ENGLISH CONVERSATION

FOR MIDWIFERY STUDENTS

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NOVIANA KURNIAJATI,M.Pd.B.I

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1
 FOREWORD

First of all,I would like to say praise to Allah SWT the most beneficient
and the most merciful.This module has very good contents and
application of daily conversation for health student,medical
staff.Considering of improvement of indonesian quality health
worker,we should prepare our education system by intregated English
program combined with health staff Science,it will improve the students
quality,Particularly for Health Academy in Indonesia.

In globalization era,English has very important roles because this

language is used in all over the world.Therefore we should improve the
English skill to all of health students,so they are prepared for future
challange and the job field.I hope this module will give a contribution for
all of health Academies and Medical Institutions.

2
 PREFACE

In the name of Allah the most merciful and the all compassionate.

All praises and thanks due to Alloh SWT,the Master of

Universe.This module is intended to assist the student of health
Academy and Medical staff in making daily conversation at their
job.Conversation English for Midwifery students is needed in guiding
the students achieve the English communication skill.

This module is very easy to be learnt in any situation.Many of

expression are adjusted to hospital setting,so that health staff will benefit
from them in the routine work.Health students will also be introduce to
help the students to communicate in conversational exchanges the
process of communication during the examination of 9-months
pregnancy and can help them to develop the reading ability so that they
are capable of understanding texts concerning midwifery..

I hope this module,the students of ‘Sekolah Tinggi Ilmu

kesehatan,Students will be able to learn and practice English according
to their professional skills.The mastery of English for health students
will,in turn,improve their quality of human resources and they will have
added value so that job opportunities will be widely open for them to
reach a bright future.

Noviana Kurniajati,S.Pd,M.Pd.B.I

3
 CONTENT

FOREWORD..............................................................................................i
.

PREFACE....................................................................................................
ii

MODULE 1.THE MIDWIFE....................................................................1

 USEFUL EXPRESSION..............................................................1
 VOCABULARY..........................................................................2
 GRAMMAR FOCUS...................................................................3
 PRACTICE...................................................................................4
 ROLE PLAY................................................................................5

MODULE 2.CHECKING VITAL SIGNS.................................................

 USEFUL EXPRESSION............................................................
 VOCABULARY.........................................................................
 GRAMMAR FOCUS.................................................................
 ROLE PLAY..............................................................................

MODULE 3.PHYSICAL EXAMINATION............................................

 READING.................................................................................
 GRAMMAR FOCUS................................................................
 PRACTICE................................................................................
 ROLE PLAY.............................................................................

MODULE 4.TEENAGE PHYSICAL CHANGE...................................

 READING.............................................................................
 VOCABULARY...................................................................
 GRAMMAR FOCUS............................................................
 ROLE PLAY........................................................................

4
MODULE 5.THE PRESENTATION AND LIE.................................

 READING.............................................................................
 VOCABULARY..................................................................
 USEFUL EXPRESSION......................................................
 ROLE PLAY.........................................................................

MODULE 6.AT THE LABOR STAGE.............................................

 ROLE PLAY..........................................................................
 VOCABULARY....................................................................
 USEFUL EXPRESSION.......................................................
 PRACTICE...........................................................................
 GRAMMAR FOCUS...........................................................

MODULE 7.CONTRACEPTIVE METHOD...................................

 READING...........................................................................
 ROLE PLAY.......................................................................
 VOCABULARY.................................................................
 USEFUL EXPRESSION....................................................

MODULE 8.DEALING WITH POST PARTUM WOMEN...........

 ROLE PLAY......................................................................
 VOCABULARY.................................................................
 USEFUL EXPRESSION.....................................................
 GRAMMAR FOCUS.........................................................

MODULE 9.NEW BORN BABY CARE........................................

 USEFUL EXPRESSION..................................................
 VOCABULARY...............................................................
 GRAMMAR FOCUS........................................................
 PRACTICE.......................................................................

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  ROLE PLAY.....................................................................

MODULE 10.WOMEN’S REPRODUCTIVE DISORDER SYSTEM

 READING...............................................................................
 VOCABULARY.....................................................................
 GRAMMAR FOCUS.............................................................
 ROLE PLAY..........................................................................

MODULE 11.STRUCTURE AND WRITTEN EXPRESSION IN

TOEFL.....................................................................................................

 MODEL TEST 1.....................................................................

MODULE 12.LISTENING IN TOEFL..................................................

 MODEL TEST 1.....................................................................

MODULE 13.READING COMPREHENSION IN TOEFL.................

 MODEL TEST 1....................................................................

APPENDIX.VOCABULARY...............................................................

6
UNIT 1 MIDWIFE

Every medical staff needs a communication skill.When you

communicate to a stranger,patient and doctor,you need some clues and
expressions to start your conversation.In this unit you will be introduced
to several common phrases starting with convversation and useful
expressions.

A. Useful Expression For Medical Staff

Good morning.
Good afternoon.
Good evening
How nice to see you?
How are you doing?
Long time no see
How’ve you been?
What is your complaint?
What’s wrong with you
What’s the matter with you?
What’s troubling you?
Have you taken your medicine?
I hope you will get well soon.
Can I ask you something?
Does it hurt here?
How long have you felt like this?
Let me examine you,Mrs.Nency.

B.Useful Expression for Patient

I am pretty well.

I am fine.

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 I am really unwell.

I am feeling unwell

I really don’t feel well.

I am going to be sick.

I feel like vomiting.

Ouch! It’s very painful.

I have got headache.

c. Vocabulary

give birth : Melahirkan

newborn : Bayi baru lahir

infant : Bayi yang masih sangat muda

implement : melaksanakan

measure : Mengukur

independent practitioner : Praktek mandiri

competent : mampu

prescribe : meresepkan

reduce : mengurangi

prevent : mencegah

improvement : peningkatam

D.Grammar Focus :Verb To Be in the simple Present Tense and

the Past Tense

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 There are generally three paterns for the use of the verb ‘to be’ or
linking verbs,in the simple

Present tense.These patterns are:

1. Subject + To be + noun

The new doctor is a surgeon.

Measles and Mumps are diseases.

2. Subject + To be + Adjective
The patient is weak.
His Temperature is high.
AIDS is contagious.
3. Subject + To be + Adverb
The patient is in the hospital.
She is at the maternity ward.

Present Tense Past Tense Past Participle

Attend attended attended

Take took taken

Go went gone

1.Mr Gunawan attends medical conferences every year.

2.Mr Gunawan doesn’t attend medical conferences every year.

3. Does Mr Gunawan attend medical conference every year?

4.His fever lasted only five hours ago.

5.His fever didn’t last only five hours ago.

6.Did fever last only five hours ago?

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 TASK 1

In the following exercises you will have to use the basic tenses that have
already been discussed in the structure focus.Try to translate with the
correct form below.

1.Dia pergi ke rumah sakit dengan Taxi setiap hari.

2.Mr.Budi bekerja di ICU pada salah satu di rumah sakit dikota.

3.Mr.Budi bekerja disana hampir lima tahun dan cukup bahagia

dengan pekerjaannya.

4.Dia tidak pernah sakit kecuali dikarenakan demam atau flu

5.Tetapi kemarin pagi dia menderita nyeri dilengannya,sebuah gejala

yang tidak pernah dia alami sebelumnya.

6.ECGnya menunjukan bahwa dia terkena serangan jantung.

7.Mrs.Ngaben bercakap –cakap kepada dokter sebelum dia dan

suaminya meninggalkan klinik.

8.Sebelum dia meninggalkan rumah sakit ,dia konsultasi dulu ke

dokter kandungan.

9.Dua hari yang lalu dia mengambil obat di apotik sambil membawa

resep dari dokter.

10.Wanita muda itu mengeluh kehamilannya di trisemester pertama.

E. Practice

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 Build a dialogue with your partner based on the situation
given:

a. Greet the patient.

b. Give response.

a. Ask about health problem.

b. Give response.

a. Ask about the frequency of the problem.

b. Give response.

a. Ask the symptom and indication.

b. Give response.

a. Measure the weight.

b. Give response.

a. Measure the height.

b. Check blood pressure

b. Give response.

a. Give advice.

b. Give response.

a. Leave taking

b. Give response.

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 F.Role Play

INFORMATION SERVICE

Situation :Mr.Erric Smith.a England businessman asks for some

Information.

Receptionist : “Good morning,Sir.Can l help you?”

Mr Smith : “Yes please.l need some information.My wife is

Expecting a baby.l think she is in her five –month

Pregnancy.”

Receptionist : Okay...Where is she?”

Mr.Smith : “She is still in the hotel.We came here six months

ago.Can l register her to get some care?”

Receptionist :”Of course.We offer a special care for a prospective

Mother.Let me fill out a form.is it your first baby?”

And what is your name,Sir?”

Mr.Smith : Erric Smith.You can have a look at my passport.”

Receptionist : “Fine.What about your wife?”

Mr.Smith : Margaretha Smith.Here is her passport.”

Receptionist : Fine.Look Mr Smith.We,in the hospital have a parent

Education program.”

Mr.Smith :”That is very interesting.When can l bring my wife

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 And What time does the doctor start to see the

patients?”

Receptionist : “Come tomorrow morning.”.At half past eight.You

Will be the first couple.”

Mr.Smith : “Thank you.We will be here early.”

Receptionist : “Which hotel do you stay at?”

Mr.Smith : “At Royal Park.It is very convenient.”

Receptionist :”Good,here is your card.Call us any time for

Emergency.Tell Miss.Smith to have enough food

And rest.”

Mr.Smith : “Thank you very much.See you tomorrow.”

Receptionist :”It’s my pleasure.Have a nice day,Sir.”

I. Translate into good English.

Nurse : Selamat pagi.

Visitor : Selamat pagi.

Nurse : Apa Kabarmu? Apakah kamu baik- baik saja ?

Visitor : T idak terlalu jelek.Saya hanya agak capek.

Nurse : Itu biasa.Bayimu saja baru 6 minggu umurnya.Cobalah

untuk tidur setiap bayimu tidur.Biarkan orang lain yang

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 melakukan pekerjaan rumah.

Visitor : Ya terima kasih.

Nurse : Tak apalah.

Apakah kamu punya beberapa kekhawatiran tentang

bayimu?

Visitor : Ya

Saya khawatir tentang bayi saya.Dia sering menangis akhir

–akhir ini.

Nurse : Apakah kamu menyusuinya.

Visitor : Ya.

Nurse : Berapa sering kamu menyusuinya.

Visitor : Setiap kali dia ingin minum.

Nurse : Apakah kamu tahu berapa banyak popoknya basah

biasanya bayimu kencing dalam 24 Jam.?

Visitor : Saya tak begitu yakin,tetapi saya kira hampir setiap 2 jam

dia kencing

Nurse : Bagus.Dia juga berkembang sangat bagus.Dia sekarang 5

kg.Itu berarti

dia mendapat cukup ASI.Lebih banyak bayi minum,lebih

banyak A akan berproduksi.Dia baik -baik saja.

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Visitor : Saya sangat lega sekarang.

Nurse : Jangan khawatir.Kebanyakan bayi ingin minum banyak

seringkali menjelang larut Malam dan mungkin sangat

tidak tenang pada sore hari.Mereka biasanya tenang

Menjelang umur 3 bulan. Baiklah ,jangan lupa

meneruskan menjaga makananmu.Ingat bahwa ASI

merupakan makanan satu-satunya yang dibutuhkan oleh

bayi untuk Usia 4 sampai 6 bulan pertama.Makanan dan

cairan secara teratur akan diperlukan selama menyusui

supaya menghasilkan cukup ASI dan mempertahankan

energi dan kebutuhan nutrisi.

Visitor : Saya akan coba yang terbaik buat bayi saya.Terima kasih

banyak.

Nurse : Sama-sama .Kamu dapat datang kapan saja kamu memiliki

kekhawatiran tentang Bayimu.Jangan lupa mengenai

jadwal imunisasi bayimu!

Visitor : Tidak.

Nurse : Sampai jumpa lain waktu.

Visitor : Sampai jumpa lain waktu.

15
UNIT 2

CHECKING VITAL SIGNS

Here are important examinations given to patient.

BP : stands for blood pressure is measured in mmHg.millimeters of

mercury.it is usually measured using sphhygmomanometer.Normal adult
blood pressure is about 120/80.A higher than normal blood pressure is
called hypertension’and a lower than normal blood pressure is called
hypotension.

T :stands for body temperature . it is measured in degrees centrigade

using a thermometer-mercury or electronic,or a heat –sensitive
strip.Normal body temperature is considered to be 36.8 degree s
centigrade.A Patient who is febrile has a high temperature or
pyrexia.Temperature is normaly lowest in the morning and the highest in
the evening.Temperature can be measured orally,or rectally.in the axilla
under the arm or in the ear.Hypothermia refers to abnormally low body
temperature.

P :stands for the pulse rate which is the wave of pressure travelling along
the arterial system,created by a contraction of the hearth forcing blood
into the aorta during ventricular systole.The pulse rate can be counted
over major arteries:the carotid artery in the neck,the redial or the
forehead,the most convenient point to take a person’s pulse is on the
anterior surface of the wrist;it is less convenient to take the apex beat
over the heart using a stethoscope.The number of beats per
minute[b.p.m] are counted and recorded.A normal pulse rate varies
between 68 and 84 b.p.m.pulse rate is not normally slower than 50
b.p.m.The pulse rate is also described as either regular or irregular.

R :The initial R stands for the patient’s respiration rate and is measured

in breaths per minute.

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 Normal respiration is approximately one breaths per

minute.[Respirations are observed without the

patient being aware usually while taking his pulse.if the patient

realizes that his breathing is being

watched ,the rhythm will change and may hold his breath.

A .USEFUL EXPRESSION

It is time for me....

I just want.....

I would like....

I am going.....

To measure your blood pressure.

To count your pulse.

To check your respiration.

To measure your temperature

To put this cuff around your upper arm.

To insert this thermometer into your anus.

To put this thermometer into your mouth.

Would you mind...

Please.....

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Now l want you to......

Would you.....

Lie down on the couch.

Lie flat on the bed

Roll your sleeve up.

Give me your right / left hand

Unbutton your shirt.

Raise your arm.

Roll your sleeves up.

Roll yourself into a side lying position.

Take a deep breath.

Responses

Ok,fine.That’s it

Fine good

All is done

Finished

B. Vocabulary

Pulse rate = jumlah denyutan

Rhythm or regularity = irama denyutan/ cepat lambat

Tension or compressibility = ketegangan

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Beats per minute = denyutan per menit

Patient’s chart = lembar penilaian pasien

Normal pulse rhythm = irama denyutan normal

Bradycardia = denyut nadi dewasa dibawah 60

beats /min

Tachyardia = denyut nadi dewasa diatas 100

beats/min

Bounding = lompatan denyut nadi yang kuat

Thready/weak = denyut nadi yang semakin menurun

C.Grammar Focus

Passive Voice

Study the following sentences

1.The patient is tired

2. The mother is brought to the delivery room.

3. The young girl is bored with her toy.

4. The medical supply is sterilized in the CSSD.

5 The pediatric unit is located near the post natal clinic

1.TASK 1

Change these sentences into passive sentence.

1.The midwife gains information from the mother.

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 2.The midwife monitors the fetal growth.

