KARYA KESEHATAN SIWALIMA
Original Article Open Access Full Text Article Innovation of Natural Therapy in Continuity of Care (CoC) Midwifery Dwi Cipto Astuti1.
Syarifah2.
Fitria Hikmatul Ulya3 1,2,3 Bachelor of Midwifery.
Faculty of Nursing and Health Sciences.
Karya Husada University.
Semarang.
Indonesia Abstract Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are key indicators of a nation's health status.
Elevated rates are often associated with unmonitored complications during pregnancy and childbirth.
The Continuity of Care (CoC) approach provides a continuous care model that enables early detection of potential complications through sustained relationships between midwives and patients.
This study aims to provide comprehensive midwifery care to Mrs.
Y .
years ol.
and Mrs.
D .
years ol.
, encompassing the third trimester of pregnancy, labor, newborn care, postpartum care, and family planning services.
The research employed a descriptive observational design using VarneyAos seven-step midwifery management approach and SOAP documentation.
The results showed that The labor process was normal, with care focusing on pain management for Mrs.
Y and comprehensive management of stages IAeIV of labor for Mrs.
The newborns were healthy, supported by the implementation of Early Initiation of Breastfeeding (EIB).
The postpartum period progressed without complications, facilitated by education on nutrition and breastfeeding techniques.
At the end of the care long-term contraceptive methods, with Mrs.
Y opting for (MOW).
implementation of CoC effectively supports a safe reproductive process and minimizes the risk of complications through continuous monitoring and patient education.
Vol 5.
,1-9 A 2026 The Author.
http://dx.
org/10.
54639/kks.
Article Information Submitted: 16-01-2026 .
Revised: 16-03-2026.
Accepted: 28-03-2026.
Published: 30-03-2026.
Corresponding Author:
Fitria Hikmatul Ulya.
Bachelor of Midwifery.
Faculty of Nursing and Health Sciences.
Karya Husada University.
Semarang.
Indonesia Email: fitria12hikmatul@gmail.
Citation Information (APA Styl.
Astuti.
DC.
Syarifah.
Ulya.
FH.
Innovation of Natural Therapy in Continuity of Care (CoC) Midwifery.
Karya Kesehatan Siwalima, 5.
, 1-9.
http://dx.
org/10.
54639/kks.
This work is licensed under a Creative Commons Attribution-ShareAlike International License.
E-ISSN: 2828-8181
P-ISSN: 2828-8408
Publisher Lembaga Penerbitan Fakultas Kesehatan.
Universitas Kristen Indonesia Maluku Keywords: Continuity of Care.
Midwifery Care.
Pregnancy.
Childbirth.
Newborn.
Postpartum Care https://ojs.
id/index.
php/KKS/index Continuity of Care (CoC) Midwifery Astuti et al.
Introduction Maternal health is one of the targets outlined in the third goal of the 2030 In 2020, the Ministry of Health Agenda for Sustainable Development, estimated that by 2024, the Maternal which aims to reduce the global MMR to Mortality Rate (MMR) in Indonesia 70 per 100,000 live births.
In Indonesia, would reach 183 per 100,000 live births.
MMR remains high and continues to be and decline to 131 per 100,000 live a major public health problem.
The births by 2030.
These figures remain far success of maternal health programs is from the targets set by the Sustainable commonly assessed using the Maternal Development Goals (SDG.
(Aisah et al.
Mortality The high maternal mortality rate pregnancy or its management, excluding accidental or incidental causes.
MMR
deliveries assisted by unskilled health represents the number of such deaths personnel and births occurring outside to causes related to or aggravated by the to high-risk pregnancies.
Additionally, childbirth, or the postpartum period due Antenatal Care (ANC) services, leading any death occurring during pregnancy, pregnant women who do not utilize (MMR) Maternal death is defined as in Indonesia is influenced by multiple Rate per 100,000 live births.
