Did it feel like you had exhausted all possible options and yet are still before the mountain – large, unconquerable, and impregnable? When encountering such enormous problems, you may feel like you’re hammering against a steel mountain. The pressure of having to solve such a problem may be overwhelming.

But rejoice! There might be some hope yet!

With some creative problem-solving techniques you may be able to look at your problem in a different light. And that light might just be the end of the tunnel that leads to possible solutions.

First of all, in the light of creative problem-solving, you must be open-minded to the fact that there may be more than just one solution to the problem. And, you must be open to the fact that there may be solutions to problems you thought were unsolvable.

Now, with this optimistic mindset, we can try to be a little bit more creative in solving our problems.

Number one; maybe the reason we cannot solve our problems is that we have not really taken a hard look at what the problem is. Here, trying to understanding the problem and having a concrete understanding of its workings is integral solving the problem. If you know how it works, what the problem is, then you have a better foundation towards solving the problem.

Not trying to make the simple statement of what problem is. Try to identify the participating entities and what their relationships with one another are. Take note of the things you stand to gain any stand to lose from the current problem. Now you have a simple statement of what the problem is.

Number two; try to take note of all of the constraints and assumptions you have the words of problem. Sometimes it is these assumptions that obstruct our view of possible solutions. You have to identify which assumptions are valid, in which assumptions need to be addressed.

Number three; try to solve the problem by parts. Solve it going from general view towards the more detailed parts of the problem. This is called the top-down approach. Write down the question, and then come up with a one-sentence solution to that from them. The solution should be a general statement of what will solve the problem. From here you can develop the solution further, and increase its complexity little by little.

Number four; although it helps to have critical thinking aboard as you solve a problem, you must also keep a creative, analytical voice at the back of your head. When someone comes up with a prospective solution, tried to think how you could make that solution work. Try to be creative. At the same time, look for chinks in the armor of that solution.

Number five; it pays to remember that there may be more than just one solution being developed at one time. Try to keep track of all the solutions and their developments. Remember, there may be more than just one solution to the problem.

Number six; remember that old adage,” two heads are better than one.” That one is truer than it sounds. Always be open to new ideas. You can only benefit from listening to all the ideas each person has. This is especially true when the person you’re talking to has had experience solving problems similar to yours.

You don’t have to be a gung-ho, solo hero to solve the problem. If you can organize collective thought on the subject, it would be much better.

Number seven; be patient. As long as you persevere, there is always a chance that a solution will present itself. Remember that no one was able to create an invention the first time around.

Creative thinking exercises can also help you in your quest be a more creative problems solver.

Here is one example.

Take a piece of paper and write any word that comes to mind at the center. Now look at that word then write the first two words that come to your mind. This can go on until you can build a tree of related words. This helps you build analogical skills, and fortify your creative processes.

So, next time you see a problem you think you can not solve, think again. The solution might just be staring you right in the face. All it takes is just a little creative thinking, some planning, and a whole lot of work.

When you feel strongly about something without logical basis to it, that’s called intuition. It comes in three impressions: clairvoyance or “the third eye”, sensing clearly and feeling through listening.

Clairvoyance is when your eye goes beyond what it can see. This is when you know what is happening somewhere.

Sensing clearly is basically what we refer to as “hunch” or “gut feel.” This is the time when you are overwhelmed with a feeling and you can’t explain it and all you can say is “I just know.”

On the other hand, feeling through listening or clairaudience is being able to “listen” between the lines. Intuition also happens at times when a certain sound, whatever it is – be it a car’s honk or a bird’s twitting – ushers in an intense feeling.

They say only a number of people are gifted with intuition. Astrologers even insist that people born under the Scorpio or Pisces signs are naturally intuitive it almost borders on E.S.P. But studies have been sprouting left and right that proclaim that anyone can develop intuition.

Why the need to develop intuition, you ask? Why not let your emotional and psychological state as it is? First and foremost, intuition promotes good communication. It makes you more sensitive to the people around you; it often keeps you from hurting those you love because you are intuitive enough to understand them. Intuition also makes you far more creative than ever. Intuition means releasing more creative juices for any means of expression. Lastly, intuition has a healing power. This healing power is not in the physical sense, but in delving deep into your soul to eradicate some negative energy buried in it.

With that being said, are you ready to develop your intuition? Here are some ways to unlock this gift:

1. Hypnosis

Oh yes, get yourself hypnotized. Hypnosis is not limited to watching a pendulum move back and forth. Perform self-hypnosis or you can avail of hypnotic programs that can strengthen your intuition.

2. Meditation

Meditating means finding peace in yourself. If your mind and heart are cluttered with too many baggage and hurt,  you wouldn’t be able to quiet down that part of you that could eventually initiate intuition. There are so many ways to meditate: take a yoga class, or just simply practice some breathing that could bring you straight to Zen.

3. Think positive!

A worry-free, fear-free state could do so much to improve your intuitive ability. By staying positive, you attract good energy that would be able to easily recognize imminent feelings and events.

4.  Just let go.

What does this mean? If you are on the brink of making a huge decision, let go of all the inhibitions and head to a quiet place where you could find out where the letting go has brought you. Sometimes you just have to listen to the voice within you, and that voice wouldn’t come out unless you let go.

5. Never expect.

After letting go of the inhibitions and all those things that stop you from thinking and feeling clearly, never expect for an answer right away. Never expect that the “hunch” would fall on your lap immediately. Give it a little time then you’d just get surprised that — wham! — now you have your answer.

6. Believe in your first impressions.

When you see someone for the first time and think that he is a bit too arrogant for your taste, chances are that impression actually holds true. Most of the time, first impressions are brought by intuition.

7. Stay happy!

See? All you need to be intuitive is to stay happy! Happiness attracts immense power and such power includes intuition. In tapping your intuition, your motivation must be happiness and contentment. Given that premise, intuition will fall to you easily.

Intuition is helpful, because sometimes it leads you to something that cannot be achieved otherwise. A lot of lives have been saved by intuition alone. Decisions are easier done if armed by this gift. Develop intuition now and reap benefits you have never imagined.

