-217805-995045Website: e-journal.unair.ac.id/JBK/index ©2023 Jurnal Biometrika dan Kependudukan ; 12(2) 210–218, December 2023 00Website: e-journal.unair.ac.id/JBK/index ©2023 Jurnal Biometrika dan Kependudukan ; 12(2) 210–218, December 2023 THE EFFECT OF BINAURAL BEATS ON PREGNANT WOMEN PRIMIGRAVIDA 3RD TRIMESTER TO REDUCE PAIN IN THE 1ST STAGE OF LABOR PROCESS*Ihya’ Ulumuddin Ar-Rayyan1, Yusva Dwi Saputra1, Ardelia Bertha Prastika2, Nunik Puspitasari11Faculty of Public Health, Universitas Airlangga, 60115 Surabaya, East Java, Indonesia-2286026987500-100965149860Published by Fakultas Kesehatan Masyarakat Universitas Airlangga00Published by Fakultas Kesehatan Masyarakat Universitas Airlangga2Faculty of Medicine, Universitas Airlangga, 60132 Surabaya, East Java, Indonesia*Corresponding Author : Ihya’ Ulumuddin Ar-Rayyan ; Email: ihyaar9@gmail.com 12718566985ABSTRACTThird-trimester primigravida mothers typically experience anxiety. Serotonin, norepinephrine, and GABA are the three primary neurotransmitters responsible for anxiety. Labor pain may be impacted by anxiety. Relaxation music can help with anxiety. Binaural beats are a sort of relaxation music that are thought to be an inexpensive, safe, and side-effect-free approach to ease anxiety and pain in patients, according to various studies. The aim of this study was to ascertain how binaural beats affected anxiety and pain during the early stages of labor. The HRS-A questionnaire was used in a quasi-experimental study with a control group for the pretest and posttest. The participants in this study are 36 primigravida moms who are 36 weeks along. The participants were then split into four groups: control, alpha, beta, and gamma. Two weeks prior to delivery, the intervention was conducted by listening to 20 minutes of the group's preferred genre of music or binaural beats. The labor pain scale was calculated using the Verbal Descriptor Scale. The collected data will be examined with Paired-Sample T-Test, One-Way ANOVA, and Regression Linear tests in SPSS. The result of alpha and beta groups, when the anxiety scale affects the pain scale of the initial stage of labor, there is a considerable drop in the anxiety scale. Binaural beats' alpha and beta waves hence effectively lower the initial stage of labor's pain scale.ABSTRAKIbu primigravida trimester ketiga biasanya mengalami kecemasan. Serotonin, norepinefrin, dan GABA adalah tiga neurotransmitter utama yang bertanggung jawab atas kecemasan. Nyeri persalinan dapat dipengaruhi oleh kecemasan. Musik relaksasi dapat membantu mengatasi kecemasan. Binaural beats adalah sejenis musik relaksasi yang dianggap sebagai pendekatan yang murah, aman, dan bebas efek samping untuk meringankan kecemasan dan rasa sakit pada pasien, menurut berbagai penelitian. Tujuan dari penelitian ini adalah untuk memastikan bagaimana binaural beats memengaruhi kecemasan dan rasa nyeri selama tahap awal persalinan. Kuesioner HRS-A digunakan dalam penelitian kuasi-eksperimental dengan kelompok kontrol untuk pretest dan posttest. Responden dalam penelitian ini adalah 36 ibu primigravida yang memiliki usia kehamilan 36 minggu. Para responden kemudian dibagi menjadi empat kelompok: kontrol, alpha, beta, dan gamma. Dua minggu sebelum persalinan, intervensi dilakukan dengan mendengarkan 20 menit sesuai dengan musik masing-masing kelompok atau binaural beats. Skala nyeri persalinan dihitung dengan menggunakan Verbal Descriptor Scale. Data yang terkumpul akan diperiksa dengan uji Paired-Sample T-Test, One-Way ANOVA, dan Regresi Linear di SPSS. Hasil pada kelompok alpha dan beta, skala kecemasan mempengaruhi skala nyeri pada kala 1 persalinan, dan terjadi penurunan yang cukup besar pada skala kecemasan. Gelombang alpha dan beta pada binaural beats secara efektif menurunkan skala nyeri kala 1 persalinan.00ABSTRACTThird-trimester primigravida mothers typically experience anxiety. Serotonin, norepinephrine, and GABA are the three primary neurotransmitters responsible for anxiety. Labor pain may be impacted by anxiety. Relaxation music can help with anxiety. Binaural beats are a sort of relaxation music that are thought to be an inexpensive, safe, and side-effect-free approach to ease anxiety and pain in patients, according to various studies. The aim of this study was to ascertain how binaural beats affected anxiety and pain during the early stages of labor. The HRS-A questionnaire was used in a quasi-experimental study with a control group for the pretest and posttest. The participants in this study are 36 primigravida moms who are 36 weeks along. The participants were then split into four groups: control, alpha, beta, and gamma. Two weeks prior to delivery, the intervention was conducted by listening to 20 minutes of the group's preferred genre of music or binaural beats. The labor pain scale was calculated using the Verbal Descriptor Scale. The collected data will be examined with Paired-Sample T-Test, One-Way ANOVA, and Regression Linear tests in SPSS. The result of alpha and beta groups, when the anxiety scale affects the pain scale of the initial stage of labor, there is a considerable drop in the anxiety scale. Binaural beats' alpha and beta waves hence effectively lower the initial stage of labor's pain scale.ABSTRAKIbu primigravida trimester ketiga biasanya mengalami kecemasan. Serotonin, norepinefrin, dan GABA adalah tiga neurotransmitter utama yang bertanggung jawab atas kecemasan. Nyeri persalinan dapat dipengaruhi oleh kecemasan. Musik relaksasi dapat membantu mengatasi kecemasan. Binaural beats adalah sejenis musik relaksasi yang dianggap sebagai pendekatan yang murah, aman, dan bebas efek samping untuk meringankan kecemasan dan rasa sakit pada pasien, menurut berbagai penelitian. Tujuan dari penelitian ini adalah untuk memastikan bagaimana binaural beats memengaruhi kecemasan dan rasa nyeri selama tahap awal persalinan. Kuesioner HRS-A digunakan dalam penelitian kuasi-eksperimental dengan kelompok kontrol untuk pretest dan posttest. Responden dalam penelitian ini adalah 36 ibu primigravida yang memiliki usia kehamilan 36 minggu. Para responden kemudian dibagi menjadi empat kelompok: kontrol, alpha, beta, dan gamma. Dua minggu sebelum persalinan, intervensi dilakukan dengan mendengarkan 20 menit sesuai dengan musik masing-masing kelompok atau binaural beats. Skala nyeri persalinan dihitung dengan menggunakan Verbal Descriptor Scale. Data yang terkumpul akan diperiksa dengan uji Paired-Sample T-Test, One-Way ANOVA, dan Regresi Linear di SPSS. Hasil pada kelompok alpha dan beta, skala kecemasan mempengaruhi skala nyeri pada kala 1 persalinan, dan terjadi penurunan yang cukup besar pada skala kecemasan. Gelombang alpha dan beta pada binaural beats secara efektif menurunkan skala nyeri kala 1 persalinan.-113665288339Keywords: binaural beats, anxiety, labor pain, primigravida00Keywords: binaural beats, anxiety, labor pain, primigravida1337945448790025406085100-92026257810Kata Kunci:binaural beats, kecemasan, nyeri persalinan, primigravida Berat Badan Lahir Rendah, Timor-Leste00Kata Kunci:binaural beats, kecemasan, nyeri persalinan, primigravida Berat Badan Lahir Rendah, Timor-Leste1338273119770027940963400-15240567077Received in 17 December 2022 ; Reviewed in 05 April 2023 ; Accepted in 05 October 2023 ; p-ISSN 2302–707X - e-ISSN 2540–8828 ; DOI: https://doi.org/10.20473/jbk.v12i2.2023.210-218 ; Cite this as : Ar-Rayyan IU, Saputra YD, Prastika AB, Puspitasari N. The Effect of Binaural Beats on Pregnant Women Primigravida 3rd Trimester to Reduce Pain in The 1st Stage of Labor Process. J Biometrika dan Kependud [Internet]. 