International Journal of Science and Society, Volume 5, Issue 4, 2023

The Effectiveness of Premarital Health

Counseling on the Attitude of Prospective
Brides in Preparing for a Healthy Pregnancy
Jihan Mentari Fitrah Rahmanda1, Maryanah2, Sri Mulyati3
Poltekkes Kemenkes Jakarta III, Indonesia
Email: Maryanah559@gmail.com

Abstract

There are 51.4% of 1,928 people in their reproductive age in DKI Jakarta who do not know the need
to conduct premarital health counseling for the bride, this shows the low essence of the
implementation of counseling for prospective brides in preparing for a healthy pregnancy. The
purpose of this study was to determine the effect of providing premarital health counseling on the
bride-to-be, in preparing for a healthy pregnancy. This research method uses a pre-experiment
method with one group pretest-posttest design. The subjects in this study were the bride aged 19 -
45 years who would do a health check at Puskesmas Tanjung Priok, with a total of 42 respondents.
The sampling technique is purposive sampling. This research using dependent t-test for data
analysis. The result is there is effectiveness in health counseling with p-value = 0,0001 (<0,005) that
show significant difference on prospective bride’s attitude in preparing healthy pregnancy.

Keywords: Healthy Pregnancies, Health Counseling; Prospective Brides.

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A. INTRODUCTION
Unpreparedness during the preconception period can have long-term impacts
such as complications during pregnancy and childbirth, depression, and even death
in the mother and child. According to WHO (World Health Organization), global
maternal deaths reached 295,000 people by 2017, this is still far from the target of
reducing maternal mortality in the SDGs which targets 70 out of 100,000 live births on
a global scale (World Health Organization, 2019). On a national scale, in 2021, maternal
deaths in Indonesia will reach 7,389 cases with one of the causes of death being
bleeding (Ministry of Health of the Republic of Indonesia, 2021).
The DKI Jakarta region also contributes to the maternal mortality rate in
Indonesia. In 2020, the maternal mortality rate reached 117 people, with causes of
death such as bleeding and hypertension in pregnancy (DKI Jakarta Health Office,
2021). Psychological impacts can also arise, such as anxiety during pregnancy, or even
symptoms of depression during pregnancy. This can occur due to ignorance in
responding to changes during pregnancy or the impact of the mother's
unpreparedness to experience pregnancy (Mardiana, Musa & Lestari, 2022).
The bride and groom play an important role in preparing themselves to face the
pregnancy period. Pregnancy planning, including early detection of problems the
prospective bride and groom have, can prevent risky pregnancies from being carried
out as early as possible. One of the government's interventions in this problem is to
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International Journal of Science and Society, Volume 5, Issue 4, 2023

establish a preconception care program, which includes premarital health counseling

which is a mandatory requirement for prospective bridal couples who are getting
married. (Kusnanti, 2018; Eka Vicky Yulivantina et al., 2021).
Effective premarital health counseling will improve the quality of preparation
during the preconception period, so that a positive attitude from the prospective bride
and groom to prepare for a healthy pregnancy can be formed. This statement is
supported by research conducted by Surtiarti and Rani (2020) which revealed that
premarital health counseling can influence positive attitudes in prospective brides and
grooms in the form of responsible behavior and being able to deal with marital
problems (Surtiati & Rani, 2022).
Nunuk et al. (2022) strengthen this idea by explaining that the changes in
attitudes of prospective brides and grooms that emerge after being given IEC are due
to increased experience, knowledge, confidence and learning processes in preparing
for pregnancy positively (Nunuk Kusumawati, Megayana Yessy Maretta and
Wijayanti, 2022). Even though it was found that there was a positive correlation
between premarital counseling and attitudes towards preparing for a healthy
pregnancy, in fact the practice of premarital counseling still found gaps such as
counseling that was only limited to providing tetanus immunization, or lectures
without any counseling that adjusted to the personal needs of the prospective bride
and groom (Ryan Chely Susanti , 2018).
Research conducted by Darmayanti, et al. (2019) found the phenomenon that
catin counseling was only limited to the flow used by prospective brides and grooms
to obtain health certificates and immunizations to register their marriage (Darmayanti,
Supiyah & Mesalina, 2020). Based on a public survey conducted by the media
publication detik.com, it appears that as many as 51.4% of 1,928 people of reproductive
age in DKI Jakarta are not aware of the need to carry out premarital health counseling
for prospective brides and grooms (Widiyanti, 2019).
Based on a preliminary study conducted at the Tanjung Priok District Health
Center, it was found that 3 out of 5 prospective brides who came before being given
counseling, did not know the essence of taking part in the examination of prospective
brides and had an attitude that was less supportive of planning a healthy pregnancy.
The aim of this research is to see the effectiveness of premarital health counseling on
the attitude of prospective brides in preparing for a healthy pregnancy at the Tanjung
Priok District Health Center in 2023.

