Reducing Postpartum Anxiety in IUD Users through Ylang-ylang Aromatherapy and Slow Deep Breathing: A Quasi-Experimental Study

  • Luh Putu Widiastini Study Program of Midwifery, STIKES Bina Usada Bali, Bali, Indonesia
  • I Gusti Agung Manik Karuniadi Study Program of Midwifery, STIKES Bina Usada Bali, Bali, Indonesia
  • Luh Gede Susila Dewi RSD Mangusada, Bali, Indonesia
Keywords: Ylang-ylang Aromatherapy, IUD, Anxiety, Post-placental, Slow Deep Breathing

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

Published
2025-05-05
How to Cite
Luh Putu Widiastini, I Gusti Agung Manik Karuniadi, & Gede Susila Dewi, L. (2025). Reducing Postpartum Anxiety in IUD Users through Ylang-ylang Aromatherapy and Slow Deep Breathing: A Quasi-Experimental Study. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(5), 337-345. https://doi.org/10.56338/mppki.v8i5.7232