CONTINUITY OF CARE DURING PREGNANCY ForMrs “N” WITH VERY HIGH RISK PREGNANCY AtTPMB ELIS YULI ASTUTIK, S. Keb. Bdn. JOGOROTO JOMBANG

Abstract

Pregnancy is a physiological process; however, it can become pathological when accompanied by specific risk factors, thereby increasing maternal and neonatal morbidity and mortality. Maternal mortality in East Java is influenced by maternal age, accounting for 63.62% in mothers aged 20–33 years, 32.43% in mothers aged >34 years, and 3.96% in mothers aged <19 years. This study aimed to provide Continuity of Care (CoC) midwifery management for a mother with a very high-risk pregnancy..

The study subject was Mrs. “N”, a 36-year-old GVIP40013 at 38–39 weeks of gestation, managed using the Continuity of Care (CoC) midwifery approach. Data were collected through interviews (anamnesis), physical examinations, observations, and documentation from the Maternal and Child Health (MCH) handbook. The study took place at Independent Midwifery Practice (TPMB) Elis Yuli Astutik, S.Keb., Bdn., Jogoroto, Jombang, in November 2025.

The assessment revealed that the mother had a history of six pregnancies and deliveries (3 living children, 1 abortion in 2022, and 1 stillbirth due to congenital anomalies in 2023). Interventions provided included Information, Education, and Communication (IEC) on third-trimester danger signs, signs of labor, balanced nutrition with a low-salt diet, post-traumatic stress management related to perinatal loss, and daily oral iron (Fe) supplementation (1x1 tablet) in accordance with Ministry of Health standards to prevent anemia. Spousal and family empowerment was optimized through the use of the MCH handbook.

Conclusion: Midwifery care focusing on promotive, preventive approaches (low-salt diet and iron supplementation), and psychological support proved effective in minimizing the risk of complications in mothers categorized as having a very high-risk pregnancy. Family involvement and adherence to follow-up visits were key factors in the success of the care