2023;12(2):210–7. Available from: https://doi.org/10.20473/jbk.v12i2.2023.210-218 00Received in 17 December 2022 ; Reviewed in 05 April 2023 ; Accepted in 05 October 2023 ; p-ISSN 2302–707X - e-ISSN 2540–8828 ; DOI: https://doi.org/10.20473/jbk.v12i2.2023.210-218 ; Cite this as : Ar-Rayyan IU, Saputra YD, Prastika AB, Puspitasari N. The Effect of Binaural Beats on Pregnant Women Primigravida 3rd Trimester to Reduce Pain in The 1st Stage of Labor Process. J Biometrika dan Kependud [Internet]. 2023;12(2):210–7. Available from: https://doi.org/10.20473/jbk.v12i2.2023.210-218 698555382900INTRODUCTIONPregnancy is a happy moment and also causes stress for women. Stress during pregnancy arises because there are many changes in pregnant women ranging from hormonal changes to physical changes. This stress scale can also be caused by pregnant women imagining a painful birth process. Pregnant women will respond to their stress with feelings of anxiety ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Introduction: A women encounters physical and psychological changes during pregnancy that are typical of this time periods pregnancy is also an individual experience that elicits a range of response from very positive to very negative the wide range of response are due the complexity of the process the physical emotional psychological and social changes that occur the womens personality. Problem Statement: “A comparative study to assess the level of anxiety towards childbirth among primigravida and multigravida mothers in selected hospitals of Pune city’’. Purpose: Pregnancy can be both an exciting and worrying time for parents to be. Pregnant women experience a range of physical and emotional changes, all of which may trigger anxiety, fear of the unknown, stress feeling of insecurity over work or money, and daily pressures add to hormonal changes during pregnancy and may make women feel overwhelmed. Sometime the level of anxiety may high in both primigravida and mutigravida. In primigravida because of first baby and first experience too. In multigravida the women will have experience before so she will be aware with the of delivery and complications due to hormonal changes the cahecholamine is increases in brain may also cause stress and anxiety there are many other factors. Objectives: The objectives are to assess the level of anxiety towards childbirth among primigravida and multigravida mothers and to compare the level of anxiety towards childbirth among primigravida and multigravida mothers. Material and Methodology: Research approach is quantitative research approach and research design is comparative, research variables are level of anxiety in primigravida and multigravida mothers Conclusion: Majority of the sample in multigravida mothers are found more severe anxiety score towards childbirth as compared to primigravida mother. Multigravida mothers had history of bad obstetric, anxious in next pregnancy outcome.","author":[{"dropping-particle":"","family":"Devi","given":"Ningthoujam Sujita","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shinde","given":"Priyanka","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shaikh","given":"Gulista","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Khole","given":"Shital","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"International Journal of Applied Research","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2018"]]},"page":"221-224","title":"Level of Anxiety Towards Childbirth among Primigravida and Multigravida Mothers","type":"article-journal","volume":"4"},"uris":["http://www.mendeley.com/documents/?uuid=f8f06976-c332-4f16-be4b-a39def660c1b"]}],"mendeley":{"formattedCitation":"(1)","plainTextFormattedCitation":"(1)","previouslyFormattedCitation":"(1)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(1). Feelings of anxiety in pregnant women are often found, especially in primigravida mothers, and increase when the pregnancy reaches the third trimester.Many primigravida pregnant women experience anxiety disorders because the mothers have never had the experience of giving birth before. A study stated that of 16 respondents, who were third trimester primigravida mothers, there were 62.5% or 10 respondents experiencing severe anxiety ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Most pregnant women in the society experience anxiety when facing labor, especially primigravida (a woman who is pregnant for the first time). Anxiety during labor can be manage by using Endorphin Massage. This study was purposed to find out the effectiveness of Endorphin Massage on anxiety during labor experienced by the primigravida women living around Puskesmas Jagir (community health cente) located in Surabaya. The study was PreExperimental in which the population involved the third trimester primigravida women, totaling 16 women living around the stated community health center. The samples were chosen using Non-Probability sampling by applying purposive sampling technique. The independent variable was Endorphin Massage, whereas the dependent variable was anxiety during labor. This study use HARS (Hamilton Anxiety Rating Scale) questionnaire to collect the data which were analyzed using Wilcoxon Signed Rank Test with the significance level α = 0,05. The result of study showed that among 16 respondents, 10 respondents (62,5%) without Endorphin Massage experienced mild anxiety after receiving Endorphin Massage. Moreover, the result of Wilcoxon Signed Rank Test showed that ρ= 0,001 < α = 0,05 illustrating that Endorphin Massage was effective to manage anxiety experienced by primigravida women during labor. Endorphin Massage was effective to decrease anxiety during labor. Therefore, nurse are expected to provide health education so that the primigravida women’s level of anxiety will decrease.","author":[{"dropping-particle":"","family":"Afiyah","given":"R. Khairiyatul","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Proceeding of Surabaya International Health Conference","id":"ITEM-1","issued":{"date-parts":[["2017","7","18"]]},"page":"317-324","publisher":"UNUSA","publisher-place":"Surabaya","title":"EFFECTIVENESS OF ENDORPHIN MASSAGE AGAINST ANXIETY THE FACE OF LABOR ON MOTHER PRIMIGRAVIDA IN THE REGION OF CLINICS JAGIR SURABAYA","type":"paper-conference"},"uris":["http://www.mendeley.com/documents/?uuid=1fc5071a-f732-3bbc-8d71-28d8717ed330"]}],"mendeley":{"formattedCitation":"(2)","plainTextFormattedCitation":"(2)","previouslyFormattedCitation":"(2)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(2). Another study also showed that 52.5% of pregnant women experienced anxiety during the third trimester and 66.2% of them were primigravida mothers ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.20527/dk.v6i1.4946","ISSN":"2541-5980","author":[{"dropping-particle":"","family":"Wardani","given":"Hartanti Wisnu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Agustina","given":"Rismia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Damayanti","given":"Emmelia Astika Fitri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Dunia Keperawatan","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2018","7","12"]]},"page":"1","title":"Tingkat Kecemasan dengan KualitasTidur Ibu Hamil Primigravida Trimester III","type":"article-journal","volume":"6"},"uris":["http://www.mendeley.com/documents/?uuid=a9e9b69c-e833-31a9-ac1e-5c7553a114fe"]}],"mendeley":{"formattedCitation":"(3)","plainTextFormattedCitation":"(3)","previouslyFormattedCitation":"(3)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(3). This is similar to research that shows a significant correlation between gravidity in the third trimester and the level of anxiety of pregnant women ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Graviditas merupakan frekuensi kehamilan yang pernah ibu alami. Kehamilan dibagi menjadi 3 periode, yaitu trimester pertama, trimester kedua, dan trimester ketiga. Saat hamil, ibu sudah mengalami kecemasan. Kecemasan meningkat pada saat menjelang persalinan terutama