B. METHOD
This research is quantitative research, using a pre-experimental method with a
one-group pretest-posttest design. This research was carried out at Catin Poly,
Tanjung Priok Community Health Center, which took place from March 2023 – April
2023. The sampling technique in this study used purposive sampling, with the sample
being prospective brides who met the predetermined inclusion and exclusion criteria.
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The inclusion criteria in this study were prospective brides and grooms aged 19
– 45 years, who were undergoing a premarital examination when the research took
place, and were willing to be respondents in this study. The exclusion criteria are
prospective brides with mental disabilities and prospective brides with limited time.
The number of samples from this research was 42 people. The independent variable
in this research is health counseling, and the dependent variable is the attitude of the
prospective bride in preparing for a healthy pregnancy. The data collection tool uses
a questionnaire about the prospective bride's attitude in preparing for a healthy
pregnancy which has been tested for validity and reliability.
This research was carried out in 3 stages. In the first stage, respondents will be
asked to fill out a pretest questionnaire. In the next stage, respondents will be given
premarital health counseling which discusses preparing for a healthy pregnancy
assisted with the help of the Procatin application belonging to the Tanjung Priok
District Health Center. After 1 week post-intervention, respondents will be asked to
complete a posttest questionnaire to determine changes in attitudes of the prospective
bride. Data analysis in this study used parametric tests, paired t-test to assess the
effectiveness of premarital health counseling through the average difference in
attitudes of prospective brides before and after the intervention was given. This
analysis test is used because the existing data is normally distributed.

C. RESULT AND DISCUSSION

Characteristics of Catin for Women at Tanjung Priok Health Center in 2023
presented in the following table:
Table 1. Characteristics of Catin for Women at Tanjung Priok Health Center in 2023
Variable Total Percentage (%)
Age
No risk 36 85.7
Risky 6 14.3
Edycatiion
Low 5 11.9
High 37 88.1
Job
In Job 34 81
Jobless 8 19
Total 42 100

The characteristics of the respondents were that 85.7% were of non-risk age (20
- 35 years), 88.1% of respondents were in higher education, namely in the high school
to university range, and 81% of prospective brides worked.

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Table 2. Tanjung Priok Health Center Women's Catin Motivation in 2023

Variable Total Percentage (%)
Motivation
Of your own accord 36 85.7
At the direction of others 6 14.3
Total 42 100

The frequency distribution of motivation for prospective brides and grooms here
is 85.7% of respondents taking part in Premarital Health Counseling activities of their
own accord.

Table 3. Women's Catin Knowledge Before and After Being Given Premarital
Health Counseling at the Tanjung Priok Community Health Center in 2023
Value
Knowledge
Standard
Average Minimal Maximum
Deviation
Before
7.86 1.907 3 10
Intervention
After
9.17 0.881 7 10
Intervention

It can be seen that the average knowledge value before the intervention was
given was 7.86 and after it was 9.17 with a difference in the average knowledge value
of 1.31.
Table 4. Women's Catin Knowledge Level before and After being given Premarital
Health Counseling at the Tanjung Priok Community Health Center in 2023
Knowledge level Before Counseling After Counseling
N % N %
Good 24 57.1% 26 61.9%
Not enough 18 42.9% 16 38.1%
Total 42 100% 42 100%

From the results of the table above, it appears that the level of knowledge before
being given good counseling was 57.1% and after being given counseling, the
dominant knowledge was in the good category with a total of 61.9%.