3.The 4 dimension USG shows the image of the fetus.

4.The obtetrician undertakes an abdominal examination.

5.The midwife detects any disorders in the pregnancy.

6. The mother undergos heartburn.

7.Obstetrician hears mother complaints.

8.Young mother experiences sleeping disorder

9.The mother feels contraction of the uterus.

10.The midwife assesses the progress of labor.

C.Practice :Translate these sentences into communicative English.

1.Silahkan berdiri diatas timbangan itu.

2.Saya perlu tahu berapa berat badan anda.

3.Saya sedang menghitung denyut nadi anda.

4.Berapa berat badan saya?

5.Tekanan darah anda 110/80

6.Tekanan darah anda sedikit diatas normal.

7.Temperature anda diatas normal.

8.Apakah berat badan saya normal?

9.Berat badan anda 65 kilogram.

10.Berapa tinggi badan anda?

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D.Role play

Examination

Patient : Good Afternoon!

Doctor : Good Afternoon! At last ,you are coming.

Patient : Iam sorry Doc,last week l couldn’t come because l was very

Busy.My relatives fro Jakarta came.

Doctor : Okay.if it is. like that.I can understand.Now please lie

down.I will examine you.

Unbutton your shirt. { check the patient’s heartbeat by

Stethoscope ].

Now l’ll check your temperature.

Now l’ll check your blood pressure.

Now l’ll extract your blood for laboratory examination.

Patient : How is my condition,Doc?”

Doctor : As far as!know,you are healthy.but we will know more after

The result of the laboratoryexamination comes out.

Patient: When is it,Doc?

Doctor : Maybe tomorrow.Please take the result in the laboratory.

After that,Please give it to me.I will see the result and make

You know if you suffer from any illness.

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Patient : Thank you.Doc.

Task 1 : Make a communication exchange on:

 Greet the patient.

 Measure the height of the patient.
 Measure the weight of the patient.
 Measure the patient’s blood pressure.
 Ask the complaints
 Give a diagnoses
 Give suggestions
 Give insruction/ prohibition.
 Give a prescription.

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UNIT 3 PHYSICAL EXAMINATION

A.Reading
Physical examination

The physical examination is performed for all women

during the’pre-conceptional visit or the first pregnancy visit. The
elements of the physical examination include : general appearance
and nutrition: head and neck, heart and lungs, breasts, abdomen,
pelvic area tenderness, extremities and back, neuromuscular ; and
pelvic evaluation – speculum and bimanual examination, clinic
pelvimetry.

At each follow-up visit, the patient should be given an

opportunity to ask question about her pregnancy or comment on
changes that she has noted. The physical exam should include
general appearance, nutrition, blood pressure, weight (including
pattern of weight gain), uterine size, heart rate of mother and fetus,
and cervical check after 40 weeks. The cervical check should
include dilatation effacement, fetal presentation, and station. The
findings of this exam should be carefully documented and should
be assessed during each visit. The patient should be asked about
fetal movement at each visit. Urine should be checked to detect
protein and glucose. Any change in the pregnancy risk assessment
should be recorded after each evaluation and an appropriate

23
management plan outlined. Continual risk assessment should be a
standard part of the ante-partum care.

B.IMPERATIVE

When you do physical examination to your clinic,you will give

some insruction.Below are some instructions using imperative that
commonly a health care givers such as a midwifes or nurses give
when they doing physical assessments

 Have a seat please

 Roll your sleeve up please
 Stand on this scale please
 Say ninety nine
 Say ah please
 Put this thermometer in your arm please
 Let me have your wrist please
 Roll your blouse up please? I need to check your abdomen
 Lower your trouser please
 Bend your knee please

Minor Problem

Minor Problem Suggestion

1.Nausea -It is normal.it’s caused by the
change of the
hormones during gestation.
-l need to refer you to an
internist.

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 2.Backache -it’s normal.it’s caused the
changing center of
gravity during pregnancy.
3.Heartburn -Just avoid bending over while
housekeeping.
-Just knee when taking
something from ground.
-Sleep with more pillows
4.Constipation -Drink a lot of water
-consume fresh fruit,vegetables
-Drink a glass of warm water in
the morning.
-Do mild exercise,such as
walking.
5.leg cramp -just sit,hold the knee straight
6.white vaginal discharge -keep personal hygiene
-wash with plain water twice a
day
-give a mild cream.
7.Varicose vein -Rest with vertical againts the
wall for short time
-make circling movements with
ankles.

C. GRAMMAR FOCUS :Degrees of comparison

The degrees of comparison

-Positive degree : is shown with”as.......as

The process of delivery takes as long as the previous one.

-The comparative degree is usually known wih more+adjective+er

and the irregular form of comparative,and the

word”than”,....er and....er .

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 No more than one hour we should reach the hospital.

Your abdomen will be bigger and bigger during your pregnancy.

-Superlative degree is shown with the+superlative form [est]

POSITIVE COMPARATIVE SUPERLATIVE

Little
Fewer
More carefully
Successful
Far
Longer
Expensive
Task 1: put the words in brackets into a correct comparative
form.

1.when a woman is pregnant,the hormons of pregnancy have [ great

] than the mechanical effects.

2.individuals nowdays have [ high ] expectations of marriage and [

little ] prepared than their parents to tolerate an unsatisfactory

relationship.

3.The abnormality rate among babies of diabetic mothers is up to

five times [ high ] than among Those.Those of non diabetics.

4.it has been suggested that midwifes should be [ many ] involved

with the confirmation of pregnancy.

5.as labor progress a mother may feel [ little ] confindent in her

ability to cope with contractions.

26
 6.pregnant women pass [great ] amount of urine than non-pregnant

woman.

7.normally all the glocose is reabsorbed,if there is already [ many ]

than sufficient in the blood.

8.Most men are now ready to take [great ] share in household Tasks.

9.Two-handed grip to asses the pelvis is favored because it is [

comfortable ] for the woman and gives the most information for

the midwifes.

10.Anterior position of the fetus is [favorable ] to deliver than

posterior position.

D. PRACTICE

Task 1: Answer all of these questions and read your answer in

front of the class.

1.Give your advice to the situation and illustrate it below.

A. Man is hit by a car

B. A lady vomits blood

C. A man looks weak

D. A blind man is going to cross the street

2.How to face a hopeless a patient?

3.What is your advice to your patient when she is in pregnancy?

27
4.Give your suggestions in improving the quality of indonesian

health students?

5.What should you do if you found one of your friend cannot

speak English at all?

Task 2: Translate into good English

1. Ny.Ratna,Anda harus istirahat total selama tiga hari.

2. Sebaiknya Anda mengunjungi bagian saraf dilantai dua.
3. Ingat! Jangan bekerja terlalu keras Nyonya Dewi.
4. Menurutmu,saya harus bagaimana?
5. Saya pikir sebaiknya Anda berkonsultasi dengan dokter.
6. Pak,Anda mengalami masalah dengan lambung anda,anda
diminta untuk menghindari makanan yang asam.
7. Saya akan menjelaskan program diet yang sesuai dengan
kebutuhan anda.
8. Apakah porsi makananya cukup untuk ibu?
9. Apakah anda alergi terhadap makanan laut?
10. Ini daftar pilihan menu ,silahkan pilih untuk sarapan anda
besok.
11. Selamat makan.
12. Anda harus membatasi diri dalam mengkonsumsi minuman
soft drink.
13. Anda harus mengurangi konsumsi karbohidrat.
14. Dokter mendiagnosis anda mengalami serangan jantung,saya
menyarankan bapak banyak mengkonsumsi banyak buah-
buahan.
15. Mengapa makan siangnya tidak dihabiskan?

E.ROLE PLAY
TASK 1 : Antenatal Care
Doctor : Ibu-ibu..Anda tampak segar dan cantik..saya senang

28
 anda hadir lagi disini disini hari ini.
Miss M :Topik hari ini apa,dokter?”
Doctor :Topik kita hari ini ialah perawatan antenatal,artinya
sebelum kelahiran bayi.Hal ini adalah Menjaga diri
anda sebelum bayi lahir.Anda harus makan yang
baik..tidur cukup..jauhkan obat-obat yang berbahaya.
Miss M : Apa contohnya?”
Doctor : Jangan sekali-sekali menyentuh alkohol dan jangan
merokok!Kalau anda ikuti nasihat ini,bayi anda akan
mendapatkan kesempatan terbaik untuk mulai awal
kehidupan.Anda akan mendapatkan tenaga anda lebih
cepat setelah melahirkan dan mempunyai tenaga lebih
untuk menyusui.kami diklinik ini mempunyai
perawatan antenatal yang diselenggarakan oleh
perawat kami untuk anda.Daftarkan diri anda
untuk pertemuan mingguan seperti ini.”
Miss M : Sebaiknya kapan,Dokter?”
Doctor : Ya..segera setelah seorang wanita tahu bahwa dirinya
hamil.”
Miss M :”Apa sebenarnya tujuannya,Dokter?”
Doctor :”Untuk memeriksa dan menjaga supaya anda tetap
sehat..bahwa bayi anda tetap sehat..bahwa bayi anda
tumbuh dengan baik..tentu untuk mendeteksi setiap
masalah sedini mungkin sebelum mempengaruhi
kesehatan anda dan bayi anda..yaa untuk memastikan
bahwa anda sehat selama hamil dan kemudian
melahirkan bayi yang sehat...datanglah sebulan sekali
..dan dua kali sebulan di akhir kehamilan.
Miss M : Terima kasih ,Dokter.

29
UNIT 4 TEENAGE PHYSICAL CHANGES

A.Text

The teenage years are also called adolescence.Adolescence is

time for growth spurts and puberty changes.An adolescent may
grow several inches in several months followed by a period of very
slow growth,then have another groth spurt.changes with puberty
[ sexual maturation ] may occur gradually or several signs may
become visible at the same time.

There is a great amount of variation in the rate of changes that

may occur.Some teenagers may experience these signs of maturity
sooner or later than others.Sexual and other physical maturation
that occurs during puberty is a result of hormonal changes.In
boys,it is difficult to know exactly when puberty is coming.There
are changes that occur,but they occur gradually and over a period
of time,rather than as a single event.While each male adolescent is
different,the following are average ages when puberty changes
may occur:Beginning of puberty 9.5 to 14 years old,first pubertal
change enlargement of testicles,appearance of pubic hair 13.5
years old,hair under arms and on the face,voice change,and
acne:15 years old.

Girls also experience puberty as a sequence of events,but their

pubertal changes usually begin before boys of the same age.Each
girl is different and may progress through these changes
differently.The following are average ages when puberty changes
occur: first pubertal change [ breast development ],pubic hair
development [shortly after breast development ],hair under the
arms [12 years old ],menstrual periods [10-16.5 years old ].

30
 The teenage years bring many changes,not only physically,but
also mentally and socially.During these years,adolescents increase
their ability to think abstractly and eventually make plans and set
long-term goals.Each child may progress at different view of the
world.in general,the following are some abilities that may be
evident in the adolescent :develop the ability to think
abstractly.concerned with philosophy,politics,and social
issues,think long-term,sets goals.

To consider ways to foster the adolescent’s social abilities by

encouraging the adolescent to take on new challenges,talking with
the adolencent about not losing sight of one’s self in group
relations,discussing ways to manage and handle stress,providing
consistent;loving disciple with limits;restrictions;rewards and
finding ways to spend time together.

Answer these questions

1.How much will the adolescent grow?

2.What changes will occur during puberty ?

3.What does the adolescent understand?

4.How to assist the adolenscent in developing ‘s social abilities?

Physical changes during adolescence

The Breasts development Growth of the penis and testes

The start of periods Change the body shape and

height

31
Growth of pubic and body hair Erections with ejaculation

Changes in body shape and Growth of the body

height
Changes to voice

Social changes Changes in Emotional

relationship changes
Searching for Want to spend less Shows strong
identity time with family feelings
Seeking more Has more arguments More sensitive to
independent with you your emotion
Looking for new More self
experience conscious
Starting to develop
and explore a
sexual identity

B.VOCABULARIES

 Teenager : remaja
 Body odour : bau badan
 Smelly feet : bau kaki
 Dental hygiene: kebersihan gigi
 Shaving : mencukur
 Adolesnce is the period of development that begins at
puberty and ends at emerging adulthood:the typical age
range is from 12 to 18 years ,and this stage of de
velopment has some predictable physical milestone
 Puberty : the age at which a person is first capable of
sexual reproduction

32
  Adolescence=the process or state of growing to
maturity..the period of physical and psychological
development from the onset of puberty to adulthood
13-19
 Occur : terjadi
 Restriction: batasan
 Develop : mengembangkan
 Growth : pertumbuhan
 Sequence : serangkaian

C.GRAMMAR FOCUS : Asking questions with Wh-questions

Who are in the clinic for morning shift? Diana and Susi are in the clinic fo
morning shift
Whose are those medical books? They are mine
What do you usually do in your spare time? I like reading a magazine

When does she usually breastfeed her baby? Every morning before going to wo

Which do you choose red one or blue one? I like blue one

Where did you go for a check up yesterday? It was in the Bagas Waras Hospita
I went to the Hospital
Why didn’t you attend the seminar last I had fever
week?
How will you suggest to a pregnant mother? I suggest to her not to work hard

33
 Which part is pain? On My pelvic

What medicine have you taken to reduce the I have taken aspirin
pain?
How long have you hospitalized in the It has been 3 days.
hospital ?
How many times should you take this Three times a day
medicine?
How should l fill this form? Just write your personal details

How much do you weigh? I am sixty kilograms

Asking qustions with Yes / No Questions

Are you a midwife? Yes,l am .I am a midwife in

state hospital.
Is it your phone number? Yes ,it is
Were They your classmate in No,They weren’t
the college years ago?
Do we need to administer the Ye s we need to do this right
drug now? away
Does your husband smoke? Yes he smokes.
No he doesn’t
Did you take a nap just now? Yes l took a nap few minutes
ago.
Did they visit you when you Yes they visited me while
were admittted in the hospital? bringing some fruits.
Are you allergic to seafood? Yes l am .
Are you worried about your Yes l am worried now.I feel
pregnancy? terrible in my stomach now.

34
 Can you get on the scale now? Yes l can.I will do now.
Will you consult your Yes I will.I plan to visit the
pregnancy disorder to the clinic this afternoon.
midwife?
May I occupy this seat? Yes you may.You can sit beside
to me.

D.Practice.

Make these sentences into English Wh-questions!

a.Siapa yang akan menemanimu untuk konsultasi nanti malam?

b.Dimanakah tempat praktek Bidan Diana sekarang?

c.Kenapa pasien itu tidak membawa surat rujukan?

d.Apa yang telah dokter resepkan kepada ibu hamil itu?

e.Kapan anda mengalami muntah dan mual?

g.Bagian yang mana yang terasa nyeri?

Make these sentences into English Yes-No questions

a.Apakah ibu merasa pusing?

b.Sudahkah anda ambil rekam medisnya?

c.Bisakah suami saya menemani persalinan nanti?

d.Apakah saya harus minum obat tiap hari?

e.Apakah ibu akan melahirkan diromah bersalin?

