Sofia Al Farizi, Vienne Citra Dewi, Dwi Izzati

Faktor Implementasi Inisiasi Menyusu Dini (IMD) pada Persalinan Sesar: Studi di Salah Satu Rumah Sakit Rujukan Sekunder di Surabaya, Indonesia

Introduction

Faktor implementasi inisiasi menyusu dini (imd) pada persalinan sesar: studi di salah satu rumah sakit rujukan sekunder di surabaya, indonesia. Temukan faktor implementasi Inisiasi Menyusu Dini (IMD) pada persalinan sesar di Surabaya. Usia, pendidikan, paritas, & jenis sesar jadi penentu keberhasilan IMD. Kebijakan RS penting.

Abstract

Latar belakang: Persalinan sesar di Indonesia mencapai angka 17,6% pada tahun 2018 yang menghambat pelaksanaan Inisiasi Menyusu Dini (IMD). IMD berperan penting dalam keberhasilan ASI eksklusif dan kesejahteraan neonatus. Penelitian ini bertujuan untuk menganalisis faktor implementasi IMD pada salah satu rumah sakit rujukan sekunder di Kota Surabaya. Metode: Penelitian observasional retrospektif menggunakan data rekam medik pasien. Sampel dalam penelitian ini sebanyak 248 perempuan bersalin yang diambil dengan random sampling. Analisis yang digunakan menggunakan pendekatan univariate dan bivariate dengan uji chi-square. Hasil: Hasil penelitian ini menunjukkan bahwa IMD yang tidak berhasil terjadi pada ibu yang bersalin sesar dengan karakteristik usia diantara 15 sampai dengan 20 tahun (70%), pendidikan SD (85.4%), primipara (91.8%) dan dengan sesar CITO (97.1%). Tingkat pendidikan, paritas, jenis sesar merupakan variabel yang memiliki hubungan signifikan dengan keberhasilan IMD. Kesimpulan: Deteksi dini dan pencegahan komplikasi harus menjadi prioritas terutama untuk komplikasi dan indikasi medis sesar, dan perlu adanya komitmen rumah sakit untuk mendukung IMD pada persalinan sesar melalui kebijakan dan regulasi rumah sakit.

Review

This paper, "Faktor Implementasi Inisiasi Menyusu Dini (IMD) pada Persalinan Sesar: Studi di Salah Satu Rumah Sakit Rujukan Sekunder di Surabaya, Indonesia," addresses a critically important public health issue: the successful implementation of Early Breastfeeding Initiation (IMD) in the context of increasing cesarean section rates. The authors rightly highlight the significance of IMD for exclusive breastfeeding success and neonatal well-being, especially given Indonesia's high C-section rates. The study aims to analyze the factors influencing IMD implementation in a secondary referral hospital in Surabaya, providing valuable insights into local challenges and contributing to the body of knowledge on this subject in a relevant geographical context. Methodologically, the study employs a retrospective observational design utilizing medical record data from 248 women, which is a pragmatic approach for identifying associations within a clinical setting. The use of univariate and bivariate analyses with chi-square tests is appropriate for determining statistical relationships between variables. The findings are compelling, revealing significant associations between unsuccessful IMD and specific maternal characteristics: younger age (15-20 years), lower educational attainment (primary school), primiparity, and CITO (emergency) cesarean sections. While the retrospective nature of the study effectively identifies *what* factors are associated, it inherently limits the ability to fully explore the underlying *reasons* or *mechanisms* behind these associations, such as specific hospital protocols or healthcare provider practices during emergency C-sections. Nonetheless, the identified demographic and obstetric variables offer clear targets for intervention. The conclusions drawn by the authors resonate strongly with the presented findings, emphasizing the need for early detection and prevention of complications, particularly those leading to emergency C-sections, which pose significant barriers to IMD. Crucially, the paper advocates for robust hospital commitment through policies and regulations to support IMD in cesarean deliveries. This recommendation is a vital takeaway, suggesting that systemic changes are necessary beyond individual patient factors. Future research could build upon this by exploring the qualitative perspectives of healthcare providers and mothers, or by evaluating the effectiveness of specific policy interventions designed to overcome these identified barriers. Overall, this study provides a solid foundation for guiding targeted interventions and policy development aimed at improving IMD rates following cesarean sections in similar settings.

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