Asuhan Kebidanan Continuity of Care pada Ny “R” Usia 40 Tahun G6P3A2 dengan Kehamilan Resiko Tinggi

Abstract

Maternal and infant mortality rates are one of the indicators for measuring the health status of a country. Early detection efforts to overcome morbidity and mortality for mothers, infants, and toddlers can be carried out by implementing Continuity of Care (COC) starting from pregnancy, childbirth, postpartum, newborns, to family planning. This study aims to provide comprehensive and continuous midwifery care to Mrs. R from pregnancy, childbirth, postpartum, neonates, to family planning. The study used a descriptive method with a case study approach and SOAP documentation. Data were obtained through interviews, observations, physical examinations, supporting examinations, documentation studies, and literature studies in February–April 2026. The results of care showed that during pregnancy, the mother experienced third-trimester discomfort in the form of back pain, which was overcome with non-pharmacological interventions such as effleurage massage. Labor took place with indications of a prolonged active phase and uterine inertia, so that a referral to the regional hospital was made and delivery was carried out by cesarean section, with the support of the birthball method to reduce pain. The postpartum period marked physiological recovery, normal uterine involution, and increased breast milk production through oxytocin massage. Neonatal care included health monitoring, exclusive breastfeeding education, open umbilical cord care, and basic immunizations. During the family planning phase, the mother chose the Operative Woman Method (MOW). It is recommended that health workers improve the quality of integrated antenatal care services, especially for high-risk pregnancies, conduct early detection of complications and timely referrals, optimize evidence-based education regarding discomforts of pregnancy, childbirth, postpartum, and infant care, and provide ongoing support, including family planning counseling, to ensure optimal maternal and infant safety.

Abstrak

Angka kematian ibu dan bayi merupakan salah satu indikator untuk mengukur derajat kesehatan bagi suatu negara. Kegiatan upaya deteksi dini untuk mengatasi kesakitan maupun kematian baik ibu, bayi dan balita tersebut dapat dilakukan dengan salah satunya yaitu implementasi asuhan berkelanjutan atau Continuity Of Care (COC) yang dimulai dari masa kehamilan, persalinan, nifas, bayi baru lahir, sampai dengan KB. Penelitian ini bertujuan memberikan asuhan kebidanan komprehensif dan berkesinambungan pada Ny. R mulai masa kehamilan, persalinan, nifas, neonatus, hingga keluarga berencana. Penelitian menggunakan metode deskriptif dengan pendekatan studi kasus dan pendokumentasian SOAP. Data diperoleh melalui wawancara, observasi, pemeriksaan fisik, pemeriksaan penunjang, studi dokumentasi, dan studi pustaka pada Februari–April 2026. Hasil asuhan menunjukkan selama kehamilan, ibu mengalami ketidaknyamanan trimester III berupa nyeri punggung, yang diatasi dengan intervensi nonfarmakologis seperti massage effleurage. Persalinan berlangsung dengan indikasi fase aktif memanjang dan inertia uteri sehingga dilakukan rujukan ke RSUD dan persalinan secara sectio caesarea, dengan dukungan metode birthball untuk mengurangi nyeri. Masa nifas mencatat pemulihan fisiologis, involusi uterus normal, dan peningkatan produksi ASI melalui pijat oksitosin. Asuhan neonatus meliputi pemantauan kesehatan, edukasi ASI eksklusif, perawatan tali pusat metode terbuka, dan imunisasi dasar. Pada tahap KB, ibu memilih Metode Operatif Wanita (MOW). Disarankan bagi tenaga kesehatan untuk meningkatkan kualitas pelayanan antenatal care terpadu terutama pada kehamilan risiko tinggi, melakukan deteksi dini komplikasi dan rujukan tepat waktu, mengoptimalkan edukasi berbasis evidence terkait ketidaknyamanan kehamilan, persalinan, nifas, dan perawatan bayi, serta memberikan dukungan berkelanjutan termasuk konseling KB agar keselamatan ibu dan bayi dapat terjamin secara optimal.