WHERE DOES THE PREGNANT WOMEN SEARCHING FOR THEIR INFORMATION NEED ?

Pregnant women tend to be more concern with the health and food issue. During pregnancy, women will have physiological changes, such as intestinal disorders, metabolic diseases, and obesity. They tend to reduce consume of food with pregnancy-related health risk. In order to achieve a healthy pregnancy, information related to health and food issue are needed. Pregnant women were actively seek information from a variety of sources. The research method used is literature review, we would like to identify which source of information that most used by pregnant to meet their information need and how is their belief about the sources. The conclusion of this study that information required by pregnant women related with information regarding medicine or medication use in pregnancy, nutrition, and health disorders. Dominant information used by pregnant women were health practitioners, online information, and family/friends. Although used by many pregnant women, the internet believed as an unreliable source of health information. Health practitioners were the main trusted information sources. This study is essential for information provider in designing healthy living information and educating health literacy for pregnant women..


I. INTRODUCTION
Applying healthy life during pregnancy is essential to ensure health for the mother and the growing fetus.Pregnant women should have enough knowledge about how best to manage their health during pregnancy.They are not only think for their own healthy, but also for their fetal development.Pregnant women who are aware of their health will actively seek information.Friends, relatives, leaflet, midwives, doctors, internet, and books are sources of information that can be used to increase their knowledge about managing a healthy living.They only use one source of information or multiple information sources when seeking information (Hämeen-anttila et al., 2014;Lee, Holden, & Ayers, 2016).Various factors may influence the way pregnant women seek and use information, because women that having their first child were seven times more likely to seek information than those with subsequent pregnancies (Willcox et al., 2015).
Exact and trusted information are the important consideration when they seek information.Women needed an accurate information to make the right decision during pregnancy.Accurate sources of information on the safety of medications during pregnancy can be challenging to find for both clinicians and pregnant women (Hansen et al., 2016).Not all available information in the internet, books, and television are necessarily accurate (Lee, Holden, & Ayers, 2016).Bianchi et al. (2016) said, pregnant women could be confused if the information obtained is too much.II.LITERATURE REVIEW Some literature has investigated the best sources of information used by pregnant women to meet their information need.Grimes, Forster, & Newton (2014) explored the use of traditional sources and the internet as a source of information for pregnant women.Wallwiener et al. (2016) only analyzed information Jurnal Ilmu Informasi, Perpustakaan dan Kearsipan.Volume 20 Nomor 2, Oktober 2018.Halaman 97-109."Where Does the Pregnant Women Searching for Their Information Need? / Ekawati Marlina, Dwiatri Kusumaningrum, dan Seno Yudhanto" ISSN 1411-0253 / E-ISSN 2502-7409.Tersedia online pada http://jipk.ui.ac.id seeking behavior of pregnant women on Internet (e-Health) and smartphone (m-Health).Nowadays, the internet, Youtube video, and social media is a technology-based information source.From any literature that investigates the information sources used by pregnant women, we would like to identify which source of information that most used by pregnant women to meet their information need, what information is needed, and how is their belief about that sources.This study is essential for health professional and information provider in designing appropriate health promotion that meets pregnant women information need and builds their health literacy.

III. RESEARCH METHOD
We used a literature review as a method.The purpose of literature review is to identify the theories and previous studies which have influenced your choice of research topic and the methodology you are choosing to adopt (Denney et al, 2013).In this case, we are collecting published article related to the topic and analyzing what can be learned.The first stage of the study was conduct a search of scholarly journal literature in PubMed.PubMed is database for medical science.The literature search was conducted through July -August 2018.The keyword used in the search were "information need" OR "information sources" OR "sources of information" AND (pregnan*).The selection process for the article included in the analysis is shown in figure 1.In total, 564 articles were found.Analysis only conducted for publication using English language and published in the past 5 years.In total, 184 articles were selected.The next step is sort out the text based on inclusion criteria.The articles were included in this review if the article focusing on source of information use by pregnant women and their respondent were pregnant women.The selection criteria was applied to title and abstract.Finally, a total of 35 articles was chosen for the review IV.DISCUSSION We retrieve the full text of the article that are match with the inclusion criteria.We analyze the text and extract the article.Example of the extracted article were presented in Table 1.Articles were extracted into authors, information need, sources of information, and result of the study.After mapped, each article was analyzed to find information need, the most used sources of information, and perceived about sources of information.
The discussion are divided into three theme, namely; information need, sources of information, and perceived about sources of information.

