Reducing Postpartum Anxiety in IUD Users through Ylang-ylang Aromatherapy and Slow Deep Breathing: A Quasi-Experimental Study
Abstract
Introduction: The number of IUD contraceptive users has declined, influenced by factors such as anxiety. Individuals with anxiety experience psychological distress, necessitating complementary therapy. Alternative treatments include ylang-ylang aromatherapy and Slow Deep Breathing. This study aimed to determine the effectiveness of ylang-ylang aromatherapy and Slow Deep Breathing in reducing anxiety among post-placental IUD users at Mangusada Hospital.
Methods: A quasi-experimental nonequivalent control group design was used, involving 70 postpartum IUD users divided into experimental (n=35) and control (n=35) groups. Anxiety was measured using the NRS-A questionnaire before and after a 15-minute intervention. Ethical approval was obtained (070/6854/RSDM/2024). Data were analyzed using descriptive statistics, Kolmogorov-Smirnov for normality, Wilcoxon Signed-Rank, and Mann–Whitney U tests, with a 95% confidence level.
Results: There was no significant difference in pre-test anxiety between the groups (mean: 5.69 ± 0.900, p = 1.000). Post-test results showed a greater reduction in the treatment group (mean: 3.03 ± 0.664) than in the control group (mean: 3.83 ± 0.785). The Mann-Whitney U test confirmed a significant difference in anxiety levels post-intervention (Z = -3.998, p = 0.000). The effect size (r = 0.676) indicates a large impact of the intervention.
Conclusion: Ylang-ylang aromatherapy and slow deep breathing are effective complementary interventions for reducing anxiety in post-placental IUD users.
References
BKKBN Prov Bali. Jumlah Pasangan Usia Subur dan Peserta KB Aktif Per Kabupaten_Kota _ Satu Data Indonesia Provinsi Bali [Internet]. Satu Data Indonesia Provinsi Bali. 2022 [cited 2023 Jul 15]. Available from: https://balisatudata.baliprov.go.id/laporan/jumlah-pasangan-usia-subur-dan-peserta-kb-aktif-per-kabupatenkota?year=2021
Sari M. Pelayanan KB [Internet]. BKKBN. 2017 [cited 2023 Jul 15]. Available from: https://kampungkb.bkkbn.go.id/kampung/1381/intervensi/45128/pelayanan-kb
Grandi G, Del MC, Alice S, Fabio T. Postpartum contraception : A matter of guidelines. Gynecol Obs. 2023;(January):1–10. Available from: https://doi.org/ 10.1002/ijgo.14928
Affandi B, Adriaansz G, Gunardi ER, Koesno H. Buku Panduan Praktis Pelayanan Kontrasepsi. Ketiga. Jakarta: Bina Pusaka Sarwono Prawirohardjo; 2014.
Matahari R, Utami FP, Sugiharti S. Buku Ajar Keluarga Berencana dan Kontrasepsi. Yogyakarta: Pustaka Ilmu Group Yogyakarta; 2018.
Badan Pusat Statistik. Profil Kesehatan Ibu dan anak 2024. Volume 10,. Jakarta: Badan Pusat Statistik; 2024.
Badan Pusat Statistik. Profil Kesehatan Ibu dan Anak 2022. Jakarta; 2022.
Badan Pusat Statistik. Banyaknya Peserta KB Aktif Menurut Metode Kontrasepsi dan Kabupaten/Kota di Provinsi Bali, 2019-2023 [Internet]. Badan Pusat Statistik. 2023. Available from: https://bali.bps.go.id/statictable/2018/06/28/118/jumlah-peserta-kb-aktif-menurut-metode-kontrasepsi-dan-kabupaten-kota-di-provinsi-bali-2019.html
Sembiring JB, Suwardi S, Saragih HJ. Faktor-Faktor yang Berhubungan dengan Kesediaan Menjadi Akseptor KB Pasca Persalinan di RSUD Deli Serdang Lubuk Pakam Tahun 2019. J Ilm Univ Batanghari Jambi. 2020;20(2):571–9. Available from: https://doi.org/ 10.33087/jiubj.v20i2.907
World Health Organization (WHO). Anxiety Disorder [Internet]. Vol. 15, World Health Organization. World Health Organization; 2023. p. 1–8. Available from: https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
Sonam K, Sharma D, Yadav P. Physical and Psychological Problems Experienced by The Intra-Uterine Contraceptive Devices User :A Descriptive Study. Obstet Gynaecol Forum [Internet]. 2024;34(3s). Available from: https://www.researchgate.net/publication/383941832
Widiastini LP, Karuniadi IGAM, Dewi LGS. Factors Associated with Post Placental Intrauterine Device ( IUD ) Use. J Ilmu dan Teknol Kesehat. 2024;11(2). Available from: https://doi.org/10.32668/jitek.v11i2.1421
Liu Y, Zhao J, Guo W. Emotional Roles of Mono-Aminergic Neurotransmitters in Major Depressive Disorder and Anxiety Disorders. Front Psychol. 2018;9(November):1–8. Available from: https://doi.org/10.3389/fpsyg.2018.02201
Zhang N, Zhang L, Feng L, Yao L. Cananga odorata essential oil reverses the anxiety induced by 1- ( 3- chlorophenyl ) piperazine through regulating the MAPK pathway and serotonin system in mice. J Ethnopharmacol [Internet]. 2018;219(March):23–30. Available from: https://doi.org/10.1016/j.jep.2018.03.013
Magnon V, Dutheil F, Vallet GT. Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Sci Rep [Internet]. 2021;19267(11):1–10. Available from: https://doi.org/10.1038/s41598-021-98736-9
Sugiyono. Metode Penelitian Kuantitatif, Kualitatif, dan R & D. 26th ed. Bandung: Alfabeta; 2017.
