Analisis Hubungan Respectful Maternity Care dengan Pengalaman Persalinan Positif: Studi Multisenter

Ririn Adam, dr. Sarrah Ayuandari, Ph.D, Sp.OG, Subsp F.E.R; Dr. dr. Shinta Prawitasari, M.Kes, Sp.OG, Subsp. Obginsos

2026 | Tesis | MAGISTER KEBIDANAN

Latar belakang: Kurangnya perhatian terhadap pengalaman persalinan positif masih terjadi terutama di negara-negara berpenghasilan rendah dan menengah. Secara global diperkirakan 16% ibu bersalin memiliki pengalaman persalinan negatif. Situasi ini dapat memicu stres psikologi yang dapat meningkatkan risiko gangguan stres pascatrauma dan depresi postpartum. Respectful maternity care (RMC) merupakan salah satu upaya dalam mencapai pengalaman persalinan positif. Pendekatan ini bukanlah sebuah perawatan opsional, melainkan hak asasi manusia yang fundamental dan merupakan landasan sistem kesehatan yang efektif. Penelitian ini bertujuan untuk menganalisis hubungan RMC dengan pengalaman persalinan positif di fasilitas kesehatan Kota Gorontalo.

Metode: Penelitian cross sectional ini melibatkan 113 ibu postpartum (1 – 6 minggu) yang melahirkan di enam rumah sakit dan empat puskesmas wilayah Kota Gorontalo. Teknik pengambilan sampel menggunakan consecutive sampling dengan mempertimbangkan kriteria inklusi dan eksklusi. Pengumpulan data menggunakan kuesioner RMC, kuesioner pengalaman persalinan dan kuesioner yang terdiri dari data sociodemografi dan obstetri ibu bersalin. Regresi linear berganda digunakan untuk menilai hubungan antara RMC dan pengalaman persalinan positif.

Hasil: Skor rata-rata RMC adalah 99,07 ± 10,08, dan skor rata-rata pengalaman persalinan positif adalah 57,49 ± 6,99. Setelah mengontrol variabel usia, pendidikan, paritas, pendamping persalinan, jenis persalinan, intervensi medis, komplikasi persalinan, IMD, dan jenis fasilitas kesehatan, RMC secara independen memiliki hubungan yang signifikan dengan pengalaman persalinan positif (? = 0.353, 95% CI: 0.243–0.463, p < 0>Koefisien determinasi menunjukkan bahwa variabel RMC, jenis persalinan dan fasilitas kesehatan 32,2% mampu menjelaskan variasi pengalaman persalinan positif (R² = 0,322).

Kesimpulan: Meskipun memiliki hubungan positif yang bermakna dengan kekuatan hubungan sedang, studi ini membuktikan bahwa cara seorang perempuan diperlakukan oleh tenaga kesehatan secara kemanusiaan jauh lebih menentukan kepuasan batinnya dibandingkan jenis persalinan maupun strata fasilitas kesehatan tempat ia melahirkan. Penguatan implementasi RMC tidak hanya meningkatkan kesejahteraan psikologis ibu, tetapi juga berpotensi meningkatkan utilisasi pelayanan kesehatan maternal secara berkelanjutan.

Background: Limited attention to positive childbirth experiences remains a challenge, particularly in low- and middle-income countries. Globally, an estimated 16% of women report negative childbirth experiences, which may lead to psychological distress and increase the risk of postpartum depression and post-traumatic stress disorder. Respectful Maternity Care (RMC) is a key strategy for promoting positive childbirth experiences. Rather than being an optional component of care, RMC is a fundamental human right and a cornerstone of an effective maternal healthcare system. This study aimed to examine the association between Respectful Maternity Care and positive childbirth experience among postpartum women in healthcare facilities in Gorontalo City, Indonesia.

Methods: A multicenter cross-sectional study was conducted among 113 postpartum women (1–6 weeks after childbirth) who delivered in six hospitals and four primary healthcare centers in Gorontalo City. Participants were recruited using consecutive sampling based on predefined inclusion and exclusion criteria. Data were collected using the Respectful Maternity Care questionnaire, the Childbirth Experience Questionnaire, and a structured questionnaire on maternal sociodemographic and obstetric characteristics. Multiple linear regression analysis was performed to assess the association between RMC and positive childbirth experience while controlling for potential confounding variables.

Results: The mean RMC score was 99.07 ± 10.08, while the mean positive childbirth experience score was 57.49 ± 6.99. After adjusting for maternal age, educational level, parity, labor companion, mode of delivery, medical interventions, childbirth complications, early initiation of breastfeeding, and type of healthcare facility, RMC was independently associated with positive childbirth experience (? = 0.353, 95% CI: 0.243–0.463, p < 0>. The final regression model showed that RMC, mode of delivery, and type of healthcare facility collectively explained 32.2% of the variance in positive childbirth experience (R² = 0.322).

Conclusions: Although the association was of moderate strength, this study demonstrates that respectful and humane treatment by healthcare providers was more strongly associated with women's positive childbirth experiences than the mode of delivery or healthcare facility level. Strengthening the implementation of Respectful Maternity Care may not only enhance maternal psychological well-being but also promote sustained utilization of maternal health services.

Kata Kunci : Respectful Maternity Care, Pengalaman persalinan positif, Studi Multisenter