Asuhan Kebidanan Continuity of Care (CoC) pada Ny “U” Umur 25 Tahun G1P0A0 di Desa Leyangan Kecamatan Ungaran Timur

Abstract

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are important indicators used to measure the level of public health in a country. The main causes of MMR in Indonesia are still dominated by hemorrhage and preeclampsia/eclampsia, while IMR is caused by Low Birth Weight (LBW), asphyxia, and congenital abnormalities. One of the strategic efforts to reduce MMR and IMR is the implementation of continuous midwifery care or Continuity of Care (CoC), which is carried out from pregnancy until family planning services. The purpose of this study was to implement comprehensive midwifery care for Mrs. U (G1P0A0) using a case study design conducted in the working area of Puskesmas Leyangan from November 1st, 2025 to May 14th, 2026. The subject of the study was Mrs. U, who was monitored starting from the second trimester of pregnancy. Data collection techniques included direct observation, structured interviews, physical examinations, and documentation using the SOAP format. Midwifery care was provided from the second to third trimester of pregnancy, abdominal delivery through Sectio Caesarea due to transverse lie and increased blood pressure, newborn care at 6 hours, 5 days, and 14 days of age, as well as postpartum care at 6 hours, 5 days, 14 days, and 30 days postpartum with comprehensive monitoring of maternal and neonatal conditions. In addition, family planning care was provided according to the mother’s condition and needs. The results showed that midwifery care was implemented according to midwifery service standards. During pregnancy, complications in the form of transverse lie accompanied by increased blood pressure were found, therefore collaboration and referral for Sectio Caesarea delivery were carried out. During the neonatal period, early signs of umbilical cord infection were identified, including a moist umbilical cord, mild odor, and slight bleeding, therefore education, monitoring, and referral to health services were provided. In general, the condition of both mother and baby remained good throughout the monitoring period. There was conformity between theory and practice in the implementation of comprehensive midwifery care with appropriate and continuous management of complications. This study shows that the implementation of Continuity of Care can improve the quality of comprehensive midwifery services in efforts to reduce MMR and IMR.

Abstrak

Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) merupakan indikator penting dalam mengukur tingkat derajat kesehatan masyarakat di suatu negara. Penyebab utama AKI di Indonesia masih didominasi oleh perdarahan dan preeklamsia/eklampsia, sedangkan AKB disebabkan oleh Berat Badan Lahir Rendah (BBLR), asfiksia, dan kelainan kongenital. Salah satu upaya strategis dalam menurunkan AKI dan AKB adalah dengan penerapan asuhan kebidanan secara berkesinambungan atau Continuity of Care (CoC) yang dilakukan mulai dari masa kehamilan hingga pelayanan keluarga berencana. Tujuan penelitian ini adalah untuk mengimplementasikan asuhan kebidanan komprehensif pada Ny. U (G1P0A0) menggunakan desain studi kasus (case study) yang dilaksanakan di wilayah kerja Puskesmas Leyangan mulai tanggal 1 November 2025 sampai dengan 14 Mei 2026. Subjek penelitian adalah Ny. U dengan pemantauan sejak trimester II kehamilan. Teknik pengumpulan data dilakukan melalui observasi langsung, wawancara terstruktur, pemeriksaan fisik, dan dokumentasi menggunakan format SOAP. Asuhan kebidanan diberikan meliputi kehamilan trimester II sampai III, persalinan per abdominal melalui Sectio Caesarea karena indikasi letak lintang dan peningkatan tekanan darah, asuhan bayi baru lahir pada usia 6 jam, 5 hari, dan 14 hari, serta asuhan nifas pada 6 jam, 5 hari, 14 hari, dan 30 hari dengan pemantauan kondisi ibu dan bayi secara komprehensif. Selain itu, dilakukan asuhan keluarga berencana sesuai kondisi dan kebutuhan ibu. Hasil pelaksanaan menunjukkan bahwa asuhan kebidanan telah dilakukan sesuai standar pelayanan kebidanan. Pada masa kehamilan ditemukan komplikasi berupa letak lintang disertai peningkatan tekanan darah sehingga dilakukan kolaborasi dan rujukan untuk persalinan Sectio Caesarea. Pada masa neonatus ditemukan tanda awal infeksi tali pusat berupa tali pusat lembab, berbau ringan, dan keluar sedikit darah sehingga dilakukan edukasi, pemantauan, dan rujukan ke fasilitas kesehatan. Kondisi ibu dan bayi secara umum dalam keadaan baik selama masa pemantauan. Terdapat kesesuaian antara teori dan praktik dalam pelaksanaan asuhan kebidanan komprehensif dengan penanganan komplikasi secara tepat dan berkesinambungan. Studi ini menunjukkan bahwa penerapan Continuity of Care dapat meningkatkan kualitas pelayanan kebidanan secara komprehensif dalam upaya menurunkan AKI dan AKB.