Based on the 2018 Central Java and delays in treatment, ultimately Provincial Health Profile, the number of maternal deaths in Central Java was 421 mortality (Suarayasa, 2.
cases, reflecting a decrease compared to 475 cases in 2017.
Consequently, the According to the World Health maternal mortality rate declined from Organization (WHO), the Maternal 05 per 100,000 live births in 2017 to Mortality Rate (MMR) remains critically 60 per 100,000 live births in 2018.
approximately 810 women die The highest number of maternal deaths occurred in Grobogan Regency .
complications related to pregnancy or case.
, followed by Brebes .
childbirth, and about 295,000 women and Demak .
Based on age die annually during and after pregnancy and delivery.
The maternal mortality women aged >35 years .
35%), while per 100,000 live births, compared to 11 the lowest occurred among those aged per 100,000 live births in developed (Setyoningsih, maternal mortality occurred among rate in developing countries reaches 462 <20 years .
56%).
Furthermore, the Continuity of Care (CoC) Midwifery Astuti et al.
causes of maternal mortality are closely planning services.
Therefore, the author intends to implement comprehensive commonly described by the Au4 TooAosAy midwifery care through the Continuity criteria: too old (>35 year.
, too young of Care (CoC) approach.
This approach (<20 year.
, too many children (>.
, and represents a holistic model of care birth intervals that are too short (<2 covering pregnancy, labor, newborn care, postpartum, neonatal care, and Efforts to accelerate the reduction of access to quality healthcare services.
Midwifery services should be provided These include antenatal care, delivery from the preconception period, early assisted by skilled health personnel in pregnancy, all trimesters, childbirth, healthcare facilities, postnatal care for and up to six weeks postpartum both mother and infant, referral services (Gitasari et al.
, 2.
for complications, and family planning through continuous interaction between focus on ensuring that every mother has sustained service quality over time the Maternal Mortality Rate (MMR) (KB).
This planning (Jasmiati et al.
, 2.
One application of the roles, functions, and strategy to improve the quality of responsibilities of midwives in providing maternal and child health services is the services to clients and serves as an effort implementation of continuous care, to reduce both the Maternal Mortality known as Continuity of Care (CoC) Rate (MMR) and the Infant Mortality (Raraningrum, 2.
Rate (IMR) (Gita & Widowati, 2.
Continuity Care (CoC) Continuity of Care (CoC) is also a patient-centered maternal health aims to improve service which students gain direct clinical Through active participation in CoC, students are able to develop healthcare providers.
To support this competencies in providing woman- effort, midwives are expected to monitor centered care.
To achieve effective pregnant women from the first antenatal Continuity visit (K.
through delivery, as well as monitor newborns for signs of infection or postnatal complications.
In addition.
Care, intranatal, and postnatal periods to midwives act as facilitators for couples different patients (Gitasari et al.
, 2.
of reproductive age in accessing family Continuity of Care (CoC) Midwifery Astuti et al.
Based on the background above, the The scope of care was carried out at PMB Asih Ariani and TPMB Syarifah Continuous Midwifery Care for Mrs.
Sriyasmo, comprehensive monitoring of third- pregnancy, labor, newborn care, and trimester pregnancy, labor and delivery, postpartum at PMB Asih Ariani.
SiT.
newborn care, postpartum care, and Kes.
, as well as for Mrs.
S, 33 years family planning services.
G3P2A0,
G3P2A0,
TPMB
Syarifah Results and Discussion Sriyasmo.
Mranggen.
The results of the Continuity of Care Method (CoC) midwifery care for Mrs.
Y at PMB The materials and methods used in Asih Ariani and Mrs.
D at TPMB these two Continuity of Care (CoC) Syarifah Sriyasmo indicate that both midwifery case studies employed a patients completed their third-trimester descriptive observational design with a The management model applied followed common complaints such as back pain VarneyAos and frequent urination.
During labor, seven-step both patients delivered spontaneously Mrs.
