EVIDENCE BASED PRE CONCEPTION

Proposed to fulfill one of the assignments for Adolescent Midwifery Courses

Supervisor : Laila Puteri Septiani SST,. M.Keb

Arranged by :

Dhea Mita Resmawati (P20624520014)

Epita Nurdianah (P20624520018)
Salsabila Qutrotunada (P20624520034)

DEPARTMENT OF MIDWIFE
STUDY PROGRAM OF APPLIED MIDWIFE GRADUATES
POLTEKKES KEMENKES TASIKMALAYA
2021
 FOREWORD

Praise be to Allah SWT who has made it easy for us so that the authors can complete
this paper on time. Without His help, of course, we would not be able to complete this paper
properly. Shalawat and greetings may be bestowed upon our beloved Prophet Muhammad
SAW, whom we look forward to for his intercession in the hereafter.
We thank Allah swt for the abundance of His healthy blessings, both in the form of
physical and mental health, so that we were able to complete the making of a paper with the
title Evidence Based Conception.
We certainly realize that this paper is far from perfect and there are still many
mistakes and shortcomings in it. For that, we expect criticism and suggestions from readers
for this paper, so that this paper can later become a better paper.
We also thank all parties, especially the anti-corruption cultural education lecturer
who has guided in writing this paper.
Thus, I hope this paper can be useful. Thank you.

Tasikmalaya, 27 October 2021

Compiler
 TABLE OF CONTENTS

FOREWORD
TABLE OF CONTENTS
CHAPTER I
1. Background....................................................................................................
2. Problem Formulation.....................................................................................
3. Purpose...........................................................................................................
CHAPTER II DISCUSSION
A. Definition of Evidence Based Midwifery Practice........................................
B. Definition of Premarital and Premarital Counseling......................................
C. Evidence Based on Pre-Marriage...................................................................
D. Criteria for Premarital Counseling.................................................................
E. Pregnancy Preparation...................................................................................
CHAPTER III CLOSING
A. Conclusion......................................................................................................
B. Suggestion......................................................................................................
CHAPTER IV REFERENCES
F.
 CHAPTER I
PRELIMINARY

A. Background
Evidence based means based on evidence. This means that it is no longer based on
mere experience or habit. Everything must be based on evidence. This evidence is not just
evidence but the latest scientific evidence that can be justified.
A broad term used in the process of providing information based on evidence from
research (Gray, 1997). So, Evidence based Midwifery is the provision of midwifery
information based on evidence from reliable research. The practice in midwifery that is
prioritized is based on scientific evidence based on observations / research and best practice
experience from all practitioners from all over the world. Routines that have no proven
benefits are no longer recommended.
This happens because Medical Science is developing very rapidly. Findings and
hypotheses that have been used in the past are swiftly replaced by newer findings that
immediately invalidate the previous theories that have been used earlier.
Then the hypothesis that has been used to be tested before will be immediately
abandoned because good and more perfect hypothesis tests have been found. To be better
understood, I will give an example, if previously it was believed that episiotomy was a
procedure that was often used in childbirth, especially in primigravida, then for now that
belief has been dispelled by findings showing that the frequently used episiotomy actually
causes various problems. which is sometimes more detrimental to the patient's quality of life.

B. Problem Formulation
1. What's that Definition of Evidence Based Midwifery Practice?
2. What's that Definition of Youth?
3. What's that Evidence Based on Adolescence?
4. What's that Definition of Premarital and Premarital Counseling?
5. What's that Evidence Based on Pre-Marriage?
6. What's that Criteria for Premarital Counseling?