There is so much to know about conversation that anyone, even I, could ever realize. You can go though watching talk shows; radio programs; clubs dedicated to public speaking; ordinary conversations; certain rules still apply when it comes to interaction through words. It may sound tedious, I know, but even though it’s your mouth that’s doing the work, your brain works twice as hard to churn out a lot of things you know. So what better way to start learning to be an effective communication is to know the very person closest to you: yourself.

1. What you know.
Education is all about learning the basics, but to be an effective speaker is to practice what you’ve learned. My stint as guest at every Toastmasters’ meeting I go to taught me that we all have our limitations, but that doesn’t mean we can’t learn to keep up and share what we know.

2. Listening.
It’s just as important as asking questions. Sometimes listening to the sound of our own voice can teach us to be a little bit confident with ourselves and to say the things we believe in with conviction.

3. Humility
We all make mistakes, and sometimes we tend to slur our words, stutter, and probably mispronounce certain words even though we know what it means, but rarely use it only to impress listeners. So in a group, don’t be afraid to ask if you’re saying the right word properly and if they’re unsure about it then make a joke out of it. I promise you it’ll make everyone laugh and you can get away with it as well.

4. Eye Contact
There’s a lot to say when it comes to directing your attention to your audience with an eye-catching gaze. It’s important that you keep your focus when talking to a large group in a meeting or a gathering, even though he or she may be gorgeous.

5. Kidding around
A little bit of humor can do wonders to lift the tension, or worse boredom when making your speech. That way, you’ll get the attention of the majority of the crowd and they’ll feel that you’re just as approachable, and as human to those who listen.

6. Be like the rest of them
Interaction is all about mingling with other people. You’ll get a lot of ideas, as well as knowing what people make them as they are.

7. Me, Myself, and I
Admit it, there are times you sing to yourself in the shower. I know I do! Listening to the sound of your own voice while you practice your speech in front of a mirror can help correct the stress areas of your pitch. And while you’re at it you can spruce up as well.

8. With a smile
A smile says it all much like eye contact. There’s no point on grimacing or frowning in a meeting or a gathering, unless it’s a wake. You can better express what you’re saying when you smile.

9. A Role Model
There must be at least one or two people in your life you have listened to when they’re at a public gathering or maybe at church. Sure they read their lines, but taking a mental note of how they emphasize what they say can help you once you take center stage.

10. Preparation
Make the best out of preparation rather than just scribbling notes and often in a hurried panic. Some people like to write things down on index cards, while other resort to being a little more silly as they look at their notes written on the palm of their hand (not for clammy hands, please). Just be comfortable with what you know since you enjoy your work.

And that about wraps it up. These suggestions are rather amateurish in edgewise, but I’ve learned to empower myself when it comes to public or private speaking and it never hurts to be with people to listen how they make conversations and meetings far more enjoyable as well as educational.

1. Leaders come in different flavors.

There are different types of leaders and you will probably encounter more than one type in your lifetime. Formal leaders are those we elect into positions or offices such as the senators, congressmen, and presidents of the local clubs. Informal leaders or those we look up to by virtue of their wisdom and experience such as in the case of the elders of a tribe, or our grandparents; or by virtue of their expertise and contribution on a given field such as Albert Einstein in the field of Theoretical Physics and Leonardo da Vinci in the field of the Arts. Both formal and informal leaders practice a combination of leadership styles.
·    Lewin’s three basic leadership styles – authoritative, participative, and delegative
·    Likert’s four leadership styles – exploitive authoritative, benevolent authoritative, consultative, and participative
·    Goleman’s six emotional leadership styles – visionary, coaching, affiliative, democratic, pacesetting, and commanding.

2. Leadership is a process of becoming.

Although certain people seem to be born with innate leadership qualities, without the right environment and exposure, they may fail to develop their full potential. So like learning how to ride a bicycle, you can also learn how to become a leader and hone your leadership abilities. Knowledge on leadership theories and skills may be formally gained by enrolling in leadership seminars, workshops, and conferences. Daily interactions with people provide the opportunity to observe and practice leadership theories. Together, formal and informal learning will help you gain leadership attitudes, gain leadership insights, and thus furthering the cycle of learning. You do not become a leader in one day and just stop. Life-long learning is important in becoming a good leader for each day brings new experiences that put your knowledge, skills, and attitude to a test.

3. Leadership starts with you.

The best way to develop leadership qualities is to apply it to your own life. As an adage goes “action speaks louder than words.” Leaders are always in the limelight. Keep in mind that your credibility as a leader depends much on your actions: your interaction with your family, friends, and co-workers; your way of managing your personal and organizational responsibilities; and even the way you talk with the newspaper vendor across the street. Repeated actions become habits. Habits in turn form a person’s character. Steven Covey’s book entitled 7 Habits of Highly Effective People provides good insights on how you can achieve personal leadership.

4. Leadership is shared.

Leadership is not the sole responsibility of one person, but rather a shared responsibility among members of an emerging team. A leader belongs to a group. Each member has responsibilities to fulfill. Formal leadership positions are merely added responsibilities aside from their responsibilities as members of the team. Effective leadership requires members to do their share of work. Starting as a mere group of individuals, members and leaders work towards the formation of an effective team. In this light, social interaction plays a major role in leadership. To learn how to work together requires a great deal of trust between and among leaders and members of an emerging team. Trust is built upon actions and not merely on words. When mutual respect exists, trust is fostered and confidence is built.

5. Leadership styles depend on the situation.

How come dictatorship works for Singapore but not in the United States of America? Aside from culture, beliefs, value system, and form of government, the current situation of a nation also affects the leadership styles used by its formal leaders. There is no rule that only one style can be used. Most of the time, leaders employ a combination of leadership styles depending on the situation. In emergency situations such as periods of war and calamity, decision-making is a matter of life and death. Thus, a nation’s leader cannot afford to consult with all departments to arrive at crucial decisions. The case is of course different in times of peace and order—different sectors and other branches of government can freely interact and participate in governance. Another case in point is in leading organizations. When the staffs are highly motivated and competent, a combination of high delegative and moderate participative styles of leadership is most appropriate. But if the staffs have low competence and low commitment, a combination of high coaching, high supporting, and high directing behavior from organizational leaders is required.