Y required special attention in terms of pain management intervention, planning, implementation, and psychological support due to her age and evaluation of care.
, while Mrs.
D received Data .
, continuous assistance from cervical dilation through placental delivery.
head-to-toe The newborns were healthy, with observation, and document review using the patientsAo Maternal and Child Health Breastfeeding Initiation (IBI/IMD) was (MCH) handbooks (KIA book.
The successfully implemented, followed by Immediate documented using the SOAP format such as eye ointment and Vitamin KCA (Subjective.
Objective.
Assessment, and During the postpartum Pla.
period, routine monitoring ensured proper uterine involution and effective Continuity of Care (CoC) Midwifery Astuti et al.
Both patients subsequently menstrual period (LMP) on March 1, chose contraceptive methods, with Mrs.
Y opting for tubectomy (MOW) as a Circumference (MUAC) was 27 cm.
She permanent method.
the reproductive process in both cases Mid-Upper Arm vomiting during pregnancy.
Based on the analysis, the success of Her Nausea and vomiting are associated with hormonal changes, particularly Continuity of Care (CoC) approach, which facilitated early risk detection Gonadotropin (HCG), which peaks at during pregnancy.
All complaints were 12Ae16 weeks of gestation and affects classified as physiological and were gastrointestinal function.
Studies show effectively managed through education The experience nausea, with approximately implementation of mother-friendly care 25% requiring rest from daily activities during labor (Febiana Sholeha, 2.
anxiety and supported smooth progression through Chorionic pregnant women Non-pharmacological management all stages of labor.
No discrepancies were such as ginger consumption is effective identified between theory and practice, due to its essential oils and gingerol as all procedures adhered to midwifery content, which help reduce nausea and care standards.
The CoC model provided improve circulation.
a strong sense of safety and trust At 21 weeks, the patient reported through consistent care from pregnancy back pain, and at 37 weeks, she to family planning.
experienced Braxton Hicks contractions Midwifery Care During Pregnancy for Mrs.
This 50Ae90% Human fatigue-related Objective findings showed stable vital signs (BP: 99/77 mmHg, management of Mrs.
Y, a 41-year-old Pulse: 80 bpm.
RR: 20/min.
Temp:
G3P2A0 at 39 weeks of gestation, 5AC) and weight gain from 55 kg to 62 presenting with nausea and occasional The recommended pregnancy weight gain comparison, and evaluation of care.
Subjective data indicated that this was her third pregnancy, with the last Continuity of Care (CoC) Midwifery Astuti et al.
the surgical site was reported, which is common following cesarean section, with varying pain thresholds among Psychological adaptation is crucial in postpartum care.
Emotional stress can inhibit milk production.
therefore, family support and education Figure Antenatal Care
(ANC)
are essential.
Documentation Family Planning Care Newborn Care for Mrs.
YAos Baby During the fourth visit.
Mrs.
Assessment indicated a normal confirmed her decision to undergo newborn with no complications.
Care tubectomy (MOW).
Proper counseling included drying, warming.
Immediate was provided to reduce anxiety and Breastfeeding Initiation (IBI), decision-making regarding effectiveness and side effects.
breastfeeding, cord care, and hygiene.
Midwifery Care for Mrs.
Preventive care included Vitamin K Hepatitis (HB-.
Mrs.
D received complete antenatal care .
, meeting recommended At 39 weeks and 2 days, she presented in normal condition with no deviations from clinical guidelines.
Labor and Delivery Care for Mrs.
Mrs.
D experienced labor beginning at 16:30 WIB with cervical dilation of 7 Figure 2.
Newborn Baby Stage I lasted 1 hour.
Stage II lasted Postpartum Care for Mrs.
30 minutes, and the baby was delivered Active management of On the second postpartum day.
Mrs.
Y experienced delayed lactation and Oxytocin administration, controlled cord traction, and uterine massage.
