Efektivitas Mobilisasi Dini Terhadap Involusi Uterus Pada Postpartum Sectio Caesarea
DOI:
https://doi.org/10.32382/mkeb.v4i2.737Kata Kunci:
Uterine involution; early mobilization; postpartum; Sectio CaesareaAbstrak
One of the causes of postpartum hemorrhage is uterine subinvolution. Uterine subinvolution causes decreased uterine contractions, so the dilated blood vessels are not completely closed and bleeding may continue. Early mobilization can help prevent uterine subinvolution. Early mobilization is an activity performed by postpartum mothers several hours after delivery; however, some mothers experience difficulty, especially postpartum mothers after Sectio Caesarea, which may affect the decrease in fundal height as a sign of uterine involution. This study aimed to determine the effectiveness of early mobilization on uterine involution among postpartum mothers after Sectio Caesarea at Syekh Yusuf Regional Hospital from March to May 2024. This study used a quantitative method with a pre-experimental design using a one-group pretest-posttest approach. The sample consisted of 30 respondents selected using purposive sampling based on inclusion criteria. Data were analyzed using SPSS version 22 with univariate and bivariate analysis using the paired sample t-test. The results showed that among 30 postpartum mothers after Sectio Caesarea who received early mobilization intervention, 24 respondents (80%) experienced a normal decrease in fundal height, while 6 respondents (20%) experienced an abnormal decrease. The paired sample t-test showed a p-value of 0.000, which was less than 0.05. This study concludes that early mobilization is effective in supporting uterine involution among postpartum mothers after Sectio Caesarea. Conclusion: Early mobilization is effective in supporting uterine involution among postpartum mothers after Sectio Caesarea. Therefore, early mobilization can be applied as a simple and useful intervention in postpartum care to accelerate uterine involution and support maternal recovery.
Referensi
1. Irnawati I, Marbun U, Sari LP. Mobilisasi dini dengan involusi uterus pada ibu postpartum Sectio Caesarea. Jurnal Ilmiah Kebidanan dan Kesehatan. 2023;1(1):28–35. doi:10.36590/jibi.v1i1.705.
2. Ganer Herman H, Ben Zvi M, Tairy D, Kleiner I, Gonen N, Kuper Sason L, et al. Enhancing patient mobility following cesarean delivery: the efficacy of an improved postpartum protocol assessed with pedometers. BMC Pregnancy Childbirth. 2020;20(1):353. doi:10.1186/s12884-020-03046-z.
3. Engel O, Haikin Herzberger E, Yagur Y, Biron-Shental T. Walking to a better future? Postoperative ambulation after cesarean delivery and complications: a prospective study. Int J Gynaecol Obstet. 2022;157(2):391–6. doi:10.1002/ijgo.13815.
4. Bollag L, Lim G, Sultan P, Habib AS, Landau R, Zakowski M, et al. Society for Obstetric Anesthesia and Perinatology: consensus statement and recommendations for enhanced recovery after cesarean. Anesth Analg. 2021;132(5):1362–77. doi:10.1213/ANE.0000000000005257.
5. Liu ZQ, Du WJ, Yao SL. Enhanced recovery after cesarean delivery: a challenge for anesthesiologists. Chin Med J. 2020;133(5):590–6. doi:10.1097/CM9.0000000000000644.
6. Chen Y, Wan J, Zhu Z, Su C, Mei Z. Embedding evidence of early postoperative off-bed activities and rehabilitation in a real clinical setting in China: an interrupted time-series study. BMC Nurs. 2022;21(1):98. doi:10.1186/s12912-022-00883-5.
7. Paemboan S, Aminuddin A, Arfah A. The effect of early mobilization on the uterine involution among postpartum mothers. Nurs Appl J. 2025;3(1):1–8.
8. Mudlikah S. Hubungan paritas dan mobilisasi dini dengan percepatan involusio uteri pada ibu nifas. Indonesian Journal of Midwifery Today. 2022;2(1):35–40.
9. Wahyuni N, Nurlatifah L. Faktor-faktor yang mempengaruhi proses involusi uterus pada masa nifas di wilayah kerja Puskesmas Mandala Kabupaten Lebak Provinsi Banten Tahun 2022. J Medikes. 2022;4(2):167–76. doi:10.36743/medikes.v4i2.83.
10. Sonda M, Marampa AP, Rahmawati R, Subriah S, Marhaeni M. Hubungan mobilisasi dini dengan proses involusio pada ibu postpartum di RSKD Ibu dan Anak Siti Fatimah Makassar. J Midwifery. 2022;4(2):62–71.