A. Information Need
Pregnant women desire to obtain information to satisfy their need.Kamali, Ahmadian, Khajouei, & Bahaadinbeigy (2018) assessed the information need by pregnant women during their pregnancy and childbirth.Based on their assessment, information about the care of the foetus is the most needed.Sequentially it followed by information about physical and psychological complications after delivery, development and growth of the foetus, pregnancy nutrition, and special tests during pregnancy.The respondent of the study were pregnant women who attended antenatal clinics and obstetricians/gynecologists' offices in Kerman, Iran.Four of the dominant information need by pregnant women were pregnancy stages, infant feeding practices, nutrition, labour and birth and postnatal care (Owusu-addo et al., 2016).The respondent of the study was pregnant teenagers aged 15-19 in Ejisu-Juaben Municipality, Ghana.Grimes et al., (2014) classified information need by pregnant women into three group, i.e. information need regarding pregnancy, birth and postpartum period.Sequentially, five information that most needed by pregnant women who birthed at the Royal Women's Hospital, Melbourne, Australia were the information regarding breastfeeding, mother's postnatal recovery, an organization of care, infant care, and infant settling and sleeping.The three article studied the information need by pregnant women in three different countries.There are Iran (Kamali, Ahmadian, Khajouei, & Bahaadinbeigy, 2018), Ghana (Owusu-addo et al., 2016), and Australia (Grimes, Forster, & Newton, 2014).Different from the other two of the article, Owusu-addo et al. (2016) assessed the information need by pregnant teenagers.Although using different characteristic of a respondent, information needed are almost the same.We could summarize that information required by pregnant women related with information regarding maternal health, foetus or infant health, and nutrition.
In pregnancy, pregnant women often experience health problems during pregnancy or before pregnancy.Pelvic floor problems (urinary incontinence, fecal incontinence, utero vaginal prolapse) are one of the health problems experienced by pregnant women.Knowledge about of pelvic floor problems is very necessary.The study was conducted in antenatal clinics of three centers in London, UK.Respondents were women attending these clinics who fulfilled the criteria of being primiparous, in the third trimester and aged 18 years or above.Infection is also often experienced by pregnant women (Chan et al., 2018).Pregnant women who are in the area of active Zika transmission virus, South America, are very likely to get zika infection.Information regarding the Zika virus includes sexually transmitted, mosquito transmitted, microcephaly, noticeable symptoms, change of travel plans, get vaccinated if available, Taking protective behaviors.Pregnant women with diabetes 1 are susceptible to pre-eclampsia (Wotherspoon et al., 2017).The information you want to obtain is the risk and complications if pregnant women with diabetes 1 have pre-eclampsia.Sometimes before becoming pregnant, pregnant women already have a disease such as pregnant women who have epilepsy (Friedrich, Sruk, & Bielen, 2018).Time to consultation with neurologist, pregnancy antiepileptic drugs (AED) permitted, risk of different AEDs, vitamin for prevention, AED and breastfeeding were information sought by pregnant women with epilepsy.
During pregnancy, both mother and fetus have an increased risk of serious complications of influenza infection, as the immune system of the mother is usually weakened, especially during the third trimester.Vaccination is a long-proven means to prevent influenza.Indeed, the influenza vaccine has a long history of safe use in all stages of pregnancy and its effectiveness has been reported to be similar between pregnant and non-pregnant women.Vaccination of pregnant women against the A (H1N1) influenza was recommended by health authorities worldwide.In many countries, pregnant women were considered one of top priority targets for vaccination.Identifying factors influencing the decision-making of pregnant women regarding H1N1 vaccination, Vulnerability to A (H1N1) (Pregnant women were more at risk regarding A (H1N1) and I believed in the risk of the pandemic), Severity of A (H1N1) (A (H1N1) could be harmful for me and A (H1N1) could be harmful for my baby), Efficiency of vaccine (The A (H1N1) vaccine could protect me from disease, Risk of vaccine (The A (H1N1) vaccine was safe for me; The A (H1N1) vaccine was safe for the baby; The A (H1N1) vaccine has not been tested enough; The A (H1N1) vaccine could lead to Guillain-Barré syndrome), Subjective norms (Spouse advice is important and Health professional advice is important) (Fabry, Gagneur, & Pasquier, 2011).
The articles were grouped based on the information need theme.It is shown at Table 2. Information related to medicine use during pregnancy was important.Pregnant women have unrealistically high perceptions of teratogenic drug effect (Widnes & Schjøtt, 2017).Pregnant women perceived that consumption medicine during pregnancy would give negative effect for the foetus growth.Congenital disability caused by medicine use during pregnancy is only about 1% (Widnes & Schjøtt, 2017).Sufficient data about the safe use of medicine during pregnancy are needed.Medicine usage is correlated with the health disorder during pregnancy.Among the health disorders, the article most discussed information about weight.It is studied by Willcox et al. (2015), Criss, Oken, Guthrie, &Hivert (2016), andMercado et al. (2017).The other theme of information needed by pregnant women is information regarding nutrition intake.During pregnancy, women become more aware with the nutrition intake (Szwajcer et al., 2005).