The placenta was delivered within 5 minutes, with no applied to stimulate milk production by Stage IV monitoring was activating the let-down reflex.
Pain at Continuity of Care (CoC) Midwifery Astuti et al.
conducted for 2 hours, consistent with Conclusion standard protocols.
The implementation of Continuity of Care (CoC) for Mrs.
Y at PMB Asih Ariani and Mrs.
D at TPMB Syarifah Sriyasmo was successfully carried out, encompassing the third trimester of postpartum care, and family planning The monitoring results indicate Figure 3.
Intrapartum Care that the entire reproductive process for Newborn Care for Mrs.
DAos Baby both patients progressed physiologically A healthy male infant was born weighing 3,100 grams and measuring 50 endanger the lives of the mother or cm, with Apgar scores of 7Ae10.
Care During complaints were effectively managed administration of Vitamin K and HB-0 through appropriate education and supportive care.
In the labor stage, the Postpartum Care for Mrs.
application of mother-friendly care facilitated smooth and spontaneous The postpartum period was normal.
The newborns were in good with no complications.
Care included monitoring maternal recovery, infant procedures, and the postpartum period care, and health education.
Postpartum visits were conducted at 6Ae8 hours, 6 days, and 6 weeks to ensure maternal Overall, the Continuity of Care and neonatal well-being.
approach proved effective in ensuring a safe reproductive process, while also supporting informed decision-making in family planning, including the selection of a long-term contraceptive method .
ubectomy/MOW) by Mrs.
Figure 4.
Postpartum Breastfeeding Continuity of Care (CoC) Midwifery Astuti et al.
Conflict of Interests Statement Mortality Indonesia.
1Ae8.
https://doi.
org/10.
21070/ijhsm.
Gitasari.
Wanisah.
Yulianti.
, &
Ulya.
Asuhan Kebidanan Berkelanjutan (Continuity of Car.
pada Ny.
N di Puskesmas Banjardawa Kabupaten Pemalang: Penelitian.
Jurnal Pengabdian Masyarakat Dan Riset Pendidikan, 4.
, 7987Ae7995.
https://doi.
org/10.
31004/jerkin.
Hastiana.
, & Khayati.
Asuhan Kebidanan Continuity of Care ( COC ) pada Ny .
H Umur 28 Tahun di Klinik Rahayu Ungaran.
, 658Ae https://callforpaper.
id/index.
p/semnasdancfpbidanunw/article/view /544 Jasmiati.
Nurmila.
Rosyita.
, &
Elizar, .
Hubungan pengetahuan dan sikap ibu hamil pemilihan tempat pelayanan kesehatan di wilayah kerja puskesmas samudera kabupaten aceh utara.
, 35Ae40.
https://doi.
org/10.
37104/ithj.
Ningsih.
Hubungan Tingkat Pendidikan Ibu Hamil Trimester i Dengan Keteraturan Kunjungan ANC.
https://doi.
org/10.
30736/midpro.
Noviyana.
Lina.
Diana.
Dwi, .
Eni.
Fransisca.
Lataminarni, .
Rani.
Ruth.
, & Welmi.
Efektifitas Pijat Oksitosin dalam Pengeluaran ASI.
Jurnal Ilmu Keperawatan Maternitas, 5.
, 23Ae33.
https://doi.
org/10.
32584/jikm.
Presilia.
Asuhan Kebidanan Bayi Baru Lahir Pada By.
Ny.
M Di Tpmb Asnaini Sekampung Udik Lampung Timur.
5Ae29.
https://doi.
org/https://repository.
kes-tjk.
id/id/eprint/7759/ Raraningrum, .
Analisis Implementasi Continuity of Care (COC).
11Ae20.
https://doi.
org/https://doi.
org/10.
0/jikr.
The authors declare that there are no conflicts of interest regarding the publication of this study.
This research was conducted independently without any financial support, sponsorship, or personal relationships that could have influenced the results or interpretation of the findings.
References