Now that you are reminded of these things, keep in mind that there are always ideas that we think we already know; concepts we take for granted, but are actually the most useful insights on leadership.

Most people are content just to stand around listening for orders. And it isn’t unusual to adopt a follow-the-leader mentality. But maybe, somewhere inside of you, you feel the desire to make things happen – to be the head, not the tail. Then maybe leadership just suits you fine.

Some people believe that great leaders are made, not born. Yes, it may be true that some people are born with natural talents. However, without practice, without drive, without enthusiasm, and without experience, there can be no true development in leadership.

You must also remember that good leaders are continually working and studying to improve their natural skills. This takes a commitment to constantly improve in whatever endeavor a person chooses.

First of all, let’s define leadership. To be a leader, one must be able to influence others to accomplish a goal, or an objective. He contributes to the organization and cohesion of a group.

Contrary to what most people believe, leadership is not about power. It is not about harassing people or driving them using fear. It is about encouraging others towards the goal of the organization. It is putting everyone on the same page and helping them see the big picture of the organization. You must be a leader not a boss.

First of all, you have to get people to follow you. How is this accomplished?

People follow others when they see a clear sense of purpose. People will only follow you if they see that you know where you are going. Remember that bumper sticker? The one that says, don’t follow me, I’m lost too? The same holds true for leadership. If you yourself do not know where you’re headed to, chances are people will not follow you at all.

You yourself must know the vision of the organization. Having a clear sense of hierarchy, knowing who the bosses are, who to talk to, the organization’s goals and objectives, and how the organization works is the only way to show others you know what you are doing.

Being a leader is not about what you make others do. It’s about who you are, what you know, and what you do. You are a reflection of what you’re subordinates must be.

Studies have shown that one other bases of good leadership is the trust and confidence your subordinates have of you. If they trust you they will go through hell and high water for you and for the organization.

Trust and confidence is built on good relationships, trustworthiness, and high ethics.

The way you deal with your people, and the relationships you build will lay the foundation for the strength of your group. The stronger your relationship, the stronger their trust and confidence is in your capabilities.

Once you have their trust and confidence, you may now proceed to communicate the goals and objectives you are to undertake.

Communication is a very important key to good leadership. Without this you can not be a good leader. The knowledge and technical expertise you have must be clearly imparted to other people.

Also, you can not be a good leader and unless you have good judgment. You must be able to assess situations, weigh the pros and cons of any decision, and actively seek out a solution.

It is this judgment that your subordinates will come to rely upon. Therefore, good decision-making is vital to the success of your organization.

Leaders are not do-it-all heroes. You should not claim to know everything, and you should not rely upon your skills alone.

You should recognize and take advantage of the skills and talents your subordinates have. Only when you come to this realization will you be able to work as one cohesive unit.

Remember being a leader takes a good deal of work and time. It is not learned overnight. Remember, also, that it is not about just you. It is about you and the people around you.

So, do you have the drive and the desire to serve required of leaders? Do you have the desire to work cooperatively with other people? Then start now. Take your stand and be leader today.

Just don’t ask how it happened, please.

But what’s really interesting is that how do people go through the usual part of life when faced with vein-popping stress? I mean, the new age thing like Zen or yoga is one of the good things and it actually works. Is there room for the intellectual side of people who can actually smell the roses-in-a-can while on the move? It kind of had me thinking that there really must be something in this ‘mind-over-matter’ thing.

Humor is indeed the best medicine there is whenever you are. I mean anyone can pay good money to listen to a comedian just to make you wet your pants after laughing so hard. Despite of what’s been happening, and to those who has gone though the ordeal, it’s better to just laugh while facing the troubles with a clear mind than anger with a clouded vision. One of my favorite celebrities of all time may have to be Woody Allen. Now this is one guy who gives you the in-your-face bluntness that he pulls out with gusto, even without even trying. You can talk just about anything with a man, and he’s bound to mock the subject and you’ll end up laughing rather than being upset about it.

Woody Allen has this to say:

1. “Money is better than poverty, if only for financial reasons.” It sounds good to me, I mean the practicality of all things does involve money but it doesn’t have to take an arm and a leg to get it.

2. “I believe there is something out there watching us. Unfortunately, it’s the government.” ‘Nuff said.

3. “There are worse things in life than death. Have you ever spent an evening with an insurance salesman?” This happens to be one of the classic ones. I mean the issue about life’s little problems isn’t all that bad, until ‘he’ shows up.

Sure, relationships can get complicated, or does have its complications that probably any author about relationships is bound to discover it soon. We follow what our heart desires, unless you’re talking about the heart as in the heart that pump blood throughout your body.

4. “Love is the answer, but while you’re waiting for the answer, sex raises some pretty interesting questions.” And if you want more, just keep on asking!

5. “A fast word about oral contraception. I asked a girl to go to bed with me, she said ‘no’.” It sounds, ‘practical’, I think.

And when it comes to everyday life, he really knows how to make the best out of every possible scenario, and it doesn’t involve a lawsuit if he strikes a nerve.

6. “Basically my wife was immature. I’d be at home in the bath and she’d come in and sink my boats.” I never had a boat in my bathtub before. Just staring at it while soaking in hot water makes me seasick already.

7. “I am not afraid of death, I just don’t want to be there when it happens.” If it rains, it pours.

8. “I am thankful for laughter, except when milk comes out of my nose.” It could get worse when you’re guzzling on beer… or mouthwash, and it happened to me once!

9. “If you want to make God laugh, tell him about your plans.” At least he doesn’t smite us with lightning, and I’m thankful for that.

