CONTINUITY OF MIDWIFERY CARE FOR A PREGNANT WOMAN WITH FIRST-DEGREE PERINEAL LACERATION AT RIMENDA TARIGAN CLINIC, MEDAN DENAI SUB-DISTRICT, MEDAN CITY,  NORTH SUMATRA PROVINCE, YEAR 2025

Ester Junita Gultom; Herna Rinayanti Manurung; Kismiasih Adethia; Aflah Hasibuan; Dina Sandriana Br Tumangger; Elsamonika Nduru; Rinda Permata Sari

Authors

Ester Junita Gultom Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Herna Rinayanti Manurung Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Kismiasih Adethia Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Aflah Hasibuan Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Dina Sandriana Br Tumangger Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Elsamonika Nduru Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Rinda Permata Sari Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan

Keywords:

Continuity of midwifery care, Perineal laceration, Postpartum care, Maternal health

Abstract

Maternal health is a key priority in improving overall public health. Indonesia has a high maternal mortality rate (MMR) of 305 deaths per 100,000 live births, largely due to postpartum hemorrhage. One contributing factor is perineal rupture, which affects 75% of vaginal births. WHO reports 2.7 million global cases, with projections reaching 6.3 million by 2050. To reduce the MMR to 70 by 2030, in line with the SDGs, the Indonesian government is working to improve women and children's health services. First-degree perineal lacerations, often caused by spontaneous tears or episiotomy, are manageable by midwives under existing health regulations. Midwifery care must be systematic, starting from data collection to problem identification, followed by planning, action, and evaluation using methods like SOAP and the Helen Varney model. The Continuity of Care (CoC) model supports integrated care across healthcare facilities—from pregnancy to postpartum—helping reduce maternal mortality and improve outcomes for both mothers and babies.

References

Ariyo, O., Ozodiegwu, I.D. and Doctor, H. V. (2017) “The influence of the social and cultural environment on maternal mortality in Nigeria: Evidence from the 2013 demographic and health survey,” PLoS ONE, 12(12), pp. 1–19. Available at:https://doi.org/10.1371/journal.pone.0190285.

Fodstad, K., Laine, K. and Räisänen, S. (2024) “Obstetric anal sphincter injuries during instrumental vaginal delivery: An observational study based on 18-years of real-world data,” BJOG: An International Journal of Obstetrics and Gynaecology, 131(13), pp. 1824–1831. Available at: https://doi.org/10.1111/1471-0528.17914.

Głoćko, P. et al. (2025) “Perspective on Perinatal Birth Canal Injuries: An Analysis of Risk Factors, Injury Mechanisms, Treatment Methods, and Patients’ Quality of Life: A Literature Review,” Journal of Clinical Medicine, 14(10), pp. 1–18. Available at: https://doi.org/10.3390/jcm14103583.

Liu, J. et al. (2020) “Reducing maternal mortality in China in the era of the two-child policy,” BMJ Global Health, 5(2), pp. 1–6. Available at: https://doi.org/10.1136/bmjgh-2019-002157.

Megadhana, I.W. et al. (2022) “The prevalence and characteristics of perineal rupture during vaginal delivery at Sanglah General Hospital and Regional Hospitals in Bali from January 2018 until December 2019 period,” Bali Medical Journal, 11(1), pp. 356–359. Available at: https://doi.org/10.15562/bmj.v11i1.3067.

Peppe, M.V. et al. (2018) “Perineal trauma in a low-risk maternity with high prevalence of upright position during the second stage of labor,” Revista Brasileira de Ginecologia e Obstetricia, 40(7), pp. 379–383. Available at: https://doi.org/10.1055/s-0038-1666810.

Sharma, S. et al. (2017) “A process evaluation plan for assessing a complex community-based maternal health intervention in Ogun State, Nigeria,” BMC Health Services Research, 17(1), pp. 1–10. Availableat:https://doi.org/10.1186/s12913-017-2124-4.

Ward, Z.J. et al. (2023) “A simulation-based comparative effectiveness analysis of policies to improve global maternal health outcomes,” Nature Medicine, 29(5), pp. 1262–1272. Availableat: https://doi.org/10.1038/s41591-023-02311-w.

Wen, Q. et al. (2018) “Temporal trends in severe maternal and neonatal trauma during childbirth: A population-based observational study,” BMJ Open, 8(3). Available at: https://doi.org/10.1136/bmjopen-2017-020578.

Yeager, A.L. and Nypaver, C. (2025) “Evidence-Based Suturing Education for Midwives,” Journal of Midwifery and Women’s Health, pp. 927–931. Available at: https://doi.org/10.1111/jmwh.70018.