35
.ROLE PLAY

Make in pairs to create a conversation using English

- Greet the child

- Tell the complaints

- give the suggestions what should be done

36
UNIT 5 THE PRESENTATION AND LIE

A .Reading
The fetal presentation refers to the part of the fetus which
occupies the center of the pelvic canal and which the examining
finger feels on the vaginal examination.Fetal lie is the position of
the fetus in the uterus.The fetal lie is determined by the raltionship
of the long axis of the fetal spine on the long axis of the maternal
uterus.

Some words which are usually combined with lie and

presentation
normal.longitudinal,transverse,oblique,breech,vertex.Normal lie is
longitudinal,the position of the fetal spine that indicates the
position of the head.Abnormal lie is transverse or oblique.There
are five main presentations of the fetus,they are :
vertex,brow,face,breech and shoulder presentation.The normal
presentation is with the head[ vertex presentation].The abnormal
presentation is called breech or shoulder presentation.Breech is and
oldword for buttocks.Abnormal presentations may require delivery
with forceps.

There are two methods of undertaking pelvic palpation to assess

the fetal presentation.

1.Using both hands.One either side of the

presentation [fingers facing towards woman’s feet

].The presentation can be felt beneath the hands.lt’s

helpful if the woman can take a deep breath and

37
 hold it for a moment while the hands are able to

feel deeply around the presentation.

2.Pawlik’s manuver.lt is using one hand with fingers

facing the woman’s head.The presenting pole is

held between the fingers and thumb.This should be

one very gently,as it is uncomfortable for awoman.

Group Discussion

1.What is your intervention .if you find an olique

position in the fetus?

2.What is delivery with forceps?

B.VOCABULARIES

 Require : meminta,memerlukan
 Undertake : melakukan
 Assess : mengkaji,menilai
 Face : menghadap
 Beneath : dibawah
 Towards : kearah
 Arround : sekitar
 Breath : bernapas
 Breath : napas
 Pole : ujung dari dua sisi bagian luar
 Uncomfortable : Tak nyaman

38
  Comfortble : nyaman
 Maneuver : gerakan teratur dan terencana
 Presentation : posisi janin yang terdepan dalam
persalinan
 Lie : posisi baring janin diperhitungkan dari posisi
lintang tulang belakang dengan posisi rahim
 Axis : garis tengah
 Spine : tulang belakang
 Vertex : belakang kepala
 Brow :kening
 Breech :pantat
 Forceps : pinset untuk membantu proses kelahiran
dengan penyulit
 Longitudinal : posisi sejajar
 Transverse : posisi melintang
 Oblique : posisi silang
 Pelvic canal : rongga panggul
 Pelvic palpation : palpasi panggul
 Presenting pole : petunjuk yang terdepan

C.EXPRESSION
A.Explaining the procedure [ Telling the intention ]

 I have to put the gel on your stomach .

 I have to check your baby’s heart beat.
 I have to give mild pressure here on your abdomen.
 There we go
 I see

39
D.ROLE PLAY

Midwife : OK,Nency,l have to put this Gel on your

stomach.

Mother : What’s for ?

Midwife : So we can check your babies heart beat and

see if he’s in correct position.

Mother : Oh l see.

Midwife : I have to check your baby heart beat.

Mother : Wow .That seems fast.

Midwife : Yes.Your baby’s heart beats much faster than

yours.

Mother : Really?

Midwife : Yes,Usually between 129 to 180 beats per

minute.

Mother : So.l’m OK then.

Midwife : Yes .fine .Now look at the screen.

Mother : Is that my baby ?

Midwife : Yes it is Nency.There is the head and there is

his foot

40
Mother : I see.Is everything normal ?

Midwife : Yes.See how the baby’s spine is the same

direction as yours.

Mother : That’s what we look for.This shows a normal

position.

Mother : Oh good.

E.GRAMMAR FOCUS : Adjective & Adverb

Study the undrlined word below

verb Noun Adjective Adverb

responsible responsibility Responsive responsibly
Beautify Beauty Beautiful beautifully
Activate Activity Active Actively
strengthen Strenght Strong Strongly
Deepen Depth Deep Deeply
Heighten Height High Highly
Create Creation Creative Creatively

Contoh : -The hall has been beautifully decorated for the

opening ceremony. Adverb
-A person who has good leader can help his
people make fast progress. Noun

41
 -Everyone must work hard if he wants to be
successful.
Adjective

TASK 1 : Complete the sentence using Adverb, Adjective or

Noun below.

1.Your contraction will......increase more [ gradual / frequent ]

2.She has.....been diagnosed with PIH.[ recent ]
3.You need an... treatment.[ immediate]
4.We will help you........[ immediate ]
5.we must do this section......[ careful ]
6.The obygn will .....help you ,as he arrive here.[immediate ]
7.The client demontrates medication instillation by....dropping
the solutionn on the cornea.[careful ]
8.You need to pay a.....visit the midwife....[ regular / month]
9.You should take the medication once......in the morning.[
day ]
10.The midwife’s best action is to have the specimen analized
.........in the laboratory.[immediate ]

42
6. AT THE LABOR STAGE

WARMING-UP

1.Apakah kamu kemarin mengumpulkan tugas?

2.Apakah kamu akan latihan besuk?

3.Apakah kamu setiap sekali seminggu berlangganan

majalah?

4.Apakah kamu sudah mengkomfirmasi dosen

kebidanan?

5.Apakah kamu diterima menjadi anggota organisasi

tersebut?

6.Apakah kamu keberatan jika saya meninggalkan kelas

saat ini?

7.Mengapa kamu tidak mentraktir kami di hari ultahmu?

8.Bagaimana kalau menyelesaikan tugas dikosku?

9.Maukah kamu mencoba untuk mengisi blangko ini?

10.Ijinkan aku mengantarmu dulu kemudian aku kembali

masuk kelas?

43
11.Dengan senang hati

12.Alangkah menyenangkan

13.ini kedengarannya menarik

14.saya tidak keberatan

15.tidak apa –apa

16.ini [menyerahkan ]

17.ini tidak jadi masalah

Three stages of delivery

-The first stage : the mother experiences regular contractions

which increase in strenght and frequency.

-The second stage : When the cervix is fully dilated the baby
moves down the birth canal.The head rotates and appears at the
opening.

-The third stage : After the baby has been born,the mother’s uterus
continues to contracts to expell the placenta or after birth.As the
placenta is pulled a

way ,this completes the third and the final stage of labor.

A. Conversation
Midwife : Mrs.Smith,let’s practice breathing for
labor.
Mother : OK.What should l do ?
Midwife : l need to explain to you about breathing

44
 during labor.
Mother : Do we need a certain technique of
breathing?
Midwife : Yes .a certain technique of breathing
will ease your labor.
Mother : Oh ,l see.What should l do?
Midwife :Ok,Now,Just try slowly inhaling and exhaling
throughout your contractions.
Mother :OK.Like this?
Midwife : That’s fine.

Translate this dialogue below using correct sentence

ASSISTING CHILDBEARING

Situasi : Suatu pagi awal.Mrs diah bangun dan terkejut dan

melihat bercak merah yang muncul dicelana dalamnya.dan dia juga
merasakan kontraksi dirahimnya.kemudian dia membangunkan
suaminya.

Mrs diah:Sayang,bangun.saya mengalami bercak darah dicelana

dalam saya dan saya merasa kontraksi dirahim saya,saya pikir ini
waktunya bayi akan lahir.

Husband:Apakah kamu yakin,ya ini sudah dekat dengan perkiraan

lahir.Saya pikir bayi akan lahir segera.saya akan antar kamu ke
bidan.

Mrs diah:Buruan sayang,mari kita pergi sekarang.

Husband:baiklah sayang,jangan kuatir,tenanglah sayang,saya akan

antar kamu ke sana segera mungkin.jangan kuatir,saya akan selalu
ada disisimu.

45
Mrs diah:beruntung,saya sudah mempsiapkan segala sesuatu yang
saya seharusnya bawa untuk proses persalinan.ini ditas itu.apakah
kamu keberatan membawakan nya dke mobil.

Husband:tentu,baru persiapkan dirimu dan naik ke mobil.

Mrs diah: Baiklah.

Mrs diah dan suaminya segera meninggalkan ke klinik bidan.Mrs

diah mencoba membuatnya tenang dimobil.dia tetap berdoa .ini
pengalaman pertama melahirkan.segera dia sampai diklinik.Bidan
langsung membantu Mrs diah ke ruang bersalin dan menyiapkan
segala sesuatu dengan cepat.

Midwife: Baiklah mrs diah jangan kuatir.dan ijinkan saya

mengecek pembukaanmu.Ambil napas untuk menghilangkan
kecemasmanmu.Apakah kamu sudah merasakan kontraksi ?berapa
kali kamu sudah merasakan kontraksi?

Mrs diah: saya pikir ini sekitar 15 menit dan kadang kadang
hilang.saya kuatir

Midwife:suami kamu lebih baik disini menemani anda

melahirkan.ini sungguh baik untuk psikologi anda.

Mrs diah:ya,dia siap dan akan berada disini segera.

Midwife: ijinkan saya memeriksa anda.saya akan mengecek

pembukaan.ini sudah 4 cm pembukaannya.kamu masih
memerlukan 6cm pembukaan sampai ini lengkap 10cm
pembukaan.kamu akan mengalami lebih banyak kontraksi dan
sabarlah karena kamu akan melihat bayimu segera.

46
Mrs diah:tentu saja.saya bahagia tetapi saya hanya kuatir.saya
berharap segala sesuatu akan baik baik saja dan saya akan
melewati proses ini.

Midwife:jangan kuatir.saya disini untuk membantu kamu

melahirkan dan lihat disini suami anda datang menemani anda.

Husband : hey sayang.saya datang dan akan disini untukmu kita

akan melihat bayi kita.

Mrs diah: ini sungguh tidak nyaman.

Midwife :ini gejala umum mam.berfikirlah betapa bahagia kamu

akan melihat bayimu segera,jadi kamu jangan kosentrasi pada
nyerimu tapi bayangkan seperti apa bayimu.mungkin bayimu
seperti mu atau suami anda.saya pikir kita tidak akan menunggu
terlalu lama untuk proses melahirkan ini.

Mrs diah akhirnya pembukaannya lengkap.dia merasa segala

sesuatu tak nyaman dan nyeri.dia tiba tiba ingat ibunya dan
membanyangkan bagaimana ibunya berjuang ketika dia mencoba
untuk melahirkan.air ketuban terjadi dan mrs diah disuruh
mengejan.

Midwife: ya coba dorong sekeras kamu bisa.itu bagus.ya.ini

kelihatan.bagus.

Husband:ayo sayang ,kamu dapat melakukannya.

Mrs diah sedang mengejan sekeras dia bisa dan akhirnya suara
bayi terdengar.

Midwife: ya dan ini bayi cowok.selamat bu diah.

47
Husband :ya,sayang ,kamu hebat.kamu telah memberikan saya
anak laki laki menakjubkan.dia memiliki matamu,dan
hidungku.lihatlah dia.

Semua nyeri yang mana mrs diah rasakan selama proses

melahirkan sudah hilang.Dia hanya merasakan kebahagiaan setelah
melihat bayi laki lakinya.

B.VocabularIes

Realize : menyadari

Preparation: persiapan

Bloody show: flek bercak darah

Childbearing: melahirkan

Opening: pembukaan[ pada awal mau melahirkan ]

Dilatation :pembukaan jalan lahir

Uncomfortable:tidak nyaman

Struggle:berjuang

Examine: memeriksa

Strain : mengejan

Water breaking : pecah ketuban

Anxious : gelisah

Cope : mengatasi

48
Witness:menyaksikan

Pant :terengah-engah

Deliver a baby :membantu persalinan

Squatt: berjongkok

Abduct:meregangkan

Semi recumbent position: posisi semi berbaring duduk setengah

berbaring dengan penopang belakang

Dorsal :berhubungan dengan bagian belakang,wanita yang

berbaring pada punggungnya dengan sedikit menaikan bagian
kepala dan bahunya.

Lateral position : posisi miring

Uterine contraction :kontraksi rahim

Placental perfusion :plasenta kemasukan cairan/darah

Cesarean section : operasi cesar

Stoical behavior: bersifat tak acuh,menahan rasa sakit tanpa

memperlihatkan pada orang lain,tidak mengeluh

Physical pain: bisanya diungkapkan dengan

ungkapan,pain,hurt,aehe

Stretching of the vagina: pelebaran vagina

Pelvic floor : dasar panggul

Preterm: prematur

49
Due date: perkiraan lahir

Puerperium: masa nifas

Primigravida: wanita yang pertama kali mengalami kehamilan

Postpartum hemorrhage:pendarahan setelah melahirkan

Uterine rupture:robekan pada rahim dalam persalinan

Umbilical cord: tali pusat

C.USEFUL EXPRESSION

-There are..two main stages of breathing

-Breath in,breath out...through your mouth/nose

-Take a....deep breath

....deeper inhalation

-Would you try to relax....

-Would you try to calm

-Would you try to be patient

-You ‘re doing Great

-You did a great thing

-That’s great

-Congratulation

-Hold on

50
Mother response

-What do l need to know?

-How am l doing?

Positioning the patient

-Would you lie flat on your back

-Would you sit upright

-Would you roll up your gown

-Would you put both your legs here

-Would you bend your knee

Other expression

-l want to start preparing you for labor

-l want to start teaching you for breathing

-l want to start examining your abdomen

D.PRACTICE

1.Proses melahirkan sudah selesai.

2.Anda harus secara rutin memeriksakan kehamilan

anda.

3.Saya perlu memeriksa bagian perut anda.

51
4.Saya sudah pernah memeriksakan kehamilan saya dua

kali.

5.Apakah anda pernah mengalami pendarahan?

6.Saya sudah minum obat anti nyeri.

7.Apakah anda sudah merasakan kontraksi?

SIGN OF LABOR

Here are some things that may happen in the weeks or days
before labor starts:

Baby drops

If this is your first pregnancy you may feel what’s known as

lightening a few weeks before labor starts.You might sense a
heaviness in your pelvis as this happens and notice less pressure
just below your ribcage,making it easier to catch your breath.

Braxton Hicks contractions

More frequent and itense Braxton Hicks contractions can signal

pre-labor:during which your cervix ripens and the stage is set for
true labor:some women experience a cramp,menstrual-like feeling
during this time.

Sometimes,as true labor draws near,Braxton Hicks contractions

become relatively painful and strike as often as every ten to 20
minutes,making you wonder whether true labor has started.But if
the contarctions don’t get longer,stronger and closer to gether and
cause your cervix to dilate progressively,then what youre feeling is
probably so called false labor.

52
 The cervix starts to change

In the days and weeks before delivery.changes in the connective

tissue of your cervix cause it to soften.what’s more ,Braxton Hicks
contraction may do some of the preliminary work of thinning and
perhaps opening your cervix.

When youre at or near you due date,your practitioner may do a

vaginal exam during your prenatal visit to see whether your cervix
has started to change.

Mucus plug or notice ‘bloody show’

You may pass your mucus plug-the small amount of thickened

mucus that has sealed your cervical canal during the last nine
months-if your cervix begins to efface significantly or dilate as
you close to labor.

The plug may come out in a lump or increased vaginal

discharge over the course of several days.The mucus may be
tinged with brown,pink,or red blood,which is why it’s refered to
as ‘’bloody show’ having sex or vaginal exam can also disturb
your mucus plug and cause you to see some blood tinged discharge
,even when labor isn’t going to start in the next few days.