And despite of what may happen to all of us in the next ten, twenty, or even thirty years, I guess we all have to see things in a different kind of light and not just perspective. I can’t seem to imagine life without any piece of wisdom that could guide us. Whether we’re religious or not, it takes more courage to accept your fears and learn how to deal with them is all that matters when it comes to even just getting along.

And to sum things up, here is the last nugget of wisdom to go by… however, whenever, and wherever we may be.

10. “The talent for being happy is appreciating and liking what you have, instead of what you don’t have.”

Ciao!

Sikap orang beriman memandang ujian sebagai bagian tak terpisahkan dari kehidupan itu sendiri. Menghadapi ujian itu dengan ketabahan dan kesabaran yang merupakan puncak keimanan dan ketakwaan. Kehidupan dan kematian merupakan jalan panjang manusia untuk menguji apakah seseorang mampu mengisinya dengan perilaku dan amal kebaikan atau tidak.

Pangkat dan derajat yang diraih seseorang pada hakikatnya adalah ujian. ”Dan Dia meninggikan (pangkat) sebagian kamu atas sebagian yang lain beberapa derajat, untuk mengujimu tentang apa yang diberikan-Nya kepadamu. (QS Al-An’am: 165). Bahkan, keburukan dan kebaikan yang merupakan standar penilaian amal manusia, sesungguhnya adalah ujian dan cobaan. ”Kami akan menguji kamu dengan keburukan dan kebaikan sebagai cobaan (yang sebenar-benarnya).” (QS Al-Anbiya: 35).

Apalagi kekayaan dan kemiskinan, harta benda dan jiwa, semuanya adalah sarana dan sekaligus bentuk konkret ujian. Oleh sebab itu, semuanya harus benar-benar dipahami dan disikapi secara objektif dan proporsional. Karena sesungguhnya pemberian Allah kepada hamba-Nya yang berupa kekayaan tidaklah identik dengan penghargaan dan penghormatan. Demikian pula sebaliknya, kemiskinan dan penderitaan yang ditimpakan kepada seorang hamba bukanlah berarti sebagai penghinaan atas dirinya.

Dalam konteks keimanan seseorang, ujian adalah titik awal dan penentu, sehingga pada gilirannya nanti manusia tidak memiliki alasan untuk menyalahkan orang lain, bahkan Tuhan sekalipun.Yang menarik untuk dicermati adalah petunjuk Rasulullah SAW bahwa antara ujian dan cinta kepada Allah SWT memiliki keterkaitan yang sangat erat. Seseorang mesti diuji untuk dicintai dan akan dicintai dengan ujian.

”Sesungguhnya jika Allah SWT (akan) mencintai sekelompok kaum maka diujilah mereka. Maka barang siapa rela (menerimanya) maka baginya adalah kerelaan (Allah SWT), dan barang siapa murka maka baginya adalah kemurkaan dari Allah SWT.” (HR Tirmidzi).

Dalam terminologi Alquran, kerelaan menerima ujian disebut dengan sabar, sebuah sikap dan keyakinan objektif bahwa semua itu terjadi semata-mata karena kehendak Allah SWT. ”Dan berikanlah berita gembira kepada orang-orang yang sabar, (yaitu) orang-orang yang apabila ditimpa musibah mereka mengucapkan, ‘Sesungguhnya kami milik Allah dan kepada-Nyalah kami kembali’. Mereka itulah yang mendapatkan keberkatan yang sempurna dan rahmat dari Allah.”

SEBUAH RENUNGAN, JAM 03.00, SUMBER DAUN BERSERAKAN, DR. PALGUNADI.
WALLAHU A’LAM BISHOWABB
Rangkuman by: A. HAMBALI

Mekanisme pemilihan presiden ini cukup sederhana, nama-nama calon presiden yang terjaring semua berhak menjadi presiden. Kok bisa seperti ini? Sangat bisa. Kenapa? kita bercermin dari putusan MK yang memberlakukan suara terbayak untuk pileg. Pilpres yang akan dilaksanakan tahun 2009 memungkinkan sekali ini dilakukan, dimana siapapun calon yang diusung partai berhak menduduki jabatan sebagai presiden jika calon tersebut mendapat suara terbanyak sedangkan untuk wakilnya diberikan secara lagsung kepada calon yang mendapat suara terbanyak kedua.

Mengenai ET (Electoral Treshold) yang sudah diputuskan, ini yang menjadi tolak ukur kita bersama, dimana partai yang benar-benar mempunyai basis pendukung (kader) atau hanya sekedar mencari sensasi saja. Disinilah ET menemui kontekstualisasinya.

Dilihat dari pendidikan politik masyarakat, mekanisme ini sangat mendukung adanya  transparansi, akuntabilitas seorang pemimpin. Masyarakat tidak lagi merasa dibodohi dengan adanya sistem paket yang selama ini dilaksanakan, karena tidak menutup kemungkinan yang jadi presiden adalah bukan kehendak rakyat sesungguhnya, justru wakilnya yang berperan besar mejadikan dia sebagai presiden. Disamping itu juga mekanisme ini akan menciptakan hubungan yang harmonis karena sedari awal meraka sudah tahu kapasitasnya masing-masing.

Banyak contoh terjadi tatkala pemilihan pemimpin kabupaten, kota, propinsi maupun pemimpin nasional itu dilakukan secara paket. Kenyataan yang terjadi bukannya membangun tim work yang solid dalam mewujudkan cita-cita bersama, justru yang terjadi adalah ketidakharmonisan diantara keduanya. Hal ini sangat dimungkinkan karena mereka tidak mengetahui secara pasti seberapa besar dukungan yang diberikan rakyat kepadanya. Efek dari ketidakharmonisan pemimpin ini adalah rakyat jadi tidak terurus, pembangunan yang terbengkalai dan yang lebih parah adalah mereka hanya memikirkan kekuasan dengan bermain opini untuk meningkatkan citra masing-masing. Mereka cenderung berjalan sendiri-sendiri, koordinasi tidak terjadi lagi.