11. Susiyanti S, Sembiring NMP. Hubungan mobilisasi dini terhadap penurunan tinggi fundus uteri ibu nifas di Bidan Praktek Mandiri Susiyanti Tahun 2022. J Sains Kesehat. 2022;6(2):1–8. doi:10.57214/jusika.v6i2.233.
12. Sylvia E, Pratama R, Yuliana Y. Mobilisasi dini terhadap penurunan intensitas nyeri pada pasien post operasi Sectio Caesarea. J Keperawatan. 2023;15(2):120–7.
13. Syahida A, Mirani N, Hartimah H. Hubungan usia dan mobilisasi dini dengan penyembuhan luka Sectio Caesarea. J Promot Prev. 2025;8(1):121–7. doi:10.47650/jpp.v8i1.1700.
14. Uzlifatul O, Rahmawati D, Sari N. Pengaruh mobilisasi dini terhadap intensitas nyeri pada pasien post Sectio Caesarea. J Medika Hutama. 2025;6(2):1–7.
15. Anggraini W, Savitri D. Pengaruh mobilisasi dini dan senam nifas terhadap involusi uterus pada ibu nifas. TSC Bidan. 2025;10(1):45–52.
16. World Health Organization. A roadmap to combat postpartum haemorrhage between 2023 and 2030. Geneva: World Health Organization; 2023.
17. Kementerian Kesehatan RI. Profil Kesehatan Indonesia 2022. Jakarta: Kementerian Kesehatan RI; 2023.
18. Kementerian Kesehatan RI. Buku Kesehatan Ibu dan Anak. Jakarta: Kementerian Kesehatan RI; 2022.
19. Kementerian Kesehatan RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 21 Tahun 2021 tentang Penyelenggaraan Pelayanan Kesehatan Masa Sebelum Hamil, Masa Hamil, Persalinan, dan Masa Sesudah Melahirkan, Pelayanan Kontrasepsi, dan Pelayanan Kesehatan Seksual. Jakarta: Kementerian Kesehatan RI; 2021.
20. Kementerian Kesehatan RI. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/320/2020 tentang Standar Profesi Bidan. Jakarta: Kementerian Kesehatan RI; 2020.
21. American College of Obstetricians and Gynecologists. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017;130(4):e168–86. doi:10.1097/AOG.0000000000002351.
22. Ituk U, Habib AS. Enhanced recovery after cesarean delivery. F1000Res. 2018;7:513. doi:10.12688/f1000research.13895.1.
23. Ani M, Rahmawati MA, Armini NW, Afni N, Ningrum NB, Wijayanti E, et al. Asuhan kebidanan pasca persalinan dan menyusui. Padang: Get Press Indonesia; 2023.
24. Nurjannah SN, Maemunah AS, Badriah DL. Asuhan kebidanan post partum dilengkapi dengan asuhan kebidanan post Sectio Caesarea. Bandung: PT Refika Aditama; 2020.
25. Prawirohardjo S. Ilmu Kebidanan Sarwono Prawirohardjo. 4th ed. Jakarta: PT Bina Pustaka; 2020.
26. Ningrum AD, Jasmawati J, Nulhakim L. The effect of early mobilization on uterine involution after cesarean section. International Journal of Nursing and Midwifery Science. 2023;7(2A):6–10. doi:10.29082/IJNMS/2023/Vol7/Iss2A/496.
27. Vihervaara H, Väänänen A, Kaijomaa M. Association between duration of urinary catheterization and post-operative mobilization following elective cesarean section: a retrospective case-control study in Espoo, Finland. Eur J Midwifery. 2024;8(November):66. doi:10.18332/ejm/193602.
28. Sultan P, Monks DT, Sharawi N, Bamber J, Panelli DM, Sauro KM, Shah PS, et al. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery Society recommendations part 3—2025 update. Am J Obstet Gynecol. 2026;233(6S):S184–S198. doi:10.1016/j.ajog.2025.01.038.
29. Na HS. Optimizing maternal recovery: insights into enhanced recovery after Cesarean delivery. Anesth Pain Med. 2025;20(2):101–108. doi:10.17085/apm.25211.
30. Grasch JL, Rojas JC, Sharifi M, McLaughlin MM, Bhamidipalli SS, Haas DM. Impact of enhanced recovery after surgery pathway for cesarean delivery on postoperative pain. Am J Obstet Gynecol MFM. 2023;5(5):100901. doi:10.1016/j.ajogmf.2023.100901.
31. Yulianti L, Rosyidah R, Rahmawati A. Early mobilization and length of wound healing post-sectio caesarea. Health Sciences International Journal. 2024;5(1):1–6.
32. Idawati I, Khaironnisa D, Aisyah S, Husna N, Setiawati D. Effect of early mobilization on post SC pain: a literature review. Science Midwifery. 2023;11(3):620–628.