Water breaks

When the fluid-filled amniotic sac surrounding your baby

ruptures.fluid leaks from your vagina.And whether it comes out in
a large gush or a small trickle,you should call doctor or midwife.

53
Article and picture taken from :
http://www.babycenter.com/o_signs_labor_181.bc

E.Grammar Focus

The Future Tense

Form : Will + verb-
To be +going to + verb
Usage : The future tense with will and to be + going to
+verb describe actions,activities and
conditions in the future.Time marker used are
words in combination with’next’[ next
year,next week,in the future ]
Examples
1.The patient will take urine and blood tests next week.
2. High doses of antibiotics will cure the infection.
3.She is going to see the doctor next Monday.
4.Those patients are going to get hepatitis B vaccine.
5.The doctor is going to examine the patients in a few
minutes.

Task 2 : Translate the sentence below.

1.Saya akan berada dirumah nanti malam.
2.Kami akan ada disana pada hari sabtu.
3.Peter akan kembali besok.
4.Aku tak akan pernah melupakanmu.
5.Dia akan membayarnya jumat depan.
6.Pasien-pasien itu akan mendapatkan vaksin hepatitis B.
7.Dokter itu akan memeriksa pasien dalam beberapa menit.
8.Virus akan masuk tubuh manusia melalui pencernaan.
9.Apakah dokter bedah akan melakukan bedah jantung
dalam beberapa menit lagi?

54
10.Apakah dokter akan memberimu resep setelah
memeriksa pasien itu?

55
UNIT 7: Contraceptive Methods

A.Reading
Education services must provide clients with the information
needed to:

 Make informed desicions about family planning

 Use specific methods of contraception and identify adverse
effects
 Perform breast self examination or testicular self
examination
 Reduce the risk of transmission of sexually transmitted
diseases and Human Immunodeficiency Virus [HIV ]
 Understand the importance of recommende screening tests
and other procedures involved in the family planning visit .

Family planning education must include face to face

instruction with individual client.Additionally film,pamplet
and group discussion may be used.
Initial clients should be offered information about basic
female and male reproductive anatomy and physiology,and
the value of fertility regulation in maintaning individual
and family health.On subsequent visits,clients should be
given information on reproductive health
promotion/disease prevention,as appropriate.
Information on all contraceptive choices.Details on the
safety,effectiveness,benefits,risks,potential side
effects,complications and instructions on how to use the
methods must be given for each contraceptive method prior

56
to the client making an informed choice of method.The
contraceptive education should be offered to clients on the
following contraceptive choices:

A Female Methods Male Methods

 Abstinence  Abstinence
 Contraceptive Sponge  Male Condoms
 Contraceptive  Male
Transdermal Patch Sterilization
 Contraceptive Vaginal
Ring
 Diaphragm/Cervical Cap
 Female Condoms
 Female Sterilization
 Fertility Awareness
Method
 Hormonal Implant
 Hormonal Injectables
 Intrauterine Device
System
 Oral Contraceptives
 Spermicides

In providing contraceptive in formation to clients,staff

should consider and discuss with the clients the methods
for both their contraceptive effectiveness and their
effectiveness in preventing STDs and HIV.Education on

57
emergency contraception must be provided and emergency
contraception must be avalaible on site.
Clinics must use any appropriate opportunity to
provide all clients with information on the following high
priority topics:emergency contraception and STD and HIV
risk and prevention.This education must be done annually
at a minimum.

B.Role play
Ny. ida dan suaminya datang ke klinik bidan untuk
konsultasi KB.Masa Nifas Ny.Ida telah berakhir.Dia perlu
tahu tentang program KB dan saran.
Bidan: Selamat pagi,bu lda,ada yang bisa saya
bantu
Ny.Ida: Begini bu,saya datang pagi ini untuk
konsultasi KB .Masa nifas saya suadah
selesai.saya pikir kita seharusnya tahu
jenis KB apa yang harus kita pilih.
Suami: Dan kita perlu tahu KB apa yang harus kita
gunakan ketika hubungan seksual.
Bidan: Baiklah KB penting untuk kehamilan yang
tidak disengaja.kita mempertimbangkan
jenis kontrasepsi yang kita pilih.ada dua
jenis KB.
Ny.Ida: Saya sudah membaca artikel
diinternet.bu,hormonal,IUD dan metode
penghalang.
Bidan : ya tepat Bu lda.KB hormonal seperti :
pil,susuk dan suntik.dan yang bukan
hormonal seperti IUD atau seperti
metode penghalang mengunakan

58
 kondom.
Suami: Dapatkah kamu jelaskan secara detail
masing –masing alat KB?
Bidan: Tentu saja,jika kamu mengunakan KB
hormonal seperti pill dan KB suntik.kamu
akan merasa efek samping seperti
pusing,berat badan tambah,mual,haid
tidak lancar,kemungkinan kamu akan
mengunakan KB kalender.Kamu juga tidak
boleh ketinggalan minum pil KB.
Ny.lda : Bagaimana KB IUD?
Bidan : Ini memiliki beberapa keuntungan seperti
kamu tidak harus minum pil secara
teratur atau suntikteratur.keefektifannya
mencapai 0.6-0.8kehamilan per 100
wanita mengunakan IUD atau kegagalan 1
kehamilan dalam 125-175 penguna
IUD.ini tidak memiliki efek hormon.ini
tidak mempengaruhi kualitas dan volume
asi.ini juga tidak menganggu sensasi
hubungan seksual antara suami istri.ini
dapat digunakan dalam 1-10 tahun dan
anda mungkin mengeceknya setiap tahun
dan ini tidak mempengaruhi siklus
hormon.
Ny.lda : bagaimana dengan kelemahan?
Bidan: Baiklah,anda mungkin mengalami
menstruasi lebih banyak tetapi ini biasanya
berhenti lebih awal dibanding menstruasi
yang mengunakan KB hormon.IUD
mempunyai lebih banyak kelebihan

59
 daripada kelemahannya.
Ny.Ida: Apakah ada cara alami untuk mencegah
kehamilan.
Bidan : Anda bisa mengunakan hitungan kalender
atau hitungan sendiri berdasarkan lamanya
siklus haid yang terdahulu.Anda tidak
diperbolehkan melakukan hubungan
seksual ketika masa subur.Anda harus
berhati hati menghitung siklus dan
menemukan masa subur berdasarkan
siklus terlama haid teratur.
Ny lda :,Baiklah saya perlu yakin saya tidak akan
salah menghitung siklus.Apakah ada
metode lain yang harus kita tahu?
Bidan : Ada KB steril laki-laki dan wanita.ini
dilakukan pasangan yang tidak ingin
memiliki lebih anak atau wanita yang tidak
diijinkan untuk hamil lagi untuk alasan
kesehatan.
Ny.lda: Baiklah bu,saya pikir tertarik mengunakan
KB IUD.Bagaimana menurut anda?
Bidan: Sekarang pemerintah sedang
mempromosikan kepada wanita yang
telah melahirkan untuk mengunakan KB
IUD.Saya sudah menjelaskan kelebihan
dan kelemahannya.Anda bebas memilih
salah satu metode yang nyaman untuk
suami anda.

C.Vocabulary
 Family planning :Keluarga berencana

60
  Post partum : Nifas
 Advice : Nasehat
 Advise : menasehati
 Sexual relationship :Hubungan seksual
 Unintended :Tidak sengaja
 Avoid :Menghindari
 Dizzy : Pusing
 Weight gain : Penambahan berat badan
 Irregular menstruation :Menstruasi tidak
teratur
 Interfere :Menganggu
 Cycle : siklus
 Weakness : kelemahan
 Sexually transmitted disease : penyakit seksual
menular
 Fertile days : Masa subur
 Withdrawal : penarikan
 Sterilization : Sterilisasi
 Comfortable : nyaman
 Preventing : Mencegah

D.EXPRESSION
 There are some effects of hormonal contraception ,aren’t
you....?

61
 What things should we consider to choose one of the types
of contraceptive methods ?
 How about the IUD contraception?
 Can you explain the detail each of those contraceptions?
 How about its weakness ?
 Is there any manual or more natural ways of preventing
pregnancy?

ISSUES IN CONTRACEPTIVE

DEVELOPMENT

I. Some thirty years ago, the introduction of birth control

pills and improved intrauterine devices (IUDS)
produced a virtual revolution in contraceptive
technology. For the first time in the history of human
reproduction, contraceptive methods which were
comparatively easy and convenient (tepat;baiksekali) to
use as well as reversible. Highly effective and relatively
free of major health risks became available, giving
women almost total control over the timing of
pregnancy. In Western countries and increasingly in

62
 developing world, this enchanced freedom from
unplanned is helping to open the way for far-reaching
changes in social and economic status.

II. For a number of the world’s developing countries in

Asia, Africa and Latin America, the diffusion of
modern birth control technology through family
planning programs is helping to reduce extraordinarily
high rates of maternal and infant death and is beginning
to limit rates of population growth which threaten
(mengancam) hard-earned economic and social
progress.

III. ADVANCES IN FERTILITY CONTROL

TECHNOLOGY: STEROIDAL CONTRACEPTIVES.
All currently available daily birth control pills and
many longer-actingcontraceptives (now available or in
advanced stage of testing) are based on contraceptive
steroids. Combined oral contraceptive, known simply as
‘the pill’, containsynthetic forms of the naturally
occurring female steroidal hormones estrogen and
progesterone.

63
IV. ORAL CONTRACEPTIVES. There are presently about
100 brands of combined oral contraceptives on the
world market containing various formulations and
dosages of estrogen and progestin. Their popularity
with millions of users (pemakai)worldwide is related to
their high levels of effectiveness, overall safety, and
accessibility (mudahdicapai) through commercial and
publicly subsidized channels as well as through private
physicians.

V. Despite ongoing (yang berkelanjutan)improvements,

oral contraceptives are still associated with a number of
minor side effects (such as nausea, weigh gain and
menstrual spotting) and with some significant health
risks for particular groups of womens. But new research
indicates that they carry significant health benefits in
addition to their effectiveness in preventing unwanted
pregnancy. These include virtual elimination of ectopic
pregnancy, lower rates of some pelvic infections and
reduced risk of ovarian and uterine cancer. On the
negative side, oral contraceptives increase the risks of
benign liver tumors, and there is preliminary (awal)
evidence that long-term use may make some women
slightly more susceptible to cervical cancer. They also

64
 decrease the quantity of breast milk among some
lactating (yang menyusukan) women, predominantly
women who are not breastfeeding on demand (in
population studies so far this has not affected infant
growth).

VI. INJECTABLE CONTRACEPTIVES. In many parts of

the world and for vast numbers of people, injections
symbolize modern medicine. Their association with
‘miracle drugs’ may help explain why injectable
contraceptives are highly popular despite irregular
supplies and continued controversy over safety.
VII. VAGINAL RINGS. Silicone rubber vaginal rings
which release (mengeluarkan;menghasilkan) a constant
dose of contraceptives steroids are another experimental
method of steroidal contraception. Vaginal rings now
under study release either progestin alone or progestin
plus estrogen. Because the steroid released by vaginal
rings enter the circulatory system through the vaginal
wall without first passing through the liver, lower doses
are effective. Development of ovulation-suppressing
progestin-only vaginal rings lasting six months is the
most advanced. The ring placed by the user in the

65
 vagina for a three-week periodand then removed for
one week for menstruation. The system has the
potential advantages of little alteration of menstrual
patterns (kebiasaan; pola). Simplicity, high
effectiveness, rapid reversibility and self-
administration.

VIII. INTRAUTERINE DEVICES.Intrauterine devices

(IUDS) are used by more and more women worldwide.
For the many women who can use them without
difficulty .they represent a very effective, long-acting,
one-stop method of contraception. Modifications in
IUD design over the years have significantly reduced
failure rates and side effects. But many women still find
the side effects unacceptable (tidakdapatditerima), and
family planning service providers have taken a more
cautious approach to the IUD since the experience of
the Dalkon Shield (which caused in increased rate of
infection, especially when pregnancy occurred with the
device in place).

IX. VOLUNTARY STERILIZATION. Over the past 15

years there has been a dramatic upswing in the use of

66
 voluntary sterilization, also referred to as
(dikenal/diketahuisebagai)permanent surgical
contraception. Worldwide, over one third of all couples
practicing an effective modern method of contraception
now rely on male (vasectomy)or female (tubectomy or
tubal ligation) sterilization. One important reason for
increased use has been the development of two
relatively simply procedures, laparoscopic sterilization
and andminilaparotomy, which allow female
sterilization to be safety provides on an outpatient basis
without general anesthesia.

X. BARRIER METHOD. Barrier (hambatan; rintangan)

method are the oldest contraceptives known.
Spermicides, diaphragms and other female barrier
methods have many early precursors. Vaginal potions
to immobilize sperm and vagina plugs to block
(menghambat) sperm passage were used by even the
most ancient civilizations. The prototype of the modern
condom-a health made of animal tissue – appeared as
early as the 16th century. Modern barrier method
represent considerableevolutionary improvement over
these centuries-old methods and, in fact, over products
available only a few decades ago. Condoms and

67
 spermicides, for example, have become both more
reliable and more attractive to use.

XI. VAGINAL SPONGES. A new product already

approved for over-the-counter sales (penjualanbebeas)
in several countries takes its inspirations from a
centuries-old folk method of contraception – the natural
sponge, soaked in an anti-sperm substance and used as
a vaginal plug. The modern version is a small
disposable polyurethane sponge which, when moistened
with water, releases the widely used spermicide
honoxynol 9. The spermicide inactivates sperm while
the sponge works to absorb (menyerap) them and block
their passage into the cervix. The sponge has an average
failure rate of 15 to 30 percent per year.

XII. CERVICAL CAPS. The conventional cervical cap is a

rubber cup used in the same manner as the diaphragm
to cover the cervix and form a barrier against sperm.
Caps currently on the market must, like the diaphragm,
be used with a spermicide and left in place for about six
hours after intercourse.

68
 XIII. PERIODIC ABSTINENCE (masatidakbersetubuh).
Abstinence from sexual intercourse during the woman’s
fertile period, often referred to as natural family
planning or fertility awareness, relies on such old and
new technique as the calendar (or rhythm) method. The
cervical mucus (lendir) (or Billings ovulation) method
and the ‘symptothermal’method. The latter relies on a
combination of indicators of fertility such as changes
in cervical mucus to predict ovulation and BBI to
detect its occurrence. All methods require
(memerlukan) substantial periods of sexual abstinence
each cycle because of the difficulty of precisely
defining the onset (awal) and duration (selama;
lamanya) of the fertile period. High levels of
motivation and good communication between sexual
partners are essential.

QUESTIONS LEADING TO DISCUSSION

1. What has contraceptive technology done to women?

2. What is meant by a reversible contraceptive?
3. Why has the choice about childbearing been a reality
for millions of women since the early 1960’s ?