Penyakit ini sebenarnya sudah lama menjangkiti birokrasi kita. Pola-pola kebijakan yang dibuat hanya untuk kepentingan sektoral. Efek jangka panjangnya tidak benar-benar dipikirkan secara serius, yang dilihat adalah hasil sesaat dan membuat rakyat ketergantungan.

Satu periode yang di tunggu tunggu bagi pasangan baru adalah kehamilan dan menanti lahirnya sang buah hati, buah cinta kasih. Semua ibu yang normal pasti menginginkan hal itu terjadi pada dirinya, tentunya kehamilan yang sehat dan normal.
Bagaimana jika terjadi hal-hal yang tidak kita inginkan…..???

Ibu hamil harus sadar, bahwa semua itu atas kehendaknya, kapan saja bisa terjadi selama masa kehamilan ( hamil muda, atau hamil tua / menjelang persalinan ) baik gangguan ringan, sedang maupun yang berat.

Setiap kesulitan pasti ada kemudahan bagi mereka yang sabar, berusaha dan bertawakkal. Setiap gangguan pada masa kehamilan bisa di atasi, bahkan bisa di cegah, dan sedikit diantaranya yang butuh pertolongan/ tindakan para ahlinya.

Berikut adalah sebagian contoh gangguan yang bisa terjadi pada kehamilan yang Saya rangkum dari beberapa sumber / literatur  dan sebagian sudah pernah saya alami. Moga anda bisa mengambil manfaat dari pengalaman saya.

1. ANEMIA

Ditandai dengan keadaan  pucat pada wajah, telapak tangan dan kelopak mata,
lekas lelah, lemah, letih lesuh.  Ini terjadi karena ibu     kekurangan unsur darah  (haemoglobin ) pada sel darah merahnya. Pada kondisi hamil, anemia terjadi karena kekurangan zat besi.
Pada kondisi yang berat bisa mengganggu jantung sang ibu yang di tandai dengan  jantung berdebar debar, sedangkan efek ke janin yaitu berkurangnya pasokan oksigen. Anemia oleh karena kekurangan zat besi bisa di atasi dengan pemberian tablet zat besi ( sulfas ferosus ).
a.   Patofisiologi anemia pada kehamilan.
Perubahan hematologi sehubungan dengan kehamilan adalah oleh karena perubahan sirkulasi yang makin meningkat terhadap plasenta dari pertumbuhan payudara. Volume plasma meningkat 45-65% dimulai pada trimester ke II kehamilan, dan maksimum terjadi pada bulan ke 9 dan meningkatnya sekitar 1000 ml, menurun sedikit menjelang aterem serta kembali normal 3 bulan setelah partus. Stimulasi yang meningkatkan volume plasma seperti laktogen plasenta, yang menyebabkan peningkatan sekresi aldesteron.
b.Etiologi
Etiologi anemia defisiensi besi pada kehamilan, yaitu :
a.  Hipervolemia, menyebabkan terjadinya pengenceran darah.
b.      Pertambahan darah tidak sebanding dengan pertambahan plasma.
c.       Kurangnya zat besi dalam makanan.
d.      Kebutuhan zat besi meningkat.
e.       Gangguan pencernaan dan absorbsi.
c.  Gejala klinis
Wintrobe mengemukakan bahwa manifestasi klinis dari anemia defisiensi besi sangat bervariasi, bisa hampir tanpa gejala, bisa juga gejala-gejala penyakit dasarnya yang menonjol, ataupun bisa ditemukan gejala anemia bersama-sama dengan gejala penyakit dasarnya. Gejala-gejala dapat berupa kepala pusing, palpitasi, berkunang-kunang, perubahan jaringan epitel kuku, gangguan sistem neurumuskular, lesu, lemah, lelah, disphagia dan pembesaran kelenjar limpa. Pada umumnya sudah disepakati bahwa bila kadar hemoglobin < 7 gr/dl maka gejala-gejala dan tanda-tanda anemia akan jelas.4Nilai ambang batas yang digunakan untuk menentukan status anemia ibu hamil, didasarkan pada criteria WHO tahun 1972 yang ditetapkan dalam 3 kategori, yaitu normal (≥11 gr/dl), anemia ringan (8-11 g/dl), dan anemia berat (kurang dari 8 g/dl). Berdasarkan hasil pemeriksaan darah ternyata rata-rata kadar hemoglobin ibu hamil adalah sebesar 11.28 mg/dl, kadar hemoglobin terendah 7.63 mg/dl dan tertinggi 14.00 mg/dl.3
d.    Dampak anemia defisiensi zat besi pada ibu hamil
Anemia pada ibu hamil bukan tanpa risiko. Menurut penelitian, tingginya angka kematian ibu berkaitan erat dengan anemia. Anemia juga menyebabkan rendahnya kemampuan jasmani karena sel-sel tubuh tidak cukup mendapat pasokan oksigen. Pada wanita hamil, anemia meningkatkan frekuensi komplikasi pada kehamilan dan persalinan. Risiko kematian maternal, angka prematuritas, berat badan bayi lahir rendah, dan angka kematian perinatal meningkat. Di samping itu, perdarahan antepartum dan postpartum lebih sering dijumpai pada wanita yang anemis dan lebih sering berakibat fatal, sebab wanita yang anemis tidak dapat mentolerir kehilangan darah.  Soeprono menyebutkan bahwa dampak anemia pada kehamilan bervariasi dari keluhan yang sangat ringan hingga terjadinya gangguan kelangsungan kehamilan abortus, partus imatur/prematur), gangguan proses persalinan (inertia, atonia, partus lama, perdarahan atonis), gangguan pada masa nifas (subinvolusi rahim, daya tahan terhadap infek¬si dan stress kurang, produksi ASI rendah), dan gangguan pada janin (abortus, dismaturitas, mikrosomi, BBLR, kematian peri¬natal, dan lain-lain).