pada trimester III. Tujuan penelitian ini adalah untuk mengetahui hubungan graviditas trimester III dengan tingkat kecemasan ibu hamil dalam menghadapi tanda-tanda persalinan. Penelitian ini menggunakan desain deskriptif korelasi dengan pedekatan cross sectional dan analisa data menggunakan metode Spearman Rank. Sampel pada penelitian ini berjumlah 50 responden dengan menggunakan teknik purposive sampling. Hasil penelitian menunjukkan adanya hubungan antara graviditas trimester III dengan tingkat kecemasan ibu hamil dalam menghadapi tanda-tanda persalinan di Puskesmas Kelurahan Cipinang Besar Utara Jakarta Timur dengan nilai korelasi (r = 0,411) nilai P-value sebesar 0,003 (P-value<0,05). Peneliti menyarankan ibu hamil, khususnya trimester III diberikan pendidikan kesehatan untuk mengurangi kecemasan ibu dalam menghadapi persalinan. ","author":[{"dropping-particle":"","family":"Septiani","given":"Firna Hasna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zakiyah","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mustikowati","given":"Tri","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Jurnal Kesehatan","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2020"]]},"page":"147-152","title":"Hubungan Graviditas Trimester III dengan Tingkat Kecemasan Ibu Hamil dalam Menghadapi Tanda-Tanda Persalinan","type":"article-journal","volume":"9"},"uris":["http://www.mendeley.com/documents/?uuid=b5e0484e-15e2-3ce1-a36c-f1ce29f2035c"]}],"mendeley":{"formattedCitation":"(4)","plainTextFormattedCitation":"(4)","previouslyFormattedCitation":"(4)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(4). The research stated that it was known that of the 50 respondents, 20 of them were primigravida mothers who experienced moderate anxiety.During pregnancy, there is a decrease in serotonin, an increase in gamma-aminobutyric acid (GABA), an increase in norepinephrine and an increase in epinephrine ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Latar Belakang : Kecemasan seringkali terjadi pada mahasiswa baru yang melanjutkan jenjang pendidikan perguruan tinggi khususnya pada mahasiswa kedokteran. Insomnia secara luas didefinisikan ketidakpuasan terhadap tidur secara kuantitatif maupun kualitatif merupakan gangguan tidur yang paling sering ditemukan. Beberapa penelitian sebelumnya menunjukkan bahwa prevalensi kecemasan dan insomnia cukup tinggi pada mahasiswa kedokteran. Peningkatan aktivitas saraf otonom pada kecemasan dapat memicu terjadinya insomnia. Tujuan : Untuk mengetahui hubungan antara tingkat kecemasan dengan insomnia pada mahasiswa angkatan 2019 Fakultas Kedokteran Universitas Hasanuddin.\nMetode : Metode yang digunakan dalam penelitian ini adalah observational analytics dengan design cross sectional, pengambilan subjek berdasarkan total sampling. Instrumen penelitian menggunakan Hamilton Anxiety Rate Scale (HARS) untuk menilai kecemasan dan Insomnia Severity Index (ISI) untuk menilai insomnia. Data dianalisis secara univariat untuk mendeskripsikan distribusi masing-masing variabel dan analisis secara bivariat menggunakan uji korelasi spearman untuk menilai korelasi kedua variabel.\nHasil : Hasil yang didapatkan menggunakan uji Spearman, p value = 0.000 (p < 0.05) menunjukkan adanya hubungan signifikan antara tingkat kecemasan dengan insomnia. Kesimpulan : Terdapat korelasi yang signifikan antara tingkat kecemasan dengan insomnia pada mahasiswa kedokteran angkatan 2019 Fakultas Kedokteran Universitas Hasanuddin\nKeywords: Tingkat Kecemasan, Insomnia, Mahasiswa Angkatan 2019","author":[{"dropping-particle":"","family":"Husaini","given":"Farhan Yaasir","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2020","2","1"]]},"publisher":"Universitas Hasanuddin","publisher-place":"Makassar","title":"Hubungan antara Tingkat Kecemasan dengan Insomnia pada Mahasiswa Angkatan 2019 Fakultas Kedokteran Universitas Hasanuddin","type":"thesis"},"uris":["http://www.mendeley.com/documents/?uuid=d2c74daf-dc0a-3183-9382-b3b852cf6db1"]}],"mendeley":{"formattedCitation":"(5)","plainTextFormattedCitation":"(5)","previouslyFormattedCitation":"(5)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(5). These neurotransmitters respectively cause anxiety, increase the risk of depression, increase heart rate, stimulate psychological stress, and cause mood swings (leading to negative mood). The resulting psychological and physiological conditions will stimulate pain by reducing the pain threshold value, thereby increasing sensitivity to pain. The pain threshold value decreases when you are in a state of anxiety, depression and discomfort ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.26630/jk.v9i1.763","ISSN":"2548-5695","author":[{"dropping-particle":"","family":"Rafika","given":"Rafika","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Jurnal Kesehatan","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2018","5","25"]]},"page":"86","title":"Efektifitas Prenatal Yoga terhadap Pengurangan Keluhan Fisik pada Ibu Hamil Trimester III","type":"article-journal","volume":"9"},"uris":["http://www.mendeley.com/documents/?uuid=97359b6c-f8ef-35d1-a5fa-98177989905d"]},{"id":"ITEM-2","itemData":{"abstract":"Pain based on The International Association for the Study of Pain (IASP) is an uncomfortable sensory experience and emotional condition accompanied by potential and actual tissue damage. Pain can be affected by age, gender, culture, race, social and others. Pain has two values such as pain threshold and pain tolerance. This study was experimental with a one-shot case study design. Samples of this study were medical students Sriwijaya University Class of 2017 which fulfills the inclusion and exclusion criteria. The instrument that used were Cold Pressor Test, Stopwatch and Numeric Rating Scale. Among 84 students (42 male and 42 female), more severe pain scale were found in female respondents with a percentage of 88.1% (n=37). The pain threshold for women were shorter than men (mean difference 14.44 seconds; p = 0.001) and pain tolerance were shorter in women (mean difference 20.16 seconds; p = 0.001). Women more sensitive with pain and have a severe pain tolerance on the pain scale. Men were more resistant with pain thresholds and pain tolerance than women. There were significant relationship between gender for pain threshold and pain tolerance in medical students Sriwijaya University Class of 2017.","author":[{"dropping-particle":"","family":"Widodo","given":"Wildan Dwi Putra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zainal","given":"Rizal","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Saleh","given":"Irsan","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-2","issued":{"date-parts":[["2020","1","11"]]},"publisher":"Universitas Sriwijaya","publisher-place":"Palembang","title":"HUBUNGAN ANTARA JENIS KELAMIN DENGAN AMBANG BATAS NYERI DAN TOLERANSI NYERI PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS SRIWIJAYA ANGKATAN 2017","type":"thesis"},"uris":["http://www.mendeley.com/documents/?uuid=7d6f6e29-ae62-3b5d-8172-95fd0622208f"]}],"mendeley":{"formattedCitation":"(6,7)","plainTextFormattedCitation":"(6,7)","previouslyFormattedCitation":"(6,7)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(6,7).The birthing process consists of four stages. The mother will experience pain caused by stretching of the uterus and stretching of the cervix during the first stage of labor ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.31983/jkb.v8i2.3740","ISSN":"2621-2870","author":[{"dropping-particle":"","family":"Juniartati","given":"Erni","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Widyawati","given":"Melyana Nurul","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"JURNAL KEBIDANAN","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2018","10","30"]]},"page":"112","title":"LITERATURE REVIEW : PENERAPAN COUNTER PRESSURE UNTUK MENGURANGI NYERI PERSALINAN KALA I","type":"article-journal","volume":"8"},"uris":["http://www.mendeley.com/documents/?uuid=86fcaca7-584e-3d26-8586-156c19f0d1f4"]}],"mendeley":{"formattedCitation":"(8)","plainTextFormattedCitation":"(8)","previouslyFormattedCitation":"(8)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(8). The uterus stretches, causing pinching of the nerve endings which causes uterine inertia. These complications are factors that cause the second stage to last a long time, apart from the lack of strength to push due to lack of energy ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Latar belakang; Senam hamil merupakan suatu program latihan bagi ibu hamil sehat untuk mempersiapkan kondisi fisik ibu dengan menjaga kondisi otot-otot dan persendian yang berperan dalam proses persalinan. Proses persalinan terdiri dari Kala I, II, III dan IV. Kala II dianggap tidak normal pada primigravida lebih dari 2 jam dan untuk multigravida lebih dari 1 jam. Tujuan penelitian ini adalah untuk mengetahui Hubungan Keikutsertaan Senam Hamil Terhadap Lama Persalinan Kala II Di Puskesmas Toroh I.