Asuhan Kebidanan Komprehensif pada Ny. M I Umur 33 Tahun G2P1A0 di Wilayah Kerja Puskesmas Karanganyar Kabupaten Pekalongan

Abstract

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) remain crucial indicators for evaluating the quality of health services. Major causes of maternal deaths include hemorrhage, hypertensive disorders in pregnancy, infection, and postpartum complications, while infant deaths are often associated with low birth weight, asphyxia, congenital abnormalities, and infections. Continuity of Care  (CoC) is an effective approach that provides comprehensive and continuous midwifery services throughout pregnancy, childbirth, postpartum, newborn care, and family planning, enabling early risk detection and prevention of complications. This descriptive case study was conducted on Mrs. M I, 33 years old, G2P1A0, who received comprehensive midwifery care at Karanganyar Public Health Center, Pekalongan. The care included antenatal assessments based on the 10T standard, fetal growth monitoring, labor management following APN procedures, postpartum care, essential newborn care, neonatal follow-up, BCG/Polio 1 immunization, and family planning counseling. Additional health education was provided based on the mother’s needs, including nutrition counseling, danger signs, breast care, and breastfeeding support. Pregnancy, childbirth, postpartum period, newborn care, immunization, and family planning services progressed physiologically without complications. The mother demonstrated good understanding of pregnancy danger signs, delivery preparedness, postpartum self-care, and exclusive breastfeeding. The newborn showed normal physiological adaptation, received complete essential newborn care and immunization, and demonstrated normal development during follow-up. Postpartum uterine involution was normal, with no signs of infection, and the mother successfully selected an appropriate contraceptive method. The implementation of Continuity of Care  (CoC) for Mrs. M I effectively supported early risk detection, enhanced maternal preparedness, and optimized maternal and neonatal health outcomes. Comprehensive and continuous care strengthened the mother’s confidence throughout pregnancy, childbirth, and postpartum. Strengthening CoC at the primary healthcare level is recommended as a key strategy to reduce maternal and infant mortality rates.

Abstrak

Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi indikator penting dalam menilai mutu pelayanan kesehatan. Penyebab utama kematian ibu meliputi perdarahan, hipertensi dalam kehamilan, infeksi, dan komplikasi masa nifas, sedangkan kematian bayi sering dipengaruhi oleh BBLR, asfiksia, infeksi, dan kelainan bawaan. Salah satu upaya untuk menurunkan AKI dan AKB adalah penerapan Continuity of Care (CoC), yaitu asuhan kebidanan komprehensif dan berkesinambungan yang diberikan mulai dari masa kehamilan, persalinan, nifas, bayi baru lahir, hingga keluarga berencana. Studi kasus deskriptif dilakukan pada Ny. M I, usia 33 tahun, G2P1A0, yang mendapatkan asuhan kebidanan komprehensif di Puskesmas Karanganyar Kabupaten Pekalongan. Asuhan meliputi pemeriksaan kehamilan sesuai standar 10T, pemantauan pertumbuhan janin, pelaksanaan persalinan sesuai standar APN, perawatan masa nifas, asuhan bayi baru lahir, pemantauan neonatus, imunisasi BCG/Polio 1, serta konseling keluarga berencana. Edukasi tambahan diberikan sesuai kebutuhan ibu, seperti tanda bahaya, nutrisi, perawatan payudara, dan dukungan menyusui. Seluruh rangkaian asuhan kehamilan, persalinan, nifas, bayi baru lahir, imunisasi, dan keluarga berencana berlangsung fisiologis tanpa komplikasi. Ibu memahami tanda bahaya kehamilan, persiapan persalinan, perawatan nifas, serta pemberian ASI. Bayi lahir dalam keadaan sehat, menunjukkan adaptasi fisiologis yang normal, serta memperoleh perawatan esensial dan imunisasi sesuai jadwal. Pada masa nifas, involusi uterus normal, tidak ditemukan tanda infeksi, dan ibu mampu memilih metode kontrasepsi yang sesuai. Simpulan penerapan Continuity of Care  (CoC) pada Ny. M I terbukti efektif dalam meningkatkan deteksi dini risiko, mendukung kesiapan ibu, serta mengoptimalkan kesehatan ibu dan bayi. Asuhan yang komprehensif dan berkesinambungan meningkatkan kepercayaan diri ibu selama kehamilan hingga masa nifas. Penguatan layanan CoC di fasilitas kesehatan primer menjadi strategi penting untuk menurunkan AKI dan AKB.