2. KENAIKAN BERAT BADAN

Kenaikan berat badan yang normal  pada wanita hamil adalah 1 kg / bulan sampai usia kehamilan 20 minggu, kenaikan 2 kg/ bulan setelah usia kehamilan 20 minggu. Jadi batas toleransi sampai usia 9 bulan adalah  kurang lebih 12-14 kg  pada posisi ibu pada saat start hamil BB nya  45-65 kg.
Oleh karena itu waspada  terhadap ibu yang kenaikan BB nya lebih dari 1 kg/ minggu di usia kehamilan awal sampai 20 minggu, apalagi di sertai kaki bengkak, tekanan darah tinggi, mata berkunang kunang. karena masuk tanda tanda pre eklamsia.

SAAT hamil setiap wanita mengalami kenaikan berat badan. Namun perlu diingat, pertambahan bobot jangan lebih dari 18 kg. Apa pasal?

Jika Anda tengah hamil saat ini, segeralah menimbang berat badan. Apakah masih dalam batas normal? Sejatinya tak ada patokan baku perihal seberapa kenaikan bobot ibu semasa hamil. Dengan kata lain, setiap ibu hamil (bumil) dapat mengalami kenaikan berbeda-beda.

Akan tetapi, hasil penelitian terbaru di Amerika menganjurkan agar bumil memantau kenaikan berat badannya supaya tidak lebih dari 18 kilogram. Pasalnya, jika lebih dari itu, dia berisiko dua kali lipat melahirkan bayi besar. Adapun yang dimaksud dengan bayi besar menurut Asosiasi Kebidanan dan Kandungan Amerika adalah bayi dengan berat 4 kilogram atau lebih. Sedangkan WHO menyebutkan, rata-rata berat badan bayi sehat dan normal saat dilahirkan adalah 3,2 kilogram.

Dalam penelitian yang dipublikasikan dalam jurnal Kebidanan dan Kandungan tersebut, peneliti melibatkan partisipan lebih dari 40.000 wanita Amerika dan bayinya. Setelah dianalisis, diperoleh data bahwa satu dari lima wanita mengalami peningkatan bobot berlebih semasa hamil, yang membuatnya berisiko dua kali lipat melahirkan bayi besar.

Kasus diabetes gestasional (diabetes yang disebabkan kehamilan) juga kerap menjadi penyebab bayi terlahir dengan berat badan berlebih. Namun, fakta lain dalam penelitian ini mengungkap bahwa bumil yang mengalami peningkatan lebih dari 18 kilogram tetap berpotensi melahirkan bayi besar sekalipun dia tidak mengidap diabetes gestasional.

“Mengingat banyaknya wanita yang mengalami kenaikan bobot lebih dari 18 kilogram saat hamil, maka anjuran untuk menghindari kegemukan semasa hamil merupakan pesan kesehatan yang penting untuk disebarluaskan,” ujar Dr Teresa Hillier, salah seorang staf peneliti dari Kaiser Permanente Center for Health Research di Portland, Oregon.

Hillier menegaskan, bumil yang mengalami peningkatan bobot berlebih berisiko lebih tinggi memiliki bayi besar, yang juga berarti risiko si bayi kelak tumbuh dengan masalah kelebihan berat badan ataupun obesitas. Bagi bumil, janin yang terlampau besar berisiko mempersulit proses kelahiran, seperti meningkatkan kemungkinan perobekan atau perdarahan vagina, serta kemungkinan harus melahirkan lewat operasi caesar. Sementara si janin sendiri berisiko mengalami “macet” di bahu atau patah tulang selangka saat proses kelahiran.

Pada penelitian tersebut, Hiller dan timnya menganalisis data rekam medis dari 41.540 wanita yang melahirkan di Washington, Oregon, dan Hawai dalam kurun waktu 1995-2003. Seluruhnya terdeteksi mengalami diabetes gestasional dan sebanyak 5,4 persen di antaranya ditangani melalui program diet, olahraga, dan bila perlu diberikan insulin untuk mengontrol kadar gula darah.

Secara keseluruhan, sebanyak 20 persen bumil yang berat badannya naik lebih dari 18 kilogram melahirkan bayi besar. Sementara bumil dengan peningkatan bobot badan normal yang melahirkan bayi besar jumlahnya hanya kurang dari 12 persen.

Kelompok paling berisiko tinggi adalah bumil yang mengalami peningkatan berat badan lebih dari 18 kg sekaligus mengidap diabetes gestasional, yang mana hampir 30 persen dari kelompok ini melahirkan bayi besar. Sementara bumil berbobot normal sekaligus diabetes yang melahirkan bayi besar jumlahnya hanya berkisar 13,5 persen.

Peneliti mengungkapkan, temuan ini menganjurkan wanita harus menghindari peningkatan bobot berlebih selama hamil dan bumil yang didiagnosis mengalami diabetes gestasional, juga harus berupaya menjaga peningkatan berat badan tidak lebih dari 18 kilogram.

Kasus naiknya bobot badan selama kehamilan memang terus meningkat selama dua dekade terakhir, dan peneliti menduga hal tersebut kemungkinan terkait epidemi obesitas yang terjadi sejak masa kanak-kanak.

3. MUAL MUNTAH

Mual muntah yang terjadi pada trimester pertama kehamilan masih bisa di toleransi/ normal, tapi perlu di lihat frekwensi muntahnya. Kalau lebih dari 7 kali dg volume banyak / hari ( hiper emesis ) ini akan menganggu kondisi ibu, ibu jadi lemah, keadan ini tidak boleh di biarkan, perlu perawatan / pengawasan yang serius di rumah sakit.

Oleh sebab itu kebutuhan makan ibu hamil harus di perhatikan, karena kebutuhan bagi ibu hamil lebih banyak daripada yang tidak hamil. berikut panduan untuk ibu hamil pada tahap tahap yang menentukan.

