Asuhan Kebidanan Continuity of Care (COC) pada Ny. H Umur 24 Tahun di Puskesmas Bergas

Abstract

In order to accelerate the achievement of the target of reducing maternal mortality and infant mortality rates, Indonesia has a programme that has focused on continuous midwifery services (Continuity of Care). Midwives as health workers who play a role in improving services that are close to the community, one of which is by supporting COC (continuity of care). Based on the description above, the authors monitored Mrs H starting from pregnancy, childbirth, postpartum, neonates and family planning at the Bergas Health Centre. The type of method used is case study. This case study was conducted at Puskesmas Bergas from July to October 2024. The subject used was taken one sample of a third trimester pregnant woman, followed by the process of childbirth, postpartum, newborn neonate and family planning. Data collection techniques using interviews, observation, examination and document study. The results of the study showed that in pregnancy care, the mother experienced complaints of back pain. So that the management given is in accordance with antenatal standards and the mother is taught pregnant gymnastics movements that can be done at home. Childbirth care was referred because from the examination notes at the doctor it was known that there were indications of a small baby. Midwives also provide complementary therapy in the form of couterpressure to reduce contraction pain. In the postpartum period, assessment was carried out at 1 day postpartum and 5 weeks postpartum. During monitoring, it was known that the mother experienced insufficient milk production at 1 day postpartum. So that the management carried out according to postpartum care standards and provide complementary care oxytocin massage. In the care of LBW, assessment was carried out at 1 day after birth and at 5 weeks of age. During the assessment, there were no complaints. Management was carried out according to neonate care standards. The midwife also taught baby massage to the mother for baby stimulation. In the assessment of family planning, subjective data was obtained. The mother said that she had not finished postpartum, and planned to use birth control pills after finishing postpartum. The management given is counselling about birth control pills. Midwives are expected to be able to provide comprehensive midwifery care with the correct procedures and according to client needs.

Abstrak
Dalam rangka mempercepat pencapaian target penurunan Angka Kematian Ibu dan Angka Kematian Bayi, Indonesia memiliki program yang sudah terfokus pada pelayanan kebidanan yang berkesinambungan (Continuity of Care). Bidan sebagai tenaga kesehatan yang berperan meningkatkan pelayanan yang dekat dengan masyarakat salah satunya dengan mendukung COC (continuity of care). Berdasarkan uraian diatas, maka penulis melakukan pemantauan pada Ny. H mulai dari hamil, bersalin, nifas, neonatus dan keluarga berencana di Puskesmas Bergas. Jenis metode yang digunakan adalah Study penelaahan kasus (Case Study). Studi kasus ini dilaksanakan di Puskesmas Bergas pada bulan Juli sampai Oktober 2024. Subyek yang digunakan yakni diambil satu sampel seorang ibu hamil trimester III, diikuti sampai proses persalinan, nifas, bayi baru lahir neonatus dan kb. Teknik pengumpulan data menggunakan wawancara, observasi, pemeriksaan dan studi dokumen. Hasil studi menunjukkan pada asuhan kehamilan ibu mengalami keluhan nyeri punggang. Sehingga penatalaksanaan yang diberikan sesuai standar antenatal dan ibu diajarkan gerakan senam hamil yang dapat dilakukan di rumah. Asuhan persalinan pada dilakukan rujukan karena dari catatan pemeriksaan di dokter diketahui bahwa terdapat indikasi bayi kecil. Bidan juga memberikan terapi kolplementer berupa couterpressure untuk mengurangi nyeri kontraksi. Pada masa nifas dilakukan pengkajian pada 1 hari postpartum dan 5 minggu postpartum. Selama pemantauan dikeaui ibu mengalami produksi ASI yang kurang pada1 hari postpartum. Sehingga penatalaksanaan yang dilakukan sesuai standar asuhan nifas dan memberikan asuhan komplementer pijat oksitosin. Pada Asuhan BBL, dilakukan pengkajian pada 1 hari setelah lahir dan pada usia 5 minggu. Selama pengkajian tidak ada keluhan. Penatalaksanaan yang dilakukan sesuai standar asuhan neonatus. Bidan juga mengajarkan pijat bayi kepada ibu untuk stimulasi bayi. Pada pengkajian KB diperoleh data subyektif Ibu mengatakan belum selesai nifas, dan berencana menggunakan KB Pil setelah selesai nifas. Penatalaksanaan yang diberikan yaitu konseling tentang KB pil. Bidan diharapkan dapat melakukan asuhan kebidanan secara komprehensif dengan prosedur yang benar dan sesuai dengan kebutuhan klien.