C. Purpose
1. To Know Definition of Evidence Based Midwifery Practice
2. To Know Definition of Youth
3. To Know Evidence Based on Adolescence
4. To Know Definition of Premarital and Premarital Counseling
5. To Know Evidence Based on Pre-Marriage
6. To Know Criteria for Premarital Counseling
 CHAPTER II
DISCUSSION
A. Definition of Evidence Based Midwifery Practice
The definition of Evidence Base when viewed from the word beheading (English)
then the Evidence Base can be interpreted as follows Evidence is evidence or facts and Based
is the basis. So evidence base is: practice based on evidence. Evidence Based Midwifery
(Practice) was founded by the Royal College of Midwives or RCM in order to help develop a
strong professional and scientific basis for a growing body of academically oriented
midwives. EBM was officially launched as an independent journal for pure evidence research
at the annual conference at RCM Harrogate, UK in 2003 (Hemmings et al, 2003).
Designed to assist midwives in advancing the bound knowledge of midwifery with the
primary aim of improving care for both mother and baby (Silverton, 2003). Evidence Based
Midwifery recognizes the value different types of evidence have to contribute to the practice
and profession of midwifery. Qualitative journals include active as well as quantitative
research, philosophical and conceptual analysis as well as structured literature reviews,
systematic reviews, cohort studies, structured, logical and transparent, so that midwives can
properly assess their meaning and implications for practice, education and further research.
So the notion of Evidence Based Midwifery can be concluded as midwifery care based on
research evidence that has been tested according to a systematic scientific methodology.
Research evidence-based practice is the systematic, scientific, and explicit use of current best
evidence in making decisions about care for individual patients.
B. Definition of Premarital and Premarital Counseling
Premarital according to the Big Indonesian Dictionary is before marriage, so it means
a period where some time before marriage. Prenup is the period before there is an agreement
between a man and a woman, the purpose of which is to legally marry a wife based on
religious marriage laws and the government. While premarital counseling according to the
Ministry of Health is advice given to couples before marriage, regarding medical,
psychological, sexual, and social problems. Prenuptial Counseling is intended to help the
bride-to-be to analyze the possible problems and challenges that will arise in their household
and equip them with problem-solving skills. Counseling/premarital education is generally
followed by couples who are about to get married and do not have significant problems in
their relationship, so it does not have to be couples who have serious problems in their
relationship (Stahmann, Senediak in Murray & Murray, Jr., 2009). Premarital counseling is
an event to encourage couples who intend to establish a marriage bond to focus on the
problem of the process of developing a good relationship and continuously maintaining that
good relationship with satisfactory results for both parties until the end of life, through a
series of sociological consultations with people who more mature and conduct medical
consultations with medical personnel. So the decision to get married is made after careful and
comprehensive consideration.
C. Evidence Based on Pre-Marriage
In carrying out their profession, midwives have roles as implementers, managers,
educators, and researchers, as roles and functions as executor of providing basic premarital
services to adolescents and by involving them as clients, including: a. Assessing the health
status and needs of adolescents and women in the premarital period. b. Determine diagnosis
and basic service needs. c. Develop an action/service plan as a fundamental priority with the
client. d. Carry out actions/services according to the plan. e. Evaluate the results of
actions/services that have been provided with the client. f. Create action/service follow-up
plans with clients. g. Recording and reporting of midwifery care. Given the benefits and
importance of premarital counseling for the integrity and happiness of marriage, in this study
the researchers tried to design a premarital counseling program for couples who are planning
to marry which aims to:
1. Provide knowledge about married life,
2. Increase the couple's agreement on important issues in marriage, and
3. Get to know your partner more deeply as part of his extended family.
The first two of the three objectives of the premarital counseling program that the
researcher compiled are the general goals of premarital counseling, while the third goal is
based on the phenomenon that exists in Indonesian society that the nuclear family system in
Indonesia cannot be separated from the influence of the system in the extended family. It is
undeniable that in the Indonesian family system, the extended family also influences the
values and motivation to take action within the individual. In choosing a life partner, for
example, the extended family takes part in family consultations to consider potential spouses
for children/grandchildren/nephews by looking at their origins, education, and habits/values
that exist in themselves and the prospective spouse's family. If it is considered suitable for
their family, then the prospective partner is accepted, otherwise many parents intervene so
that their child breaks off relations with the candidate. In the end, the values that exist in a
large family after a person is married will affect his relationship with his life partner, for
example in determining the role of husband/wife in the household and parenting patterns.
When two individuals who come from families with conflicting values and habits marry, it is
predictable that conflict will arise if they cannot understand and accept each other's
differences (Landis; DeGenova, 2008).
Therefore, couples who are getting married need to know the habits and values that
exist in their partner's extended family and understand how these affect the couple. Premarital
counseling has a very diverse topic, time (duration), and method of implementation. From
various studies on the effectiveness of premarital counseling/education programs and the
topics that are considered the most useful in premarital counseling, the topics that are
considered most useful in premarital counseling are communication, conflict resolution,
finance, parenting, relationships with parents/in-laws, roles and responsibilities in the home.
household, sexuality, spouse's family of origin, religion, leisure/recreation, and commitment.
D. Criteria for Premarital Counseling
Premarital guidance and counseling can be arranged by meeting several criteria
(Hawkins, Carroll, Doherty, & Willoughby, 2009), namely:
1. Content Dimensions a. Relational Skills (Relationship Skills). Skills that need to be in
the couple as skills in achieving the vision of marriage. b. Awareness, Knowledge,
and Attitudes. Good relationship skills require awareness, knowledge, and attitude
 from each partner, such as elements of mental and ethical readiness, realistic
expectations, willingness to make significant personal sacrifices. c.
Motivation/Virtues (Motivation and Virtue). The character and motivation that
individuals give to relationships is critical to understanding a healthy marriage, as are
virtues, such as generosity, justice, and fidelity.

