The Effect of Health Education through Booklet Media on Reproductive Health Knowledge in Preventing Pregnancy Risk in Pre-Marriage Couple

Pregnancy. also known as graviditas or gestation, is the time during which one or more babies develop inside a woman. Multiple Pregnancy involves more than one child, as with twins. Pregnancy can occur by sexual intercourse or assisted by reproductive technology. It usually lasts about 40 weeks from the Last Menstruation and ends with childbirth. The purpose of this study was to determine To find out the effect of health education through booklet media on reproductive health knowledge in preventing the risk of pregnancy in pre-marriage couples. The population studied was all puerperal mothers whose milk production was not smooth with a sample of 12 respondents. The technique used was total sampling then using the Wilcoxon test. The results of the study showed that the effect of health education through booklet media on reproductive health knowledge in preventing pregnancy risk in pre-marriage couple. The results of the analysis showed that ( α = 0.05 obtained ρ value = 0.005 so that ρ value < α means H0 rejected H1 is accepted ) there is an the effect of health education through booklet media on reproductive health knowledge in preventing pregnancy risk in pre-marriage couple The conclusion of all pre-marriage couple There is an effect Of Health Education Through Booklet Media On Reproductive Health Knowledge In Preventing Pregnancy Risk In Pre-Marriage Couple.


INTRODUCTION
Pregnancy with complications in pregnant and maternity mothers is a complex problem, since such pregnancy complications can lead to the immediate death of the expectant or maternity mother. Early detection in pregnancy can be used as an effort to detect and handle high-risk pregnancies in pregnant women. The high risk of pregnancy is a pregnancy in which the soul and health of the mother and or baby can be threatened (Intan and Ismiyatun, 2020).
Knowledge about the risk of pregnancy needs to be given early so that pregnant women can recognize the danger signs so that they are able to make a decision to immediately seek the right emergency services. Seeing this reality, knowledge about reproductive health needs to be given to brides-to-be (Irawati, Kartini and Nugraheni, 2019).
The bride and groom as someone who is about to enter the wedding gate really need information and education about reproductive health, especially about the right pregnancy planning so that one day they have healthy offspring and the mother gives birth safely. Information and education need to be provided because there are still many wrong assumptions about reproductive health so that equality of perception and information is needed so as not to misbehave in reproductive health (Hasanah, 2017).
Health education is carried out to increase the knowledge of brides-to-be, one of which is the bride-to-be course activities held at KUA, where one of the materials provided is about reproductive health (Kementrian Agama Islam RI, 2017). The reproductive health material in the catin course is still delivered by conventional counseling methods so that innovations in health education are needed. One of the innovations carried out is to use booklets (Irawati, Kartini and Nugraheni, 2019). Based on the results of the study, it is stated that the media booklet is able to increase knowledge and attitudes of reproductive health (Oktarina, Margono and Purnomo, 2017). Therefore, the purpose of this study is to intervene in health education with booklet media on the level of reproductive health knowledge in preventing pregnancy risk. Pregnancy for a woman is a thing full of happiness as well as anxiety, anxiety about bad things that can happen to her and the fetus, especially during the delivery process (Fourianalistyawati, 2006). There is a lot of evidence and it continues to develop that a woman's health behavior during pregnancy has a lifelong influence, not only on her own health, but also on her children (Baron et al., 2017). Reproductive Health is a state of overall health encompassing physical, mental and social life related to reproductive tools, functions and processes that think reproductive health is not a condition free from disease but rather how a person can have a safe and fulfilling sexual life before and after marriage (Prijatni and Rahayu, 2016).

MATERIALS AND METHODS Design and Samples
The design of this study is a pre-experiment that is one group pretest-postest design. The free variable in this study is reproductive health knowledge. The bound variable in this study is the media booklet in preventing the risk of pregnancy in pre marrital couples. The research instrument is in the form of a questionnaire sheet. Research site in the Working Area of puskesmas Sukorame Kediri City November 2021. In this study, the sampling technique used the total population.

Data Collection
Respondents were given health education using booklet media. Health education is carried out for approximately 100 minutes, then a booklet is given to respondents to take home. Furthermore, after 2 weeks, a postest was carried out to measure the reproductive health knowledge of the bride and groom related to the prevention of pregnancy risk.

Data Analysis
Data processing using computer-based SPSS computer programs for windows 24. Univarat analysis was performed to analyze the data that had been collected using the descriptive percentage method and Bivarat analysis was used with a device test marked from wilcoxon with an error rate of 5%.

