Asuhan Kebidanan Komprehensif Ny. S Usia 22 Tahun G1P0A0, di Wilayah Kerja Puskesmas Kaliwungu Kecamatan Kaliwungu

Abstract

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) remain crucial indicators for assessing the quality of healthcare services. According to the 2022 data from the Indonesian Ministry of Health, the MMR was 207 per 100,000 live births, while the IMR was 22 per 1,000 live births, both still above the national targets. The main causes of maternal death include hemorrhage, preeclampsia/eclampsia, infection, prolonged labor, and postpartum complications. Infant mortality is influenced by prematurity, asphyxia, infection, and congenital anomalies. Efforts to reduce MMR and IMR are implemented through the Safe Motherhood program and the Continuity of Care (CoC) approach, which provides integrated midwifery services from pregnancy, labor, postpartum, newborn care, to family planning. Comprehensive and continuous care contributes to early risk detection, complication prevention, and improved maternal and neonatal health. This study employed a descriptive case study method on Mrs. S, 22 years old, P1A0, who received comprehensive midwifery care at Puskesmas Kaliwungu. The care included pregnancy assessment, labor monitoring, postpartum care, newborn care, and family planning counseling. Interventions followed standard protocols, including ANC examination, normal labor management, physiological newborn care, breastfeeding education, and postpartum family planning. All stages of care—from pregnancy, labor, postpartum, newborn care, to family planning—proceeded physiologically without complications. The mother demonstrated good understanding of pregnancy warning signs, labor preparation, postpartum self-care, exclusive breastfeeding, and newborn care. She chose postpartum contraception (3-month injectable) according to her condition. The newborn adapted well and showed normal growth and development. Comprehensive Continuity of Care (CoC) midwifery services are effective in early risk detection, increasing maternal knowledge, supporting maternal and neonatal health, and optimizing breastfeeding and maternal comfort. Continuous implementation of CoC services is crucial to support efforts in reducing MMR and IMR.

Abstrak

Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) masih menjadi indikator penting dalam menilai kualitas pelayanan kesehatan. Berdasarkan data Kemenkes Indonesia tahun 2022, AKI tercatat sebesar 207 per 100.000 kelahiran hidup, sedangkan AKB sebesar 22 per 1.000 kelahiran hidup, masih di atas target Renstra. Penyebab kematian ibu umumnya meliputi perdarahan, preeklamsia/eklamsia, infeksi, partus lama, dan komplikasi nifas, sementara kematian bayi dipengaruhi oleh prematuritas, asfiksia, infeksi, dan kelainan bawaan. Upaya penurunan AKI dan AKB dilakukan melalui program Safe Motherhood dan penerapan Continuity of Care (CoC), yaitu pelayanan kebidanan berkesinambungan mulai kehamilan, persalinan, nifas, bayi baru lahir hingga keluarga berencana. Pelayanan yang komprehensif dan terintegrasi berkontribusi dalam deteksi dini risiko, pencegahan komplikasi, serta peningkatan kesehatan ibu dan bayi. Penelitian ini menggunakan metode studi kasus deskriptif pada Ny. S, usia 22 tahun, P1A0, yang menerima asuhan kebidanan komprehensif di Puskesmas Kaliwungu. Asuhan meliputi pengkajian kehamilan, pemantauan persalinan, perawatan nifas, perawatan bayi baru lahir, dan konseling keluarga berencana. Tindakan yang diberikan sesuai standar, antara lain pemeriksaan ANC, manajemen persalinan normal, perawatan bayi baru lahir fisiologis, edukasi menyusui, serta konseling dan pemberian KB pasca persalinan. Seluruh proses asuhan berlangsung fisiologis tanpa komplikasi. Ibu menunjukkan pemahaman yang baik mengenai tanda bahaya kehamilan, persiapan persalinan, perawatan diri masa nifas, pemberian ASI eksklusif, dan perawatan bayi. Pemberian KB pasca persalinan dipilih sesuai kondisi ibu (KB suntik 3 bulan). Bayi baru lahir menunjukkan adaptasi yang baik dan tumbuh kembang normal. Asuhan kebidanan berkesinambungan (CoC) terbukti efektif dalam mendeteksi dini risiko, meningkatkan pengetahuan ibu, mendukung kesehatan maternal dan neonatal, serta membantu optimalisasi pemberian ASI dan kenyamanan ibu. Penerapan layanan CoC secara komprehensif perlu terus dilakukan untuk mendukung penurunan AKI dan AKB.