69
4. Based on your own findings, try to tell the class the
number of married couples using the different birth
control method in Indonesia.
5. In the 1960’s.why were the contracepties not popular in
the low-income third World countries?
6. Can u describe the term ‘long-acting contraceptive?
7. Oral contraceptives have been widely used because of
the numerous brands available on the market. Can you
explain some of their health risks and health benefits?
8. Explain the term ‘injectable contraceptive’
9. Why are lower doses of steroids effective in the vaginal
rings contraceptives?
10. Between the two birth control methods, the oral
contraceptives and the intrauterine devices, which has
the higher number of user?
11. What is permanent surgical contraception?
12. What accounts for the increased use of surgical
contraception?
13. Explain the two barrier method; 1. The vaginal sponge
2.The cervical cap and periodic abstinence.
14. Do you have any knowledge of the oldest form of
contraception in ancient civilizations? If you do, share
you knowledge with your frends by presenting it in
front of the class.

70
15. Which birth control method is widely used in
Indonesia? And which is most effective?
16. Some analysts state that Indonesia, among the
developing countries, has been most successful in its
family planning program. Can you comment on the
analysts’ statement?
17. Which province in Indonesia is most successfulin its
family planning program? Do you know why?

71
UNIT 8 DEALING WITH POST PARTUM WOMEN

A.Conversation
Midwife : Do you remember yesterday when you just

delivered the baby l did early initiation of

breastfeeding?

Mrs.lda : Oh yeah,when you put the baby on my body

and he crawled to find the nipple and got his

first milk.

Midwife : Exactly,the first milk is also called colostrums

and it is really rich in protective factors for the

baby.you succeed in your early initiation of

breastfeeding.

Mrs ida : Thanks God.that was a successful early parent

baby relation ship.

Midwife : Yes it was.How about the breast milk now?

Mrs.lda : I think lt’s Ok.lt’s abundant and l can easly

breastfeed my son.

Midwife : That’s good news.Breastfeeding has many

health benefits for both the mother and

72
 infant.To reduce infant mortality and ill

health.

Mrs.lda :l will try to give exclusive breastfeeding for my

baby.

Midwife : Great.and have you been able to go to the

toilet? Have you urinated or defecated after

giving birth?

Mrs.lda : l have this morning.lt’s really hard.At first when

urinated.l felt really pain.

Midwife : Of course Mrs lda.you still have inflammation

on your perineum stitches.The stitches will be

dry after 4 days in a normal case.For those

who have vaginal birth you did.The recovery

process will be faster than those who have

cesarean section.

Mrs lda : Well at first l try to convince my self that l have

to be able to have vaginal birth process.l want

to feel how exactly a mother delivers the

baby normally.l have question related to my

73
 post partum,l have such a heavy bleeding,ls it

normal?

Midwife : lt’s normal Mam.The quantitative will lessen

after a week or more and at the last weeks

during approximately your 40 days post

partum period,the bloody spots will lessen

much more.Don’t worry about that.

Mrs.lda : Oh thank you,that’s relieve.

Midwife : You have anytime for a consultation with me

here in my clinic after you come back.

Mrs.lda : Thank you Midwife.lt’s been a very kind of you.

B. Vocabularies
 Breastfeed: Menyusui
 Early initiation of breastfeeding : inisiasi Menyusui Dini
{ MD]
 Nipple : Puting
 Crawl : Merangkak
 Relationship : Hubungan
 Breast milk : Air susu / asi
 Urinate : Buang air kecil /BAK
 Defecate : Buang air besar / BAB
 Inflammation : Peradangan

74
  Perineum stitches : Luka jahitan di perineum pasca
melahirkan
 Vaginal Birth : Kelahiran normal
 Convince : Menyakinkan
 Owe : berhutang
 Benefits : Manfaat
 Mortality rate : Angka kematian
 Reduce : Mengurangi
 Cesarean section : Operasi sesar

C.EXPRESSION
 Your main diet should consist of nutritious meals.
 OK.It sounds good to me.
 Don’t use soap when bathing a newborn baby
 Don’t try to lose weight.
 Great
 Fine ,I can do that

D.GRAMMAR FOCUS
QUESTION TAGS
STATEMENT TAGS
(+)/(-) (+)(-)
I am Aren’t I
Kalimat perintah
will/would/can/can’t/could you
Kalimat larangan will you
Kalimat ajakan(let’s) won’t you
( shall we )
Nobody,nothing,seldom,hardly (+)
Never,few

75
 Task 1 : Fill in the blank with correct question tags!
a. Mrs.Martina ‘s able to get up today,..........?
b. She was ill again,last month,..............?
c. I am going to get better,Nurse............?
d. He is looking a lot better today,..........?
e. They are increasing nurse pay next month.......?
f. He’s started his new treatment..........?
g. You’ve a chest x-ray recently............?
h. You will remember to keep to the diet,........?
i. Mr.Arif hasn’t had surgery today,................?
j. You are not going to hurt me,............?

UNIT 9 NEWBORN BABY CARE

A.USEFUL EXPRESSION

1. Emphatic word

 The word “exactly” is used to emphasize the whole

sentence,showing strong agreement. [ together with :
certainly,really,definitely ]
 The word “alright “ is used to express or to ask for
agreement or acceptence [exclamation], Example : is
it alright?

2.[1]got it : understand [ an argument or person making it ] or to

76
 acquire [ knowledge] by

study= oh,l see : understand

3.Be prepared! [ prepared: adj./ prepare :verb : menyiapkan, l

am preparing the equipments for the delivery ]

4.You need [ to prepare ]......[ a changing mat, a cloth nappy,a

container of warm water,cotton

balls,a nappy rash cream,fasteners ]

THE HYGIENE NEEDS OF A BABY

Nappy changing. There are two types of nappies, reusable

and disposable. Reusable nappy is usually made of toweling or
cloth. Disposable nappy is the one that is made to be used once
only.

Nappies should be changed as soon as possible following

soiling with either urine or faces. The skin should be cleaned at
this time with either warm water or a baby wipe to minimize the
risk of the skin becoming either excoriated or nappy rash
occurring. This is likely happen when urine remains in contact
with the skin, particulary if fecal organisme are also present which

77
cause urea to be broken down to ammonia, one causes of nappy
rash commonly occurring after the first month. The midwife
should demonstrate how to change the babay’s nappy using one of
methods.

Cleaning the eyes. Eyes should not be cleaned unless

discharging, to minimize the risk of trauma and infection
occurring. Sticky eyes are commonly due to blocked tear ducts
and are usually neither infected nor inflamed. The discharge is a
yellowish color and may be seen as crusting on the eyelid. A
profuse or offensive or discharge of a different color is most likely
due infection and may be accompanied by both erythema and
localized edema of the eye. If infection is suspected, a swab may
be taken, referral made and antibiotics commenced. Both left eye
and right eye are cleaned separately, the cotton wool ball is used to
wipe the eye once, then disposed of and the eye should be wiped
from the inner part outwards. Either sterile water or cooled boiled
water can be used. The midwife should demonstrate this procedure
to the parents.

Cord care. The umbilical cord is clamped and cut at birth,

leaving 2-5 cm of umbilical cord that has no further function. The
cord separates over the next 5 to 16 days by a process of dry
gangrene. The clamp is removed on the third or fourth day, once
hemostasis is secure. Cleaning the cord with either a spirit-based

78
substance or the application of powder delay the separation time of
the cord and may increase the risk of infection. Current
management for the baby not a high risk of infection centers on
both keeping the cord clean and using water when either bathing or
nappy changing.

A.Provide words or phrases in boxes which describes the words

listed below

1.Nappy

2.Eye discharge

3.The umbilical cord

B.Rewrite about the following activities using the following points

as a guide.

1.Nappy changing

Frequency :

Medium :

Rational :

79
 2.Cleaning the eyes

When to clean :

When not to clean :

Medium :

How to clean :

3.Cleaning the umbilical cord

The use of spirit –based substance and :

How to clean

B. VOCABULARY

Nappy = popokbayi

Reusable = dapatdigunakankembali

Disposable = sekalipakai

To dispose = membuangmenyingkirkan

Due to = disebabkankarena……

To soil = mengotori

Toweling =kain (berbahandasarhanduk yang

mempunyaikemampuanmenyerap)

80
To occur = terjadi

Likely =
sepertinya…………,kemungkinan…………

Sticky = lengket

To crust = mengeras (dipermukaanya)

To wipe = mengusap

Profuse = hal yang berlebihan

Offensive = serangan

Whilst / while = sementara

To suffice = mencukupi

To clamp = menjepit

Spirit-based substance = zat berbahan dasar spiritus

(dengankadar alcohol yang tinggi)

To commence = memulai

Cotton wool ball = pembersih (telinga, berupakapas

yang dibantuk bulat diujungnya,

Dapat juga untuk membersihkan

kotoran diujung mata bayi)

81
Modesty = ketertutupan dalam berpakaian.

Erythema = warnakemerahanpadakulit.

Edema =sembab, Nampak

membesarpadabagiantubuhtertentu.

Rash = ruam. (nappy rash : ruam-

ruamkemerahan yang

disebabkanpemakaianpopokbayi.

Feces = tinja, kotoranb.a.b (fecal : adj.)

Discharge =
aliranzatatausubtansitertentudaridalamtubuh
(eye discharge

= kotorancairandarimata)

Swab = menyeka

Referral = lengkapnyaditulis (referral latter)

suratrujukan.

Antibiotics =antibiotic.Obat untuk menahan laju

perkembangan organisme

Didalam tubuh.

82
Umbilical cord = talipusat.

Gangrene =kematian jaringan, jaringan yang

mati pada daerah yang luas,

maupun pada tempat tertentu.

Excoriate = lecet (bagian permukaan kulit yang

mengelupas)

Hemostatis = penghentian pendarahan.

Duck = pipa atau saluran untuk

mengalirkan secret kelenjar.

Secretion = secret, substansi yang di produksi

oleh kelenjar,

UTI = Urinary Tranct Infection : ISK

InfeksisaluranKencing

PREPARING FOR A NAPPY CHANGING

Listen to this dialogue,and then complete the blanks.

Midwife : we start your baby’s nappy changing the same as

for his bath

83
Mother :Isee,youmean (1)
…………………………………………..?

Midwife : exactly

Mother :OK, (2)

…………………………………………………………?

Midwife : well, for a starter, a changing mat or a cloth nappy

to place under your baby.

Mother : I have that.

Midwife : then you need fasterners if you are using reusable

nappies, a countainer of

Warmwater and cotton balls and nappy rash cream

or petroleum jelly

Mother : (3)
…………………………………………………….

Midwife : OK then let’s begin.

Mother : Alright

Midwife : but first remember,. Babies should never be left

unattended, even for a secon. Even a newborn
might surprise you with his abilithy to roll.

84
Mother : ok I’ll remember.

Midwife : Alright then. Let’s get started.

C. GRAMMAR FOCUS : Both....and/

either....or.....neither......nor......
We can use both.....and../either....or...../neither.....nor.../
negative sentence ]-neither.....[ positive sentence /
statement ]
1. When we are talking about two things in one sentence.
You can use these words with a noun.
Mrs.lina wants to give birth either in the hospital or
clinic
2. The combination of these two structures is called
correlative coordination/ coordinating conjunction that
is made more emphatic.
Her doctor permits her neither to drink alcohol nor to
smoke.
3. You can use Both-and,either-or,neither-nor with a verb
[ see above,or see the example
After giving birth a baby,the mother feels both
exhausted and thirsty.
I found the child neither in the living room nor in the
bedroom.
4. Another use of neither is shown below:

85
 It is not necessary to bath the baby every day,neither is
it necessary to wash the baby’s
Hair with each bath

Refer to the reading passages: Make eight sentences containing

either both...and/ either...or.../neither...nor

1. ................................................................................................
.....................................
2. ................................................................................................
.....................................
3. ................................................................................................
.....................................
4. ................................................................................................
.....................................
5. ................................................................................................
.....................................
6. ................................................................................................
......................................
7. ................................................................................................
.....................................
8. ................................................................................................
.....................................
D. Practice
Task 1

86
Translate into using English both-and, either-or, neither-nor
appropriately.

1. Kebersihan pribadi di dalam unit maternitas sangatlah

penting baik bagi para ibu maupun pengunjungnya.
(attendans – personal hygiene)
2. Setelah menerima analgesia narkotik, seorang ibu
tidakmampu berjalan keliling atau berdiri, karena ia akan
menjadi tidak stabil berpijak pada kakinya. (on her feet –
narcotic analgesia – be able to walk – unsteady)
3. Riwayat medis yang lengkap harus diambil dari kedua
pasangan dan masing-masing pasangan harus menjalani test
kesehatan yang umum. (undergo – partners – full medical
history – general examination)
TASK 2
Put both-and,either-or,neither nor,in the blank
appropriately
1.The fetus......obtains oxygen....excrete carbon dioxide
through the placenta.
2,Some drugs are known.....to cause damage.....to give
beneficial condition to the fetus.
3.The source of amniotic fluid is thought to
be....fetal......maternal.

87
 4.It is just a blockage of the tear ducts,it
is....infected.....inflamed.
5.Severe cardiac condition ........of the mother will
influence the pregnancy and ....the mother....the fetus may
be affected.
6.She is in a good condition to be
pregnant....diabetes....cardiac condition is found.
7.Modesty is an important aspect of islam,women of this
faith will wish to keep...their arms...legs covered.[ both-
and]
8.Contraction will usually.....be accompanied...be
preceeded by A bloodstained,mucould”show”.
9.2-3 weeks before the onset of labor....the heart....stomach
can function more easily.

10.A vaginal examination during labor is an septic

procedure.It is done.....carelessly..inattentively.

E. ROLE PLAY

Make a conversation on preparing a mother for a nappy

changing.This will help you or you can

Midwife : Opening.Ask the mother whether she is prepared

or not to practice the nappy changing.

88
 Mother : Say that you prepared,and ask what you need to

know about nappy changing

Midwife : Tell her about the types of nappy

changing,suggestions and tips.

Mother : Tell the midwife that you understand

Midwife : Ask the mother to prepare the stuffs for nappy

changing

Exclusive breastfeeding

Breastfeeding is an unequalled way of providing ideal food

for the healthy growth and development of infants; it is also and
integral part of the reproductive process with important
implications for the health of mothers. Review of evidence has
shown that, on a population basis, exclusive breastfeeding for 6
months is the optimal way of feeding infants. Thereafter infants
should receive complementary foods with continued breastfeeding
up to 2 years of age or beyond.

To enable mothers to establish and sustain exclusive

breastfeeding for 6 months, WHO and UNICEF recommend :

 Initiation of breastfeeding within the first hour of life

89
  Exclusive breastfeeding - that is the infant only receives
breast milk without any additional food or drink, not even
water
 Breastfeeding on demand – that is as often as the child
wants, day and night
 No use of bottles, teats or pacifiers.

Breast milk is the natural first food babies, it provides all the
energy and nutrients that the infant needs for the first month of life,
and it continues to provide up to half or more of a child’s
nutritional needs during the second half of the first year, and up to
one-third during the second year of life.

Breast milk promotes sensory and cognitive development, and

protects the infant against infectious and chronic diseases.
Exclusive breastfeeding reduces infant mortality due to common
childhood illnesses such as diarrhea or pneumonia, and helps for a
quicker recovery during illness.

 List the new vocabularies that you haven’t known the

meaning and discuss the meaning of those words
 Summarize the overall advantages of giving exclusive
breastfeeding.

Translate into a good senetance below

90
PERAWATAN BAYI BARU LAHIR

1.Berapa umur bayi yang memerlukan perawatan khusus?