B. Sources of Information Used
During pregnancy, women become aware of their nutrition intake and medicine use.This awareness stimulates pregnant women looking for information.Increasing their knowledge in a particular area was also the reason why they were looking for information from specific sources.Pregnant women in the third-semester period of pregnancy were looking for information because they have low knowledge about pelvic floor problem (O'Neill et al., 2017).Another reason why pregnant women were actively seeking information was conflicting information.The study conducted by Bianchi et al. (2016) emphasized that French pregnant actively found information because they received heterogeneous and conflicting information.Willcox et al. (2015) and Criss, Oken, Guthrie, & Hivert (2016) studied Gestational Weight Gain (GWS).In collecting the data, two of the article using different research method and different of locus area.Willcox et al. (2015) used the quantitative approach 100 and conducted in Melbourne, Australia.The other used the qualitative method and performed in Boston, Massachusetts.Both studies said that pregnant women were seeking information across multiple of information.The single primary sources of information used by pregnant women in Willcox et al. (2015) study was the internet.Criss, Oken, Guthrie, & Hivert (2016) didn't assess the most sources of information used by pregnant.They said, mainly trusted information sources was their health care provider.
The other article that has the same focus is the article written by Yamamoto & Wada (2018) and Nosrat, Sedehi, & Golalipour (2012).They have the same topic of the study, information sources of folic acid intake and also used the same quantitative research method.But they had the different locus of the study.Yamamoto & Wada (2018) researched Japanese pregnant women while Nosrat, Sedehi, & Golalipour (2012) researched Iranian pregnant women.The result of the investigation is different.
The most used Sources of information were the Internet, newspaper/magazine, and medical staff (Yamamoto & Wada, 2018).While in the Nosrat, Sedehi, & Golalipour (2012) assessment, the most common information sources on folate were healthcare service.
The same topic in study information source used by pregnant women also done by Sayakhot & Carolan-Olah (2016) and Khooshehchin T.E., Keshavarz Z., Afrakhteh M., Shakibazadeh E. (2017).The two article discusses the source of Gestational Diabetes Mellitus (GDM).This twoarticle have a different approach and different sample, Sayakhot & Carolan-Olah (2016) used a qualitative research method with Australian pregnant women as a sample while Khooshehchin T.E., Keshavarz Z., Afrakhteh M., Shakibazadeh E. ( 2017) used qualitative research method with Iranian as a sample.Sayakhot & Carolan-Olah (2016) found that general practitioners were the best source of GDM information.This result was strengthened by the result from other.Khooshehchin T.E., Keshavarz Z., Afrakhteh M., Shakibazadeh E. (2017) didn't assess the most used source of information but they studied what was the reliable information used.They found the majority of the pregnant women relied on physicians as their reliable sources of information.
From the three cases above, we can conclude that the same information needs are not necessarily obtained from the same information source.It influenced by several factors, such as the characteristics of the sample.The assessment of the most information sources used conducted using the quantitative method.Qualitative method is used to identify the pregnant women perceptions about the sources of information.
Pregnant women used various information sources.The literature also studied the preferences of pregnant women to use specific information sources.
From the text analysis of 36 article, there are four sources of information that are most used by pregnant, namely, family and friend, online information, book, and health practitioners.Online information is a technology-based information source, i.e. the internet, you tube video, web, online forum, and social media.Health practitioners are those who have health problems expert.Ariadne et al. (2018), Fabry, Gagneur, & Pasquier (2011), (Chabert et al., 2016) states that general health practitioners are general practitioners, midwives, gynecologists and / or obstetricians gynecologist.In this study, health practitioners include psychologists, nutritionists, doctors, pharmacists, nurses, nutritionists, nutritionists.The mapped of the most information sources used is shown in Table 3.

