THE EFFECT OF SELF AFFIRMATION ON STRESS ON WOMEN IN WAITING FOR PREGNANCY

Background : Stress infertility is a problem that is often faced by women of childbearing age. This of course will trigger stress to peak when the unexpected menstruation finally arrives, which in fact indicates that the wife is not pregnant. This causes women of childbearing age to experience long-term stress. The purpose of this study was to analyze "The Effect of Self Affirmation on Stress in Women in Waiting for Pregnancy in an Online Forum. Methods: The research design is a one group pre-post test design. Respondents were taken by purposive sampling technique with a sample of 30 people who met the inclusion and exclusion criteria. The independent variable is Self Affirmation and the dependent variable is Stress on Women in Waiting for Pregnancy Online Forum. The results of statistical tests using the Wilcoxon test. Results : The results showed that before self-affirmation that almost all respondents as many as 15 (75%) in the category of severe stress while after self-affirmation that almost all respondents as many as 17 (85%) in the category of mild stress. Analysis : The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 is rejected and H1 is accepted. Thus, there is an effect of self-affirmation on stress in women in waiting for pregnancy in an online forum. Conclusion : Based on the results of the study, it is concluded that with self-affirmation carried out by the mother, it can reduce stress in waiting for her pregnancy.


INTRODUCTION
Problems that are often faced by women of childbearing age in waiting for pregnancy include the emergence of stress characterized by headaches, sleep disturbances, worry, anxiety, fear, job dissatisfaction, depression, fatigue, moodiness, and lack of enthusiasm because of the mother's high hopes for having children. Another problem that occurs in women of childbearing age is infertility (infertility). This condition certainly has an impact on stress in expecting pregnancy (Hawari, 2019). Stress in women of childbearing age is felt from the first months of marriage until waiting for the results of the treatment that has been undertaken. The stress level is even higher when the unexpected menstruation finally arrives, which in fact indicates that the wife is not pregnant. This causes women of childbearing age to experience long-term (chronic) stress, which generally takes place periodically, namely every month. This is related to the menstrual cycle experienced by women of childbearing age (Malpani, 2020). Self-affirmation is very useful for women of childbearing age to be able to change one's point of view in responding to life and the surrounding environment so that it will make the minds of women of childbearing age more positive (Sweeney, 2020).
The World Health Organization (WHO) (2021) estimates that globally there are cases of infertility in couples of childbearing age, namely 8%-10% or around 50-80 million infertile couples in the world. In the United States, according to the National Survey of Family Growth (NSFG), the percentage of infertile women in 2018 and 2019 was 8.4% and increased to 10.2% (6.2 million) in 2020. According to research by Stephen and Chandra (2020) It is estimated that 6.3 million women in the United States are infertile and are expected to increase to (5.4-7.7) million by 2025. Infertility in developing countries is higher, which is about 30% compared to developed countries. The prevalence of infertility in Asia is around 30% in Cambodia, 43.7% in Turkmenistan (WHO, 2021). Infertility in Indonesia according to data from the Central Statistics Agency (BPS) in (2020) was 21.3%. Of the 39.8 million couples of childbearing age (EFA) in Indonesia in 2020, 10-15% of them are infertile or around 4-6 million couples, the incidence of infertility in Indonesia is increasing every year. The prevalence of infertile couples in Indonesia in 2021 is around 15-25% of all existing couples (Riskesdas, 2021). Stress experienced by infertile women has different levels ranging from not experiencing stress to panic. Based on Dessy's research (2019), from 42 people it is known that the case and control groups have the same number, namely 35 (83%) in the normal category, while in the case group as many as 4 (9%) experience mild stress, the control group as much as 2 ( 5%) mild stress and case group as much as 3 (7%) in the category of severe stress control group as many as 5 (12%) in the category of severe stress. The results of this study are also in line with Nani's research (2022), in his research journal, it was found that from 104 respondents, 38 (76%) experienced primary infertility stress and 12 (24%) experienced secondary infertility stress, and 24 (44%) did not. experienced stress primary infertility and as many as 30 (56%) did not experience stress secondary infertility.
Based on the results of researcher interviews with respondents on December 21, 2021 through social media facebook grub tips on marriage and pregnancy programs, there are a total of 10 WUS Nuliparas, it is known that 5 (50%) mothers say that they feel very lonely because they do not have children, the statement is wrong. One mother said that she felt stressed about her body condition, which was getting older, and had not even had a chance to have children. Mother also said that sometimes she gets angry for no reason and also experiences depression with her current condition. 3 (30%) mothers said that they feel ashamed of their neighbors because they do not have children, mothers feel less confident when outside the house, feel uncomfortable, unhappy during the marriage due to the absence of a child in the family. 2 (20%) mothers said that they have faith and can definitely get the pregnancy they want if they keep trying and praying, mothers and husbands also always try and ask God to give them what they want so far, mothers also do not feel inferior, disappointed with current conditions and even mothers are always patient, think positively and always stay away from stress (Results of Preliminary Study With Interviews with Respondents Through Social Media Facebook, 2021). One of the factors that influence stress in women in expecting pregnancy is selfaffirmation. Affirmation itself is an affirmation in oneself or an action that helps a person to convince himself that he is a good and competent person (Lestariningsih, 2020). So that stress in women of childbearing age can be overcome by self-affirmation which will increase energy and bring positive things to life every day. Affirmations can strengthen the self-confidence and confidence of women of childbearing age in overcoming situations and produce something positive by repeating affirmations (affirmations) so as to create a tendency to say positive things that can increase self-integrity in interpreting life. Thus self-affirmation can change a person's negative thoughts as well as dealing with stress in women of childbearing age (Haris, 2020). Self-affirmation or in other words selfaffirmation is an emotional support or encouragement from within a person so that they take certain actions related to positive things. Affirmations come from oneself and are only aimed at oneself in order to be able to see things from a positive point of view. Affirmations have many benefits for yourself, especially if these positive affirmations are injected regularly so that they can build selfconfidence, improve body health, keep depression/stress away, provide comfort, make yourself happier (Lestariningsih, 2020).
The self-affirmation technique is one of the stress management methods carried out by means of physical strategies (deep breathing relaxation) from strategic cognitive affirmations. Self-affirmation will make individuals feel calm, comfortable and peaceful because affirmations can affect the parasympathetic nervous system and sympathetic nerves to trigger the secretion of endorphins, reduce blood pressure, slow down breathing and reduce estrangement in the body (Winkjosastro, 2017). Self affirmations focus on thoughts and behavior. Self-affirmation techniques can reduce anxiety, stress by changing the way they think, feel or act, regardless of the situation. Self-affirmations increase the likelihood that individuals will immediately feel their feelings towards something or another person. This means that once individuals affirm their values, they become more likely to be trusting, open, and loving. These feelings, in turn, reduce the likelihood of defensive reactions such as stress (MOH, 2020). The solution to be able to overcome the above problems where women of childbearing age can deal with stress with positive self-affirmations. Because self-affirmation is a form of affirmation of oneself related to positive things. So that through these positive words, the brain will indirectly be indoctrinated so that the point of view of women of childbearing age will also change. In addition, women of childbearing age must respond to the conditions experienced at this time is only a trial and will pass over time by still trying to wait for pregnancy. Various ways to be able to cope with stress where women of childbearing age can access a lot of information related to pregnancy on various social media (internet), women of childbearing age must also be active in conducting or consulting with health workers such as doctors, midwives related to the pregnancy process so that with this knowledge and information they can reduce the stress of the mother in waiting for her pregnancy. Women of childbearing age should also avoid negative perceptions in expecting pregnancy to avoid prolonged stress. Based on the background of the problem above, the researcher is interested in conducting a study with the title "The Effect of Self Affirmation on Stress in Women in Waiting for Pregnancy ".