Bayi baru lahir meliputi umur 0 - 28 hari.

2.Mengapa bidan harus mempunyai Jadwal Kunjungan

Kerumah bayi? Kunjungan neonatal dilakukan untuk
memantau kesehatan bayi sehingga bila terjadi
masalah dapat segera diidentifikasi seperti bayi mengalami
kesulitan untuk menyusui, tidak BAB dalam 48 jam, likterus
yang timbul pada hari pertama, kemudian tali pusat merah
atau bengkak/ keluar cairan dari tali pusat, bayi demam
lebih 37,5 C sehingga keadaan ini harus segera dilakukan
rujukan.
Kunjungan neonatal bertujuan untuk meningkatkan akses
terhadap pelayanan kesehatan dasar, mengetahui bila
terdapat kelainan pada bayi atau bayi mengalami masalah
kesehatan.Resiko terbesar kematian..
3.Pelayanan kesehatan apa yang harus dilakukan bidan
terhadap bayi yang baru lahir?Pelayanan kesehatan
neonatal dasar menggunakan pendekatan komprehensif
meliputi:
a. Pemeriksaan tanda bahaya seperti kemungkinan infeksl
bakteri, ikterus, diare, berat
badan rendah.

91
 b. Perawatan tali pusat.
c. Imunisasi Hep B 0 bila belum diberikan pada saat lahir
d. Konseling terhadap ibu dan keluarga agar memberikan
ASI eksklusif dan memberika buku KIA
e. Penanganan dan rujukan kasus
4. Apa yang akan dilakukan bidan untuk menangani bayi baru
lahir?
Managemen segera setelah lahir yaitu membersihkan lendir
dan benda-benda lain dari mulut, hidung dan tenggorokan
bayi dengan alat penghisap, bayi akan segera bernafas
sendiri.
Tali pusat dijepit pada dua tempat dan dipotong
diantaranya. Bayi kemudian dikeringkan dan dibaringkan diatas
selimut hangat yang steril atau di atas perut ibunya.
Kondisl bayi secara keseluruhan di nilai pada menit
partarna dan 5 menit setelah kelahiran
dengan menggunakan Apgar . Skor Apgar adalah penilaian
bayi baru lahir yang didasarkan pada:Warna kulit bayi (merah
muda atau biru),Denyut jantung,Pernafasan

92
Unit 10.woman’s Reproductive System Disorder

A.Reading
PELVIC INFLAMMATORY DISEASE

Pelvic inflammatory disease is a common cause of pain in the

pelvic region in women .in this condition some of the female
reproductive organs become inflamed,usually as a result of an
infection.young and sexually active women are most likely tobe
affected. Inflammation of the female reproductive organs,most
often due to a sexually transmitted infection.Most common
between the ages of 15 and 24,rare before puberty.Lifesyle as a
risk factor depends on the cause.Genetics is not a significant on the
cause

The female reproductive organs are the ovaries,fallopian

tubes,uterus,cervix,vagina and vulva.since the combined primary
function of these organ is reproduction,disorders affecting them
can result in fertility and should be treated as soon as

93
possible.particularly if children are planned,such disorders may be
caused by infections,physical damage or hormonal imbalances

PID may have no obvious systoms and some women are

unaware that they have had the condition until years later,they are
investigated for infertility.PID is usually caused by sexually
transmitted infection such as gonorrhoea.PID may also be caused
by infection developing after termination of pregnancy or after
childbirth.in rare case,PID can occur as a result of tuberculosis
developing in the pelvis or from the spread of a severe infection
from the large intestine.

The infection spreads upwards from the vagina to the uterus and
fallopian tubes.The ovaries may also be affected.AnIUD makes
this spread of infection more likely if an infection is present at the
time the IUD is inserted.if you think you may have an
infection,tests will usually be performed so that you can be treated
before PID develops.When PID is discovered during investigations
for infertility the original cause may remain unknown

PID have no obvious symptoms especially when caused by

chlamydia.if there are symptoms,they may include:Pain in the
pelvic region,Fever,An abnormal vaginal discharge,Heavy or
prolonged periods,Pain during sexual intercourse,Tiredness.If PID
develops suddenly,you may have severe pain,nausea and vomiting
and urgent hospital attention is required.if the conditionn is not
treated,the fallopian tubes may be damaged.The infection may also
spread to other organs in th pelvis and the abdomen.

If the doctor suspects that you have PID ,she will carry out a
pelvic examination,Swabs may be taken from both the cervix and
the vagina to identity the organisms causing the

94
infection.Ultrasound scanning of the pelvis may also be
performed.if you have severe symptoms,you will be admitted to
hospital,and a laparoscopy may be performed to view the
abdominal and pelvic cavities.

The doctor will probably prescribe antibiotics which may be

given intravenously in some cases.you may be given painkillers.if
you use IUD ,you may be advised to change a different methods of
contraception.

If PID is detected and treated early,you should make a complete

recovery.If PID is not treated,damage to the fallopian tubes can
increase the risk of having an ectopic pregnancy or may lead to
infertility.

Answer these questions

1.What is pelvic inflamantory disease?

2.Please mention the symptoms of pelvic inflamantory

disease?

3.what ways can be done to cure inflamantory disease?

4.Are there any effect to PID patient that are apllying

IUD?

5.What are the other diseases included in woman’s

reproductive system disorder?

B.VOCABULARIES
 Inflamation : Peradangan

95
 Fallopian tubes : Saluran telur
 Disorder : gangguan
 Transmitted : menular
 Pelvic : pinggul
 Severe : parah
 Significant : penting
 Damage : kerusakan
 Carry out : melaksanakan
 Admitted : dipondokan

96
Examples of cancers of the Examples of functional
reproductive system include: problems of the
reproductive system
 Prostate cancer - Cancer of include:
the prostate gland
 Breast cancer - Cancer of the  Impotence - The
mammary gland. inability of a male
 Ovarian cancer - Cancer of to produce or
the ovary. maintain an
 Penile cancer - Cancer of erection.
penis.  Hypogonadism - A
 Uterine cancer - Cancer of the lack of function of
uterus. the gonads, in
 Testicular cancer - Cancer of regards to either
the testicle/(plural:testes). hormones or
 Cervical Cancer - Cancer of gamete production.
the cervix  Ectopic pregnancy
- When a fertilized
ovum is implanted
in any tissue other
than the uterine
wall.
 Hypoactive sexual
desire disorder - A
low level of sexual
desire and interest.
 Female sexual
arousal disorder -
A condition of
decreased,
insufficient, or
absent lubrication
in females during
sexual activity
 Premature

97
 ejaculation - A lack
of voluntary
control over
ejaculation.
 Dysmenorrhea - Is
a medical condition
of pain during
menstruation that
interferes with
daily activities[3]

C.USEFUL EXPRESSION : How to comfort the patient

 Everything will be ok.I will do the best...
 Don’t worry and relaxe in order to get well soon..
 Pray to the God .There will be a miracle
 There are many ways to cure your illness..
 You had better.....
 You should.....
 It’s better for you to avoid.....

In the following dialog a doctor and his patient.Mrs.Susi are

discussing the topic on cancer.

Doctor : Good to see you,Mrs Susi.

Patient : I’am glad to see you,too,Doc...if you have the

Time.I hope you can explain to me the most

98
 -dreaded disease called cancer.

Doctor : What exactly do you want to know about it?

Patient : Almost everything..You see l don’t understand

Much about it although l have done some

reading on the topic.I am afraid l am getting

the incorrect information about it.

Doctor : Well,when we talk about cancer.first we must

understand the full meaning of the term

tumor.Tumor is abnormal enlargement of some

part of the body.It is a mass of tissue composed

of unusual cells that have multiplied more than

they should,that are not a part of the body’s

normal design and that serve no useful purpose.

Patient : Is this what they call “neoplasm”?

Doctor : Hm..you are using a veryy scientific term.How

did you know that?

Patient : Well.l read it some books..l want to check with

you whether l am saying ihe right thing

Doctor :That’s right..in simple terms ,a tumor is

99
 composed of cells which are out of contol.There

are two types of tumors: benign and

malignant...Mrs Susi ,are you still following me?

Patient :Oh yes,indeed..The word benign implies that

the tumor is harmless.Malignant tumors are

composed of cells so far out of conrol that they

grow extensively and invade surrounding tissues

such tumors are called cancers.Thank you very

much,doctor for this interesting discussion.

Doctor :It’s my pleasure...Bye-bye

D.ROLE PLAY
Penanya : Assalamualikum warahmatullahi wabarakatuh!
Narasumber : Waalikum salam warahmatullahi wabarakatuh!
anda yang bisa saya bantu?
Penanya : Sebelumnya maaf mengganggu Ibu. Nama saya
Halimatus Syakdiyah dan ini rekan saya Qurrotu
Aini. Kami dari kelas XI-Akselerasi. Dalam
rangka tugas Bahasa Indonesia, kami ingin
mewawancarai Ibu sebagai guru biologi
dengan tema Menjaga Kesehatan Reproduksi

100
 Remaja. Apakah Ibu ada bersedia?
Narasumber : Ya, silahkan!
Penanya : Menurut Ibu, apa kesehatan reproduksi remaja itu?
Narasumber : Kesehatan reproduksi remaja itu adalah sesuatu
yang penting bagi remaja. Remaja harus menjaga
kesehatan reproduksinya agar reproduksinya tidak
terganggu. Kalian tentu tahu kan apa itu
reproduksi? Dan kita harus menjaganya dari hal
yang paling sederhana.
Penanya : Mengapa remaja perlu mengetahui kesehatan
reproduksi?
Narasumber : Oh ya tentu, itu sangat perlu bagi remaja untuk
mengetahui tentang kesehatan reproduksinya.
Apalagi remaja sekarang ini sibuk dengan
kegiatan-kegiatan dan lupa untuk menjaga
kesehatan dirinya sendiri terutama pada kesehatan
reproduksinya. Reproduksi adalah investasi untuk
masa depan jadi kita harus menjaganya dengan
hati-hati agar terhindar dari hal -hal negatif dan
berdampak pada kesehatan reproduksi.
Penanya : Siapa sajakah yang harus mengetahui kesehatan
reproduksi? Apa hanya untuk wanita saja?
Narasumber :Oh tidak! Tidak hanya wanita yang harus
mengetahui tentang kesehatan reproduksi, tapi

101
 bagi laki-laki juga perlu. Sebab jika kita tidak
mengetahuinya, itu akan berdampak buruk bagi
remaja dan bisa mengakibatkan kegagalan
reproduksi.
Penanya : Menurut Ibu, informasi apa saja yang diperlukan
oleh remaja agar memiliki kesehatan reproduksi
yang baik?
Narasumber : Informasi tentang cara menjaga kebersihan organ-
organ reproduksi, cara
mencegah terjadinya penyakit-penyakit pada organ
reproduksi, dan remaja perlu mendapat
penyuluhan tentang dampak dari pergaulan bebas
dan seks bebas. Karena kalian tahu sendiri kan
sekarang ini banyak remaja yang terganggu
kesehatan reproduksinya akibat pergaulan bebas.
Penanya : Apa saja faktor-faktor yang dapat mempengaruhi
kesehatan reproduksi remaja?
Narasumber : Ya itu tadi, kebersihan organ-organ reproduksi
sangat berpengaruh pada kesehatan reproduksi.
Contohnya bila seorang wanita mengalami
menstruasi, kuman akan mudah masuk melalui
darah yang ada pada pembalut yang lembab. Jadi
disarankan bagi remaja apalagi yang bersekolah
sampai sore, untuk tidah hanya menggunakan satu

102
 pembalut, tapi sering- seringlah berganti pembalut
agar tidak lembab.
Penanya : Seperti apakah macam-macam penyakit pada
sistem reproduksi terutama pada remaja?
Narasumber : Seperti keputihan, ya kan? Pada wanita biasanya
ini sering terjadi. Keputihan terjadi biasanya
karena kondisi kita yang lelah. Dan yang lain
seperti sifilis dan ada juga raja singa. Ini terjadi
‘ akibat kita kurang menjaga kebersihan pada organ
reproduksi kita.
Penanya : Apakah anemia dapat mempengaruhi kesehatan
reproduksi remaja puteri?
Narasumber : Sebenarnya bukan pada kesehatan reproduksi,
tetapi pada kesehatan badan pada umumnya.
Anemia itu kan kekurangan darah. Jika ini terjadi
pada wanita yang sedang menstruasi, ini akan
mengakibatkan wanita itu mudah lelah dan lemah.
Jadi sebenarnya terletak pada kesehatan badan itu
sendiri.
Penanya : Menurut Ibu, apakah pendidikan reproduksi
remaja itu perlu?
Narasumber : Ya, itu sangat perlu. Remaja perlu mengetahui
bagaimana cara menjaga kesehatan
reproduksinya agar tidak mengalami gagal

103
 reproduksi. Pendidikan yang benar dari orang tua,
guru, atau orang-orang terdekat sangat diperlukan
bagi para remaja.
Penanya : Kapan waktu yang tepat untuk pendidikan
kesehatan reproduksi bagi remaja?
Narasumber : Sejak dini. Tapi tergantung berapa usia anak itu.
Pendidikan reproduksi bagi anak SD tentu jelas
berbeda dengan pendidikan kesehatan reproduksi
bagi anak SMP dan SMA. Informasi yang
diberikan terus bertahap sehingga anak
mengetahui apa pentingnya menjaga kesehatan
reproduksi itu.
Penanya : Bagaimana solusi yang tepat mengatasi masalah
kesehatan reproduksi pada remaja?
Narasumber : Solusinya dengan menjaga pola hidup. Pola hidup
yang sehat sangat
berpengaruh bagi kesehatan reproduksi pada
remaja. Selain itu kita juga perlu menjaga
kebersihan tentunya agar terhindar dari kuman-
kuman penyakit penyebab kerusakan system
reproduksi remaja. Dan yang terakhir
ialah penyuluhan. Remaja harus sering diberi
penyuluhan tentang bagaimana menjaga
kesehatan system reproduksinya sehingga biasa

104
 lebih dini mengatasi masalah yang ada pada
sistem reproduksi remaja.
Penanya : Ya, hanya itu yang kami tanyakan. Terima kasih
atas waktu Ibu.
Wassalamualaikum warahmatullahi wabarakatuh.
Narasuber : Sama-sama, senang bisa membantu.
Waalaikumsalam warahmatullahi wabarakatuh.

105
UNIT 11

STRUCTURE AND WRITTEN EXPRESSION IN TOEFL

Part A
DIRECTIONS
Question 1 – 15 are incomplete sentences. Beneath each
sentence you will see fourwords or phrases, marked (A), (B), (C),
and (D). choose the one word or phrase that best completes the
sentence. Then, on your answer sheet, find the number of the
question and fill in the space that corresponds to the letter of the
answer you have chosen. Fill in the space so that the letter inside
the oval cannot be seen.
1. ……, the outermost layer of skin, is about as thick as a
sheet of paper over most of the skin.
a. It is the epidermis
b. In the epidermis
c. The epidermis
d. The epidermis is

2. Sam spade in the Maltese Falcon and Rick Blaine in

Casablanca …… of Humphrey Bogart’s more famous
roles.
a. They are two
b. Two of them are

106
 c. Two of them
d. Are two

3. The compound microscope has not one …… two lenses.

a. And also
b. But
c. And there are
d. But there are

4. During the Precambrian period, the Earth’s crust formed,

and life …… in the seas.
a. First appeared
b. First to appear
c. Is first appearing
d. Appearing

5. The hard palate forms a partition …… and nasal passages.

a. The mouth
b. Between the mouth
c. Is between the mouth
d. It is between the mouth.

