The Influence of Rebozo Technique on the Duration of Active Phase of Stage I Labor in Primigravida Mothers

Abstract


INTRODUCTION
The natural process of ending a pregnancy that reaches full term or 37-40 weeks is a highly anticipated condition, namely the process of childbirth. In this condition, almost every woman will feel tension and happiness [1]. Labour is a physiological process involving the delivery of the fetus, placenta, and membranes from the uterus through the birth canal. This process begins with the opening and dilation of the cervix, which is caused by regular contractions of the uterus in terms of frequency, duration, and intensity.
Labor is considered normal when it occurs at term (after 37 weeks) without complications [2]. Pain during labor can cause anxiety in The progress of labor in the active phase of Stage I, from 3 cm to 10 cm dilation, takes approximately 7 cm and lasts for 6 hours. The active phase of Stage I labor is divided into several parts, including the acceleration phase, which lasts 2 hours and involves dilation from 3 cm to 4 cm, the maximal dilation phase, which takes 2 hours and involves rapid dilation from 4 cm to 9 cm, and the deceleration phase, which lasts 2 hours and involves slower dilation until reaching 10 cm. The active phase of Stage I labor is the most exhausting and challenging period, and most mothers start experiencing intense pain or discomfort as the uterine activity becomes more active. During this phase, contractions become longer, stronger, and more frequent, which can lead to anxiety. Anxiety in Stage I labor can result in increased adrenaline secretion. One of the effects of adrenaline is the constriction of blood vessels, leading to decreased oxygen supply to the fetus. The decrease in blood flow also weakens uterine contractions and prolongs the labor process, resulting in prolonged labor. Weak or inadequate uterine contractions are the most common cause of prolonged labor [3].
Rebozo is a shawl/cloth that is placed on the pelvis of the laboring mother, with controlled movements to help move the hips or slightly swing them from side to side. This movement provides pressure by rocking or shaking in the pelvis continuously during contractions, where the emphasis is precisely placed on the lumbar, sacrum and coccyx (Lumbosacral) bones of the patient with the rebozo cloth [4]. Research conducted by Damayanti and Fathimah (2021) states that the rebozo technique to reduce pain during labor which causes proper circular movements will make the mother feel hugged and trigger the release of the hormone oxytocin or happy hormone. so that the mother's labor is smoother. In the labor phase, there is muscle and ligament tension so 395 this rebozo movement is very helpful when the mother gives birth. This rebozo technique can help to become more relaxed without the help of any drugs. This makes this technique very useful when labor is long and the mother begins to feel comfortable [5]. The rebozo technique is effective in reducing contraction pain or in other words there is an effectiveness of the rebozo technique in reducing contraction pain during labor, this is revealed in the research of Maryati and Nursitiyaroh (2023) it is believed that the provision of non-pharmacological techniques rebozo is able to provide physiological effects by providing a stimulus effect on the body that releases endorphins hormones [6]. Thus, the rebozo technique can be used during labor to help muscle fibers and ligaments in the uterus relax so as to reduce pain during contractions [7].
There are various efforts to effectively enhance contractions, including ambulation technique, changing positions, emptying the bladder, nipple stimulation, providing food and drink, and reducing maternal stressors, which have been proven effective in increasing the frequency of contractions [8].
Additionally, one effective method is the use of the Rebozo technique. The Rebozo technique helps create a wider pelvic space for the mother, making it easier for the baby to descend into the pelvis and speeding up the labor process. The function of the Rebozo technique is to optimize the position of the baby, relax the pelvic muscles and ligaments, and ensure optimal positioning of the baby in the womb. This technique is particularly useful during prolonged labor and provides comfort for the mother. Furthermore, the technique can also be used to create space for the baby, ensuring that the baby is in the most optimal position for delivery [9].  Table 1 shows that from the 32 respondents, the majority were in the age range of 17-25

RESULTS
years. All respondents were in the active phase of Stage I labor, with the majority having a labor duration of less than 6 hours, amounting to 23 individuals, and birth weight between 2500-3500 grams.   hours and a birth weight between 2500-3500 grams. This is consistent with the findings of a study by Ardhiyanti (2016), which revealed that the mother's age is a factor related to the physical and psychological readiness of the mother, which can influence fetal growth and development as well as the duration of the labor process [9]. and "shifting while lying down" variations.
Rebozo is a shawl or wrap that is used on the mother's pelvis, with controlled movements to help move the pelvis or gently sway it from side to side [14]. Moreover, the slight swaying of the fabric swing on the mother helps provide a wider pelvic space for the mother so that the baby descends the pelvis more easily and the delivery process is faster. Looking at the results of the study, it can be seen that Rebozo can be used during labor to help the muscles and muscle fibers in the uterine ligament relax so as to reduce pain during contractions [15]. However, there were two respondents who experienced a slow active Phase I labor despite receiving the Rebozo technique. One of the reasons could be psychological factors, such as the mother's unfocused behavior during body positioning or excessive fear and worry about the labor process, which can also affect the progress of labor.

CONCLUSION
The conclusion of this study is that there is a can affect the psychology of the mother and the first stage can be faster.

CONFLICT OF INTEREST
No conflict of interest has been declared by any of the authors.