
previous studies that show the effect of Hemoglobin levels in pregnant women are education through Whatsapp Groups on increasing Hb levels in pregnant women consuming iron tablets can significantly and there is a significant difference in Hb increase Hb levels, if consumed in the levels in two examination evaluations right way to increase absorption (Satriani, (Sang et al.
, 2.
In addition, there were significant changes in hemoglobin levels Pregnant women in this study were given and the proportion of anemia in pregnant educational counseling using attractively women in the intervention group in the packaged leaflets door to door.
Detailed form of nutrition education and counseling education was provided prioritizing the who had much better hemoglobin levels comfort and safety of mothers so that than pregnant women in the control group mothers could understand the importance (Wakwoya et al.
, 2.
Therefore, of education on consuming Fe tablets with pregnant women who are given counseling increased Hb levels and the importance of using the media will increase their consuming Fe tablets regularly to prevent knowledge about anemia in pregnancy.
Efforts to prevent and overcome anemia Pregnant women who have been given have been carried out by the government education will be monitored to monitor the and have been standardized through the Regulation of the Minister of Health of the Sabilla Ratu Cetrin1.
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Republic of Indonesia No.
88 of 2014 health promotion methods using visual concerning the standard for iron tablets for persuasive message delivery is education women of childbearing age and pregnant using leaflets (Ekayanthi & Purnamasari, women (Syari et al.
, 2.
This effort not 2.
The effectiveness of using leaflets only includes the provision of iron tablets as a health promotion medium is effective during pregnancy or a minimum of 90 for use as an educational prop on public health issues, so that there is an influence importance of counseling, information and of using leaflets as a medium in carrying out health promotion efforts on community (Ekayanthi & Purnamasari, 2.
One of the efforts to overcome the towards health behavior (Sutrisno & incidence of anemia is to provide health Sinanto, 2.
Leaflet media is effective Providing health education in increasing pregnant women's knowledge interventions can have a positive effect on about anemia (Fajrin, 2.
Febriyanti et changes in health behavior to prevent , .
research shows that direct anemia and will have an impact on the delivery of information .
ace to fac.
hemoglobin levels of pregnant women.
accompanied by print media has a positive Health education can change knowledge, impact on conveying health messages.
attitudes and behavior about preventing Leaflets are important in reinforcing the anemia during pregnancy where this will material delivered verbally because they form a positive attitude of pregnant women towards the material about anemia information at home.
that they have just learned, with the consumption of iron tablets can increase CONCLUSION Hb levels significantly, if consumed in the A significant effect was found between the right way to increase its absorption influence of education on iron tablet (Satriani, 2.
consumption and increased Hb levels in Efforts to enhance pregnant womenAos knowledge and attitudes regarding anemia 4-week prevention can also be supported by using engaging and easily understandable media THANK YOU (Amelia et al.
, 2.
Education about The author would like to thank the anemia in pregnant women will get good Lecturer Team of Universitas 'Aisyiyah results if using the right media, one of the Yogyakarta who have supported the Sabilla Ratu Cetrin1.
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completion of this research.
to the Head of place for research and all parties involved Mlati I Health Center who has provided a in the preparation of the research.
BIBLIOGRAPHY