\n\nMetode; Jenis penelitian menggunakan penelitian analitik dengan pendekatan retrospektif menggunakan uji Chi Square. Penelitian ini dilaksanakan di Puskesmas Toroh I. Populasi menggunakan ibu bersalin sebanyak 337 responden dan sampel 183 responden yang diambil dengan cara sistem random sampling.\n\nHasil; Ibu yang tidak melakukan senam hamil dengan lama persalinan kala II tidak normal sebanyak 14 (7.7%) dan ibu yang tidak melakukan senam hamil dengan lama persalinan kala II normal sebanyak 81(41%). Sedangkan ibu yang melakukan senam hamil dengan lama persalinan kala II tidak normal sebanyak 20 (10%) dan ibu yang melakukan senam hamil dengan lama persalinan kala II normal sebanyak 68 (38%). Hasil penelitian yang didapatkan dari rumus chi square adalah HO diterima Ha ditolak yaitu x2 hitung < x2 tabel yaitu sebesar 1,928 < 3,841.\n\nKesimpulan; Tidak ada hubungan keikutsertaan senam hamil terhadap lama persalinan kala II.\n\n \n\nKata Kunci : Senam Hamil, Lama Persalinan Kala II\n","author":[{"dropping-particle":"","family":"Martini","given":"Sri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dewi","given":"Rosmala Kurnia","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The Shine Cahaya Dunia Kebidanan Universitas An Nuur","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2020","5","20"]]},"page":"30-39","title":"HUBUNGAN KEIKUTSERTAAN SENAM HAMIL TERHADAP LAMA PERSALINAN KALA II","type":"article-journal","volume":"5"},"uris":["http://www.mendeley.com/documents/?uuid=c809fd04-6604-3bd7-8eab-422e8f132e18"]}],"mendeley":{"formattedCitation":"(9)","plainTextFormattedCitation":"(9)","previouslyFormattedCitation":"(9)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(9). Based on one study, 37% of maternal deaths occurred due to the second stage which lasted a long time ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Latar belakang; Senam hamil merupakan suatu program latihan bagi ibu hamil sehat untuk mempersiapkan kondisi fisik ibu dengan menjaga kondisi otot-otot dan persendian yang berperan dalam proses persalinan. Proses persalinan terdiri dari Kala I, II, III dan IV. Kala II dianggap tidak normal pada primigravida lebih dari 2 jam dan untuk multigravida lebih dari 1 jam. Tujuan penelitian ini adalah untuk mengetahui Hubungan Keikutsertaan Senam Hamil Terhadap Lama Persalinan Kala II Di Puskesmas Toroh I.\n\nMetode; Jenis penelitian menggunakan penelitian analitik dengan pendekatan retrospektif menggunakan uji Chi Square. Penelitian ini dilaksanakan di Puskesmas Toroh I. Populasi menggunakan ibu bersalin sebanyak 337 responden dan sampel 183 responden yang diambil dengan cara sistem random sampling.\n\nHasil; Ibu yang tidak melakukan senam hamil dengan lama persalinan kala II tidak normal sebanyak 14 (7.7%) dan ibu yang tidak melakukan senam hamil dengan lama persalinan kala II normal sebanyak 81(41%). Sedangkan ibu yang melakukan senam hamil dengan lama persalinan kala II tidak normal sebanyak 20 (10%) dan ibu yang melakukan senam hamil dengan lama persalinan kala II normal sebanyak 68 (38%). Hasil penelitian yang didapatkan dari rumus chi square adalah HO diterima Ha ditolak yaitu x2 hitung < x2 tabel yaitu sebesar 1,928 < 3,841.\n\nKesimpulan; Tidak ada hubungan keikutsertaan senam hamil terhadap lama persalinan kala II.\n\n \n\nKata Kunci : Senam Hamil, Lama Persalinan Kala II\n","author":[{"dropping-particle":"","family":"Martini","given":"Sri","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dewi","given":"Rosmala Kurnia","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The Shine Cahaya Dunia Kebidanan Universitas An Nuur","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2020","5","20"]]},"page":"30-39","title":"HUBUNGAN KEIKUTSERTAAN SENAM HAMIL TERHADAP LAMA PERSALINAN KALA II","type":"article-journal","volume":"5"},"uris":["http://www.mendeley.com/documents/?uuid=c809fd04-6604-3bd7-8eab-422e8f132e18"]},{"id":"ITEM-2","itemData":{"DOI":"10.33859/psmumns.v0i1.22","ISSN":"2686-1011","abstract":"<p>Latar Belakang: Lama Kala II dalam persalinan yaitu jangka waktu mulai dari serviks berdilatasi penuh sampai dengan kelahiran bayi tidak boleh melebihi 2 jam pada primigravidan dan 1 jam pada multigravida. Pemilihan posisi melahirkan sangat dianjurkan untuk memberikan rasa nyaman pada ibu, posisi dapat membantu penurunan janin ke dasar panggul dan mempercepat proses persalinan. Dari data yang diperoleh bulan Januari 2018 jumlah persalinan kala II lama sebanyak 0,30% dari 240 persalinan normal.Tujuan: Menganalisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II.Metode: Jenis penelitian ini adalah Analisis kuantitatif. Rancangan penelitian menggunakan quasi eksperiment. Populasi penelitian semua ibu bersalin di RSUD Dr. H. Moch Anshari Saleh Banjarmasin. Pengambilan sebanyak 30 responden. Pengambilan data dilakukan dengan menggunakan ceklist. Analisa data yang dilakukan adalah Analisa Univariat dan Analisa Bivariat dengan uji Fisher Exact Test.Hasil: Responden yang menggunakan posisi meneran miring kiri 15 orang (50%) dan setengah duduk sebanyak 15 orang (50%). Jumlah responden primipara yang mengalami persalinan kala II &lt;60 menit sebanyak 12 orang (40,0%), primipara yang mengalami kala II&gt; 60 menit sebanyak 2 orang (6,7%) dan responden multipara yang mengalami kala II &lt;30 menit sebanyak 16 orang (53,3%), multipara yang mengalami kala II &gt;30 menit sebanyak 0 orang (0%) dari hasil uji Fisher Exact Test dengan nilai p sebesar 0,483.Simpulan: Tidak ada perbedaan posisi miring kiri dengan posisi setengah duduk terhadap kemajuan persalinan kala II di RSUD Dr. H. Moch. Anshari Saleh Banjarmasin. Kata Kunci: Lama Kala II, Persalinan, Posisi Meneran.  Analysis of Different Left and Half Posisition Straining on Mother with Second Duration of Labour In RSUD Dr. H. Moch Anshari Saleh BanjarmasinABSTRACT Background: The duration of second stage of labor is the period from the full dilated cervix to the birth of the baby should not exceed 2 hours in primigravida and 1 hour in multigravida. Position selection is very beneficial for giving comfort to the mother, the position can help lower the fetus to the pelvic floor and improve labor. From the data obtained in January 2018 the number of prolonged second stage deliveries was 0.30% of 240 normal deliveries.Objective: Analyze the Differences in Position Meniring Left and Half Seated at the Maternity with Long Time II.Method: This type of research is quanti…","author":[{"dropping-particle":"","family":"Sinambela","given":"Dewi Pusparani","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hateriah","given":"St.