6. Conditions required for seed germination include abundant

water, an adequate supply of oxygen, and ……
a. The temperatures must be appropriate.
b. Having appropriate temperatures
c. Appropriate temperatures
d. Appropriately temperate

7. When fluid accumulates against the eardrum, the second

more insidious type of ……
a. Otitis media may develop
b. Developing otitis media
c. The development of otitis media
d. To develop otitis media

107
8. Some general theories of motivation …… of central
motives, from which other motives develop.
a. Identify a limited number
b. Identification of a limited number
c. Identify a limited amount
d. Identifying a limited number

9. Before the statue of Liberty arrived in the United States,

newspaper invited the public to help determine where ……
place after its arrival.
a. Should the statue be
b. The statue being
c. It should be the statue
d. The statue should be

10. Hydroelectric power can be produced by …… and using

tidal flow to run turbines.
a. Water basins are dammed
b. Damming water basins
c. To dam water basins
d. Dams in water basins

11. Abraham Lincoln and Jefferson Davis, …… of the Union

and the Confederacy during the civil War, were both born
in Kentucky.
a. They were opposing presidents
b. Were opposing presidents
c. Opposing presidents
d. Presidents opposed

12. A stock …… at an inflated price is called a watered stock.

a. Issued
b. Is issued
c. It is issued

108
 d. Which issued

13. The leaves of the white mulberry provide food for

silkworms, …… silk fabrics are woven.
a. Whose cocoons
b. From cocoons
c. Whose cocoons are from
d. From whose cocoons

14. Not only …… generate energy, but it also produces fuel for
other fission reactors.
a. A nuclear breeder reactor
b. It is nuclear breeder reactor
c. Does a nuclear breeder reactor
d. Is a nuclear breeder reactor

15. D. W. Griffith pioneered many of the stylistic features and

filmmaking techniques …… as the Hollywood standard.
a. That established
b. That became established
c. What established
d. What became established
Part B
DIRECTIONS
In question 16 – 40, each sentence has four underline words or
phrases. The four underlined parts of the sentence.are marked (A),
(B), (C), and (D). identify the one underlined word or phrase that
must be changed in order for the sentence to be correct. Then, on
your answer sheet, find the number of the question and fill in the
space that corresponds to the letter of the answer you have chosen.
16. Mosquitos will accepts the malaria parasite at only one
A B C

109
 stage of the parasite’s complex life cycle.
D
17. The counterpart of a negative electrons is the positive
A B C D
protons.

18. The ankle joint occur where the lower ends of the tibia and
A B
fibula slot neatlyaround the talus.
C D
19. In the United States and Canada, motor vehicle laws
A
Affect the operate of motorcycle as well as automobiles.
B C D

20. The neocortex is, in evolutionary terms, most recent layer

of the brain. A B C D
21. There are more than eighty – four million speciments in the
A B
National museum of natural
history’s collection of biological, geological, archeological,
C
and antrhropology.
D
22. After George Washington married widow Martha Custis,
A B
the couple came to resides at
C D
Mount Vernon.
23. at this stage in their development, rubberized asphalt can
A B
hardly be classified as cutting edge. C
D
24. Rhesus monkeys exhibit patterns of shy similar tothose in
humans. A B C D

110
 25. In space, with nografity for muscles to work against, the
A B
body become weakly.
C D
26. Fort Jefferson, in the Dry Tortugas off the southern tip of
Florida, can be reachonly by boat or plane.
A B C
D
27. A zoom lens produces an inverted real image, either on the
A B C
film in a camera and on the
D
light-sensitive tube of a television camera.
28. Supersonic flight is flight that is faster the speed of sound.
A B C D
29. The Betataken House Ruins at Navajo National Monument
is among the largest and most
A B
elaborate cliff dwellings in the country.
C D
30. It is a common observation that liquids will soak through
A B
some materials but not through
C
other.
D
31. The number of wild horses on Assateague are increasing
A B
lately, resulting in overgrazed
C D
marsh and dune grasses.
32. The newsreels of Hearst Metronome News, which formed
part of every moviegoer’s

111
 A
experience in the era beforetelevision, offer an unique
B C
record of the events of the 1930’s.
D
33. Unlikely gas sportballons, hot air ballons do not havenets.
A B C D
34. Born in Massachusetts in 1852, Albert Falbankshas
A B
begunmaking banjos in Boston in
C
the late 1870’s.
D
35. Dwight David Eisenhower, military officer and thirty-
fourth president of the United States, A

lived in the white House and of least thirty-seven other

B C D
residences.
36. Methane in wetlands comes from soil bacteria that
A B
consumes organic plant matter.
C D
37. Alois Alzheimer made the first observers of the telltale
A B
signs of the disease that today bears
C
his name.
D
38. Edward MacDowell remembers as the composer of such
A B
perennialfavorites as to a wild rose
C D
and to a water lily.
39. Animism is the belief that objects and natural phenomena

112
 A B
such as rivers, rocks, and wind arelive and have felling.
C D
40. Newtonian physics accounts for the observing orbit of the
planets and the moons.A B C D

UNIT 12

LISTENING IN TOEFL

PRACTICE TEST
Part A
DIRECTIONS
In part A, you will her short conversation between two people.
At the end of each conversation, a third voice will ask a question
about what was said. The question will be spoken just one time.
After you hear a conversation and the question about it, read the
possible answer and decide which one would be the best answer to
the question you have heard. Then, on your answer sheet, fine the
number of the problem and mark your answer.
1. a. Hand the man a drink.
b. Drink a diet soft drink.
c. Go to a store to buy a drink.
d. Go without of soft drink.

2. a. they both like it.

b. Neither like it
c. the mother didn’t like it, but the father did
d. the mother didn’t like it because it wasn’t in English.

113
3. a. A supermarket
b. A department store
c. A pharmacy
d. A car repair shop

4. a. A supermarket
b. A department store
c. A pharmacy
d. A car repair shop

5. a. The program was on too late

b. The rain didn’t let up until after the speech
c. He doesn’t like the president
d. He had a late class

6. a. Lawyer – client
b. Doctor – patient
c. Dentist – Patient
d. Bank teller – Customer

7. a. There is a quieter place available.

b. He doesn’t care for tennis matches.
c. The noise should die down shortly
d. It’s even louder in the meeting room.

8. a. She’s not hungry

b. She’s at the orthodontist’s
c. The food tastes like an old shoe
d. she is in too much pain.

9. a. Packing her own groceries

b. A like of variety in meats
c. The unreasonable prices
d. The attitude of the employees

114
10. a. She does not feel well enough to return to work
b. She hates her work
c. She hasn’t finished the assignment
d. She is steel unable to walk

11. a. Home economics

b. Business administration
c. Microbiology
d. History

12. a. It is no longer delicious

b. It makes delicious butter
c. It is the best cheese
d. There are many better cheeses

13. a. The game is temporarily delayed because of rain

b. The will be no game if it rains
c. There will be a game regardless of the weather
d. it rains every time there is a game

14. a. She knew the answer to the question

b. she had read the material, but she didn’t know the
answer
c. She was not prepared for the class
d. Even though she hadn’t read the material, she knew the
answer

15. a. Thirty people returned the evaluation forms

b. Sixty people filled out the evaluation forms
c. Eight people return their forms
d. Only thirty people revived the evaluation forms

16. a. He is a professional musician

115
 b. He is very talented, but he will never be a professional
musician because he doesn’t practice.
c. He practices every day, but he will never be a
professional player.
d. he doesn’t want to be a professional musician because he
wants to practice law

17. a. Stay home if the weather is nice

b. Spend the weekend at the beach if the nice weather holds
out.
c. Stay home because the weather will not be pleasant.
d. Go to the beach if the weather improves

18. a. Only he saw a terrible accident

b. No one at all saw his terrible accident
c. He saw no one in the accident
d. No one in the terrible accident saw him

19. a. She writes and speaks Spanish equally well

b. She both writes and speaks Spanish, but she writes it
better
c. Even though she writes Spanish, she speaks it better
d. She doesn’t like to write Spanish, but she speakes it

20. a. They missed the homework assignment, but they turned

it in later
b. They hate each other since their dispute
c. They caught a baby squirrel, but they soon let it go
d. They had an argument, but now they are friends again

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21. a. A taxi
b. A plane
c. A boat
d. A bus

22. a. He does not want to be helpful

b. He does not understand the math problem
c. He doesn’t had a change to work on the math calculation.
d. He has already figured out the problem

23. a. Mary works in nursery

b. Mary’s children stay in a nursery while she works
c. Mary takes her children to work with her
d. Mary’s children are ill today

24. a. He will move to Florida when he quits his job here.

b. As soon as his new jobs in Florida is confirmed, he will move
there.
c. He want to move to Florida but he can’t find a job there.
d. He plants to move to Florida when he retires.

25. a. He doesn’t like fishing on a hot, summer day

b. Although he like fishing, he doesn’t want to do it on a hot
summer day
c. Fishing is his favorite enjoyment on a hot, summer day.
d. He like to eat hot fish for breakfast in the summer.

26. a. When the production had begun, they realized that they should
have practiced more.
b. Before the production began, they reviewed their lines one
more time.
c. Although they had practiced for months, the production was a
flop.
d. they went to the theater in to separate car.

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 27. a. She gave the class an assignment.
b. She gave the student a hand with their assignment.
c. She asked the students to turn in their assignment.
d. She asked the students to raise their hands if they wanted to ask
a question about the assignment.
28. a. Stacey will buy their dog.
b. After they return from vacation, they are going to buy a dog.
c. Stacey will take care of their dog while they are on vacation.
d. Stacey will be very tired after the long vacation.

29. a. It originated in the United States.

b. It’s very popular in Scotland.
c. It originated in the United States, but now it’s more popular in
Scotland.
d. It originated in Scotland, but now it’s more popular in the
United States.

30. a. He saw them thirteen years ago

b. They arrived thirty years ago.
c. He has not seen them for thirty years.
d. He sees them every thirteen years.
Part B
DIRECTIONS
In part B, you will her longer conversations. After each
conversation, you will be asked some questions and the question will be
spoken just one time. They will not be written out for you, so you will
have to listen carefully in order to understand and remember what the
speaker says.
After you hear question, read the four possible answers in your
text book and choose the best answer. Then, on your answer sheet, find
the number of the question and fill in the space that corresponds to the
latter of the answer you have chosen.

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 Remember, you are not allowed to take notes or write in your text
book.
31. a. She was sick.
b. She couldn’t make up her mind as to which countries she
should visit.
c. She couldn’t think of topic for her composition.
d. She was totally disorganized.

32. a. That she take a cruise.

b. That she try to get organized.
c. That she ride a camel.
d. That she write about her trip.

33. a. Hungary
b. North Africa
c. Egypt
d. The Holy Land

34. a. To pack his bags for his trip.

b. To write his own composition.
c. He’s not feeling well.
d. To pick up some photograps

35. a. Type his paper

b. help him with his research.
c. Present his findings at the july conference.
d. Verify his findings.

36. a. He’s about to leave for a new job

b. He wants to present it at a conference.
c. His employer has requested it.
d. it’s very important for his livelihood.

37. a. July

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 b. September
c. May
d. February

38. a. He’s completed typing his notes.

b. He’s completed the research,
c. He’s still performing research.
d. He’s begun typing.
Part C
DIRECTIONS
In part C, you will her several talks. After each talk, you will be
asked some questions. The talks and questions will be spoken just one
time. They will not be written out for you, so you will have to listen
carefully in order to understand and remember what the speaker says.
After you hear a question, read the four possible answer in your text
book and choose the best answer. Then, on your answer sheet, find the
number of the question and fill in the space that corresponds to the latter
of the answer you have chosen.
39. a. Nathaniel Bacon and his friends fought against Indian
marauders.
b. Bacon and his friends were piedmont farmers.
c. Bacon and few farmers marched on the capital to protest the
Indian raids.
d. Governor Berkeley did not listen to the demands of the
farmers.

40. a. Less than 1 year

b. 5 years
c. 10 years
d. 23 years.

41. a. He was killed by Indians

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 b. Governor Berkeley made him hanged.
c. He succumbed to malaria.
d. He was accidently shot by one of the farmers.

42. a. Death of its sculptor.

b. Lack of funds.
c. Disinterest in the project.
d. Too many Indian raids.

43. a. Abraham Lincoln

b. Franklin Roosevelt.
c. Thomas Jefferson
d. George Washington

44. a. 27 years old

b. 41 years old
c. 60 years old
d. 74 years old

45. a. They bear little resemblance to the people they represent.

b. The figures are gigantic, but too serious.
c. They portray the people they represent.
d. Because they are old and weatherbeaten, the faces are
disfigured.

46. a. This magnificent work of art os located very high in the black
Hills.
b. Four American Presidents have been sculpted as a lasting
memorial to their leadership.
c. It took fourteen years to complete the project.
d. Gutzon Borglum was near retirement age when he began this
project.

47. a. In a chemistry class.

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 b. At a gas station
c. Near an oil well
d. In a nuclear plant

48. a. Refined oil

b. Unrefined oil
c. Amixture of simple inorganic compounds.
d. The product of burning.

49. a. By the percentage of nitrogen.

b. By the percentage of oxygen
c. By the percentage of hydrogen and carbon
d. By the percentage of sulful.

50. a. oil that has been separated by distilling.

b. Oil that has greater than one percent of sulfur.
c. Oil that has less than one percent of sulfur.
d. Oil that is in its simplest form.

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UNIT 13

READING COMPREHENSION IN TOEFL

DIRECTIONS

In this section you will read a number of passages. Each one is

followed by approximately ten questions about it. For questions 1-50,
choose the one best answer (A), (B), (C), and (D), to each question.
Then, find the number of the question on your answer sheet, and fill in
the space that corresponds to the latter basis of what is stated or implied
in that passage.
Question 1 trough 9
The larges diamond ever found is the cullinan diamond. This
diamond weighed 3.106 caracts in its uncut state when it was discovered
in south Africa on Januari 25, 1905.
TheCullinan diamond was cut into 9 major stones and 96 smaller ones.
The largest of the cut stones, and still the largest cut diamond in the
world, is the pear-shaped Cullinan I at 530 carats. This diamond, which is
also known as the greater became part of the British crown jewels in
1907.
1. What is the best title for this passage?
a. Dismond Cutting
b. The world’s biggest Diamond, Uncut and Cut.
c. Measuring Diamonds in carats.
d. The British Crown Jewels.

2. The word “uncut” in line 2 is closest in meaning to which of the

following?
a. Finished
b. Unnatural
c. Pear
d. Whole

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3. The word “discovered” in line 2 is closest in meaning to ……
a. Created
b. Found
c. Buried
d. Wighed

4. It can be inferred from the passage that the Cullinan Diamond

was cut into how many total stones?
a. 9
b. 96
c. 105
d. 3.106

5. The word “major” in line 3 could bestbe replaced by ……

a. Well-know
b. Military
c. Natural
d. Big

6. Which of the following is NOT true about Cullinan i?

a. It was cut from the Cillinan Diamond
b. It weighs 3.106 carats
c. It is the biggest cut diamond in the world
d. It is sometimes called the Greater Star of Africa.