2. Dimension II Identity
a. Low Level (Low Level). Low-level intensity is a campaign effort through pamphlets
to pre-wedding couples, through creative media messages to teach the basic principles
of healthy marriages.
b. Moderate Level (Medium Level). Moderate intensity provides a framework for
curriculum scope in marriage education. Presenting participants, there is a jointly
determined time to discuss content in marriage education.
c. High Level (High Level). A high level of intensity is essential for a comprehensive
marriage education strategy, in-depth exploration of a more complete topic, and
enabling individuals and couples to explore personal issues at a deeper level with a
trained facilitator. In higher education, it can be carried out with moderate intensity
level with the assumption that as a form of preparation, the content framework
discussed is not so in-depth, but sufficient to accommodate content in the discussion
of marriage.

3. Dimension III Dimension a. Instructions. The method of instruction or teaching needs

to adapt and present curricular content to fit the participants' life experiences very
effectively, on the other hand the instructor or trainer who provides marriage
education programs must be familiar with the specific issues that the participants face.
b. Learning style (Learning Style). Methods adapted to a variety of learning styles,
such as presentation of didactic information, showing examples (for example, in
videos), interactive discussions, and role-playing. Educated individuals and couples
are familiar with the typical cognitive and didactic approaches of higher education
may prefer more active experimental learning methods. Premarital counseling
programs in universities can be designed with a series of curricular/content that is
adapted to the learning style in universities.

4. Dimension IV Target The target for marriage education is to meet the needs of all
racial, ethnic, and socio-economic groups. This target needs to be met in order to
maintain social jealousy among individuals who wish to receive marital education.