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Proceeding Of Sari Mulia University Midwifery National Seminars","id":"ITEM-2","issue":"1","issued":{"date-parts":[["2019","7","22"]]},"page":"39-46","title":"Analisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II Di RSUD Dr. H. Moch Anshari Saleh Banjarmasin","type":"article-journal","volume":"1"},"uris":["http://www.mendeley.com/documents/?uuid=a9ee7e15-04d7-3d22-ac35-bb17ba66382b"]}],"mendeley":{"formattedCitation":"(9,10)","plainTextFormattedCitation":"(9,10)","previouslyFormattedCitation":"(9,10)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(9,10). The treatment method related to this is often by providing food or drink to increase the mother's energy during the second stage. However, this method is considered less than optimal, because often the mother does not have the desire to eat and drink ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Latar Belakang: Kecemasan merupakan salah satu faktor psikologis yang memengaruhi primigravida dalam persalinan. Prevalensi kematian wanita yang bersalin maupun bayi yang dilahirkan masih cukup tinggi di Indonesia. Tujuan: Mengetahui karakteristik primigravida yang bersalin dan hubungan kecemasan primigravida dengan lamanya partus kala I fase aktif. Metodologi: Penelitian ini merupakan studi analitik observasional dengan pendekatan jenis desain penelitian cross sectional dan untuk menganalisis data menggunakan uji Chi-Square dan Spearman. Data diambil dari rekam medik dan kuesioner yang diberikan kepada primigravida yang bersalin di RSUD dr. Soedarso Pontianak, Rumah Sakit Bersalin Jeumpa Pontianak, RSUD Sultan Syarif Mohamad\n\nAlkadrie Pontianak, dan Bidan Praktek Mandiri Mariyani Pontianak. Jumlah sampel dalam penelitian ini adalah 29 primigravida. Hasil: Sebanyak 44,83% primigravida memiliki tingkat kecemasan berat dan sebanyak 51,72% primigravida melewati partus kala I fase aktif normal. Hasil uji Chi Square dikategorikan per tingkat kecemasan didapatkan hasil tingkat kecemasan berat dan sedang yang memiliki hubungan bermakna dengan lamanya partus kala I fase aktif pada primigravida (p=0,005 dan p=0,16). Kesimpulan: Terdapat hubungan bermakna pada masingmasing tingkat kecemasan berat dan sedang terhadap lamanya partus kala I fase aktif pada primigravida.\n\n \n\nKata kunci: Kecemasan, partus kala I fase aktif, primigravida","author":[{"dropping-particle":"","family":"Difarissa","given":"Ristra Retrianda","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Jurnal Mahasiswa PSPD FK Universitas Tanjungpura","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2016"]]},"title":"HUBUNGAN TINGKAT KECEMASAN DAN LAMANYA PARTUS KALA I FASE AKTIF PADA PRIMIGRAVIDA DI PONTIANAK","type":"article-journal","volume":"3"},"uris":["http://www.mendeley.com/documents/?uuid=6a409877-7c2f-3bf1-9643-838aa99dfdf0"]}],"mendeley":{"formattedCitation":"(11)","plainTextFormattedCitation":"(11)","previouslyFormattedCitation":"(11)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(11). The stretching of the uterus and cervix caused in the first stage can increase the potential for uterine inertia to occur in the second stage, which lasts longer. The author states that there is a need for innovative interventions related to reducing first stage pain in order to reduce maternal and infant mortality rates to realize the achievement of Sustainable Development Goals (SDGs) number 3, namely healthy and prosperous lives, especially in maternal and child health.Relaxation music can significantly reduce emotional recall and trauma ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.nlm.2011.12.005","ISSN":"10747427","author":[{"dropping-particle":"","family":"Rickard","given":"Nikki S.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wong","given":"Wendy Wing","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Velik","given":"Lauren","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Neurobiology of Learning and Memory","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2012","2"]]},"page":"220-228","title":"Relaxing music counters heightened consolidation of emotional memory","type":"article-journal","volume":"97"},"uris":["http://www.mendeley.com/documents/?uuid=ab3110fc-1df1-32bb-b024-d9e85b974f9b"]}],"mendeley":{"formattedCitation":"(12)","plainTextFormattedCitation":"(12)","previouslyFormattedCitation":"(12)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(12). Relaxation methods for reducing anxiety in the medical field are very diverse, one of which is the use of binaural beats. Binaural beats are based on the use of the difference between two sound waves of fixed intensity, and heard through different ears ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.4317/medoral.24051","ISSN":"16986946","author":[{"dropping-particle":"","family":"Menziletoglu","given":"D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Guler","given":"AY.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cayır","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Isik","given":"BK.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Medicina Oral Patología Oral y Cirugia Bucal","id":"ITEM-1","issued":{"date-parts":[["2021"]]},"page":"e97-e101","title":"Binaural beats or 432 Hz music? which method is more effective for reducing preoperative dental anxiety?","type":"article-journal"},"uris":["http://www.mendeley.com/documents/?uuid=f48beef1-2adc-3d8a-b6a6-9ea3fab6dbff"]}],"mendeley":{"formattedCitation":"(13)","plainTextFormattedCitation":"(13)","previouslyFormattedCitation":"(13)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(13). Delta waves (0.1-4 Hz), theta waves (4-8 Hz), alpha waves (8-13 Hz), beta waves (13-30 Hz), and gamma waves (30-100 Hz) are binaural waves beats. Several previous studies stated that binaural beats can reduce anxiety and reduce pain. A research result states that listening to binaural beats for 20 minutes has better results in reducing the anxiety scale ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.3389/fpsyg.2014.01248","ISSN":"1664-1078","author":[{"dropping-particle":"","family":"McConnell","given":"Patrick A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Froeliger","given":"Brett","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Garland","given":"Eric L.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ives","given":"Jeffrey C.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sforzo","given":"Gary A.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Frontiers in Psychology","id":"ITEM-1","issued":{"date-parts":[["2014","11","14"]]},"title":"Auditory driving of the autonomic nervous system: Listening to theta-frequency binaural beats post-exercise increases parasympathetic activation and sympathetic withdrawal","type":"article-journal","volume":"5"},"uris":["http://www.mendeley.com/documents/?uuid=63c75c9f-1183-30e2-b12e-8632515ec23c"]},{"id":"ITEM-2","itemData":{"abstract":"When two tones of similar frequencies are presented in each ear, the brain responds by perceiving a third tone, known as a binaural beat. Binaural beat technology is marketed as a self-improvement tool to reduce stress, improve mood, increase cognition, deepen meditation, and alter states of consciousness. The purpose of this study is to explore the effects of binaural beats with delta and theta frequencies to determine if these changes can improve mood and creativity using a pre- and post-test experimental design. Participants completed the Positive Affect and Negative Affect Schedule (PANAS) to measure mood by identifying how closely they felt to certain words pertaining to positive affect and negative affect, respectfully. Participants also completed the Remotes Associates Test (RAT) to measure convergent creativity by generating a fourth word pertaining to three stimulus words. Participants were randomly assigned to listen to 20 minutes