METHODE
The research design used in this study was a one group pre-post test design with a preexperimental approach. The sampling technique used was purposive sampling that met the inclusion and exclusion criteria with a sample of 20 mothers. In this study, the independent variable is self-affirmation and the dependent variable is stress on women in expecting pregnancy via online forums. Data processing through the stages of editing, coding, scoring, tabulation. The statistical test used is the Wilcoxon Test with a value of = 0.05. Based on the table above shows that the age of women in waiting for pregnancy is known that most of the respondents are aged 25-35 years, namely as many as 13 (65%) respondents. It is known that women's education in expecting pregnancy is known that almost half of the respondents with a high school education level are 8 (40%) respondents. It is known that the work of women in expecting pregnancy is that almost half of the respondents work as traders, namely 9 (45%) respondents. Based on the table above shows that the stress on women in expecting pregnancy before selfaffirmation is known that most of the respondents as many as 15 (75%) respondents in the heavy category. Stress on women in waiting for pregnancy after self-affirmation, it is known that almost all respondents as many as 17 (85%) respondents in the Mild category. Based on the table above shows that the results of the cross tabulation of stress reduction in women in expecting pregnancy before and after self-affirmation, it is known that almost all respondents as many as 12 (80%) are in the Mild category.

D. Analisys
The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 is rejected and H1 is accepted, thus there is an effect of self-affirmation on stress in women in waiting for pregnancy in an online forum.