Kegunaan makanan tersebut adalah :
1.Untuk perumbuhan janin yang ada dalam kandungan.
2.Untuk mempertahankan kesehatan dan kekuatan badan ibu sendiri.
3.Agar supaya luka-luka persalinan lekas sembuh dalam nifas.
4.Guna mengadakan cadangan untuk masa laktasi
Caranya :
1.Ibu harus makan teratur tiga kali sehari.
2.Hidangan harus tersusun dari bahan makanan bergizi yang terdiri : makanan pokok, lauk pauk, sayuran dan buah-buahan dan diusahan minum susu 1 gelas setiap hari.
3.Pergunakan aneka ragam makanan yang ada.
4.Pilihlah, belilah, berbagai macam bahan makanan yang segar.
Berapa banyak makanan yang dibutuhkan
Bila kondisi badan si ibu tidak terganggu maka jumlah atau besar makanan yang dapat dimakan ialah seperti tercantum pada lampiran. Namun bila terjadi gangguan masa kehamilan maka dapat diatur sebagai berikut :

1. Pada Trisemester I :
Pada umur kehamilan 1-3 bulan kemungkinan terjadi penurunan berat badan. Hal ini disebabkan adanya gangguan pusing, mual bahkan muntah. Untuk itu dianjurkan porsi makanan kecil tetapi sering. Bentuk makanan kering atau tidak berkuah.

2. Pada Trisemester II :
Nafsu makan ibu membaik, makan makanan yang diberikan : 3 x sehari ditambah 1 x makanan selingan. Hidangan lauk pauk hewani seperti : telur, ikan, daging, teri, hati sangat baik dan bermanfaat untuk menghindari kurang darah.

3. Pada Trisemester III :
- Makanan harus disesuaikan dengan keadaan badan ibu.
- Bila ibu hamil mempunyai berat badan kelebihan, maka makanan pokok dan tepung-tepungan dikurangi, dan memperbanyak sayur-sayuran dan buah-buahan segar untuk menghindari sembelit. Bila terjadi keracunan kehamilan/uedem (bengkak-bengkak pada kaki) maka janganlah menambah garam dapur dalam masakan sehari-hari.

Berapa yang anda butuhkan setiap hari ?
Nama Bahan    Berat
Gram    Ukuran Rumah Tangga
Beras    300    4 gelas nasi
Daging    75    3 potong sedang
Tempe    75    3 potong kecil
Sayuran    300    3 gelas
Buah    200    2 potong
Susu    200    1 gelas
Gula    10    1 sendok makan
Minyak    25    5 sendok makan
Selingan    2 X
Nilai gizi
-Kalori    :    2500
-Lemak    :    82
-Protein:    85
-H.A.    :    414

Pembagian makanan sehari :
Waktu    Jenis Makanan    Jumlah (gr)    Ukuran
Pagi    -  Nasi    200    1¼ gls
-  Daging    50    1 ptg
-  Telur    25    ½ btr
-  Tempe    -
-  Sayuran    50    ½ gls
-  Minyak    10    1 sdm
-  Gula    10    1 sdm
10.00    -  Susu    200    1 gls
-  Gula    10    1 gls
Siang    -  Nasi    250    1¾ gls
-  Daging    50    1 ptg
-  Telur    50    1 btr
-  Tempe    50    1 ptg
-  Sayuran    75    ¾ gls
-  Minyak    15    1½ sdm
-  Buah    100    1 bh
16.00    -  Kacang Hijau    25    2 sdm
-  Gula    15    1½ sdm
Sore    -  Nasi    250    1¾ gls
-  Daging    50    1 ptg
-  Telur    25    ½ btr
-  Tempe    50    1 ptg
-  Sayuran    75    ¾ gls
-  Minyak    10    1 sdm
-  Buah    100    1 bh

Contoh Menu
Pagi
- Susu manis
- Nasi
- Telur ceplok
- Kering tempe
- Tumis kacang panjang

Jam: 10.00
- Bubur kacang ijo

Siang
- Nasi
- Ikan goreng
- Botok tempe, kemangi, melandingan
- Sayur asam
- Pepaya

Jam : 16.00
- Kolak labu kuning + pisang

Malam
- Nasi
- Smoor daging + tahu
- Orak-arik wortel + kool
- Pisang

Pesan- pesan penting bagi ibu hamil
1.Ibu hamil harus makan dan minum lebih banyak dari pada saat tidak hamil.
2.Untuk mencegah kurang darah selama hamil ibu harus banyak makan makanan sumber zat besi, seperti sayuran hijau tua, tempe, tahu, kacang hijau, kacang merah dan kacang-kacangan lainnya, telur, ikan, dan daging.
3.Jangan lupa minum tablet tambah darah 1 butir setiap hari.
4.Untuk mencegah gigi rontok dan tulang rapuh, ibu hamil harus banyak makan-makanan sumber zat kapur, seperti : kacang-kacangan, telur, ikan teri/ikan kecil yang dimakan bersama tulangnya, sayuran daun hijau.
5.Kenalilah gejala kurang darah (Anemia) selama kehamilan, yaitu : pucat, pusing, lemah dan penglihatan berkunang-kunang.
6.Selama hamil makanlah beraneka ragam makanan dalam jumlah yang cukup.
7.Bila nafsu makan ibu kurang, makanlah makanan yang segar-segar, seperti : buah-buahan, sari buah, sayur bening, dsb.
8.Hindari pantangan terhadap makanan, karena akan merugikan kesehatan ibu.
9.Hindari merokok dan minum-minuman keras karena akan membahayakan keselamatan ibu dan janin.
10.Jangan lupa memeriksakan diri kepada bidan atau Puskesmas secara teratur, agar ibu dan kandungannya tetap sehat.

4. SERING BERDEBAR, SESAK, MUDAH LELAH

Waspadalah jika keluhan tersebut berlangsung terus-menerus, dan kian hari kian bertambah berat. Jika tadinya keluhan itu muncul hanya pada saat melakukan aktivitas fisik, namun sekarang tidak melakukan aktivitas fisik pun sudah berdebar dan sesak napas, kemungkinan ada gangguan jantung dalam kehamilan (vitium cordis). Ibu dengan kondisi begini memerlukan perawatan khusus di rumah sakit, dan pertolongan khusus pula sewaktu persalinan.

