Asuhan Kebidanan Continuity of Care (CoC) pada Primigravida di Puskesmas Sumowono: Studi Kasus

Abstract

Continuity of Care (CoC) is a continuous midwifery care approach provided from pregnancy, childbirth, postpartum, newborn care, to family planning to improve maternal and neonatal health outcomes. This study aimed to describe the implementation of comprehensive midwifery care using the Continuity of Care approach for Mrs. E, a 23-year-old primigravida, at Sumowono Community Health Center. This study used a descriptive case study design. Care was provided from November 18, 2025, to January 29, 2026, through interviews, observation, physical examination, and documentation using the maternal and child health handbook, partograph, and medical records. Care was carried out continuously from the third trimester of pregnancy through childbirth, postpartum, newborn care, and family planning services. The results showed that Mrs. E experienced a physiological pregnancy with complaints of back pain during the third trimester, which improved after prenatal yoga education. Labor occurred spontaneously vaginally at 40 weeks of gestation. During the first stage of labor, inadequate uterine contractions were identified and successfully managed with oxytocin augmentation, resulting in adequate contractions and normal labor progression. The postpartum period was physiological, with normal uterine involution, improved breast milk production following breastfeeding education and oxytocin massage, and good maternal psychological adaptation. The baby was born at term with a birth weight of 3000 grams, APGAR scores of 9–9–10, successful early initiation of breastfeeding, exclusive breastfeeding, and weight gain to 3300 grams by 14 days of age. In family planning services, the mother chose an implant contraceptive method, which was safely inserted without complications and was appropriate for breastfeeding. In conclusion, the implementation of comprehensive midwifery care using the Continuity of Care approach was successfully carried out, with all stages progressing physiologically without complications and supporting optimal maternal and neonatal health. This approach may serve as an effective model of midwifery care in primary healthcare settings.

Abstrak

Continuity of Care (CoC) merupakan pendekatan asuhan kebidanan berkesinambungan yang diberikan sejak kehamilan, persalinan, nifas, bayi baru lahir, hingga keluarga berencana untuk meningkatkan kualitas pelayanan kesehatan ibu dan bayi. Penelitian ini bertujuan mendeskripsikan penerapan asuhan kebidanan komprehensif berbasis Continuity of Care pada Ny. E usia 23 tahun G1P0A0 di Puskesmas Sumowono. Metode yang digunakan adalah studi kasus deskriptif. Asuhan dilakukan pada 18 November 2025 sampai 29 Januari 2026 melalui wawancara, observasi, pemeriksaan fisik, dan dokumentasi menggunakan buku KIA, partograf, dan rekam medis. Asuhan diberikan secara berkesinambungan mulai trimester III kehamilan, persalinan, nifas, bayi baru lahir, hingga pelayanan keluarga berencana. Hasil menunjukkan bahwa kehamilan Ny. E berlangsung fisiologis dengan keluhan nyeri punggung trimester III yang berkurang setelah edukasi prenatal yoga. Persalinan berlangsung spontan pervaginam pada usia kehamilan 40 minggu. Pada kala I terjadi kontraksi uterus tidak adekuat yang berhasil ditangani melalui augmentasi oksitosin hingga persalinan berlangsung lancar. Masa nifas berlangsung fisiologis dengan involusi uterus baik, produksi ASI meningkat setelah edukasi menyusui dan pijat oksitosin, serta adaptasi psikologis ibu berlangsung normal. Bayi lahir cukup bulan dengan berat lahir 3000 gram, nilai APGAR 9–9–10, berhasil dilakukan Inisiasi Menyusu Dini, mendapatkan ASI eksklusif, dan mengalami kenaikan berat badan menjadi 3300 gram pada usia 14 hari. Pada pelayanan keluarga berencana, ibu memilih kontrasepsi implan yang aman untuk ibu menyusui dan terpasang tanpa komplikasi. Disimpulkan bahwa penerapan asuhan kebidanan Continuity of Care pada Ny. E berjalan baik, seluruh tahapan berlangsung fisiologis tanpa komplikasi, serta mendukung kesehatan ibu dan bayi secara optimal. Pendekatan ini dapat menjadi model pelayanan kebidanan efektif di fasilitas kesehatan primer.