Studi Kasus: Asuhan Kebidanan Berkelanjutan (Continuity of Care) pada Ibu Hamil dengan Anemia di Puskesmas Tanjung Selor

Abstract

Anemia during pregnancy remains a significant health problem that increases the risk of maternal and neonatal complications. This condition may impair oxygen transport, leading to a higher risk of postpartum hemorrhage, preterm labor, and low birth weight. This case study aimed to describe the implementation of Continuity of Care (CoC) midwifery care for a pregnant woman with mild anemia. The subject of this study was Mrs. A, a 23-year-old G2P1A0 woman at 34 weeks of gestation with a hemoglobin level of 10.5 g/dL. Midwifery care was provided continuously from the third trimester of pregnancy until family planning services. The methods used included interviews, observation, physical examination, and documentation studies using the SOAP approach. During third-trimester pregnancy care (34 weeks of gestation), mild anemia with an Hb level of 10.5 g/dL was identified and managed through the administration of iron tablets, vitamin C, calcium supplements, and nutritional education. During labor care (39 weeks of gestation), the Hb level increased to 11.8 g/dL. In the active phase of the first stage of labor, complementary therapy using counter-pressure massage was applied to reduce lower back pain, and the delivery proceeded spontaneously per vaginam. During the postpartum period, the mother complained of insufficient breast milk production on the ninth day due to lack of rest, which was successfully managed through oxytocin massage techniques. Newborn care showed that the baby was in normal and healthy condition, and the umbilical cord detached normally on the seventh day. In family planning care, the mother received counseling regarding postpartum contraceptive methods. In conclusion, the implementation of comprehensive midwifery care (Continuity of Care) for Mrs. A was carried out according to standard operating procedures and midwifery authority. The entire process from pregnancy to postpartum progressed well without complications in either the mother or the baby. Evaluation showed that the mother’s condition remained stable without complications, and there was no discrepancy between theory and practice. Continuity of Care was effective in monitoring and managing mild anemia during pregnancy.

Abstrak

Anemia pada kehamilan masih menjadi masalah kesehatan yang berisiko meningkatkan komplikasi maternal dan neonatal. Kondisi ini dapat menyebabkan gangguan transportasi oksigen yang berdampak pada peningkatan risiko perdarahan postpartum, persalinan prematur, dan berat badan lahir rendah. Studi kasus ini bertujuan untuk memberikan gambaran asuhan kebidanan Continuity of Care (CoC) pada ibu hamil dengan anemia ringan. Subjek penelitian adalah Ny. A usia 23 tahun G2P1A0 dengan usia kehamilan 34 minggu dan kadar hemoglobin 10,5 g/dL. Asuhan kebidanan dilakukan secara berkesinambungan mulai dari masa kehamilan trimester III hingga pelayanan kontrasepsi. Metode yang digunakan meliputi wawancara, observasi, pemeriksaan fisik, dan studi dokumentasi menggunakan pendekatan SOAP. Pada asuhan kehamilan trimester III (usia gestasi 34 minggu ), ditemukan masalah anemia ringan dengan kadar Hb 10,5 gr/dl yang ditatalaksana melalui pemberian tablet Fe, vitamin C, kalk, serta edukasi nutrisi. Pada asuhan persalinan (usia gestasi 39 minggu) kadar HB 11.8g/dl i,pada kala I fase aktif dilakukan terapi komplementer pijat counter pressureuntuk mengurangi nyeri pinggang dan persalinan berlangsung spontan pervaginam. Pada masa nifas, ibu sempat mengeluhkan ASI keluar sedikit pada hari ke-9 akibat kurang istirahat, yang berhasil diatasi melalui pemberian teknik pijat oksitosin. Asuhan bayi baru lahir (neonatus) menunjukkan kondisi bayi normal dan sehat, serta tali pusat lepas secara normal pada hari ke-7. Pada asuhan keluarga berencana, ibu diberikan konseling mengenai metode kontrasepsi pascapersalinan. Kesimpulan yang diperolah pada Pelaksanaan asuhan kebidanan komprehensif (Continuity of Care) pada Ny. A telah dilakukan sesuai standar operasional dan kewenangan bidan. Seluruh proses dari kehamilan hingga nifas berjalan dengan baik tanpa adanya komplikasi  baik pada ibu maupun bayi. Evaluasi menunjukkan kondisi ibu stabil tanpa komplikasi serta tidak terdapat kesenjangan antara teori dan praktik. Asuhan Continuity of Care efektif dalam pemantauan dan penanganan anemia ringan pada kehamilan.