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International Journal of Science and Society, Volume 5, Issue 4, 2023

Table 5. Exposure to Catin Information for Women at Tanjung Priok Health

Center in 2023
Variable Total Percentage (%)
Information Exposure
Exposed 9 21.4
Not Exposed 33 78.6
Total 42 100

Based on the table above, it is known that 33 prospective brides were not exposed
to information regarding premarital health counseling (78.6%).

Table 6. Description of Female Catin's Attitude before and after being given
Premarital Health Counseling at the Tanjung Priok Community Health Center in
2023
Value
Attitude Standard
Average Minimal Maximum
Deviation
Before
52.71 4.474 41 59
Intervention
After
55.36 3.406 48 60
intervention

The average value of the prospective bride's attitude regarding preparation for a
healthy pregnancy before being given intervention in the form of counseling was 52.71
and after being given the intervention it was 55.36. It appears that there is a difference
in the average attitude value before and after the intervention is 2.12.

Table 7. Attitude Level of Prospective Brides before and After being given
Premarital Health Counseling at the Tanjung Priok District Health Center in 2023
Attitude Level Before Counseling After Counseling
N % N %
Positive 29 69% 25 59.5%
Negative 13 31% 17 40.5%
Total 42 100% 42% 100%

The attitude level before counseling was given was 69% positive. After being
given counseling, it appeared that 59.5% of people were still at a positive attitude level.
Although there was a decrease in attitude in 4 people.

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 Table 8. Changes in Catin Women's Attitudes Before and After Premarital
Counseling at Tanjung Priok Community Health Center in 2023
Value
Attitude Variables P-Value
Mean SD
Before Intervention 52.71 4.474 0.0001
After Intervention 55.36 3.406
Difference in attitude 2.65

Analysis of the data above used bivariate analysis with a paired t-test which
showed a p-value of 0.0001 (P<0.05), so it can be seen that there is significant
effectiveness in premarital health counseling on the prospective bride's attitude in
preparing for a healthy pregnancy. The effectiveness of providing premarital health
counseling can be influenced by factors within the client such as characteristics,
motivation to attend counseling, knowledge possessed, and sources of information
obtained. Utilizing the characteristics of the client can maximize the effectiveness of
counseling to change the client's attitude.
In this study, the majority of prospective brides and grooms were at a non-risk
age, which shows that there is readiness in terms of age to prepare for a healthy
pregnancy. Apart from that, research by Dewi et al. (2023) adds that age can influence
a person's level of maturity, because the older they are, the more knowledge they gain
compared to younger age groups (Wayan Erviana Puspita Dewi et al., 2023). Knowing
the work background will help counselors to know risk factors that might influence
negative behavior in preparing for a healthy pregnancy, such as commercial sex
workers. Apart from that, Oktavynany in Kusumawati, et al. (2022), added that work
will influence a person's understanding, comprehension and knowledge, which will
later change a person's attitude (Kusumawati et al., 2022).
In this research, it appears that the majority of prospective brides and grooms
work, so this can influence the attitudes of prospective brides and grooms. The
researcher's assumption is that changes in attitude can occur, because while working
the prospective bride and groom can discuss pregnancy with their colleagues and the
preparations needed. This makes delivery during counseling more effective.
Education also influences the effectiveness of providing premarital health counseling.
Susanti (2018) explains that the attitude of a prospective bride is influenced by her
level of education, the higher a person's level of education, the better the knowledge
they have, so the more positive their attitude will be in preparing for a healthy
pregnancy (Susanti et al., 2018).
Significant changes in this research can occur due to the high level of education
of the respondents which makes communication in counseling take place well due to
active interaction, and the counselor's delivery is more easily absorbed by the
prospective bride. Researchers themselves see that the majority of prospective brides
and grooms participate in premarital health counseling of their own accord, this
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shows the high awareness and interest of women in participating in counseling
activities to create a healthy pregnancy.
Research conducted by Meda et al. (2020) also supports this statement by stating
that the effectiveness of providing counseling will help prospective brides and grooms
be able to prepare well for their pregnancy (Yuliani, Mulyati & Maesaroh, 2020). The
dominance of respondents who are at a good level of knowledge shows that they have
a good foundation, which will influence them in taking the right attitude in preparing
for a healthy pregnancy. Research conducted by Fifit (2022) strengthens this idea by
saying that counseling can influence women's knowledge. Women who have changes
in knowledge after being given health counseling show that the individual cares about
their health (Fifit et al., 2022).
In this study, it was very dominant that prospective brides and grooms did not
have exposure to information regarding premarital health counseling or preparation
for a healthy pregnancy. In fact, exposure to information is one of the enabling factors
that can shape a person to take a positive attitude. Apriliana (2022) said that with the
many sources of education or information obtained by a person, it will influence his
lifestyle to become healthy, considering that education can increase knowledge to
grow a person's self-confidence as well as attitudes and behavior to form a positive
attitude (Tri Apriliana, 2022).
In this research, it appears that there is the effectiveness of providing premarital
health counseling on the prospective bride's attitude in preparing for a healthy
pregnancy. The change in attitude that occurred was because respondents began to
understand the essence of the implementation of counseling itself, and respondents
understood how to plan a pregnancy for themselves according to their conditions. The
results of this research are in line with research by Simatupang (2018) which explains
that premarital counseling will have a significant influence on respondents before and
after health counseling is given, so that counseling can change the respondents'
attitudes (Simatupang, 2018).
Yuliani (2020) explains that giving KIE to prospective brides is effective in
helping prospective brides to prepare for married life, and be able to prepare for their
pregnancy well (Yuliani, Mulyati & Maesaroh, 2020). Balebu, et al. (2019) said that
preconception counseling aims to increase women's knowledge in preparing
themselves for pregnancy, including establishing an appropriate and balanced diet to
prepare for adequate nutrition during pregnancy (Balebu et al., 2019). Premarital
health counseling is carried out to explore problems and discuss solutions to overcome
these problems (Mundakir, 2016). This method will increase a person's chances of
experiencing a change in attitude considering that the preparations made are in
accordance with the individual's needs and desires.

