Mitra Husada Health Internasional Conference (MIHHICo)

CASE STUDY-BASED LEARNING MODEL ON STUDENTS' KNOWLEDGE IN SELF-CARE DEFICIT PATIENTS

2026-07-20T16:01:33+07:00

Background: Self-care deficit is a psychiatric nursing issue that requires students to develop appropriate nursing knowledge in assessing, diagnosing, planning, implementing, and evaluating nursing care. However, lecturer-centered learning often fails to develop students' critical thinking skills and clinical understanding. Therefore, this study aimed to determine the effect of the case study learning model on students' knowledge in caring for psychiatric patients with self-care deficits.
Methods: This study used a pre-experimental design with a one-group pretest-posttest approach. The sample consisted of 30 nursing students enrolled in a psychiatric nursing course and were selected using a random sampling technique. The intervention involved the application of a case study learning model focused on nursing care for patients with self-care deficits. Students' knowledge levels were measured using questionnaires before and after the intervention. Data were analyzed using statistical tests appropriate to the data distribution with a significance level of p<0.05.
Results: The results showed an increase in students' average knowledge score after the case study learning compared to before the intervention, from 80.67 to 90.67. Statistical analysis showed a significant difference between pretest and posttest scores (p<0.05), indicating that the case study learning model was effective in improving students' knowledge regarding caring for patients with self-care deficits.
Conclusions and Recommendations: This method can be used as an alternative learning strategy in nursing education to improve critical thinking and clinical problem-solving skills. Future research is recommended to use an experimental design with a control group and a larger sample size to obtain more robust results.

THE APPLICATION OF MIDWIFERY CARE TO REDUCE DISCOMFORT CAUSED BY FREQUENT URINATION IN THIRD-TRIMESTER PREGNANT WOMEN AT THE MITRA HUSADA CLINIC IN MEDAN IN 2026

2026-06-23T13:50:21+07:00

ABSTRACT Background: Frequent urination is a physiological discomfort experienced during the third trimester due to mechanical pressure from the fetal head, which reduces bladder capacity by up to 50%. If left untreated, this condition can lead to insomnia and increase the risk of urinary tract infections (UTIs). Objective: To implement and evaluate comprehensive midwifery care to reduce the discomfort of frequent urination in third-trimester pregnant women at the Mitra Husada Clinic in Medan in 2026. Methods: This study employed a descriptive case study design, utilizing Helen Varney’s 7-Step Midwifery Care Management and SOAP documentation. The study subject was Mrs. M, G1P0A0, at 31 weeks of gestation, who complained of frequent urination. The intervention was conducted over 14 days and included nighttime fluid restriction (the 8-2-1 regimen), the double voiding method, and self-administered Kegel exercises. Data were analyzed descriptively and comparatively. Results: Objective evaluation showed significant changes after two weeks of intervention. The frequency of nighttime urination (nocturia) decreased from an average of 8.5 ± 0.5 times to 3.0 ± 0.2 times per night. Effective sleep duration increased from an average of 4.0 ± 0.5 hours to 7.0 ± 0.5 hours without any complaints of physical fatigue. Clinical evaluation also showed no symptoms of urinary tract infection (UTI). Conclusion: The implementation of midwifery care based on Helen Varney’s 7-step approach-which focuses on adjusting fluid intake and strengthening the pelvic floor muscles-has been shown to be effective in reducing the frequency of urination and optimizing sleep quality in pregnant women in their third trimester.

