INISIASI MENYUSU DINI MEMPERCEPAT INVOLUSI UTERUS

Background: One of the factors that influence uterine involution is early initiation of breastfeeding (IMD). When breastfeeding occurs stimulation and the release of hormones, including oxytocin, which functions in addition to stimulating contraction of the smooth muscles of the breast, also causes uterine muscle contraction and retraction. This will put pressure on the blood vessels resulting in reduced blood supply to the uterus. This process helps to reduce the placenta implantation site or site as well as reduce bleeding. The Maternal Mortality Rate (MMR) in Indonesia is 250 / 100,000 (KH). one of them is caused by bleeding. One of the causes of bleeding is the sub-involution of the uterus. Uterine involution or uterine contraction is a process by which the uterus returns to its pre-pregnancy state.Purpose: To determine the influencing of early initiation of breastfeeding on uterine involution.Methods: The study was carried out by early initiation of breastfeeding and observation and measuring the height of the uterine fundus (TFU) to assess uterine involution. The design of this study used an analytical survey method with a Cohort research design. This study used primary data. The population in this study were all women with normal gestational age at the Independent Practice Midwives (BPM) Choirul Mala and PMB Fauziah Hatta. The sampling technique was non propability sampling with purposive technique. The sample size was n1 = n2 for each group of 48 people. The analysis used univariate and bivariate with Chi Square. The study was conducted at BPM Choirul Mala and BPM Fauziah Hatta from December 2018 to February 2019.Results: The results of data analysis from 96 respondents showed that the proportion of non-initiation of early breastfeeding with abnormal uterine involution was 45.8% smaller than those with early initiation of breastfeeding as much as 0%. The results of the Chi-square statistical test showed that the p value = 0.00 was smaller than 0.05, this indicated that there was an influencing of early initiation of breastfeeding on uterine involution with an OR: 0.083.Conclusion: There was an influencing of early initiation of breastfeeding on uterine involution in BPM Choirul Mala and BPM Fauziah Hatta in 2019 Suggestion: It is expected that midwives, to carry out their role in carrying out midwifery care by providing education to pregnant women about early initiation of breastfeeding and its benefits and consistently doing IMD in maternity mothers for at least 1 hour.  Keywords: Early Initiation of Breastfeeding, Uterine Involution ABSTRAK Latar Belakang : Salah satu faktor yang mempengaruhi involusi uterus adalah Inisiasi menyusu Dini (IMD). Saat menyusui terjadi rangsangan dan dikeluarkannya hormon antara lain oksitosin yangberfungsi selain merangsang kontraksi otot-otot polos payudara, juga menyebabkan terjadinya kontraksi dan retraksi otot uterus. Hal ini akan menekan pembuluh darah yang mengakibatkan berkurangnya suplai darah ke uterus. Proses ini membantu untuk mengurangi situs atau tempat implantasi plasenta serta mengurangi perdarahan. Angka Kematian Ibu (AKI) di Indonesia adalah 250/100.000 (KH). salah satunya disebabkan oleh perdarahan. Penyebab perdarahan salah satunya yaitu sub involusi uterus. Involusi uterus atau pengerutan uterus merupakan suatu proses dimana uterus kembali ke kondisi sebelum hamil.Tujuan : Mengetahui pengaruh inisiasi menyusu dini terhadap involusi uterus.Metode : Penellitian dilakukan dengan cara melakukan inisiasi menyusu dini dan observasi serta mengukur Tinggi Fundus Uteri (TFU) untuk menilai involusi uteri. Desain penelitian ini menggunakan metode survey analitik dengan rancangan penelitian Cohort. Penelitian ini menggunakan data primer. Populasi dalam penelitian ini adalah seluruh ibu bersalin normal dengan usia kehamilan aterm di Bidan Praktik Mandiri (BPM) Choirul Mala dan PMB Fauziah Hatta. Tehnik Pengambilan sampel secaranon propability sampling dengan teknik purposive. Besar sampel n1 =n2 masing-masing 48 orang setiap kelompok.Analisa yang digunakan univariat dan bivariat dengan Chi Square. Penelitian dilakukan di BPM Choirul Mala dan BPM Fauziah Hatta pada bulan Desember 2018 sampai dengan Februari 2019.Hasil : Hasil analisis data dari 96 responden, didapatkanproporsi tidak inisiasi menyusu dini dengan involusi uterus tidak normal sebanyak 45,8 % lebih kecil daripada yang inisiasi menyusu dini sebanyak 0 %. Hasil uji statistik Chi-squarediperoleh nilai p value = 0,00 lebih kecil dari  0,05 hal ini menunjukkan bahwa ada pengaruh inisiasi menyusu dini terhadap involusi uterus dengan nilai OR : 0,083.Kesimpulan : Ada pengaruh inisiasi menyusu dini terhadap involusi uterus di BPM Choirul Mala dan BPM Fauziah Hatta tahun 2019Saran : Diharapkan kepada bidan, untuk menjalankan perannya dalam melakukan asuhan kebidanan dengan memberikan edukasi pada pada ibu hamil tentang inisiasi menyusu dini dan manfaatnya serta secara konsisten melakukan IMD pada ibu bersalin mimimal selama 1 jam. Kata Kunci : Inisiasi Menyusu Dini, Involusi Uterus