of binaural beats masked by rainforest sounds in the experimental group, or rainforest sounds without binaural beats in the control group. Researchers predicted that listening to delta and theta binaural beats would improve mood and creativity at posttest, whereas no influences would be observed for the control group. There was no effect of binaural beats on either positive or negative affect; for positive affect, both conditions declined in their responses at posttest. Similarly, both conditions declined in their responses for negative affect at posttest. RAT performances revealed no significant effects of binaural beats on convergent creativity.","author":[{"dropping-particle":"","family":"Petrovich","given":"Olivera","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-2","issued":{"date-parts":[["2018","3","26"]]},"publisher":"University of South Florida St. Petersburg","publisher-place":"St. Petersburg, Florida","title":"The Effects of Binaural Beats on Emotion and Cognition","type":"thesis"},"uris":["http://www.mendeley.com/documents/?uuid=c3e4f608-228c-36b8-8fb9-b8380bb05bca"]}],"mendeley":{"formattedCitation":"(14,15)","plainTextFormattedCitation":"(14,15)","previouslyFormattedCitation":"(14,15)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(14,15).Binaural beats is considered a cheap, safe and side effect-free method for alleviating anxiety and pain in patients ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.4317/medoral.24051","ISSN":"16986946","author":[{"dropping-particle":"","family":"Menziletoglu","given":"D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Guler","given":"AY.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cayır","given":"T.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Isik","given":"BK.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Medicina Oral Patología Oral y Cirugia Bucal","id":"ITEM-1","issued":{"date-parts":[["2021"]]},"page":"e97-e101","title":"Binaural beats or 432 Hz music? which method is more effective for reducing preoperative dental anxiety?","type":"article-journal"},"uris":["http://www.mendeley.com/documents/?uuid=f48beef1-2adc-3d8a-b6a6-9ea3fab6dbff"]}],"mendeley":{"formattedCitation":"(13)","plainTextFormattedCitation":"(13)","previouslyFormattedCitation":"(13)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(13). Binaural beats have the potential to be a good method for reducing anxiety and pain. However, so far there has been no specific research regarding the effect of binaural beats on the anxiety scale of third trimester primigravida mothers and the pain scale during labor. Therefore, research regarding the effect of giving binaural beats on the anxiety scale experienced by primigravida pregnant women in the third trimester, the pain scale in the first stage of labor, and the differences in influence between the types of alpha, beta and gamma waves on binaural beats needs to be carried out. The results of this research can be used as a solution to reduce the anxiety experienced by primigravida mothers and/or in the third trimester which will have the impact of minimizing pain in the first stage during the birthing process.METHODSThis research used a quasi-experimental design which carried out a pretest and posttest on the experimental and control groups. This research was carried out in the city of Surabaya and Sidoarjo Regency, by getting 52 initial respondents, who were then divided into four groups, namely the experimental group (alpha, beta, and gamma) and the control group which differed in the type of audio intervention. Several respondents dropped out at the end of the research, because they did not routinely carry out audio therapy intervention activities (binaural beats and audio control group) during the research period. There were 16 respondents who dropped out (four people from each group), so that the number of research respondents who could be analyzed was 36 people (nine people from each group).The use of alpha, beta and gamma waves is based on indications during labor, namely in a conscious condition. The purposive sampling technique used was to take every respondent who met the research criteria and the respondents were present at the time of the research with the inclusion criteria, namely if you are pregnant for the first time (primigravida), in the third trimester or equivalent to a minimum gestational age of 36 weeks, and are willing to become respondents by agreement on the informed consent sheet provided before the research begins.The anxiety level of pregnant women respondents was measured using the Hamilton Rating Scale for Anxiety (HRS-A) questionnaire given to respondents. The HRS-A questionnaire has 14 parameters with answer options using a 0-4 Likert scale (0=none; 1=mild; 2=none; 3=severe; and 4=very severe). The results of each parameter are summed and averaged. The final score is categorized into four categories, namely a scale of 0-<13=no anxiety; 13-19=mild anxiety; 20-26=moderate anxiety; 27-40=severe anxiety; The HRS-A questionnaire was distributed twice before the intervention and after the intervention (after delivery). Data regarding the first stage of labor pain scale was collected by distributing the Verbal Descriptor Scale (VDS) questionnaire to respondents after delivery. The VDS questionnaire has a scale of 0-10 (0=no pain; 1-3=mild pain; 4-6=moderate pain; 7-9=controlled severe pain; and 10=uncontrolled severe pain).The intervention is carried out for 20 minutes per day, at least two weeks before the Expected Birth Day or Hari Perkiraan Lahir (HPL). This is based on research which states that relaxation memories from binaural beats can be formed at least one week after listening to them regularly. One week later, intervention continues to be implemented to maintain the neurotransmitter pathway. This is related to the average decline in HPL with a standard deviation of 2.28 ± 11.57 days. A research result states that listening to binaural beats for 20 minutes has better results in reducing the anxiety scale.Levene Test was used as a homogeneity test and the Shapiro-Wilk test as a normality test in the analysis prerequisite tests. In addition, inferential and descriptive analyzes were also carried out. This research uses Statistical Program for Social Science (SPSS) 18.0 software to produce descriptive and inferential analysis. Inferential analysis using Paired-Sample T Test, One-Way Analysis of Variance (ANOVA), and linear regression tests were used in inferential analysis. HRS-A pretest and posttest anxiety scores will be compared using the Paired-Sample T Test. Testing variations in the pain and anxiety scores of each group used One-Way ANOVA. The linear regression test was used to determine the effect of anxiety scores on the pain scale for the first stage of labor.RESULTThe results of descriptive analysis from Table 2 show that each group experienced a decrease in the average anxiety scale with the highest decrease, namely the alpha group of 12.639. The results of this descriptive analysis can be interpreted to mean that alpha wave type binaural beats can reduce anxiety. Meanwhile, the first stage pain scale with the lowest average was in the beta group with an average of 5.00.The Paired-Sample T Test in this research analysis was used to determine the decrease in the anxiety scale for each group. This test was used because the results of normality testing and homogeneity testing of research data showed that the data were normal and homogeneous. The results of the normality test using Shapiro Wilk showed that all the data obtained were normally distributed with sig>0.05. The results of the homogeneity test on the data obtained using the Levene test with the results of the anxiety scale before the intervention were not homogeneous, whereas the anxiety scale after the