Asuhan Kebidanan Komprehensif pada Ny RWKH 32 Tahun G4P1A2 di RSU Banyumanik 2 Semarang

Abstract

Maternal Comprehensive and continuous midwifery care or Continuity of Care (CoC) is a continuous and integrated health service, especially in midwifery care, which ensures patients receive comprehensive and integrated care starting from early pregnancy, childbirth, postpartum, newborn care, to family planning programs. The goal is to build a trusted relationship between patients and health workers, so that they can monitor the patient's condition optimally, detect problems and complications as early as possible, improve well-being and reduce maternal and infant mortality rates. This case study was conducted at Banyumanik 2 General Hospital, Semarang on November 28, 2025 – May 18, 2026. The subject of the case study was Mrs. RWKH G4P1A2. Data collection techniques used primary data and secondary data. Primary data were obtained through observation, physical examination, and individual interviews, as well as documentation using an assessment format, while secondary data were obtained from the KIA book. Monitoring of pregnant women was carried out once in TM2, and three times in TM3. The monitoring results were obtained in TM 3 pregnant women complained of back pain and anxiety because at 30-34 weeks of pregnancy the baby's position was transverse. After being given complementary therapy education of light exercise/pelvic rocking exercise and knee chest position (prostration) in the morning and evening for 10-15, Giving acupressure points BL 23, BL 40, GV 3 and GV 4 to reduce back pain. At 36 weeks of pregnancy the baby's position was longitudinal with a head presentation, convergent. During the labor process, Mrs. RWKH experienced premature rupture of membranes, uterine inertia, and labor pain so that antibiotics and complementary therapy (acupressure and counter pressure) were given. After 5 hours of inpartu observation, on April 16, 2026 at 08.14 WIB the baby was born vaginally. The postpartum period was normal, there was no bleeding, good uterine contractions, vaginal discharge within normal limits, 2nd degree perineal tears and breast milk had come out. In newborns, the results of anthropometric examinations were within normal limits. Care for KF 2 to KF 4 and KN 1 to KN 3 was carried out well without any problems. Mrs. RWKH decided to use condoms and the lactational amenorrhea method.

Abstrak

Asuhan kebidanan yang komprehensif dan berkelanjutan atau Continuity of Care (CoC) adalah pelayanan kesehatan yang berkelanjutan dan terintegrasi, terutama dalam asuhan kebidanan, yang memastikan pasien menerima perawatan yang komprehensif dan terpadu mulai dari awal kehamilan, persalinan, nifas, perawatan bayi baru lahir, hingga program keluarga berencana. Tujuannya adalah untuk membangun hubungan yang terpercaya antara pasien dan tenaga kesehatan, sehingga dapat memantau kondisi pasien secara optimal, mendeteksi masalah dan komplikasi sedini mungkin, meningkatkan kesejahteraan dan menurunkan angka kematian ibu dan bayi. Studi kasus ini dilaksanakan di RSU Banyumanik 2 Semarang pada 28 November 2025 – 18 Mei 2026. Subjek studi kasus yaitu Ny. RWKH G4P1A2. Teknik pengumpulan data menggunakan data primer dan data sekunder. Data primer diperoleh melalui observasi, pemeriksaan fisik, dan wawancara individu, serta dokumentasi menggunakan format pengkajian, sedangkan data sekunder diperoleh dari buku KIA. Pemantauan ibu hamil dilakukan sebanyak 1x pada TM2, dan 3x pada TM3. Hasil pemantauan didapatkan pada TM 3 ibu hamil mengeluh nyeri punggung dan cemas karena pada usia kehamilan 30-34 minggu posisi bayinya melintang. Setelah diberikan edukasi terapi komplementer latihan ringan/pelvic rocking exercise dan posisi knee chest (sujud) pagi dan sore selama 10-15, Memberikan akupresur titik BL 23, BL 40, GV 3 dan GV 4 untuk mengurangi nyeri punggung. Pada usia kehamilan 36 minggu posisi bayi membujur dengan presentasi kepala, konvergen. Pada proses persalinan Ny. RWKH mengalami ketuban pecah dini, inersia uteri, dan nyeri persalinan sehingga diberikan antibiotik, dan terapi komplementer (akupresur dan counter pressure). Setelah dilakukan observasi inpartu selama 5 jam, tanggal 16 April 2026 jam 08.14 WIB bayi lahir pervaginam. Masa nifas berlangsung normal tidak ada pendarahan, kontraksi uterus baik, pengeluaran pervaginam dalam batas normal, robekan perineum derajat 2 dan ASI sudah keluar. Pada bayi baru lahir, hasil pemeriksaan antropometri dalam batas normal. Asuhan KF 2 sampai KF 4 dan KN 1 sampai KN 3 dilaksanakan dengan baik tanpa masalah. Ny. RWKH memutuskan menggunakan kontrasepsi kondom dan metode amenore laktasi.