Asuhan Kebidanan Asuhan Kebidanan Continuity of Care pada Ny. S dengan Riwayat Sectio Caesarea

Abstract

The Maternal Mortality Rate (AMR) and Infant Mortality Rate (IMR) serve as critical indicators of healthcare service effectiveness. In Bulungan Regency, fluctuations in AMR and the elevated risks faced by pregnant women necessitate rigorous attention through continuous care. One strategic approach to early complication detection and reducing AMR/IMR is the Continuity of Care (CoC) model. The objective is to provide comprehensive and sustained obstetric care to Ms.S—from the third trimester of pregnancy through delivery, postpartum recovery, neonatal care, and family planning services at UPTD Puskesmas Tanjung Selor. The methodology employed is the Comprehensive Obstetric Case Management Study (Continuity of Care). The case study involves a 27-year-old woman (G2P1A0) with a prior history of cesarean section (SC). Care was delivered from February to April 2026, encompassing two prenatal visits, delivery assistance, three postpartum recovery visits, and three neonatal check-ups. During the third trimester of pregnancy (gestational age 33+1 weeks), mild anemia was identified with an Hb level of 10.5 g/dL, which was managed with iron tablets, vitamin C, calcium supplements, and nutritional counseling. At the delivery stage (gestational age 38 weeks), due to a history of cervical erosion (SC) and to prevent uterine rupture, the mother was referred for planned delivery via cervical dilation and curettage (D&C) at PONEK Hospital, which proceeded smoothly. During the postpartum period, the mother reported reduced breast milk production on day 14 due to insufficient rest; this was resolved with oxytocin massage therapy. The newborn exhibited normal health, and the umbilical cord detached successfully on day 7. During family planning consultations, the mother received guidance on postpartum contraception methods. The conclusions drawn from the Comprehensive Maternal Care Implementation for Ms.S were conducted in accordance with standard operating procedures and the midwife's professional authority. The entire process, from pregnancy to postpartum recovery, proceeded smoothly without any postoperative complications for either the mother or the baby.

Abstrak

Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) merupakan indikator penting keberhasilan pelayanan kesehatan. Di Kabupaten Bulungan, fluktuasi AKI dan risiko tinggi pada ibu hamil memerlukan perhatian serius melalui asuhan yang berkesinambungan. Salah satu pendekatan strategis untuk mendeteksi dini komplikasi dan menurunkan AKI/AKB adalah melalui pelayanan Continuity of Care (CoC). Tujuan pemberian asuhan kebidanan secara komprehensif dan berkelanjutan (Continuity of Care) pada Ny. S mulai dari masa kehamilan trimester III, persalinan, nifas, bayi baru lahir, hingga pelayanan keluarga berencana (KB) di UPTD Puskesmas Tanjung Selor. Metode yang di gunakan yaitu studi penatalaksanaan kasus kebidanan komprehensif (Continuity of Care). Subjek asuhan adalah Ny. S umur 27 tahun G2P1A0 dengan riwayat persalinan Sectio Caesarea (SC) sebelumnya. Asuhan diberikan mulai  Februari hingga April 2026, mencakup 2 kali kunjungan kehamilan, asuhan persalinan, 3 kali kunjungan nifas, dan 3 kali kunjungan neonatus. Pada asuhan kehamilan trimester III (usia gestasi 33+1 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 38 minggu), atas indikasi riwayat SC dan untuk mencegah risiko robekan rahim, ibu dirujuk dan melahirkan secara berencana melalui tindakan SC di RS PONEK berjalan dengan lancar. Pada masa nifas, ibu sempat mengeluhkan ASI keluar sedikit pada hari ke-14 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. S telah dilakukan sesuai standar operasional dan kewenangan bidan. Seluruh proses dari kehamilan hingga nifas berjalan dengan baik tanpa adanya komplikasi pascaoperasi baik pada ibu maupun bayi.