intervention and the pain scale for the first stage of labor were homogeneous, that the pain scale for the first stage experienced by pregnant women had a different perception of pain..The results of the homogeneity test on the data obtained using the Levene test showed that the anxiety level results before the intervention were not homogeneous. Meanwhile, the level of anxiety after the intervention and the level of pain in the first stage of labor were homogeneous.Table 1.Results of Descriptive Analysis of Anxiety Scale Data Before Intervention, Anxiety After Intervention, and Pain Scale in the First Stage of LaborRespondent GroupnMeanelementary schoolMinimumMaximumAnxiety Scale Before InterventionAlpha920,5565,65913.0030.00Beta922,3336,6338.0031.00Gamma923,3333,42817.0027.00Control919,66710,8976.0039.00Post-Intervention Anxiety ScaleAlpha97,9175,8381.0017.75Beta915,2947,1236.1327.13Gamma922,50113,9499.0050.75Control922,38912,1628.0046.50Pain Scale for First Stage of LaborAlpha95,8893,0181.0010.00Beta95,0002,2362.008.00Gamma96,0003,1621.0010.00Control96,7782,5392.0010.00Based on the results of Table 2, it can be seen that the significance value in the alpha and beta groups is smaller than the 0.05 significance level. The results of the hypothesis test can be interpreted, namely that there is a decrease in anxiety levels in the alpha and beta groups. Meanwhile, the significance value for gamma and control is greater than the 0.05 significance levelThe results of the hypothesis test can be interpreted, namely that there is no decrease in anxiety levels in the gamma and control groups. The conclusion from this interpretation is that there is an influence of alpha and beta wave binaural beats on reducing the level of anxiety experienced by third trimester primigravida female respondents.Table 2.Test Results of Differences in Anxiety Scores Before and After Using Binaural Beats in the Alpha, Beta, Gamma and Control GroupsRespondent GroupnMeanElementary SchooltSignificance Value(p<0.05)InformationAlpha (before and after intervention)912,6394,6648.1300.000SignificantBeta (before and after intervention)97,0397,9632.6520.029SignificantGamma (before and after intervention)90.83211,7650.2120.837Not significantControl (before and after intervention)9-2,72213,780-0.5930.570Not significantTests for differences in average anxiety scores after the intervention were carried out on third trimester primigravida mother respondents analyzed using One-Way ANOVA. The significance value of the One-Way ANOVA results for the anxiety value variable after the binaural beats intervention was smaller than the 0.05 significance level (F=4.066, p value = 0.015), so H0 was rejected. The results of this analysis can be interpreted to mean that there are differences in the average anxiety scores after the binaural beats intervention in primigravida mothers in the alpha, beta, gamma and control groups. Least Significance Difference (LSD) analysis was used to see the differences between groups (Table 3) with the results that there were no differences in the average anxiety scores after the binaural beats intervention in the alpha and beta groups and in the gamma and control groups, and there were differences in the alpha and control groups. Gamma and alpha groups with controls are marked with the notations a and b, as markers of differences between groups.Table 3. LSD Analysis of Differences in Mean Anxiety Scale After Intervention for Each GroupRespondent GroupAverage ValueAlpha5.00aBeta5.50aGamma9.88bControl11.81bTests for differences in the average pain scale in the first stage in primigravida mothers were analyzed using One-Way ANOVA. It was found that the One-Way ANOVA significance value for the pain scale value variable was greater than the 0.05 significance level, so H1 was rejected. So the results of the hypothesis test can be interpreted to mean that there is no difference in average pain in the first stage of labor between the alpha, beta, gamma and control groups. It can be seen from the average (mean) level of pain in the first stage of labor as measured using the VDS questionnaire that is not much different. The average level of pain in the first stage of labor in the alpha group was 5.889; beta group of 5.000; gamma group of 6.000; and the control group was 6.778. Based on these average figures, it shows that the level of pain in the first stage of labor is almost the same, namely moderate pain based on the pain categorization on the verbal descriptor scale questionnaire, thus the hypothesis is rejected.Another result obtained by the researchers was the result of measuring the duration of labor of primigravida mothers, with the assumption that the duration of labor will certainly influence the level of labor pain in the first stage with its impact in the second stage. The results showed that the significance value of the One-Way ANOVA results was for the variable duration of labor after intervention, namely 0.022m which is smaller than the significance level used, namely 0.05, so that H0 is rejected, with an F value of 3.733. The test results can be interpreted to mean that there is an average difference in the duration of labor between the respondent groups.Supported by the results of the LSD follow-up test, there was no difference in the duration of labor between the alpha and beta groups and the gamma group and the control group (there was a difference in the group with notation a and notation b). From these results it can be stated that alpha and beta waves have a shorter duration of labor, so they can reduce fatigue during labor, which has an impact on reducing the risk of maternal and fetal death.Table 4. LSD Analysis of Differences in Mean Duration of Labor for Each GroupRespondent GroupAverage ValueAlpha7.92aBeta15.29aGamma22.50bControl22.39bTable 5.Test Results of the Effect of Anxiety in Primigravida Mothers in the Third Trimester on the Pain Scale in the First Stage of ChildbirthRegression CoefficientsQSignificance Value (p<0.05)(constant)4.4735.8240.000Anxiety levels after binaural beats intervention0.0852.2650.030The test of the influence of anxiety in third trimester primigravida mothers on pain in the first stage of labor was analyzed using the linear regression test. Based on the results of Table 5, it is known that the significance value of the anxiety level variable after the binaural beats intervention on the pain scale for the first stage of labor shows a value of 0.030, which means Ha is accepted or had an influence on anxiety in third trimester primigravida mothers regarding pain in the first stage of labor. The magnitude of the influence of anxiety in third trimester primigravida mothers on pain in the first stage of labor can be predicted using the formula "Pain scale = 4.473 + 0.085* anxiety value," which means that the assumed pain scale value is the sum of the constant value of 4.473 and the product of the coefficient of 0.085 with the number anxiety after intervention. Linear regression analysis also shows that anxiety in primigravida mothers has a 10.6% effect on pain in the first stage of labor.DISCUSSIONThe occurrence of psychological changes during pregnancy will cause complications and have an impact on the health of the mother and fetus, and even have an impact on postpartum depression. Providing an introduction to pregnancy stress management is very important in reducing the potential negative effects on the physical and psychological health of mothers and babies in the postpartum period ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1080/01443615.2020.1867970","ISSN":"0144-3615","author":[{"dropping-particle":"","family":"Ertekin Pinar","given":"Sukran","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Daglar","given":"Gulseren","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Duran