A. Stress on Women in Waiting for Pregnancy
Before Self Affirmation Based on the results of the study, it is known that stress in women in waiting for pregnancy before self-affirmation is known that most of the respondents as many as 15 (75%) respondents are in the heavy category. This is in accordance with the results of the questionnaire that the mother feels that I am angry because until now I have not gotten a pregnancy, often cry because I have not gotten a pregnancy, often feel ashamed of the neighbors around, feel sad because I only live with my husband without a baby in the house. family, feeling inferior when with friends who have gotten pregnant, feeling less confident when outside the home, feeling disappointed and hopeless with the current condition because they have not gotten a pregnancy.
Susilawati (2017), said that women who have severe stress levels are less likely to get pregnant compared to women who do not experience stress. The cause is an imbalance of hormones including hormones related to the reproductive system that can affect the process of ovulation. So that one way to be able to cope with stress in women in anticipation of pregnancy is Self Affirmation. Sweeney (2020), says that affirmations can change a person's perspective in responding to life and the environment around him. As a result, affirmations will make our thoughts more positive. The self-affirmation technique is one of the stress management methods carried out by means of physical strategies (deep breathing relaxation) from strategic cognitive affirmations. Self-affirmation will make individuals feel calm, comfortable and peaceful because affirmations can affect the parasympathetic nervous system and sympathetic nerves to trigger the secretion of endorphins, reduce blood pressure, slow down breathing and reduce estrangement in the body (Winkjosastro, 2017). Self affirmations focus on thoughts and behavior. Self-affirmation techniques can reduce anxiety, stress by changing the way they think, feel or act, regardless of the situation. Selfaffirmations increase the likelihood that individuals will immediately feel their feelings towards something or another person. This means that once individuals affirm their values, they become more likely to be trusting, open, and loving. These feelings, in turn, reduce the likelihood of defensive reactions such as stress (MOH, 2020).
The assumption in this study is that before being given self-affirmation, it is known that the mother is experiencing severe stress due to the increasing age factor and until now she has not gotten a pregnancy so she sometimes feels embarrassed when she hears other people talking about her. Likewise, the low level of education causes mothers to never seek information either through electronic media, mass media, print media, peers and even health workers about how to deal with stress. Besides that, there is also a factor in the work of mothers who work from morning to evening who sometimes lift heavy loads, causing physical fatigue which will be at risk for getting pregnant. In the opinion of researchers that mother's education is very important in reducing stress. This can be done by the behavior of mothers always seeking updated information about how to prevent stress while expecting pregnancy. So that with the information obtained, positive attitudes and behavior will arise in waiting for her pregnancy. In addition, mothers must be able to reduce the workload every day in order to avoid fatigue which is at risk for physical conditions that can cause work stress. Even with the increasing age of the mother where the mother and husband always try and ask God to be able to give pregnancy according to expectations. Therefore the right way to be able to deal with stress in expecting pregnancy is that the mother must say self-affirmation for 5 minutes 2 times a day because with self-affirmation, the mother can grow self-confidence, improve body health, provide self-comfort, make happier and even less stressed. So that self-affirmation is very useful if it is said every day. One way that mothers must do in saying self-affirmations is to stand in front of a mirror and then say affirmations aloud repeatedly for at least 5 minutes. Because the more often the mother says affirmations, the more effective it is in empowering the brain to imagine the desired positive impact. The results will be better if you can say the affirmations. Researchers also assume that in addition to self-affirmation, mothers can also drink lots of water to be able to overcome the condition of the body that lacks fluids. When body fluids recover, the feeling of tiredness will begin to fade, so stress can be overcome.

