CONTINUITY OF CARE (COC) PADA NY “A” G1P0000 MASA KEHAMILAN SAMPAI DENGAN MASA NIFAS DI PMB NY. ANIS PURWANINGSIH, S.Keb., Bdn

CONTINUITY OF CARE (COC) TO MRS. “A” G1P0000 FROM PREGNANCY TO POSTPARTUM PERIOD AT INDEPENDENT PRACTICE OF MIDWIFERY MRS. ANIS PURWANINGSIH, S.Keb., Bdn

Abstract

Abstrak  

Kehamilan, persalinan, dan nifas adalah proses yang fisiologis namun dapat menjadi kondisi patologis yang dapat mengancam jiwa ibu serta bayi hingga mengakibatkan kematian. Tujuan pemberian asuhan kebidanan secara Continuity Of Care (CoC) adalah memberikan asuhan kebidanan mulai dari masa kehamilan hingga masa nifas dan KB. Metode penelitian yang digunakan adalah studi kasus dengan subjek penelitian satu pasien yaitu Ny “A” G1P0000 mulai masa kehamilan sampai dengan masa nifas dan KB di PMB Anis Purwaningsih mulai tanggal 14 September 2024 sampai 11 Januari 2025. Metode pengumpulan data pada asuhan kehamilan sampai dengan masa nifas dan KB dilakukan melalui observasi, wawancara, pengamatan, dan dokumentasi serta dengan memperhatikan etika penelitian. Alat bantu pemeriksaan yang digunakan pada asuhan kehamilan yaitu berupa buku Kesehatan Ibu dan Anak (KIA), Kartu Skor Poedji Rochdjati (KSPR), dan format pengakjian kehamilan. Alat bantu pada asuhan persalinan yaitu penapisan persalinan, lembar observasi dan partograf serta format pengkajian persalinan. Alat bantu pada asuhan masa nifas dan Bayi Baru Lahir (BBL) yaitu leaflet dan format pengkajian masa nifas dan BBL. Alat bantu pada asuhan KB yaitu penapisan KB, Alat Bantu Pengambilan Keputusan (ABPK), dan format pengkajian KB. Pelaksanaan monitoring evaluasi asuhan kebidanan dilaksanakan setiap kunjungan berikutnya.   Selama kehamilan Ny “A” G1P0000 ditemukan keluhan sering BAK teratasi dengan pemberian mengurangi konsumsi cairan pada malam hari, keluhan keputihan teratasi dengan personal hygiene, keluhan bengkak pada ekstremitas teratasi dengan posisi dengan tidak menggantung kaki dan senam hamil, dan keluhan gatal teratasi dengan personal hygiene. Proses persalinan Ny “A” G1P0000 dilakukan secara SC karena KPD dan induksi gagal serta prolong laten phase. Pada masa nifas Ny “A” P1001 terdapat keluhan nyeri luka jahitan post SC teratasi dengan teknik relaksasi dan distraksi, keluhan perubahan psikologis teratasi dengan istirahat cukup dan dukungan psikologis, dan keluhan bengkak pada ekstremitas teratasi dengan posisi yaitu tidak bersandar terlalu lama. Pada masa BBL By Ny “A” neonatus cukup bulan, kenaikan berat badan minimal bayi kurang, keluhan demam teratasi dengan menggunakan pakaian bayi yang tipis, dan menyusui bayi sesering mungkin. Pada masa KB Ny “A” P1001 menggunakan KB MAL. Kehamilan fisiologis dengan KSPR 2 beresiko menjadi patologis pada saat persalinan sehingga perlu deteksi dini melalui asuhan secara CoC sehingga ibu dapat melalui masa hamil, bersalin, dan nifas dengan nyaman dan lancar. Diharapkan bagi ibu yang telah didampingi mulai dari masa kehamilan TM III sampai dengan KB dapat lebih kooperatif dan komunikatif dengan tenaga kesehatan dan memeriksakan kondisi kesehatannya secara rutin sehingga dapat memperoleh gambaran mengenai pentingnya pengawasan pada saat hamil sampai KB.

Abstract  

Pregnancy, childbirth and postpartum is a physiological processes but can be pathological conditions that can threaten the life of the mother and baby and result in death. The purpose of providing midwifery care through Continuity Of Care (CoC) is to provide midwifery care starting from pregnancy, to postpartum and family planning. The research method used was a case study with one research subject, namely Mrs. "A" G1P0000 starting from the gestation period to postpartum and the family planning period in the independent practice of midwife Anis Purwaningsih from September 14th, 2024 to January 11th, 2025. The data collection method was carried out through observation, interviews, observations, and documentation and by paying attention to research ethics. The examination tools used in maternity care include the Maternal and Child Health Book, Poedji Rochdjati Score Card, and pregnancy assessment forms. Tools for childbirth care include delivery screening, observation sheets, partograph, and childbirth assessment forms. Tools for postpartum care and newborn care include leaflets and postpartum and newborn assessment forms. Tools for family planning care include family planning screening, decision support tool, and family planning assessment forms. Monitoring and evaluation of midwifery care is carried out at each subsequent visit. During pregnancies Mrs. “A” G1P0000 found complaints of frequent urination which were resolved by reduce fluid consumption at night, complaints of vaginal discharge were resolved by personal hygiene, complaints of swelling in the extremities were resolved by position not hanging your legs and pregnancy exercises, complaints of itching were solved with personal hygiene. The delivery process Mrs. “A” G1P0000 is carried out by caesarean section because the amniotic membrane ruptures prematurely and induction fails as well as the latent prolong phase. In the postpartum period Mrs. “A” P1001, there were complaints of pain in post-section caesarean section sutures that were resolved by relaxation and distraction techniques, complaints of psychological changes were resolved by sufficient rest and providing psychological support, complaints of swelling in the extremities were resolved by not leaning on for too long. In the newborn period By Mrs. 'A', full term neonate, the minimum weight gain of the baby was less, there are fever complaints resolved by use thin baby clothes, and breastfeed the baby as often as possible. During family planning Mrs. “A” P1001, mothers used the amenorrhea lactation method. Even though physiological pregnancy with a poedji rochdjati score of two were occur pathological conditions at the time of delivery so early detection was needed to overcome it through continuity of care so that mothers were go through pregnancy, childbirth, and postpartum comfortably and smoothly. It is hoped that mothers who have been assisted from the third trimester of pregnancy through family planning can be more cooperative and communicative with healthcare workers and routinely check their health condition so that they can gain an understanding of the importance of monitoring during pregnancy up to family planning.