5. Dimension V Delivery: Marriage education can be delivered by marriage education

specialists (marriage education specialists), namely counselors or psychologists in
higher education institutions which can be accessed through guidance and counseling
service centers at universities available at each state and private university
institution. . Overall, the program designed is tailored to individuals who are in early
adulthood, especially students who are in college, at least covering: a. Individuals pay
attention to the family background of each partner. Premarital couples need to pay
attention to the couple's family background (Gardner, Busby, & Brimhall, 2009). b.
Exploring a relationship involves two individuals, and the characteristics of both
 influence the nature of the relationship commitment to marriage to attend marriage
education programs (Blair & Cordova, 2009). In addition, individual factors that
experience stress, anxiety, emotional disorders and the like affect marriage in
adulthood. So that the increase in daily anxiety and physical welfare indirectly
reduces marital satisfaction (Falconier, Nussbeck, Bodenmann, Schneider, &
Bradbury, 2015) should be provided for students as individuals in early adulthood. c.
Couples' positive interactions make it possible to explore individual expectations of
marriage (Heafner et al., 2016) enhance all mental, emotional, physical, and spiritual
dimensions (Roberts, Booth, & Beach, 2016) and provide the individual with a sense
of security and satisfaction in the relationship (Salvatore). , Kuo, Steele, Simpson, &
Collins, 2011). Marriage preparation will have an impact on individuals who are in a
relationship with a partner that focuses on realistic relationship commitments and
expectations. Premarital guidance and counseling is an effort to help individuals and
couples in planning and preparing everything that is considered important in terms of
marriage/marriage based on couple resources to have various skills and develop a
vision of married life.
E. Pregnancy Preparation
Pregnancy is a great gift that Allah subhanahu wa ta'ala gives to every mother-to-be.
By His will and destiny, for 9 months the fetus will live a very interesting new life in its
mother's womb. It is appropriate if a woman who is planning to become pregnant is eager to
make preparations by keeping her body healthy. This is a form of endeavor to gain benefit.
As for the result, we hope for the best from Allah Subhanahu wa Ta'ala. A mother has a big
responsibility to be able to make her children born are healthy and intelligent children. How
all of that can be formed, one of them is by trying to prepare for a healthy pregnancy. This
information is very important, especially for those of you who are about to get pregnant for
the first time or who want to get more offspring with better quality. Who is the person who
wants to have a physically handicapped child, weak in intelligence and mentally weak?
There's none right? Therefore, do not underestimate how to prepare for a healthy pregnancy,
because this is very much about how your baby will be after birth. Health begins before the
baby is born from the womb. The period of pregnancy is a period that is quite vulnerable and
will determine how the health of the baby after birth, even when he starts to grow. Not only
this, preparation for a healthy pregnancy is also related to how to have a good and healthy
delivery. The period of pregnancy that is not maintained and prepared will have an influence
on the labor or delivery process. Now let's discuss one by one about the preparation for
pregnancy above that must be considered by prospective mothers or fathers.
1. Health checkup Health check-up is very important for expectant mothers before
becoming pregnant. This period is called preconception. The time is between 3-6
months before getting pregnant. Thus, God willing, the mother-to-be is ready to
accept the presence of the fetus and is healthy during her pregnancy. Regular health
checks including treatment of illnesses suffered before pregnancy until declared cured
or allowed to become pregnant by a doctor and under supervision. This health check
may also include: a) Disease and Virus Examination: Examination of the rubella
virus, cytomeglovirus, herpes, varicella zoster to avoid defects in the fetus.
Examination of the hepatitis virus and HIV virus to avoid passing on the disease
caused by these viruses to the fetus. Check for toxoplasmosis, because this disease
 can cause disability and miscarriage. Examination of sexually transmitted diseases,
because this can cause the death of the mother, fetus, and baby to be born. In addition,
examinations are also carried out on diseases that are being suffered such as asthma,
diabetes mellitus and heart disease. In pregnant women, diseases like this can get
worse and be dangerous if they are not treated and treated regularly. To avoid
dangerous conditions, doctors will usually monitor their patients and determine when
is the most appropriate time to get pregnant. Examination of diseases due to
deficiency of certain substances such as iron deficiency. Iron deficiency can cause
anemia. This can lead to premature birth and miscarriage. b) Blood Examination
Examination of blood group and rhesus/Rh blood (elements that affect antibodies
contained in red blood cells) in married couples is carried out to anticipate differences
in blood and rhesus groups between the blood of the mother and her baby. Differences
in blood type and rhesus blood can threaten the fetus in the womb c) Examination of
Genetic Factors The essence of this genetic examination or test is to find out diseases
and congenital defects that may be experienced by the baby as a result of genetics
from one or both parents. Especially if the husband and wife are still related to
kinship. This test is ideally done before pregnancy to get complete information. If
necessary, you must collect all medical records owned by the husband and wife,
including the family. So that if the complete medical data is known, it can be known
early if there are abnormalities in the fetus or prospective parents, so that they can
make wiser decisions.