D. CONCLUSION

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 In this study it can be concluded that there is effectiveness of premarital health
counseling on the prospective bride's attitude in preparing for a healthy pregnancy,
with a p-value <0.05. The change in attitude that occurred in this research occurred
because of factors within the client that could help maximize the process of delivering
premarital health counseling. However, it is hoped that there will be other researchers
who will be able to examine in more depth the factors that most influence the
effectiveness of providing premarital health counseling on the attitude of prospective
brides in preparing for a healthy pregnancy.

REFERENCES
1. Afrilia, E., Musa, S. M., & Lestari, M. (2022). Metode Hypnosis Dalam Mengatasi
Perubahan Psikologis Selama Masa Kehamilan: Studi Literatur. Jurnal JKFT, 7(1),
54-58.
2. Balebu, D. W., Labuan, A., Tongko, M., & Sattu, M. (2019). Hubungan
Pemanfaatan Posyandu Prakonsepsi dengan Status Gizi Wanita Prakonsepsi di
Desa Lokus Stunting Kabupaten Banggai: The Relationship between the
Utilization of Posyandu Prakonsepsi and the Nutrition Status of Preconception
Women in Stunting Locus, Banggai Regency. Jurnal Kesmas Untika Luwuk: Public
Health Journal, 10(1), 12-19.
3. Darmayanti, D., Supiyah, S., & Mesalina, R. (2020). Analisis Pelaksanaan
Komunikasi Informasi Edukasi (KIE) Kesehatan Reproduksi dan Seksual pada
Calon Pengantin di Kota Bukittinggi Tahun 2019. Jurnal Sehat Mandiri, 15(1), 62-
78.
4. Department of Reproductive Health and Research World Health Organization.
(2019). Maternal mortality Evidence Brief Progress towards Achieving the Sustainable
Development Goals. 1–4. (Accessed: 27 September 2022).
5. Dewi, N. W. E. P., Dwiyanti, N. K. N., Teja, N. M. A. Y. R., & Indriana, N. P. R. K.
(2023). Hubungan Karakteristik dengan Pengetahuan Skirining Prakonsepsi pada
Wanita Usia Subur (WUS). Jurnal Ilmu Kesehatan MAKIA, 13(1), 27-32.
6. Dinkes DKI Jakarta. (2021). Profil Kesehatan Provinsi DKI Jakarta Tahun 2020, Dinas
Kesehatan Provinsi DKI Jakarta. Jakarta.
7. Eka, B. D. (2021). Modul Praktikum Asuhan Pranikah dan Prakonsepsi. Yogyakarta:
STIKES Guna Bangsa Yogyakarta.
8. Fifit, K. I. S., Sofiyanti, I., Nashita, C., Permana, D. N. D. N. E., & Rahmadhani, T.
D. (2022, December). Pengaruh Konseling Gizi Prakonsepsi terhadap
Pengetahuan dan Sikap Wanita Pranikah. In Prosiding Seminar Nasional dan CFP
Kebidanan Universitas Ngudi Waluyo (Vol. 1, No. 2, pp. 696-707).
9. Kementerian Kesehatan RI (2021) Profil Kesehatan Indonesia Tahun 2020. Available
at: https://pusdatin.kemkes.go.id/resources/download/pusdatin/profil-
kesehatan-indonesia/Profil-Kesehatan-Indonesia-Tahun-2020.pdf (Accessed: 7
September 2022).
IJSOC © 2023
http://ijsoc.goacademica.com

