Effectiveness of Marc in Reducing Stress and Anxiety in Pregnant Women in the Third Trimester
DOI:
https://doi.org/10.37287/ijghr.v8i6.2644Keywords:
anxiety, MARC, pregnant women, stress, third trimesterAbstract
The third trimester of pregnancy is a period that can increase stress and anxiety due to physical changes, pregnancy discomfort, and concerns about childbirth and the baby's condition. Safe and easy-to-implement non-pharmacological interventions are needed, one of which is MARC (Massage aromatherapy combination of Rosa oil and Cajapaut oil typical of Merauke). This study aims to determine the effectiveness of MARC in reducing stress and anxiety levels in pregnant women in the third trimester in Merauke Regency. The study used a randomized controlled trial design.This study used a quasi-experimental approach using a pretest-posttest control group design. The sampling technique used in this study was purposive sampling, a non-probability sampling method in which participants were selected based on predetermined inclusion criteria. Respondents were 34 pregnant women in their third trimester who met the research criteria. Stress and anxiety levels were measured before and after the intervention using the DASS-21 instrument. The DASS-21 instrument has demonstrated good construct validity and reliability in previous Indonesian research, with Cronbach’s alpha coefficients of 0.84 for both the stress and anxiety subscales. Analysis was conducted to determine differences in stress and anxiety levels before and after MARC administration. The results showed that there were significant differences in stress levels (p value 0.003) and anxiety levels (p value 0.000) before and after MARC administration. The decrease in scores after the intervention indicated that MARC was effective in helping reduce stress and anxiety levels in pregnant women in their third trimester. MARC is effective in reducing stress and anxiety levels in pregnant women in their third trimester. MARC can be an alternative non-pharmacological intervention that supports maternal relaxation and comfort before labor.
References
Arjanto, P. (2022). Uji reliabilitas dan validitas Depression Anxiety Stress Scales 21 (DASS-21) pada mahasiswa. Jurnal Psikologi Perseptual, 7(1). https://doi.org/10.24176/perseptual.v7i1.6196
Amalia Hanifa, A., Nurul Widyawati, M., Ramlan, D., Kumorowulan, S., Kemenkes Semarang, P., & Litbangkes Magelang, B. (2022). The Relationship of Hypnoprenatal Massage to the Mental Health of Pregnant Women in the Third Trimester. Indonesian Health Management, 10(3), 271–279.
Anggorodiputro, RRR, Sapi'i, TW, & Faried, A. (2023). Effect of Special Massage on Hamilton Anxiety Rating Scale (HARS) Scores among Primigravida Pregnant Women in the Third Trimester in Coping with Childbirth During the Covid-19 Pandemic. Embryo, 15(1), 63–74. https://doi.org/10.36456/embryo.v15i1.6824
Aprilia, T. (2025). The Effect of Yoga on Psychological Changes in Pregnant Women in the Second and Third Trimesters. Journal of Midwifery, 14(1).
Dadi, AF, Hassen, TA, Ketema, DB, Ahmed, KY, Kassa, ZY, Amsalu, E., Kibret, GD, & Alemu, AA (2025). Anxiety symptoms during pregnancy and risk of adverse birth outcomes in Gondar Town Ethiopia. Scientific Reports, 15, 1–7.
Dewi, AR, Ulfiana, E., & Anggraini, DD (2025). Factors Influencing Anxiety in Third Trimester Pregnant Women at the UPTD Sambong Health Center, Blora Regency. JUSINDO, 7(2), 612–628.