2. Maintain body fitness and health Maintain body fitness and health with regular
exercise. During preconception, make sure you get enough exercise. This physical
activity does not need to be done for hours. Enough 3 times a week for 1/2 hour, and
do it regularly. Exercise in addition to healthy, also prevent the occurrence of excess
weight. Physically a woman is healthy when she is about to get pregnant and at the
time of pregnancy is expected not to be too fat or not too thin or normal. Try to lose
weight if you are obese (overweight) and gain weight if you are too thin. You can
consult with your midwife and doctor for an assessment of your BMI or body mass
index. To find the ideal body weight must also take into account the height factor.
Ideal body weight can be calculated using the formula 90% multiplied by (a person's
height and then subtracted by 100). However, if the woman's height is less than 150
centimeters, then the formula is deducting her height by 100. Apart from weight,
another thing from the mother's physical preparation is the matter of Body Mass Index
(BMI). Make sure your BMI is normal before getting pregnant or while preparing for
pregnancy. The method used to calculate the BMI is weight divided by height in
meters squared (BMI = (BB) / [(TB) x (TB)]. If the results of BMI are between 18.5-
22.9, then you can say your BMI is normal. For example: BB = 45 kg and TB = 165
cm, then BMI = (45) / [(1.65) x (1.65)] = 16.5. Are you underweight, normal, or
overweight? below:
 BMI < 18.5 = underweight
 BMI 18.5 – 24 = normal
 BMI 25 - 29 = overweight
 BMI > 30 = obesity A
 Healthy weight helps conception and pregnancy makes more comfortable. A
weight loss diet must be strictly controlled in order to be safe during pregnancy,
especially recommended for women who are seriously overweight, but should always be
accompanied by always consulting your doctor who may suggest a referral to a
nutritionist. Underweight can make You are infertile, people are too thin because of lack
n fat that can support. While being overweight puts you at greater risk for complications,
such as high blood pressure and diabetes during pregnancy. There is also a high risk of
complications during labor and delivery and people who are overweight will experience
irregular ovulation.

3. Stopping bad habits Stopping bad habits such as heavy smokers, morphines, addicts to
narcotics and other illegal drugs, alcoholism, lifestyle with free sex behavior. The
habit of smoking, drinking alcohol, or even using drugs, can cause various problems
during pregnancy, as well as the fetus in the womb. Babies can be born prematurely,
born with congenital defects to fetal death. Research shows that the habit of
consuming alcohol will interfere with fertility, therefore consuming alcohol before
and during pregnancy will worsen the health conditions of the mother and fetus.
Women who drink alcohol have a lower chance of getting pregnant. As for men,
drinking alcohol can affect sperm quality by lowering testosterone levels and can
cause the testicles to wither. Quit smoking completely when planning a pregnancy
and also during pregnancy. Passive smoking is as dangerous as active smokers,
therefore you should ask your husband to stop smoking. Women smoking directly
reduce fertility. Toxins in cigarettes are very harmful to the fallopian tubes, can cause
chromosomal damage in eggs, and weaken the ability to produce estrogen which is
needed to prepare the lining of the uterus for pregnancy. A study in Finland found that
41.9% of men who smoke are infertile compared to 27.8% of men who do not smoke.
Men who smoke have less sperm when they ejaculate. And medically, smoking is
proven to cause impotence. Smoking parents are also more likely to produce children
with genetic defects and are twice as likely to develop childhood cancer. Of course
you can't replace alcohol and cigarettes with marijuana or cocaine. Because drugs are
far more dangerous for the user and the fetus they will contain later. No less important
is to get used to having sex. Always practice safe sex. Unless you are sure that your
partner is protected from sexually transmitted diseases, condoms are a good safety
device to prevent threats to fertility, such as Chlamydia/fungus that can cause
infertility. In addition, have sex at the right time. Of course this is obvious, but what
should be noted is that regular sex increases the chances of getting pregnant. Take
advantage of the most fertile time and make sure you have sex regularly around that
date. Women mostly ovulate once during each cycle, and the most likely time for
conception is 14 days before the next menstruation. Also check your vaginal/pubic
fluid, it will have a different consistency when it is at its most fertile. You'll know
what looks and feels normal to you, and can see the changes, if you do this regularly.