558
10. Kusnanti, S. (2018). Persepsi dan Harapan Calon Pengantin terhadap Pelayanan Pra
Konsepsi di Kecamatan Sedayu Bantul Yogyakarta (Doctoral dissertation, Universitas
Alma Ata Yogyakarta).
11. Mulyati, I., & Maesaroh, M. (2020). Efektifitas Komunikasi Informasi dan Edukasi
(Kie) Tentang Kesehatan Reproduksi pada Calon Pengantin (Catin) dalam
Mempersiapkan Pernikahan dan Kehamilan. Jurnal Medika: Karya Ilmiah
Kesehatan, 5(2).
12. Mundakir (2016). Buku Ajar Komunikasi Pelayanan Kesehatan. 1 ed. Diedit oleh
Indomedia Pustaka. Yogyakarta: Indomedia Pustaka. Tersedia pada:
http://repository.um-
surabaya.ac.id/5434/1/Buku_Ajar%2C_Komunikasi_Pelayanan_Kesehatan.pdf
(Accessed: December 11, 2022).
13. Nunuk, K. (2022). Pengaruh Booklet Kesehatan Reproduksi dan Skrining Prakonsepsi
terhadap Sikap Catin Wanita Tentang Persiapan Kehamilan Sehat di Puskesmas
Pracimantoro 1 (Doctoral dissertation, Universitas Kusuma Husada Surakarta).
14. Ryan, C. S. A. (2018). Persepsi dan Harapan Bidan Tentang Pelayanan Pranikah di
Puskesmas Sedayu I dan Puskesmas Sedayu II Kabupaten Bantul Yogyakarta (Doctoral
Dissertation, Universitas Alma Ata Yogyakarta).
15. Simatupang, A.M. (2018). Pengaruh Konseling Gizi Prakonsepsi terhadap Pengetahuan
dan Sikap Wanita Pranikah. Politeknik Kesehatan Kemenkes Medan.
16. Surtiati, E., & Rani, Y. (2022). Pengaruh Konseling Pranikah terhadap
Pengetahuan dan Sikap Memilih Pasangan Hidup pada Mahasiswa Dewasa
Awal. Jurnal Riset Kesehatan Poltekkes Depkes Bandung, 14(1), 105-113.
17. Susanti, D., Doni, A. W., & Rustam, Y. (2018). Pengaruh Pendidikan Kesehatan
Pranikah terhadap Pengetahuan dan Sikap Calon Pengantin di Lubuk Begalung
Padang Tahun 2017. Jurnal Sehat Mandiri, 13(2), 18-25.
18. Tri, A. T. (2022). Pengaruh Edukasi Gaya Hidup Sehat terhadap Sikap dan Perilaku
Wanita Usia Subur dalam Mempersiapkan Kehamilan Sehat (Doctoral dissertation,
Universitas Kusuma Husada Surakarta).
19. Widiyanti, W. (2019). Duh! Banyak Netizen Belum Tahu Nikah di DKI Butuh
“Sertifikat Layak Kawin,” Health Detik. Available at: https://health.detik.com/berita-
detikhealth/d-4383405/duh-banyak-netizen-belum-tahu-nikah-di-dki-butuh-
sertifikat-layak-kawin (Accessed: 7 September 2022).

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