FACTORS RELATED TO THE INCIDENCE OF ABORTION AT TORA BELO HOSPITAL

ABSTRACT


Introduction
Abortion or the scientific language is Abortus Provocatus, is the most commonly used means of terminating unwanted pregnancies, although it is the most dangerous way.According to WHO, abortion is a reproductive health problem that needs attention and is the cause of suffering for women around the world (Hawari, 2016).Abortion is divided into two, namely spontaneous abortion and provocatus abortion.Spontaneous abortion is the loss of pregnancy at the age of <20 weeks or a fetus weighing <500 grams.The frequency of spontaneous abortion in Indonesia is 10%-15% of 6 million pregnancies each year and 2500 of them end in death, this causes the problem of abortion to receive attention, because it can affect maternal morbidity and mortality (Silitonga & Sitorus, 2017).There are several factors that can cause abortion, one of which is maternal factors, namely maternal age, parity, gestational age, education level, occupation, marital status, economic status, various medical diseases, maternal nutritional status and history of abortion (Sulistyawati, 2015).
Abortion will have a very serious impact on society, causing pain and death to the mother.As is known, the main causes of death of pregnant women and childbirth are bleeding, and infection.Abortion is usually performed by a pregnant woman, both married and unmarried for various reasons.The main reasons for abortion are non-medical reasons including not wanting to have children for fear of interfering with career, school or other responsibilities, not having enough money to care for children, and not wanting to bear children without a father (Wulandari & Sarwoprasodjo, 2020).
In the Obsetri and Gynecology Ethics Guidelines (POGI) are also mentioned."Safe abortion is done only as an emergency exit or emergency exit," where the intended abortion is an abortion that is indeed done as an effort and last resort for the safety of the life of the mother and fetus (Rahma, Sahputri, & Nadira, 2022).Emergencies that are allowed are contraceptive failure, rape victims, incest victims, severe mental disorders, fetal disorders (Down syndrome) or congenital defects, infected with HIV/AIDS, or physically unwell, mentally, and economically.Although abortion is allowed due to medical indications, there are conditions that must be met by the patient (Adjei et al., 2015).
One of the efforts made by public health services at Tora Belo Hospital is a persuasive approach as well as communication, and education (Fajria, 2013).Pregnant patients who carry out periodic pregnancy checks are educated at the beginning of the meeting regarding the impact of abortion and the risk of abortion that will occur and conduct an assessment of the cadres of the surrounding puskesmas to invite the surrounding community to participate in the abortion impact counseling program in the local area.Based on this explanation, a study was conducted on "Factors Causing Abortion at Tora Belo Hospital"

Materials and Methods
In this study, the cross-sectional analytical research design method was used.The data used in this study is retrospective secondary data based on patient registers in 2021 and 2022 with a history of abortion so that sampling was taken as a whole at Tora Belo Hospital.This study used data analysis through two steps, namely by using univariate analysis and bivariate analysis.
Univariate analysis is used to determine respondents based on characteristics (age, educational status, economic status, body mass index, history of abortion) and data presented in tabular form.Bivariate analysis to determine the relationship between age status, educational status.economic status, body mass index, history of abortion Each of these variables was tested with data understanding the impact of abortion using the Simultaneous F test and partial t test

Analisa Univariat
Univariate analysis serves to obtain data on age, educational status.Economic status, body mass index, history of abortion (Manuaba, 2013)  Table 1 shows that the majority of respondents in 2021 based on age are dominated by 23 to 45 years old with a percentage of 50.4% of all respondents, in the characteristics of respondents' education status dominated by high school education with 44.2% of 50 respondents, this can be seen in the characteristics of economic status, it is found that the economic status is below 73 respondents or 64% (Masing, 2022).The body mass index is dominated by normal respondents with a total of 41.5%.In the history of abortion, only 2 respondents experienced abortion more than 1 time (Pratiwi & Mariyana, 2014).
in 2022 based on age dominated by 23 to 45 years old with a percentage of 55.5% of all respondents, in the characteristics of respondents' education status dominated by high school education with 47.0% of 55 respondents, this can also be seen in the characteristics of economic status, it was found that the economic status was below 65 respondents or 55%.The body mass index was dominated by thin respondents with 46.9%.In the history of abortion, only 2 respondents experienced abortion more than 1 time (Purnama, 2019).

Bivariate Analysis
Bivariate Analysis is an analysis to determine the relationship between variables.The statistical tests used to determine the relationship between these variables are simultaneous F and partial t tests (Langie, 2014).In table 2, results related to the relationship between the incidence of abortion and the characteristics of respondents found that age, educational status and economic status had a relationship related to the incidence of abortion both in 2021 and 2022, but the body mass index and abortion history were not related to the incidence of abortion at Tora Belo Hospital in 2021 and 2022 (Fentiningrum, 2021).In the partial t test, it was found that age, educational status and economic status had a positive relationship with the incidence of abortion both in 2021 and 2022.In 2021, age contributed 89% to the incidence of abortion, this is greater than other variables such as education status only 35% and economic status only 79%, as well as in 2022 that age still dominates causes related to abortion rates at Tora Belo Hospital (Syahrida, 2013).

Discussion
Based on the results of this study, it was found that there were several variables related to the incidence of abortion at Tora Belo Hospital in 2021 and 2022.In age characteristics, it is found that the age of 23 to 35 years contributes and dominates the incidence of abortion, this is because age will affect the maturity of pregnancy in a mother.Individuals who have a lower age will have a high risk of pregnancy or a higher age will also experience problems with high pregnancy risk due to decreased physical conditions5.Other studies have shown that over the age of 35 on the mother's side increases the risk of abortion by 2% because biological conditions affect the defense of pregnancy and the process of pregnancy that occurs (Suryani, 2019).
Based on variables, education status accounted for 35% to 55% of abortion incidents at Tora Belo Hospital in 2021 and 2022.This is related to mental readiness and pregnancy knowledge and optimization of ANC (Ante Natal Care).The respondents were dominated by high school education which in this case had gained a basic understanding of the process of pregnancy or the incidence of pregnancy but related to the risk of pregnancy and abortion was still not optimal.This is due to the taboo of information on the impact and effect of abortion on e-ISSN: 2723-6692  p-ISSN: 2723-6595 maternal health as well as religious and legal reviews7.At other levels of education in this study, elementary schools also have a considerable influence on the incidence of abortion due to the absence of learning and knowledge related to the process of pregnancy and abortion (Winoto, 2020).
Based on economic status variables that there is a significant relationship to the incidence of abortion.Economic status is one of the important elements in household development, some show that unpreparedness of family economic status will result in pregnancy readiness8.In this condition, families who are not economically prepared will experience problems with the tendency to abort and are not ready to meet the needs of the child.

Conclusion
Based on the results of research conducted at Tora Belo Hospital related to the incidence of abortion in 2021 and 2022, several variables related to the cause of abortion were obtained, including age, educational status and economic status.Other variables are not too related, namely body mass index and history of abortion.In this case, the focus in reducing the incidence of abortion is to increase knowledge on the process of pregnancy, approaches from a socioreligious perspective are also expected to develop to reduce the number of abortions in the following year.On the other hand, abortion can occur due to the urgency of pregnancy from a medical point of view that must be done to save the life of the mother e-ISSN: 2723-6692  p-ISSN: 2723-6595