4. Increase intake of nutritious food Preparation for a healthy pregnancy is very

important related to the food and nutrition you consume. Increasing consumption of
fruits and vegetables is one solution. Instead, avoid foods that contain additives such
as flavoring, preservatives, coloring and the like. The content of free radicals from
these additives can trigger genetic mutations in children, causing physical
abnormalities, defects and the like. Make sure during pregnancy you consume healthy
foods and do not overdo one particular nutrient. For example, if you consume too
much protein during pregnancy, it will cause the fetus in the womb to grow too large,
your body to become swollen in the legs and so on. So it is proportional in consuming
a certain menu and nutrition. For pregnant women's food is usually adjusted to
gestational age. This will affect the factor embryo growth. When fertilization occurs,
the fetus has been exposed to what the mother has eaten for the previous two weeks.
Choose healthy foods, and pay attention to food intake that supports the formation of
a healthy fetus. We recommend consuming foods that contain: a) Protein, increases
sperm production. Eat eggs, fish, meat, tofu and tempeh. b) Folic acid, important for
mothers-to-be from preconception to the first trimester of pregnancy. Plays a role in
the development of the central nervous system and fetal blood, sufficient folic acid
reduces the risk of babies born with nervous system defects by as much as 70%. Eat
dark green vegetables, oranges, avocados, beef liver, soybeans, tempeh, and cereals.
Taking 400 micrograms of folic acid daily, if a woman has adequate levels of folic
acid for at least 1 month before and during pregnancy, can help prevent defects in the
baby's brain and spine. Folic acid can be obtained through foods, such as dark green
vegetables (spinach, mustard greens, caisim mini), asparagus, broccoli, papaya,
oranges, strawberries, raspberries, nuts, avocado, okra, cauliflower, celery, carrots,
fruit beets, and corn. Some milk for pregnant women also contains high enough folic
acid, so it can help meet the needs of the mother. Mothers can choose milk for
pregnant women that tastes good to reduce nausea, and of course is a high-quality
product. c) Consumption of various Vitamins Vitamin A. Plays an important role in
the production of healthy sperm. Found in liver, butter, margarine, eggs, milk, fatty
fish, broccoli, carrots, spinach, and tomatoes. Vitamin D. Vitamin D deficiency will
reduce fertility rates up to 75%. Sources of vitamin D are produced in the body
with the help of sunlight, but it can also be obtained from eggs, milk, liver, fish oil,
tuna, margarine, and salmon. Vitamin E. Vitamin E can increase the ability of sperm
to fertilize eggs and prevent miscarriage because of its role in maintaining the health
of the uterine wall and placenta. Many are found in vegetable oils, wheat bran, and
sprouts or bean sprouts. Vitamin B6. Lack of this vitamin will cause a hormonal
imbalance, whereas the balance of the hormones estrogen and progesterone is
important for pregnancy. Sources of vitamin B6 include chicken, fish, brown rice,
soybeans, peanuts, bananas, and cabbage. Vitamin C. In women, vitamin C plays an
important role for the function of the ovaries and the formation of egg cells. In
addition, as an antioxidant (in collaboration with vitamin E and beta carotene) vitamin
C plays a role in protecting the cells of the body's organs from attack by free radicals
(oxidants) that affect the health of the reproductive system. Vitamin C is found in
guava, oranges, strawberries, papaya, mango, mustard greens, tomatoes, and red
chilies. d) Adequate zinc. Plays an important role in the growth of sex organs and also
the formation of healthy sperm. For mothers-to-be, zinc helps in the production of
generative material when fertilization occurs. For prospective fathers, launch sperm
formation. Sources of zinc include seafood / seafood (such as lobster, fish, crab meat,
ed.), meat, nuts (cashews and almonds), seeds (pumpkin and sunflower seeds, ed.),
and processed products. milk. e) Adequate iron. Lack of iron disrupts the mother's
 ovulation cycle (release of eggs). Foods or multivitamins that contain iron will help in
preparation for pregnancy and avoid anemia which is often complained of by pregnant
women. Sources: liver, red meat, egg yolks, vegetables greens, oranges, and iron-
fortified cereals. f) Phosphorus. If it is deficient, it reduces the sperm quality of the
prospective father. It's in milk, and anchovies. g) Selenium (Se). Plays an important
role in the production of healthy sperm. Symptoms of selenium deficiency include
high blood pressure, sexual dysfunction and infertility. Sources of selenium include
rice, garlic, egg yolks, seafood, mushrooms, and watermelon. h) Reduce consumption
of oily food content. You should replace it with olive oil. The content of fatty acids
contained in olive oil is beneficial for heart health, body, and cholesterol levels so that
it balances a healthy endocrine. i) Extra Calories. Also pay attention to the need for
extra calories that can support your pregnancy. You can prepare it before pregnancy
by getting it from various types of food such as cereals, rice, bread and pasta. Calories
are useful for supporting the changes in the mother's body during pregnancy. j)
Limiting Caffeine. Limit the consumption of coffee and tea because they contain
caffeine which can worsen health before pregnancy preparation. Recommendations
from health experts that starting pregnancy can be done with a limit of consuming
caffeine as much as 200 milligrams, this can also be limited to pregnancy. Avoid
consumption of: a) Raw meat, because it contains Toxoplasma, a parasite that causes
fetal infection, and E.coli bacteria which are harmful to pregnancy and the fetus. b)
Raw vegetables (lalap and salad). If the washing process is not good, it can contain
toxoplasma. c) Chicken meat and eggs cooked or raw, there may be salmonella
bacteria that causes severe diarrhea. d) Mercury fish. Mercury that accumulates and
remains in the blood will affect the nervous system of the fetus. Be wary of eating
canned tuna, frozen tuna, barramundi, black pomfret, marlin, tuna, and shark.
Although rich in omega 3 and 6, fish from some Indonesian waters are suspected to be
contaminated with mercury through the decline in water quality and the food chain. e)
Soft cheeses (brie, camembert, blueveined cheese, goat's and sheep's milk cheese).
Risk of carrying listeria bacteria. f) Caffeine, inhibits pregnancy and reduces iron
absorption. A study in America found that drinking three cups of coffee a day with a
caffeine content of about 300 mg, can lower the chances of pregnant women by about
27% compared to those who are not coffee drinkers.