C. Perceived about Source of Information
The contradictory result are found about internet usage.Internet is most used by pregnant women to meet their information need but they perceived internet is not a reliable source of information about health.They should rather get information from health professionals (Palosse-cantaloube et al., 2014).Information from health professionals is more reliable compared with information from internet.
Receiving information are not guarantee that pregnant women meet their need.Unreliable information are given negative effect for pregnant mother psychology.Pregnant women who are received unreliable information are found to have higher anxiety compared with pregnant women who receive professional information (Çakar et al., 2016).
Internet provide a huge amount of information.Because of that, getting relevant information in internet is not easy (Carlsson et al., 2015).Pregnant women need certain technique to find relevant information from an overwhelming amount of information on internet.For some pregnant women, internet were considered as an unhelpful information (Lee, Holden, & Ayers, 2016).Beside health practitioners, family and friends belief as a trusted sources of information (Lee, Holden, & Ayers, 2016).Health professionals should actively give information for pregnant women (Crawford-Williams et al., 2015).Not received information regarding the ways to control the disease or the side effect from the midwives become an unpleasant experience (Khooshehchin T.E., Keshavarz Z., Afrakhteh M., Shakibazadeh E., 2017).
V. CONCLUSION The information need by pregnant women that discuss in the article is medicine or medication use in pregnancy, nutrition, and health disorders.Pregnant women are actively seeking information to increase their knowledge.During pregnancy, they more aware of their health.Almost all literature mentions health practitioners as the sources of information.Sources of information that used by pregnant are family and friend, online information, book, and health practitioners.
The internet is perceived as unreliable information.Health practitioners are the trusted sources of information.Health practitioners should be actively exposed information to pregnant women.Online information is a tool that can be used by health practitioners to expose health information.Pregnant women should carefully choose the information from the internet.The anxiety level of women who received any information, other than professional sources, is increase.
13 (Khooshehchin T.E., Keshavarz Z., Afrakhteh M., Shakibazadeh E., 2017) Gestational diabetes physicians, family, the mass media, health personnel as, books, internet The majority of the participants expressed that they had mostly relied on physicians, family, the mass media, and health personnel as their reliable sources of information.

SOURCES OF INFORMATION USED BY PREGNANT WOMEN
No. Sources of information Article 1.
Family and friend • Family and friend were the most source of information used pregnant women to meet their information need about zika virus (Chan et al., 2018) • Family and neighbor were the predominant sources of information for pregnant teenagers in Ejisu-Juaben Municipality, Ghana (Owusu-addo, Owusu-addo, & Morhe, 2016) • In Complementary medicine products used in pregnancy and lactation, women elders being the most commonly identified information sources (Ariadne, Barnes, Barclay, Mccaffery, & Aslani, 2018) • Informal sources to get information about herbal medicine are friends and relatives (Abdollahi & Yazdani Cherati, 2018) • Third group (thrid trimester): Information about breastfeeding from friends (Szwajcer, Hiddink, Koelen, & van Woerkum, 2005) 2.