Prokopowicz A, Stanczykiewicz B, Uchmanowicz I. Validation of the Numerical Anxiety Rating Scale in postpartum females : a prospective observational study. Ginekol Pol. 2022;93(9):686–94. Available from: https://doi.org/10.5603/GP.a2021.0197
Hazra A, Gogtay N. Biostatistics Series Module 1_ Basics of Biostatistics. Indian J Dermatol [Internet]. 2016;61(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763618/
Sundjaja JH, Shrestha R, Krishan K. McNemar And Mann-Whitney U Tests [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560699/
Febriani Y, Rasipin, Runjati. Analysis Of Factors Related To Anxiety Level In Postpartum Mothers at Citra Insani Maternity Home, Semarang. Str J Ilm Kesehat. 2020;9(2):670–7. Available from: https://doi.org/10.30994/sjik.v9i2.357
Nguyen L, Lamarche L, Lennox R, Ramdyal A, Patel T, Black M, et al. Strategies to Mitigate Anxiety and Pain in Intrauterine Device Insertion: A Systematic Review. J Obstet Gynaecol Canada [Internet]. 2019;(June). Available from: https://doi.org/10.1016/j.jogc.2019.09.014
Nuss P. Anxiety disorders and GABA neurotransmission : a disturbance of modulation. Neuropsychiatr Dis Treat. 2015;11:165–75. Available from: https://doi.org/10.2147/NDT.S58841
Borgonetti V, L´opez V, Galeotti N. Ylang-ylang (Cananga odorata (Lam.) Hook. f. & Thomson) essential oil reduced neuropathic-pain and associated anxiety symptoms in mice. J Ethnopharmacol J. 2022;294(May). Available from: https://doi.org/10.1016/j.jep.2022.115362
Zhang N, Wang S, Yao L. Inhalation of Cananga odorata essential oil relieves anxiety behaviors in autism-like rats via regulation of serotonin and dopamine metabolism. J Integr Med [Internet]. 2023;21(2):205–14. Available from: https://www.sciencedirect.com/science/article/abs/pii/S2095496423000067
Desnita E, Yesika R. Pemanfaatan Minyak Kenanga ( Cananga Odorata ) untuk Pencegahan Depresi Lansia pada Masa Covid-19 di Panti Jompo Sumatera Barat. Heal Med J. 2023;V(2):80–5. Available from:https://doi.org/10.33854/heme.v5i2
Sundara AK, Larasati B, Meli DS, Wibowo DM, Utami FN, Maulina S, et al. Review Article : Aromaterapi Sebagai Terapi Stres dan Gangguan Kecemasan. J Buana Farma. 2022;2(2):78–84. Available from: https://doi.org/10.36805/jbf.v2i2.396
Ashhad S, Kam K, Negro CA Del, Feldman JL. Breathing Rhythm and Pattern and Their Influence on Emotion. Annu Rev ofNeuroscience. 2022;45:223-247(July):223–47. Available from:https://doi.org/10.1146/annurev-neuro-090121- 014424
Birdee G, Nelson K, Wallston K, Nian H, Diedrich A, Paranjape S, et al. Slow breathing for reducing stress : The effect of extending exhale. Complement Ther Med [Internet]. 2023;73(March):102937. Available from: https://doi.org/10.1016/j.ctim.2023.102937
Aslamiah K, Martini S, Novita N, Studi P, Terapan S, Poltekkes K, et al. The Effect of Slow Deep Breathing Technique on Anxiety During. J Matern Child Heal Sci. 2023;3(June):6–11. Available from: https://doi.org/10.36086/maternalandchild.v3i1.1683
Zhang N, Wang S, Yao L. Inhalation of Cananga odorata essential oil relieves anxiety behaviors in autism-like rats via regulation of serotonin and dopamine metabolism. J Integr Med [Internet]. 2023;21(2). Available from: https://www.sciencedirect.com/science/article/abs/pii/S2095496423000067
Shao R, Man ISC, Lee TMC. The Effect of Slow ? Paced Breathing on Cardiovascular and Emotion Functions : A Meta ? Analysis and Systematic Review. Mindfulness (N Y) [Internet]. 2024;15(1):1–18. Available from: https://doi.org/10.1007/s12671-023-02294-2
Copyright (c) 2025 Media Publikasi Promosi Kesehatan Indonesia (MPPKI)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with Media Publikasi Promosi Kesehatan Indonesia retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:
-
Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.
-
Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Media Publikasi Promosi Kesehatan Indonesia.
-
License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.