5. Psychological and mental preparation Mothers can start planning a pregnancy by

thinking about the goals of having children or not having children, and how to achieve
these goals. This is called the reproductive life plan. For example, if you think you
want to delay pregnancy, choose the appropriate contraception to achieve that goal. If
you are thinking about getting pregnant, it is very important to take steps so that you
can have a healthy pregnancy and give birth to a healthy baby. You can enrich your
knowledge about pregnancy related to planning, care during pregnancy, before
delivery, after delivery and also baby care from various trusted sources. If necessary,
you can directly ask the experts so that you can prepare for your pregnancy in a
healthy way. So that the pregnancy to be lived does not cause tension. Avoid things
that will have a bad influence on hormonal balance. Stress can disrupt the monthly
cycle, and prevent ovulation. A study proves, women with high stress levels generally
find it difficult to get pregnant. So it's a good idea to start learning how to deal with
 stress so it doesn't affect your cycle. You can prepare psychologically, including the
changes that will occur when your pregnancy will take place. You can get support
during pregnancy from the closest people such as your husband and extended family
so that you are ready to become a new mother. In addition, mental conditions can
greatly affect the content of the womb, therefore parents must prepare themselves
mentally to face this process. During the nine months of pregnancy, psychological
changes usually occur not only in the mother but also in the father of the future baby.
For nine months, our emotions can be squeezed by it. Try to condition the mind and
heart of both parents so that they are far from negative thoughts. Always remember
that everything is controlled by your mind. Accept the reality, it is best to always be
grateful and leave everything to God. In addition, always communicate everything, try
to always be open and talk about each other's feelings so that they can find solutions
so that difficulties that arise can be resolved. Equip yourself with various information
and resources about pregnancy, including finding out from the experiences of friends
or close people who have experienced pregnancy. And no less important is the
husband's support to his wife is needed. Try to grow confidence in your wife, so that
she is mentally strong enough to face the pregnancy process. Helping the wife in
preparing for the baby's needs, and paying attention to the details of the wife's needs
during pregnancy will foster self-confidence and a sense of security in the wife.