5. GANGGUAN KELENJAR GONDOK

Jika kelopak mata sembab menonjol, tapi bukan sakit mata, jemari gemetar, sering berdebar-debar walau tidak habis melakukan aktivitas fisik, badan terasa lebih panas (gerah) dari biasa, dan banyak berkeringat, kemungkinan ini gejala aktivitas kelenjar gondok di batang leher berlebihan (hyperthyroid). Kelenjar gondok tidak harus membengkak seperti pada penyakit gondok endemik akibat kekurangan iodium, namun fungsi gondoknya saja yang berlebihan, sehingga menimbulkan keluhan dan gejala seperti di atas itu. Agar tidak sampai mengganggu kehamilan, maupun janin yang dikandung, gangguan kelenjar gondok pun perlu diatasi.

6. GULA DARAH NAIK

Ibu hamil dicurigai kencing manis jika bertubuh gemuk, berasal dari keluarga dengan riwayat kencing manis, mengeluh sering haus terus, banyak berkemih, dan merasa lapar terus. Ibu hamil dengan kencing manis akan melahirkan anak yang lebih besar dari normal. Seberapa bisa, kencing manis ibu hamil terkontrol agar tidak berpengaruh buruk terhadap anak yang dikandung. Pertolongan khusus perlu diberikan untuk bayi yang dilahirkan dari ibu yang kencing manis.

7. INFEKSI

Ibu hamil dengan demam tinggi dan berlangsung lebih dari 3 hari harus dipikirkan kemungkinan terjadi infeksi. Apa pun penyebab infeksinya, tidak menyehatkan bagi janin yang dikandung. Dokter perlu memeriksa kalau-kalau infeksinya berefek buruk terhadap anak.

8. KEJANG KEJANG

Ibu hamil dengan kejang-kejang tidak boleh dianggap enteng. Kejang-kejang sendiri bisa disebabkan oleh infeksi selaput otak (meningitis), atau pada otak sendiri (encephalitis). Namun, paling sering disebabkan oleh penyakit eclampsia seperti sudah dibahas di atas. Jangan tunda pergi ke dokter, sebab setiap kejang-kejang harus dianggap keadaan yang serius.

9. KELUAR DARAH/ LENDIR

Keluar darah dari liang rahim pada masa kehamilan kurang dari 28 minggu atau 7 bulan, kemungkinan terjadi keguguran. Ancaman keguguran yang masih awal dapat dibendung dengan perawatan khusus, agar janin selamat sampai cukup bulan. Namun akan gagal mempertahankan kehamilan jika perdarahan telanjur banyak dan berlebihan. Keluar darah pada kehamilan yang lebih tua, kemungkinan ada gangguan pada air-ari. Keluar darah dapat disertai rasa nyeri mulas melilit di perut bawah, bisa juga tidak. Keluarnya darah dengan rasa nyeri disertai keluarnya lendir, apalagi jika sampai keluar air ketuban (menyerupai air seni), tergolong keadaan gawat darurat kehamilan. Ibu harus segera dilarikan ke rumah sakit, mencegah seberapa mungkin dalam 24 jam kehamilan masih dapat dipertahankan. .

10. KELUAR CAIRAN KETUBAN

Ketuban atau bungkus bayi dalam kandungan tidak boleh pecah sebelum tiba waktunya persalinan. Jika sampai pecah, berarti cairan ketuban akan tumpah keluar dari liang rahim, dan anak yang seharusnya terlindung steril di dalamnya terancam bahaya tercemar oleh bibit penyakit dari dunia luar. Keadaan ini disebut Ketuban Pecah Dini (KPD), yakni keluar cairan menyerupai air seni tapi tak berbau pesing, sebelum merasa mulas-mulas tanda awal persalinan. Adakalanya, cairan ketuban tidak bening lagi, melainkan sudah kehijau-hijauan, tanda sudah terinfeksi kuman dari luar. Infeksi cairan ketuban mengancam janin yang terbungkus di dalamnya. Ini pun tergolong gawat darurat. Janin perlu diselamatkan agar tidak sampai menderita infeksi di dalam kandungan ibunya.

TERIMAKASIH BUAT REDAKSI  ( MOGA SEDIKIT TULISAN INI DAPAT DI MUAT DI MAJALAH BIDAN DAN BISA BERMANFAAT BUAT SESAMA ) AMIN

SALAM SEJAWAT………
DARI SAYA,  BIDAN  NY. KURNIA HAMBALI, AMd. Keb
(Puskesmas Mejayan Caruban, Madiun Jatim)

Demokrasi Parlementer (1950-1959)
Parlemen memainkan peranan yang dominan
Akuntabilitas pemegang jabatan dan politisi sangat tinggi
Partai baru hidup bebas dengan sistem multipartai  Pemilu 1955 dilaksanakan sangat demokratis  Hak-hak dasar masyarakat sangat dikurangi  Partai besar mempunyai surat kabar

Demokrasi Terpimpin (1959-1966)

Mengaburnya sistem kepartaian
Terbentuknya DPR-GR, peranan legislatif lemah
Penghormatan hak dasar melemah, presiden menyingkirkan lawan-lawan politik
Kebebasan pers meredup, beberapa media yang dibredel
Sentralisasi kekuasaan dominan dalam hubungan pusat daerah

Era Produsen Soeharto

Demokrasi Pancasila (1966-1998)
Kekuasaan kepresidenan pusat dari seluruh proses politik
Rotasi kekuasaaan politik hampir tidak pernah terjadi
Rekruitmen politik tertutup
Pemilu dilakukan lima tahun sekali
Partai politik dibatasi
Hak-hak dasar manusia dibatasi.

Era Pasca Soeharto

Demokrasi Era Transisi (1998-sekarang)
Kepala negara dan kepala daerah dipilih lagsung
Sistem presidensial dengan multipartai
Kebebasan pers, kebebasan berorganisasi, dan kebebasan berpendapat
Lembaga perwakilan terdiri dari DPR dan DPD
Lembaga pengadilan diawasi komisi yudisial
Munculnya komisi-komisi negara.