Febriana, L., & Zuhana, N. (2021). Midwifery Care for Pregnant Women in the Third Trimester. Proceedings of the National Health Seminar, 1, 1669–1673. https://doi.org/10.48144/prosiding.v1i.910
Hall, H., Munk, N., Carr, B., et al. (2021). Maternal Mental Health and Partner-Delivered Massage: A Pilot Study. Women and Birth, 34(3), 237–247. https://doi.org/10.1016/j.wombi.2020.05.003
Hall, A.H.G., Cant, R., Munk, N., Carr, B., Tremayne, A., Weller, C., Fogarty, S., & Lauche, R. (2020). The Effectiveness Of Massage For Reducing Pregnant Women's Anxiety And Depression; Systematic Review And Meta-Analysis. Midwifery, 1–24. https://doi.org/10.1016/j.midw.2020.102818
Hedigan, F., Sheridan, H., & Sasse, A. (2023). Benefits of Inhalation Aromatherapy as a Complementary Treatment for Stress and Anxiety in a Clinical Setting – A Systematic Review. Complementary Therapies in Clinical Practice, 52(March), 1–16. https://doi.org/10.1016/j.ctcp.2023.101750
Linda Juwita, & Pangestika, Y. (2023). Demographic Characteristic Factors Influencing the Level of Anxiety in Third Trimester Primigravida. LENTERA Nursing Journal, 11(1), 410–421. https://doi.org/10.48175/ijarsct-13062
Liya Lugita Sari, & Kintan Anissa. (2023). Effect of Endorphin Massage on the Level of Anxiety among >36 Weeks Pregnant Women. Embryo, 15(1), 49–56. https://doi.org/10.36456/embryo.v15i1.6995
Marina, H. (2020). The Relationship between Parity, Age and Education of Pregnant Women in the Third Trimester with Anxiety Levels in Facing the Period Before Delivery at the Petir Health Center, Serang Regency in 2020. Jurnal Antara Kebidanan, 4(1).
Mueller, S. M., & Grunwald, M. (2021). Effects, Side Effects and Contraindications of Relaxation Massage During Pregnancy: A systematic Review of Randomized Controlled Trials. Journal of Clinical Medicine, 10(16), 1–17. https://doi.org/10.3390/jcm10163485
Nuswantoro, UD, Meirany, A., Jannah, M., & Asmita, G. (2024). Literature Review: Factors Influencing Anxiety in Pregnant Women in the Third Trimester. Health Journal of the Faculty of Health, Dian Nuswantoro University, 23(1), 1–12.
Pawestri, P., Rachmawati, A., Khayati, N., & Machmudah, M. (2023). Empowering Cadres in Antenatal Care Management for Pregnant Women with Back Pain with Progressive Muscle Relaxation, Acupressure at Point BL 23 and Point GV 3. SALUTA: Journal of Community Service, 3(2), 68–75. https://doi.org/10.26714/sjpkm.v3i2.13405
R, WR, & Yuliastanti, Y. (2020). Stress Effect Of Pregnant Women On Trimester III Fetal Activities In The Health District Grabag 1 Magelang. Journal of Midwifery, XII(02), 146–156.
Retni, AKMB, Harismayanti, Sudirman, AN, & Daud, AW (2023). Endorphin Massage Method in Reducing Anxiety in Third Trimester Pregnant Women at TPMB Linda Verawati Depok. Muhammadiyah Bengkulu Nursing Journal, 8(1), 50–56.
Salsa Putri Kusumah, SR, & Setiawan, MR (2025). Analysis of Risk Factors for Anxiety in Pregnant Women in the Third Trimester Approaching Delivery at Dr. Adhyatma, MPH Regional General Hospital, Central Java Province. Indonesian Journal of Medical and Health Sciences, 5(2), 1–12.
Santi, LKS, Sudewi, AAR, Duarsa, DP, Lesmana, &, Komang, L., Santi, S., Sudewi, AAR, Duarsa, DP, Bagus, C., & Lesmana, J. (2021). The Effect of Pregnancy Massage on Levels of Depression, Anxiety and Stress in Pregnant Women. International Journal of Health & Medical Sciences, 4(2), 220–225. https://doi.org/10.31295/ijhms.v4n2.1692
Santi, L. Komang S., Sudewi, AAR, Duarsa, DP, & Lesmana, CBJ (2021). The Relationship of Pregnancy Massage to the Rate of Anxiety Depression and Stress in Pregnant Women. International Journal of Health & Medical Sciences, 4(2), 208–214. https://doi.org/10.31295/ijhms.v4n2.1699
Simanjuntak, L., Owkwulu, T., Ahmed, T., Andrianto, R., & Wulansari, L. (2025). Impact of Maternal Anxiety and Stress During Pregnancy on Fetal Neurodevelopment: A Longitudinal Cohort Study in Jakarta, Indonesia. Scientia Psychiatrica, 648–661.