7. All the following are true about the shape of the greater star of
Africa EXCEPT that ……
a. It is in a shape of a pear
b. It is 5,4 centimeter long
c. It is longer than it is wide
d. It is 4,4 inches wide

8. According to the passage, what happened to Cullinan I?

a. It remained in Africa

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 b. It was cut into smaller stones
c. It was cut and changed in to the Greater Star of Africa.
d. It became the property of the British Royal family.

9. Where in the passage does the outhor mention the Cullinan

Diamond’s weight when it was mined?
a. Line 1-2
b. Line 3
c. Line 4-5
d. Line 6
Question 10 through 20
Coca cola was invented in 1886 by Atlanta pharmacist John S.
Pemberton. The name for the product was actually proposed by
Pemberton’s assistant, Frank Robinson. The name was taken from the
two most unusual ingredients in the drink, the South American coca leaf
and the African cola nut.
The recipe for today’s coca cola is very well guarded. Many of the
ingredients are know : in addition to coca leaves and cola nut, they
include lemon, orange, lime, cinnamon, nutmeg, vanilla, caramel, and
sugar. The proportion of the ingredients and the identity of coke’s secret
ingredients are known by only a few of the Coca-Cola Company’s senior
corporate officers.
10. The passage mainly discusses ……
a. The success of the Coca-Cola Company.
b. The unusual ingredients in Coca-Cola
c. John S. Pemberton
d. Coca-Cola’s recipe and who developed it.

11. According to the passage, who created Coca-Cola?

a. The Coca-Cola Company
b. John S. Pemberton
c. Pemberton’s assistant
d. Frank Robinson

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12. The word “unusual” in line 3 is closest in meaning to ……
a. Uncommon
b. Important
c. Unused
d. Tasty

13. Which of the following is NOT true about the name Coca-cola?
a. The name “coca” comes from the coca leaf.
b. The name “cola” comes from the cola nut.
c. Frank Robinson suggested the name.
d. The inventor came up with the name
14. A “recipe” in line 4 is ……
a. Information about drugs for a pharmacy.
b. A description of how to prepare something
c. An accounting statement.
d. A corporate organizational plan.

15. The passage states that the recipe for Coca-Cola is ……

a. Well known
b. Known by only a limited number of people
c. Unknown
d. Published information.

16. Which of the following is NOT true mentioned as an ingredient of

Coca-Cola?
a. Orange leaves
b. Nutmeg
c. Citrus fruits
d. Sugar

17. The word “secret” in line 6 could best be replaced by ……

a. Unrevealed
b. Delicious
c. Business

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 d. Speechless

18. It can be inferred from the passage that ……

a. The public knows all the ingredients in Coca-Cola.
b. The public is not sure that coca leaves are used in Coca-Cola.
c. The public does not know how many cola nuts are used in a
batch of Coca-Cola.
d. No one knows the exact proportions of ingredients used in
Coca-cola.

19. The word “senior” in line 7 could best be replaced by ……

a. Trustworthy
b. High-level
c. More mature
d. Really decisive

20. Where in the passage does the author mention who gave Coca-
Cola its name?
a. Line 1-2
b. Line 3
c. Line 4
d. Line 6-7
Questions 21 through 30
Most people would say that the world’s tallest mountain is mount
Everest. This mountain in the Himalayas is just over 29.000 feet high.
However, if mountains are measured a little bit differently, then
the tallest mountain on earth is Mauna Kea, in the Hawaiian island.
Mauna Kea is only about 14.000 feet above sea level, so in comparison to
Mount Everest it just does not look anywhere near as high as Mount
Everest to a person standing at sea level.
Mauna Kea, however, does not begin at sea level. It rises from an
ocean floor that is more than 16.000 feet below the surface of the water.

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This mountain therefore measures more than 30.000 feet from its base to
its top, making it a higher mountain than Mount Everest.
21. The main idea of the passage is that ……
a. Mount Everest is the world’s tallest mountain.
b. Mount Everest and Mauna Kea are located in different parts
of the world.
c. Mauna Kea’s base is below sea level.
d. Mauna Kea could be considered the tallest mountain in the
world.

22. Which of the following is NOT stated about mount Everest.

a. Many people believe it is the world’s tallest mountain.
b. It is part of the Himalayas
c. It is over 29.000 feet high.
d. It rises from the ocean floor.
23. The word “just” in line 2 could best be replaced by ……
a. Noticeably
b. Soon
c. Barely
d. Recently

24. the expression “a little bit” in line 3 is closest in meaning to ……

a. a small size
b. quite
c. somewhat
d. extremely

25. according to the passage, Mauna Kea is how far above the level
of the water?
a. 14.000 feet
b. 16.000 feet
c. 29.000 feet
d. 30.000 feet

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 26. The expression “in comparison to” in line 5 could best be
replaced by ……
a. Close to
b. In relation to
c. As aresult of
d. Because of

27. It is implied in the passage that Mauna Kea does not seem as tall
as Mount Everest because ……
a. People do not want to look at it.
b. Part of Mauna Kea is under water.
c. Mount Everest has more snow.
d. Mauna Kea is in a different part of the world than Mount
Everest.

28. The word “floor” in line 7 could best be replaced by ……

a. Carpet
b. Bottom
c. Roof
d. Water

29. The passage indicates that Mauna Kea ……

a. Measures 16.000 feet from top to bottom.
b. Is completely covered with water.
c. Is more than half covered by water.
d. Is 1.000 feet shorter than Mount Everest.

30. Where in the passage does the author mention Mount Everest’s
total height?
a. Line 1-2
b. Line 4-6
c. Line 7
d. Line 8-9
Questions 31 through 40

129
 When Columbus arrived in the Americas in 1942, there were
already an estimated thirty to forty million people living in the North and
South America. It has therefore been quite easy for some to refute the
idea that Columbus “discovered” America. How and when these
inhabitants came to America has been the sources of much scientific
research and discussion.
Most archeologists agree that the first Americans, the true
“discovers” of America, came from northeastern Asia. There is also a
considerable amount of proof that inhabitants have been in the Americas
for at least 15.000 years.
To get to the Americas, these people had to cross over the 55-
milewide Bering Strait that separates Asia and north America. According
to one theory, these people crossed over during periods when a land
bridge existed between the two continents.
During Ice Ages, so much of the earth’s water was frozen that the sea
levels dropped, and it was possible to walk from Asia to North America.
31. What is the author’s main purpose?
a. To explain how Columbus discovered America.
b. To show how people came to America before Columbus.
c. To demonstrate the importance to archeologists of
northeastern Asia.
d. To explain how to cross the Bering Strait.

32. In 1492, how many people were probably in the Americas?

a. Fewer then thirty million
b. Exactly thirty million
c. Forty million or fewer
d. At least forty million

33. The word “refute” in line 3 is closest in meaning to ……

a. Theorize
b. Support

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 c. Contradict
d. Defend

34. It is implied in the passage that ……

a. Columbus was really the first person in America.
b. Scientists are sure about America’s first inhabitants.
c. Columbus arrived at almost the same time as America’s first
in habitants.
d. All is not known about Americas’s first inhabitants.

35. There is general agreement that the first people who came to
North America came from ……
a. Europ
b. South America
c. Northeastern Asia
d. Africa

36. The word “ considerable” in line 6 could best be replaces by

which of the following?
a. Large
b. Weak
c. Well-known
d. Considerate

37. The word “ separates” in line 9 is closest in meaning to ……

a. Differentiates
b. Divides
c. Joins
d. Crosses.

38. Which of the following is NOT stated about the Bering Strait?
a. It is 55 miles wide
b. It separates North America and Asia
c. It was probably a land bridge during the Ice Ages.
d. It is a land bridge today.

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 39. The word “frozen” in line 11 could best be replaced by …..
a. Cool
b. Dirty
c. Solid
d. Wet

40. Where in the passage does the author mention how long people
have probably been in the Americas?
a. Line 1-2
b. Line 3-4
c. Line 6-7
d. Line 8-9
Questions 41 through 50
Alpha Centauri is a triple star system. One of the three star in
Alpha Centauri is proxima Centauri, which is the nearest star to the earth,
except of course for the sun. the name “Proxima” comes from a Latin
word which means “close”.
Even though Proxima Centauri is the closest star to the Earth
outside of our solar system, it is not really close. Interstellar distances are
so large that they are almost impossible to imagine. A person traveling in
a modern spacecraft would not arrive at proxima Centauri within this
lifetime, or the next, or even ten lifetimes because the distances is so
great. Light travels at a speed of 186.000 miles per second, and it still
takes light more than four years to travel from Proxima Centauri to the
Earth.
Alpha Centauri can be easily seen in the night sky without a telescope
from certain part of the earth. It is the third brightest star in the sky, out
of approximately 6.000 visible stars. It cannot be seen from the most
parts of the United States because most of the United Sates is too far
north, however it can be seen from the southern parts of the southernmost
states.

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41. The main subject of this passage is …..
a. The closest star to the Earth.
b. Modern space travel
c. The speed of light
d. Interstellar distances.

42. The passage indicates that which of the following is NOT true ?
a. Alpha Centauri is composed of three star.
b. Proxima Centauri is the closest star to the Earth.
c. Proxima Centauri is one of the star in Alpha Centauri
d. It is possible to see Alpha Centauri from the Earth.

43. The word “comes” in line 3 could best be replaced by ……

a. Travels
b. Is derived
c. Is directed
d. Visits

44. “interstellar distances” in line 5 are …...

a. Distances between stars.
b. Distances between the Earth and various stars.
c. Distances measured by the speed of light.
d. Distances from the sun to each of the planets, including the
earth.

45. It can be inferred from the passage that if a person left in one of
today’s spacecrafts, he or she would arrive at Alpha Centauri
……
a. Within this lifetime
b. Within the next lifetime
c. Within ten lifetimes
d. After more than ten lifetimes.

46. The word “great” in line 7 could best be replaced by which of the
following?

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 a. Famous
b. Well-known
c. Accomplished
d. Big

47. Which of the following is true according to the passage ?

a. Light travels at 186.000 miles per hour.
b. A person could travel from Earth to Proxima Centauri in four
years.
c. Light from Proxima Centauri reaches the Earth in more than
four years.
d. It is 186.000 miles from the Earth to Proxima Centauri.

48. The word “brightest” in line 11 could best be replaced by ……

a. Smartest
b. Palest
c. Shiniest
d. Largest

49. It can be inferred from the passage that from the Alaska Alpha
Centauri is ……
a. Always visible
b. Frequently visible
c. Occasionally visible
d. Never visible

50. Where in the passage does the author explain how fast light can
travel?
a. Line 1-2
b. Line 5
c. Line 7-9
d. Line 10-11

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IDIOMATIC EXPRESSION

A bag of bones :kurus kering

all over :semua telah selesai

all the same :sama saja

arm in arm :bergandeng tangan

as if : seolah olah

as usual : seperti biasa

as you please : sesukamu

at all : sama sekali

at first :mula mula

at last :akhirnya

at least :setidak tidaknya

by chance : secara kebetulan

by the way : ngomong ngomong

in advance : dimuka

in and out :sering datang dan pergi

in general :umumnya

just now :tadi

let bygones be bygones:yang lalu biarlah berlalu jangan diingat lagi

no doubt :tidak sangsi lagi

off duty : sedang bertugas

on purpose :sengaja

on sale :diobral

on the side street : diujung jalan

open secret : bukan rahasia lagi

on the spot : di tempat kejadian

out of order : rusak

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on trial : dalam percobaan

running out of gasoline : kehabisan bensin

safe and sound :selamat tak kurang satupun

slip of tougue:salah ngomong

take it easy: tenanglah

side by side: berdampingan

take over ; ambil alih

to and from :mondar mandir

break down :mogok

get lost :tersesat

get on :naik

get off: turun

keep dark: merahasiakan

learn by heart:menghafal

give birth: melahirkan

look forward to:mengharap-harap

look into:menyelidiki

make eyes at: bermain mata

look back: merenungkan

look after : menjaga

pick up: menjemput

plays up : kambuh lagi

put out: memadamkan

run away:melarikan diri

run out: habis

set up: menyusun

over come: mengatasi

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sign up:mendaftar

slow down:memperlambat jalan

stay up: bergadang

take a seat :mempersilahkan duduk

take a walk: jalan jalan

turn on : menghidupkan

turn over:serah terima

tug of war:tarik tambang

over age:ketuaan

under age;kemudaan

pretend: berpura pura

flaccid;lembek

wrickled;berkerut

not firm: tidak tegas

disobey:tidak taat

prevent :mencegah

preempt:mendahului

forswear:mengingkari

give up:menyerah

explode :meledak

garish[adj]:norak

gaudy: mencolok

awkward:kikuk

sharpen:mempertajam

purposeless:tanpa tujuan

fawning;menjilat

turn round; berpaling

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abusive; melecehkan

toss ; terombang ambing

speed:ngebut

sigh :menghela napas

citation: surat tilang

authoritative: berwibawa

spice rack: tempat bumbu

quip:menyindir

postpone;menunda

suggest: menyarankan

annoyed: jengkel

attentive: penuh perhatian

sneak :menyelundupkan

sniff:mengendus

dash :bergegas

couch :sofa

installment;cicilan

gnaw on ; mengrogoti

couldn’t bear :tidak tahan

wrap :membungkus

condemn: terdakwa

accumulated junk : barang barang bekas

consist of ;terdiri dari

flat tire :ban kempes

tap : menepuk

offer :menawari

convince :menyakinkan

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rummage: menggeledah

whisper :berbisik

fine :mendenda

contempt : penghinaan

squash : jeruk peras

overheard : mendengar tanpa sengaja

elegant: anggun

persuade :mendesak

glance:melirik

approach :mendekati

attendant : petugas

nodd : mengangguk

stamp : menghentak-hentak

fold ; melipat

complai; mengeluh

extend: memperpanjang

lean back : bersandar

wipe : mengusap

tranquility :ketenangan

chase : mengejar

inmate : tahanan

dig : mengali

grow : menanam

scratch :menggaruk

awake : terbangun

miserable : sengsara

knit: merajut

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enrich :memperkaya

beam : tersenyum lebar

groan : menggeram

tremble: gemetar

litter : membuang sampah sembarangan

regret : menyesali

remind : mengingat

140
REFERENCES

Glendining, Eric & Beverly Holmstrom 1994 English in Medicine a course in communication skills,

Cambridge University Press, New York.

Abdoelrahman 1951 English Grammar,Penerbit Pembangunan, Djakarta

Pyle, Michael A and Page, Mary Ellen Munoz 1995 TOEFL Preparation Guide, CLIFFs

Notes Incorporates, Lincoln, Nebraska

Darmawan, Iyan 1997 English for Nurses, Kesaint Blanc, Jakarta

David Austin 1974 English for Nurses, longman

Tiran, Denise 2005 Kamus Saku Bidan, Edisi 10 . EGC. Jakarta

Johnson, Ruth,& Wendy Taylor 2001 Skills for Midwifery Practice ,Churchill Livingstone,London

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