B. Stress In Women In Waiting For Pregnancy After Self Affirmation
Based on the results of the study, it is known that stress in women in waiting for pregnancy after self-affirmation is known that almost all respondents as many as 17 (85%) respondents are in the mild category. This is supported by the results of the questionnaire that self-confidence increases, does not feel inferior, embarrassed, sad, anxious, does not even feel disappointed and discouraged with current conditions and the mother always prays to God to be able to give pregnancy according to the mother's expectations and husband. This is also of course supported by the attitude and behavior of mothers who always say self-affirmation for 5 minutes 2 times a day so that they can overcome the stress of waiting for pregnancy. The results of this study are supported by the opinion of Niawati (2017), which says that mothers who routinely perform affirmation techniques experience reduced stress compared to mothers who do not routinely perform affirmation techniques. Damayanti (2019), also said that effective positive affirmations can change a person's negative thoughts. Affirmation manipulation has the potential to increase a person's desire, especially mothers, in expecting their pregnancy. Affirmations are used to reprogram the mind and get rid of false beliefs in the subconscious mind (subconscious). The hope is that affirmations can program the mind. Affirmations, like prayer and hypnosis, can work when the mind is calm and focused. Affirmations tune a person's mind through his subconscious programming (Cohen, 2019). Concentration, focus, and enthusiasm will increase along with increasing the success rate of affirmations in influencing the subconscious. For affirmations to succeed in influencing the subconscious, one must lower the waves of his brain consciousness (Morgan, 2020).
The assumption in this study is that after being given self-affirmations, it is known that there is a decrease in stress in the mild category which is supported by the behavior of mothers who always routinely say selfaffirmations for 5 minutes 2 times a day, so they are able to overcome stress in expecting pregnancy. Therefore, the more often mothers say self-affirmations, the feelings of stress experienced during pregnancy can be prevented. In addition, with a high mother's education, she can know about the importance of self-affirmation, especially in preventing stress in waiting for her pregnancy. Besides that, at work, the mother always sets aside at least 5 minutes a day to say affirmations to herself over and over again. Thus the stress can be overcome by the mother. In the opinion of researchers that selfaffirmation plays an important role for women who are expecting a pregnancy. Because affirmations come from oneself and are only aimed at oneself in order to be able to see things from a positive point of view. Affirmations have many benefits for yourself, especially if these positive affirmations are injected regularly so that they can grow selfconfidence, improve body health, keep depression/stress away, provide self-comfort, make yourself happier. In addition, with the relaxation audio provided and carried out by the researcher, the mother must use the present time, use positive words or sentences, use specific sentences. Before practice, relax and clear your mind. Make affirmations to strengthen it can be written on a note that is easy to read, then read the note before going to bed every day. Researchers propose to be able to cope with stress in women of childbearing age in anticipation of pregnancy where the mother can take a breath to breathe fresh air, meditate, exercise, avoid highcarbohydrate foods and get adequate rest, thereby dealing with stress experienced.

C. The Effect of Self Affirmation on Reducing Stress in Women in Expecting Pregnancy Online Forums
The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 is rejected and H1 is accepted. The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 is rejected and H1 is accepted, thus there is an Effect of Self Affirmation on Stress In Women Expecting Pregnancy Online Forum. Based on the results of the cross tabulation of stress reduction in women in anticipation of pregnancy before and after self-affirmation, it is known that almost all respondents as many as 12 (80%) are in the Mild category.
One of the factors that influence stress is self-affirmation. Self-affirmation is an action that helps a person to convince himself that he is a good and competent person. Selfaffirmations reduce a person's resistance to health messages that imply that he is not a good and competent person. Vice versa, where a woman who always has a negative perception of the pregnancy process, does not have a positive personality style in accepting the changes that will occur in pregnancy later it will have an impact on stress (Lestariningsih, 2020). Self-affirmation or in other words self-affirmation is an emotional support or encouragement from within a person so that they take certain actions related to positive things. Affirmations come from oneself and are only aimed at oneself in order to be able to see things from a positive point of view. Affirmations have many benefits for yourself, especially if the injections of these positive affirmations are carried out regularly so that they can grow self-confidence, improve body health, keep depression/stress away, provide self-comfort, and make themselves happier (Lestariningsih, 2020). According to the researcher's opinion, mothers should always think positively and say positive words so that the brain will indirectly be indoctrinated so that the mother's point of view will also change. In addition, mothers must respond to the conditions experienced at this time is only a trial and will pass over time while still trying to wait for pregnancy. Various ways to be able to cope with stress where women of childbearing age can access a lot of information related to pregnancy on various social media (internet), women of childbearing age must also be active in conducting or consulting with health workers such as doctors, midwives related to the pregnancy process so that with this knowledge and information they can reduce the stress of the mother in waiting for her pregnancy. Mothers should also avoid negative perceptions in expecting pregnancy to avoid prolonged stress.

CONCLUSION
Stress on Women in Waiting for Pregnancy Before Self Affirmation It is known that most of the respondents as many as 15 (75%) respondents are in the heavy category. Stress in Women in Waiting for Pregnancy After Self Affirmation it is known that almost all respondents as many as 17 (85%) respondents are in the Mild category. The results of data analysis show that the significance level is 0.000 < = 0.05 so that H0 is rejected and H1 is accepted thus there is a Self Effect Affirmations Against Stress In Women In Expecting Pregnancy Online Forum. For respondents, it is suggested that mothers should be able to avoid negative perceptions in expecting pregnancy so that there is no prolonged stress. This can be done by always thinking positively and saying positive words in yourself and even the mother must respond to the conditions experienced at this time is only a trial and will pass over time by still trying to look forward to pregnancy. This can be done by mothers always saying selfaffirmations for 5 minutes 2 times a day so that with self-affirmations, mothers can grow self-confidence, improve body health, provide selfcomfort, make themselves happier and even keep away from stress. Health workers are advised to apply standard operating procedures for self-affirmation as the role of health workers, especially midwives in terms of educators to be able to prepare women of childbearing age in anticipation of pregnancy and even reduce stress experienced by women of childbearing age by thinking positively about the current conditions.