RESULTS
Based on table 1, it can be interpreted that most of the respondents Answered correctly more than 75% as many as 6 people (50 %). Analysis of the Effect Of Health Education Through Booklet Media On Reproductive Health Knowledge In Preventing Pregnancy Risk In Pre-Marriage Couple will be presented in table 1. Based on table 1, it is stated that all of the respondents answering corecctly is less than or equal 75% before the education 8 ( 66,67% ) and answered correctly more than 75% before eduaction is 4 (33,33) and afters asnwered correctly more than 75% eduaction is 6 (50%). And answered correctly more than 75% after education6 (50%). In α = 0.05 obtained ρ value = 0.005 so that ρ value < α interpreted H0 rejected H1 is accepted. ). Pregnancy may be confirmed by a urinary pregnancy test, most often first by the patient at home and then in the doctor's office with a series of blood tests. Both urine and blood tests detect the presence of a hormone called Human Chorionic Gonadotropin (hCG). It's a hormone produced by the placenta as soon as the embryo attaches to the lining of the uterus and builds up quickly in your body in the first few days of pregnancy. It is this rapid hormonal shift that triggers most pregnancy symptoms (Obrowski, 2016). To accommodate the changes that occur during pregnancy, many nutrients are needed in greater quantities than before pregnancy. Pregnant women will experience an increased BB, the addition of BB can be measured from BMI (Body Mass Index) / BMI (Body Mass Index) before pregnancy. BMI is calculated by means of BB before pregnancy in kg divided (TB dlm m)2for example: a woman pregnant BB before pregnancy 50 kg,TB 150 cm then BMI 50/(1.5)2= 22.22 (including normal). To meet the addition of BB, nutritional needs must be met through daily food with a balanced menu (Tyastuti, 2016) . Efforts to promote and prevent reproductive health problems also need to be directed at the bride-to-be, where the reproductive organs are mature so that they are ready to face pregnancy. But not infrequently brides-to-be still have limited knowledge about reproductive health. Information and counseling, counseling and clinical services need to be improved to address reproductive health problems in brides-to-be. Premarital health promotion is a process to improve people's ability to maintain and improve their health aimed at premarital reproductive communities (Susilowati, 2016) Obstetrics services begin with the health pets of mothers-to-be. Adolescent women who are about to enter the marriage stage need to be maintained in their health condition. To the brides-to-be are given an understanding of healthy sexual relations, mental readiness in facing pregnancy and knowledge about the process of pregnancy and childbirth, health maintenance in the pre-and post-pregnancy period (Ministry of Health RI, 2015). The booklet is effectively able to change the behavior of the target audience. The higher the ability of the booklet to stimulate the occurrence of learning in the target audience through the five senses and change behavior, the more effective the booklet will be (Marlina, Saleh and Lumintang, 2009).

DISCUSSION
The Effect Of Health Education Through Booklet Media On Reproductive Health Knowledge In Preventing Pregnancy Risk In Pre-Marriage Couple on table 1, it was found that asnwered correctly more than 75% eduaction is 6 (50%). And answered correctly more than 75% after education6 (50%). In α = 0.05 obtained ρ value = 0.005 so that ρ value < α interpreted H0 rejected H1 is accepted. Reproductive health services for prospective brides who will hold marriages are carried out in health service facilities in the form of communication, information, and education (IEC) on sexual and reproductive health for prospective brides, and health checks (Ministry of Health ri, 2015). The lack of active participation of brides-to-be is also caused by the large number of brides-to-be who judge that the reproductive health services they get are not in accordance with the needs they feel today. This is because the services provided are only limited to providing TT immunization and reproductive health provision when the Premarital Course is implemented (Addina, Nugraheni and Jati, 2020). The provision of effective health education may depend on the content as well as on the underlying communication skills to convey the content. Women consider their midwives to be an important source of information, but in several previous studies from the Netherlands and other countries, women reported receiving little or no information from their midwives on topics of health behaviors, such as physical exercise, alcohol, weight gain, or nutrition (Van der Wulp, Hoving and De Vries, 2013); (Wennberg et al., 2013). The bride and groom are the couple who will hold the wedding. The bride-to-be who is about to get married is the forerunner of the formation of a family, so before marriage the bride and groom need to prepare their health conditions in order to carry out a healthy pregnancy so that they can give birth to a healthy, prosperous, and quality next generation and create a healthy, prosperous, and quality family (Ministry of Health, 2020). Marriage leads to the development of the family, reproduction and expansion of the family in man, which is advocated in all religions. If done with the right knowledge, it will have an important effect on the health of the individual and society. (Mahmoodi, 2016). A new couple is a marker of the future of a country and the healthy life of the group reflects the well-being of society. Health education programs are the primary and secure way of providing family and community health. Informing the couple about the issue of safe reproduction before marriage is very important. Regarding the prevention of pregnancy and maintaining a time distance between pregnancies, the couple must have sufficient knowledge and awareness (Mahmoodi, 2016).

CONCLUSION
The result of this study proves that the massage There is an Effect Of Health Education Through Booklet Media On Reproductive Health Knowledge In Preventing Pregnancy Risk In Pre-Marriage Couple

ACKNOWLEDGMENTS
The author is thankful to respondents for their valuable information and their awareness to participate in this research.

CONFLICTS OF INTEREST
The author declares that they have no conflict of interest The Effect of Health Education through Booklet Media…..