<![CDATA[Perineal rupture is one of the most common complications of vaginal delivery and may lead to hemorrhage, infection, pain, and pelvic floor dysfunction. One of the factors presumed to be associated with the occurrence of perineal rupture is physical activity during pregnancy, particularly in the third trimester. Regular physical activity is believed to improve pelvic floor muscle strength, increase perineal tissue elasticity, and enhance maternal physical preparedness for childbirth. Objective: This study aimed to analyze the relationship between physical activity among third-trimester pregnant women and the incidence of perineal rupture during normal vaginal delivery at the Independent Midwifery Practice (PMB) Piska Mariati in Muara Enim. Methods: This study employed a quantitative analytic research design with a cross-sectional approach. The study population consisted of women who underwent normal vaginal delivery at the Independent Midwifery Practice (PMB) Piska Mariati in Muara Enim in 2026. Samples were selected using a total sampling technique based on the established inclusion criteria. Physical activity during the third trimester was assessed using the Pregnancy Physical Activity Questionnaire (PPAQ), while data on perineal rupture were obtained through an observation checklist. Data were analyzed using univariate and bivariate analyses, with the Chi-square test applied at a significance level of α = 0.05. Results: The findings indicated that the majority of respondents engaged in a moderate level of physical activity. The incidence of perineal rupture was higher among women with low physical activity than among those with moderate or high levels of physical activity. Bivariate analysis demonstrated a statistically significant relationship between physical activity during the third trimester of pregnancy and the incidence of perineal rupture during normal vaginal delivery (p < 0.05). Conclusion and Recommendation: There was a significant relationship between physical activity during the third trimester of pregnancy and the incidence of perineal rupture during normal vaginal delivery at the Independent Midwifery Practice (PMB)Piska Mariati in Muara Enim. Pregnant women are encouraged to engage in regular physical activity according to healthcare professionals' recommendations to improve childbirth preparedness and reduce the risk of perineal rupture. Healthcare providers, particularly midwives, are expected to strengthen health education regarding safe physical activity during pregnancy through antenatal care services.]]>
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