Childbirth experience in women at high risk in facing the delivery process at

Background: A high-risk pregnancy is a severe health and life-threatening for pregnant women and babies, regarding to its effect on an increase of the risk of complications during pregnancy, childbirth, and the puerperium. About 20 million women worldwide have high-risk pregnancies, and it is known that more than 800 die each day. Pregnant women have potential risks during pregnancy, childbirth, and the puerperium. The mother's lack of knowledge about pregnancy health problems and health service providers can increase inappropriate handling risk by health workers. So, women should understand the concept of high-risk pregnancies to reduce these risks. This research aims to determine the childbirth experiences of mothers at high risk in the delivery process at UGM Academic Hospital, Yogyakarta. Materials and Methods : This study is a Qualitative Research with Descriptive-Narrative Design, conducted by in-depth interview with 5 high-risk birth mothers as primary informants, two husbands as supporting informants, and one midwife as a supporting informant. Results : The mothers knew the risks of pregnancy, but they were less aware of the risks of other pregnancies. Mothers’ experience in choosing a place of delivery was influenced by personal experiences, family, friends, or other people. The availability of adequate hospital facilities, service flow, and ownership of insurance coverage were also other factors in choosing a maternity hospital. Conclusion: Mothers are aware of the risks of pregnancy, but they are less aware of other pregnancy risks.

A high-risk pregnancy is a severe lifethreatening to the pregnant women and babies, considering that it can increase the risk of complications during pregnancy, childbirth, and puerperium 2 . The condition categorized as highrisk pregnancies are pregnancies with medical or obstetric conditions. This is an unpredictable problem and has potential negative effect to the pregnancy and the health of the mother and fetus 3 . About 20 million women worldwide have highrisk pregnancies, and more than 800 die each day.
Thus, the percentage of high-risk pregnancies increased from 6% to 33% due to various high-risk pregnancy conditions 2 .
The choice of place of delivery for pregnant women is an important decision. Giving birth at home is considered safe for women with low-risk pregnancies. Some women with risky pregnancies will also choose to have a home birth.
The reason is that pregnant women at low risk believe that giving birth in the hospital is no safer than a home. A higher level of medical intervention at the hospital can increase the risk of giving birth.

Materials and methods
This research was a qualitative research with a descriptive-narrative design. The research subjects consisted of 5 high-risk birth mothers as primary informants, two husbands as supporting informants, and one midwife as a supporting informants. The researchers had in-depth interviews to obtain research data. The interview guideline was related to Childbirth Experience in

Results
The diagram below (Figure 1   The sub-theme "husband's knowledge" describes the risk of pregnancy experienced by the mother. As disclosed by informant 6 follows: "Yes, I get it, my wife's pregnancy has exceeded the due date, the placenta has also undergone calcification so that it could poison my baby (Informant 6).

Informants' lack of knowledge about
other high-risk pregnancies was disclosed by informants 3 and 5 as follows: "There are many risks of pregnant women described in the MCH book….

Such as bleeding and pre-eclampsia, but in my opinion, it is not clear and the information discussed
is only in general, then I find out the information by myself on the internet so that the information is more complete "(inf 3)." The officer always explains, but not much "(Informant 5).

The Knowledge of Risk in Pregnancy
The Wife's Knowledge The Husband's Knowledge The Source of The knowledge of risk in pregnancy "The Wife's Knowledge" "The Husband's Knowledge" The Experience of High-Risk Pregnant Women at RSA UGM In facing the labour process at RSA UGM

Supports
"Family" "The Service Facility" "Medical Staff" "Fund" "Service flow and insurance." Knowledge about a high-risk pregnancy and childbirth is necessary for mothers to know, as expressed by informants 2, 4, and 8 as follows: "I think such information is essential, the risks during childbirth are significant to know" (Informant 2). "It needs to be explained ... so that we will be more aware of our pregnancy" (Informant 4). "About the risks during pregnancy, childbirth, postpartum even in newborns, not only to the patient and her husband but the other member of the family should also know" (Informant 8).
The theme of the experience of high-risk pregnant women in facing the labour process is based on the experience of whom, with the subthemes: "Self", "Family", and "Other People"    " (Informant 7).
The theme of support here relates to the choice of place of delivery, whether based on the support that is categorized into sub-themes, namely: "family", "service facilities", "funds", and "health personnel" (Figure 4).

Oneself
Other People Family The sub-theme of "health workers" illustrates that the role of health workers is also one of the factors that provide satisfaction when The theme "sources of information" describes where informants get information about referral hospitals divided into the following sub-themes: "Family", "Friends", "Social Media", and "Health Workers" (Figure 5). The sub-theme of "family" contains information that the hospital they chose when they were about to give birth was based on information from the family, as conveyed by   Moreover, it has a variety of products that will attract the public to use its services. Adequate medical service facilities will make the services provided to patients better 12 . Hospitals with adequate medical facilities are also an option for mothers planning to give birth in the hospital. It is not only because of the high risk of childbirth.
Moreover, some pregnant women also think that this is important for the safety of both mother and baby 13 .
The informants in this study revealed that in addition to having insurance to prepare for labour, they had also prepared special funds if the insurance was not valid or could not be used.
According to the 2020 Nourmayansa research, it is stated that policies that support the delivery process are not a requirement for mothers to choose a place of delivery. Some mothers choose a place of delivery that has a sound referral system because this is one of the essential things that might affect the safety of mothers and babies 14 .
Marwan Azmi's research explained that informants were ready to seek additional funds from other sources to obtain the desired place of

Conclusion
The mothers already know the pregnancy Mothers should be aware of the risks of pregnancy they experience and learn more about high-risk pregnancy knowledge so that it is hoped that they will be better prepared to deal with highrisk pregnancies.