Anxiety can didefininisikan a feeling state of concern, anxiety, lack of requirements for, or fear of real or perceived threat that the actual source is unknown or known (Stuart and Sundeens, 1998). Based on these definitions can be concluded that anxiety is an unpleasant feeling, not feeling, worry and anxiety. This emotional state without a specific object, experienced subjectively driven by ignorance, which is preceded by a new experience, and communicated in interpersonal relationships.
Primigravida is a newly pregnant woman for the first time. primigravida mothers usually have difficulty in recognizing the changes that occur in the body that cause discomfort during her pregnancy lasted. This affects the mother's psychological, because of the lack of knowledge of pregnant women. Lack of knowledge can also lead to primigravida mothers do not know how to cope with the discomfort that women feel (Ulfah, 2009).
Predisposing factors Anxiety
Any changes in life or life events can cause stress are called stressors circumstances. Stress experienced by a person can cause anxiety, or anxiety is a direct manifestation of the stress of life and is closely associated with lifestyle (Wibisono, 1990).
Various predisposing factors that may cause anxiety (Roan, 1989) that genetic factors, organic factors and psychological factors. In patients who will undergo surgery, predisposing factors are highly influential anxiety is a psychological factor, in particular uncertainty about the procedures and operations to be undertaken.
A primigravida who will first undergo a process of labor tend to experience anxiety. This is because labor is something new to be experienced.
Symptoms of Anxiety
Patients who experience anxiety usually have symptoms that are typical and are divided into several phases, namely:
- Phase 1
The physical objec-phase reaction on alert, the body prepares itself to fight (fight), or flight (run away as soon as possible). In this phase the body to feel uncomfortable as a result of increased secretion of adrenaline and non adrenaline.
Therefore, the symptoms of anxiety can be a sense of tension in the muscles and fatigue, especially in the muscles of the chest, neck and back.In preparation for the fight, causing the muscles will become more rigid and consequently will cause pain and muscle spasms in the chest, neck and back. Tension of the agonists and antagonists will cause tremors and shaking that can easily be seen on the fingers (Wilkie, 1985). In this phase of anxiety is the mechanism of enhancement of the nervous system that reminds us that the nervous system function begins to fail to process the information correctly (Asdie, 1988).
- Phase 2
Besides the clinical symptoms as in phase one, such as restlessness, muscle tension, sleep disturbances and stomach complaints, the patient also started could not control his emotions and no self motivation (Wilkie, 1985).
Emotional lability can manifest easily cry for no reason, a few moments later a laugh. Crying easily associated with stress easily identified.However, sometimes a bit of a laugh to hard to show signs of anxiety disorder phase two (Asdie, 1988). Loss of self-motivation can be seen in circumstances like someone dropping to the ground, then he remain silent for some time by just looking at stuff that falls without doing anything (Asdie, 1988).
- Phase 3
Anxiety state of the phase one and two that are not resolved while the stressor is still ongoing, the patient will fall into three phases anxiety. In contrast to the symptoms seen in phase one and two are easily identified related to stress, anxiety symptoms in phase three is usually a change in behavior and are generally not readily visible relation to stress. In phase three can be seen symptoms like: intolerance to sensory stimuli, loss of ability to tolerate something that previously had been able to tolerate it, impaired reaction to something that a cursory look as personality disorders (Asdie, 1988).
Classification level of anxiety
There are four levels of anxiety, mild, moderate, and severe panic (Townsend, 1996).
- Mild anxiety;
Mild anxiety associated with stress in daily life and causes people to be vigilant and increase the perception of dialaminya.Manifestasi circumstances that arise at this level are exhausted, iritabel, airy perception increases, higher consciousness, capable of learning, increased motivation and behavior according to the situation.
- Anxiety is;
Allows one to concentrate on the important issues to the exclusion of others that someone is having a selective attention, but can do something purposeful. Manifestations that occur at this level is increased fatigue, heart rate and breathing rate increases, increased muscle tension, rapid speech with high volume, the land narrows perception, able to learn, but not optimal, decreased concentration ability, selective and focused attention on stimuli that do not add to anxiety, irritability, impatience, forgetfulness, anger and tears.
- Severe anxiety;
Greatly reduce the perception of one's land. A person with severe anxiety tend to focus on something that is detailed and specific, and can not think of anything else. That person can take a lot of direction to focus on one area to another. Manifestations that appear on this level is complained of dizziness, headache, nausea, can not sleep (insomnia), frequent urination, diarrhea, palpitations, narrowed field of perception, not willing to learn effectively, focusing on himself and his desire to eliminate the high anxiety,feelings of helplessness, confusion, disorientation.
- Panic;
Panic associated with the awe, fear and terror because it had lost control.People who are panicking are not able to do anything even with directions.Signs and symptoms that occur in these circumstances is difficult breathing, dilated pupils, palpitations, pallor, diaphoresis, incoherent speech, can not respond to simple commands, yelling, screaming, hallucinations and delusions.
Of the various explanations above can be concluded that a primigravida who will experience the birth process the first time tend to experience anxiety. Anxiety level of each primigravida influenced by many factors such as level of education, employment, sources of information, support her husband and other factors that trigger the occurrence of anxiety for pregnant women who are physically and mentally prepared to undergo the process of pregnancy until the birth process smoothly. The problem is not all women are physically and mentally ready.
Before delivery, many things come to mind worrying mother. Fear of deformed babies, surgery should be afraid, afraid of a long labor, and so forth. Especially if there is a friend or relative who tell their birthing experience, complete with a creepy comment.
Peak coincided with the start concerns the signs of labor. Contraction increased gradually increase the burden of the mother, so the concern is greatly increased. In this condition feelings of fear, if not handled properly, can damage the mother so that the concentration of the estimated labor smoothly, apart from the mother panicked.