Suhartatik, BSN, Rofiah, K., Dewi, RK, & Firdaus, N. (2025). The Relationship Between Pregnant Women's Class Activity and Anxiety in Primigravida Pregnant Women TM III in Facing Childbirth at Kumbe Community Health Center Merauke Regency, South Papua Province. Jurnal Mahasiswa Kesehatan, 6(2), 164–172.
Susilawati, M., Noviyani, EP, & Sugesti, R. (2024). The Effectiveness of Lavender Aromatherapy for Third Trimester Pregnant Women in Preparation for Childbirth. Tambusai Health Journal, 5(3), 9986–9990. https://journal.universitaspahlawan.ac.id/index.php/jkt/article/view/28964
Tan, L., Liao, FF, Long, LZ, Ma, XC, Peng, YX, Lu, JM, Qu, H., & Fu, CG (2023). Essential Oils for Treating Anxiety: A Systematic Review of Randomized Controlled Trials and Network Meta-analysis. Frontiers in Public Health, 11, 1–20. https://doi.org/10.3389/fpubh.2023.1144404
Thi, L.M., Manzano, A., Thi, B., Ha, T., Vui, L.T., Thai, N., Chi, Q., Thi, D., & Duong, T. (2024). Mental Health Stigma And Health Seeking Behaviors Amongst Pregnant Women In Vietnam: A Mixed Method Realist Study. International Journal for Equity in Health, 23(163), 1–14. https://doi.org/10.1186/s12939-024-02250-z
Velga Yazia, US (2022). Factors Associated with Stress Levels in Pregnant Women Facing Childbirth. Journal of Mental Health Nursing (JKJ): Indonesian National Nurses Association, 10(4), 837–856.
Vidal-García, E., Vallhonrat-Bueno, M., Pla-Consuegra, F., & Orta-Ramírez, A. (2024). Efficacy of Lavender Essential Oil in Reducing Stress, Insomnia, and Anxiety in Pregnant Women: A Systematic Review. Healthcare (Switzerland), 12(23), 1–10. https://doi.org/10.3390/healthcare12232456
Wang, Z., Mao, C., Zeng, S., Chen, L., Feng, Z., & Liu, W. (2025). The Effects of Aromatherapy on Anxiety and Sleep Quality in Maternal Women: A Systematic Review and Meta-analysis. Frontiers in Public Health, 13(November), 1–13. https://doi.org/10.3389/fpubh.2025.1701126
Widia Lilis Nur Indah Sari, Sholaikhah Sulistyoningtyas, NS (2025). Factors Influencing Anxiety in Third Trimester Pregnant Women at the Peninjauanogan Komering Ulu Community Health Center. TAMBUSAI HEALTH JOURNAL, 6(2), 9120–9130.
Wurisastuti, T., Mubasyiroh, R., Suryaputri, IY, Anastasia, H., Isfandari, S., Agustiya, R.I., Kurniawan, A., & Wardhani, Y.F. (2025). Barriers to Treatment-Seeking Behaviors Among Pregnant Women With Depression: A National Cross-Sectional Study in Indonesia. Korean Journal of Family Medicine, 1–10. https://doi.org/https://doi.org/10.4082/kjfm.24.0078 Barriers
Yang, J. ming, Li, Z. qin, Ye, H., Wu, Y. lin, Long, Y., Zhong, Y. biao, Luo, Y., & Wang, M. yuan. (2024). Effects of Foot Reflexology Massage on Pregnant Women: A Systematic Review and Meta-analysis of Randomized Controlled Studies. Scientific Reports, 14(1), 1–12. https://doi.org/10.1038/s41598-023-51107-y
Mesirngsih, R., Latifah, & Fetriyah, UH (2024). The Relationship between Stress Levels and the Incidence of Preeclampsia in Pregnant Women in the Second and Third Trimesters. Journal of Mental Health Nursing (JKJ): Indonesian National Nurses Association, 12(3), 543–550.
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