6. Financial/financial planning Thorough financial/financial preparation for preparation

for health care and preparation for pregnancy and childbirth. This problem is one of
the important factors because of the emergence of psychological tension and the
unfulfilled need for good nutrition during pregnancy often arises due to the partner's
unpreparedness in terms of finances. Pregnancy is something that can be estimated
including the cost. The cost of this pregnancy can be discussed between husband and
wife. The cost of pregnancy is part of the cost of married life. You certainly want your
child to get the best in any field. The costs that need to be considered in preparation
for this pregnancy include health costs (consultation fees, examinations, medicines
and childbirth), post-natal costs (baby cribs, baby clothes, diapers, blankets, etc.)
-unexpected things. 7. Don't be shy about asking and consulting. Consult your
doctor/midwife/other health workers regarding your mother's reproductive health.
Discuss your history and current medical conditions that may affect your future
pregnancy. Doctors / midwives can also provide advice on problems in previous
pregnancies, what medications you are currently taking, as well as recommend the
necessary vaccinations and some healthy steps that can be taken before entering the
pregnancy period to prevent defects in the baby. Make a list of questions to discuss
with your doctor/midwife. Talk to your doctor about any family medical history that
needs attention. Maybe the doctor will suggest further consultation with a geneticist,
so that it can reduce the risk of miscarriage, fetal death, infertility or difficulty in
having children or other conditions / birth defects that are genetically inherited. In
addition, the consultation can be a guide for preparing for the pregnancy that will be
undertaken by the mother. Ask for help in case of domestic violence (KDRT).
Domestic violence can cause injury to death, including during pregnancy. Many
women who survive domestic violence experience physical and mental trauma. Ask
 for help if you experience domestic violence, because violence can destroy
relationships in the family.
Not only prospective mothers who have to prepare for pregnancy, prospective fathers
also have to take part in it. Because the success of a healthy pregnancy is a collaboration and
shared responsibility between the prospective mother and the father-to-be, as well as the
preparation for pregnancy for the prospective father:
1) Quit smoking. Smoking reduces fertility, and the wives of men who smoke have a
reduced chance of getting pregnant as well. Fathers who smoke also affect the health
of their babies, before and after delivery, such as the risk of respiratory problems and
increased infant mortality.
2) Stop drinking alcoholic beverages. Alcoholic beverages can affect sperm quality and
make it less likely to have a successful pregnancy.
3) Minimize stress. This can cause hormonal changes in the body, which can lead to
fertility problems.
4) Maintain body temperature. Sperm are made at slightly below body temperature, so
try not to spend too long in warm baths and wear boxers to increase circulation
around the testicles.
5) Eat nutritious food. A healthy diet and regular exercise will reduce stress and improve
your overall fitness.
6) And last but not least, show support for your wife.
 CHAPTER III
CLOSING

A. Conclusion
From the material above, it has been explained what the definition of evidence-based
midwifery practice is, then the definition of evidence-based youth related to adolescent
mothers, the definition of premarital and counseling. evidence based premarital and about
anemia and its causes
B. Suggestion
We should pay more attention to premarital counseling in the next couple so that they
better understand how to be a prosperous couple
 CHAPTER IV
REFERENCES

Deliani Ramadhanti, 2019, file:///C:/Users/ASUS/Downloads/pdfcoffee.com_makalah-

evidence-based-remaja-pranikah-prakonsepsi-docx-pdf-free.pdf