Aksoy","given":"Ozlem","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Obstetrics and Gynaecology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2022","1","2"]]},"page":"17-22","title":"The effect of stress management training on perceived stress, anxiety and hopelessness levels of women with high-risk pregnancy","type":"article-journal","volume":"42"},"uris":["http://www.mendeley.com/documents/?uuid=464a7723-45d9-467f-ae08-81adeca06281"]}],"mendeley":{"formattedCitation":"(16)","plainTextFormattedCitation":"(16)","previouslyFormattedCitation":"(16)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(16), by relaxing using music or audio media binaural beats.Binaural beats is auditory music that is produced by stimulating different frequencies (the magnitude of the wave frequency in audio binaural beats that enters the right ear is different from that that enters the left ear) and separately in each ear to stimulate the brain. Binaural beats alpha, beta and gamma waves can target the Limbic Hypothalamus Pituitary Adrenal Axis (LHPA), which will be stimulated and cause the release of the hormone Corticotropin-Releasing Hormone (CRH). This can increase the secretion of the hormone cortisol from the adrenal cortex and also activate adrenergic activity from the Locus Ceruleus (LC) which is where norepinephrine is produced ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"H. Mardjan","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"editor":[{"dropping-particle":"","family":"Abrori","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2016"]]},"title":"Pengaruh Kecemasan pada Kehamilan Primipara Remaja","type":"book"},"uris":["http://www.mendeley.com/documents/?uuid=6fee03a3-1bc8-359e-9d55-1eeaf31461fa"]}],"mendeley":{"formattedCitation":"(17)","plainTextFormattedCitation":"(17)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(17). Norepinephrine and other neurotransmitters are homeostatic so that it will decrease stress and anxiety management in pregnant women in the third trimester, especially primigravida mothers; this is positively correlated with preventing vasoconstriction. The majority of blood flow is obstructed in cases of mothers with high anxiety, so giving birth without obstruction to blood flow will minimize pain in the mother giving birth. The results of this study also found that there was no significant difference in average pain in the first stage of labor between the group using binaural beats and the control group. There is no difference in the average pain in the first stage of labor because the scale of pain measurement for each individual is not the same, so a definite measurement is needed of the labor pain felt (not subjective) by pregnant women in labor. This research produced findings that there was significance in the duration of labor in the alpha and beta wave groups. The size of the duration of labor during the delivery process will determine a mother's level of fatigue, which will then influence the continuation of labor.The results of this study prove that anxiety in third trimester primigravida mothers influences the pain scale in the first stage of labor. The higher the level of anxiety experienced by primigravida mothers in the third trimester, the higher the pain scale in the first stage of labor. Vice versa, so it is necessary to balance the anxiety that can occur in primigravida mothers in the third trimester before the birth period, with the aim of reducing the scale of pain that will be felt in the first stage of labor. These results still need to be studied further because they have a constant value that has a fairly large influence on the pain scale in the first stage of labor, apart from the level of anxiety in primigravida mothers. Pregnant women will be influenced by external variables which can also cause pain in the first stage of labor, such as demographic factors and social and environmental factors for primigravida pregnant women.There was a significant reduction in anxiety levels in the alpha and beta groups, where the anxiety level had an influence on the pain scale in the first stage of labor, so that alpha and beta wave binaural beats had a good influence on reducing the pain scale in the first stage of labor.CONCLUSIONS AND SUGGESTIONSConclusionIt has been proven that anxiety in third trimester primigravida mothers has an influence on the pain scale in the first stage of labor, so emotional management is needed that can minimize anxiety, one of which is using audio binaural beats. Audio binaural beats alpha and beta waves have an influence on reducing anxiety levels, as well as having an influence on the pain scale of the first stage of labor. Binaural beats alpha and beta waves have a good influence on reducing the pain scale in the first stage of labor.SuggestionBased on the results of this research, it can be recommended that alpha and beta wave binaural beats can be used as a relaxation method for pregnant women to reduce anxiety, which will have an impact on reducing first stage pain with a shorter duration of labor. The results of this research can then be utilized by health workers who provide services to pregnant women, such as Independent Midwife Practices (PMB), Community Health Centers, Mother and Child Hospitals.ACKNOWLEDGMENTThe researchers express their gratitude to all parties and agencies who have contributed to this research. Without contributions and collaboration from the following parties, the researchers would not necessarily be able to complete this writing well. The researchers would like to thank the Ministry of Education, Culture, Research and Technology of the Republic of Indonesia, Universitas Airlangga, Faculty of Public Health Universitas Airlangga, Faculty of Medicine Universitas Airlangga, Surabaya City Health Service, East Java Province Indonesian Midwives Association, and all parties who have helped carry out this research.REFERENCESADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY 1. Devi NS, Shinde P, Shaikh G, Khole S. Level of Anxiety Towards Childbirth among Primigravida and Multigravida Mothers. Int J Appl Res. 2018;4(5):221–224. Available from: https://www.academia.edu/download/88051444/4-5-18-620.pdf2. Afiyah RK. Effectiveness of Endorphin Massage Against Anxiety the Face of Labor on Mother Primigravida in the Region of Clinics Jagir Surabaya. In: Proceeding of Surabaya International Health Conference. Surabaya: UNUSA; 2017. p. 317–324. Available from: https://conferences.unusa.ac.id/index.php/SIHC17/article/download/298/46/3823. 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Front Psychol. 2014;5:1–10. Available from: https://psycnet.apa.org/doi/10.3389/fpsyg.2014.0124815. Petrovich O. The Effects of Binaural Beats on Emotion and Cognition. [St. Petersburg, Florida]: University of South Florida St. Petersburg; 2018. Available from: https://digitalcommons.usf.edu/cgi/viewcontent.cgi?article=1170&context=masterstheses16. Pinar SE, Daglar G, Aksoy OD. The Effect of Stress Management Training on Perceived Stress, Anxiety and Hopelessness Levels of Women with High-Risk Pregnancy. J Obstet Gynaecol (Lahore) [Internet]. 2022;42(1):17–22. Available from: https://doi.org/10.1080/01443615.2020.186797017. Mardjan H. Pengaruh Kecemasan pada Kehamilan Primipara Remaja. Abrori, editor. Pontianak: AG Litera; 2016. 124 p.131762550165JURNAL BIOMETRIKA DAN KEPENDUDUKAN (Journal of Biometrics and Population)00JURNAL BIOMETRIKA DAN KEPENDUDUKAN (Journal of Biometrics and Population)1479559207500-60325507900-4635559689900 PAGE \* MERGEFORMAT 210 PAGE \* MERGEFORMAT 211 Jurnal Biometrika dan Kependudukan, Volume 12, Issue 2 December 2023: 210–218Ar-Rayyan, Saputra, Prastika, and Puspitasari, The Effect of Binaural Beats on Pregnant Women... 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