Efektifitas Teknik Counterpresure Terhadap Penurunan Intensitas Nyeri Persalinan Kala I pada Ny.A Umur 34 G2 P1 A0 Kebidanan di Ruang Bersalin RSUD Kudungga

Abstract

Continuity of Care (COC) is an important principle in midwifery practice that emphasizes continuous service between midwives and clients and ensures patients receive comprehensive and integrated care from early pregnancy, delivery, postpartum, newborn care, and family planning programs. This study examines the implementation of COC midwifery care for Mrs. A, a 34-year-old pregnant woman with gestational age 2, gestational age 1, and abortion stage 0 (G2P1A0), who was treated at Kudungga Regional Hospital, East Kutai. The application of complementary therapies in COC care is currently a positive alternative to provide comfort and psychophysical well-being for mothers during the reproductive process. This study emphasizes the importance of COC implementation as a primary strategy in reducing maternal mortality through quality and sustainable midwifery services that integrate prevention, early detection of complications, and family education. The application of complementary therapies such as acupressure massage during labor provides an effective alternative for pain management without pharmacological side effects. The implementation of COC-based midwifery care and the implementation of complementary therapy, counter-pressure massage, was carried out on Mrs. A, 34 years old, in the delivery room of Kudungga Regional Hospital. The method used in the case study report of Mrs. A is a case report. During the monitoring conducted from the third trimester of pregnancy, the first to fourth stages of labor, the newborn, the postpartum period, and the neonate, to contraceptive services, the author used Varney's 7-Step Midwifery Management. In the case conducted at Kudungga Regional Hospital on May 6, 2026, during the active phase of the first stage of labor monitoring, the mother experienced 3x10' contractions with a duration of 30-35''. Complementary therapy in the form of counterpressure massage was given, which effectively reduced physiological pain during labor. After 5 hours of in-partum monitoring, the baby was born vaginally at 1:10 PM, a healthy, female baby, weighing 3400 grams. The postpartum period proceeded normally, with no bleeding, good uterine contractions, a second-degree perineal rupture, and colostrum discharge. Mrs. A ended her postpartum period by choosing the contraceptive implant method, which consisted of two capsules. CoC care integrated with complementary therapies for Mrs. A has been shown to provide optimal clinical outcomes, increase patient comfort, and minimize the risk of complications during labor and postpartum. Midwives, educational institutions, pregnant women, and families are expected to collaborate in early detection and prevention of complications during pregnancy, labor, postpartum, and family planning.

Abstrak

Continuity of Care (COC) merupakan prinsip penting dalam praktik kebidanan yang menekankan pelayanan berkelanjutan antara bidan dan klien serta memastikan pasien menerima perawatan yang komprehensif dan terpadu mulai dari awal kehamilan, persalinan, nifas, perawatan bayi baru lahir, hingga program keluarga berencana. Studi ini mengkaji penerapan asuhan kebidanan COC pada Ny. A, ibu hamil usia 34 tahun dengan status gravidas 2, para 1, abortus 0 (G2P1A0), yang dirawat di RSUD Kudungga Kutai Timur. Penerapan terapi komplementer pada asuhan COC pada saat ini menjadi salah satu alternatif positif untuk memberikan kenyamanan dan kesejahteraan psikofisik ibu selama proses reproduksi. Penelitian ini menegaskan pentingnya pelaksanaan COC sebagai strategi utama dalam menurunkan AKI, melalui pelayanan kebidanan berkualitas dan berkelanjutan yang mengintegrasikan aspek pencegahan, deteksi dini komplikasi, dan edukasi keluarga. Penerapan terapi komplementer seperti pijat akupresure selama persalinan memberikan alternatif efektif untuk manajemen nyeri tanpa efek samping farmakologis. Penerapan asuhan kebidanan berbasis coc serta di implementasikan terapi komplementer pijat counter-pressure pada Ny.A umur 34 thn di ruang bersalin RSUD Kudungga. Metode yang di gunakan pada laporan study kasus Ny.A adalah (case report). Pada pemantauan yang telah di lakukan dari kehamilam TM III, Persalinan kala I-IV, bayi baru lahir, nifas serta neonatus, sampai ke pelayanan kontrasepsi penulis menggunakan manajemen Kebidanan 7 Langkah Varney. Pada kasus yang di laksanakan di RSUD Kudungga pada tanggal 06 Mei 2026 pada pemantauan persalinan kala I fase aktif ibu mengalami kontraksi 3x 10’ durasi 30-35’’, di berikan terapi komplementer berupa pijat counterpressure yang efektif mengurangi nyeri fisiologis pada persalinan. Setelah di lakukan pemantauan inpartu selama 5 jam. Bayi lahir pervaginam pukul 13.10, bayi lahir bugar, perempuan, Berat badan 3400 gr. Pada masa nifas berlangsung normal tidak ada pendarahan, kontraksi uterus baik, ruptur perineum derajat 2, kolostrum sudah ada keluar. Ny. A mengakhiri masa nifas dengan memilih metode kontrasepsi implan 2 kapsul. Asuhan CoC yang diintegrasikan dengan terapi komplementer pada Ny. A terbukti memberikan luaran klinis yang optimal, meningkatkan kenyamanan pasien, serta meminimkan resiko komplikasi masa persalinan dan nifas. Bidan, institusi Pendidikan, ibu hamil dan keluarga diharapkan mampu bekerjasama dalam deteksi dini dan pencegahan komplikasi dalam kehamilan, persalinan, nifas dan keluarga berencana.