COMMUNITY MIDWIFERY CARE MRS. W EARLY PREGNANCY IN BANGUN REJO VILLAGE REGENCY DELI SERDANG 2026

2026-06-23T12:02:03+07:00

Background: young-age pregnancy remains a global public health concern linked to elevated maternal and infant morbidity and mortality; an initial community assessment in Dusun V, Bangun Rejo Village, identified limited maternal knowledge in managing adolescent pregnancy, contributing to nausea and vomiting that threaten maternal and fetal nutritional status. Objectives: This study aimed to provide comprehensive community midwifery care to Mrs. W, a 21-year-old woman experiencing early pregnancy discomforts, using an analytical observational design with a longitudinal case study approach following Helen Varney’s seven steps of midwifery management. Methods: Care was delivered through four intensive home visits during the field period in Deli Serdang Regency, with data collected via interviews, physical examinations, and SOAP documentation. Results: At baseline, the patient reported frequent morning sickness with vomiting and reduced appetite; midwifery interventions consisted of health education on appropriate pregnancy nutrition, counseling to eat small, frequent meals and avoid known triggers, regular monitoring, and provision of iron and folic acid supplements. Progressive follow-up at each visit included reinforcement of dietary guidance and assessment of symptoms and vital signs. By the fourth visit the patient’s nausea had resolved, appetite normalized, and vital signs remained stable. These findings suggest that. Conclusions: targeted community midwifery care combined with structured education and simple nutritional support can effectively reduce early pregnancy physiological discomforts and help prevent nutritional compromise in young pregnancies.

THE EFFECTS OF YOGA ON BACK PAIN IN PREGNANT WOMEN AT THE EKA SRIWAHYUNI MATERNITY CLINIC

2026-06-23T14:29:28+07:00

ABSTRACT

Background: One of the most common musculoskeletal problems experienced by pregnant women, especially in the third trimester, is back pain. Back pain can develop due to weight gain, changes in posture, stretching of ligaments, and changes in the body's center of gravity during pregnancy. According to a recent meta-analysis, 40.5% of pregnant women worldwide experience back pain, with the third trimester having the highest frequency at 47.8%. A safe and effective non-pharmacological treatment for pregnancy-related discomfort, particularly back pain, is prenatal yoga. The purpose of this study was to determine how prenatal yoga affects back pain in third-trimester pregnant women at the Eka Sriwahyuni Maternal and Child Health Clinic. Research Methods: Data were collected from a single cohort without a comparison group using a pre-experimental approach that included a single case study. Purposeful sampling was used in the sampling process, meaning that study participants were individuals who met the inclusion and exclusion criteria according to the objectives. The study sample consisted of 58 third-trimester pregnant women with gestational ages between 28 and 40 weeks. This study used univariate and bivariate data analysis, with the bivariate analysis using the Wilcoxon test. Research Results: According to the study findings, most respondents experienced mild back pain (19 people, or 32.8%) and moderate back pain (39 people, or 67.2%) before participating in prenatal yoga. Most respondents reported mild back discomfort (49 participants, or 84.5%) and moderate back pain (9 participants, or 15.5%) during prenatal yoga. Prenatal yoga significantly reduced the severity of back pain in pregnant women in the third trimester, according to the Wilcoxon test findings, which showed a p value of 0.000 (p < 0.05).

Keywords: Prenatal Yoga, Back Pain, Third-Trimester Pregnant Women

EFFECTIVENESS OF BENSON RELAXATION ON PAIN INTENSITY AND BREAST MILK PRODUCTION IN POST CAESAREAN SECTION MOTHERS AT ARUN HOSPITAL LHOKSEUMAWE, ACEH PROVINCE

2026-07-21T17:46:53+07:00

Background: Caesarean section is a surgical procedure that often causes postoperative pain, which may interfere with maternal mobility, breastfeeding initiation, and breast milk production. Uncontrolled pain can increase stress levels and inhibit the release of oxytocin, resulting in delayed lactation. Benson relaxation therapy is a non-pharmacological intervention that combines deep breathing and spiritual focus to induce relaxation and improve physiological responses. Objectives: This study aimed to determine the effectiveness of Benson relaxation therapy on pain intensity and breast milk production among post-caesarean section mothers at Arun Hospital, Lhokseumawe City, Aceh Province. Methods: A quasi-experimental study with a one-group pretest-postest design was conducted from April to June 2025. Thirty post-caesarean section mothers were selected using accidental sampling. Pain intensity was measured using the Numeric Rating Scale (NRS), while breast milk production was assessed through observation of milk volume before and after the intervention. Benson relaxation therapy was administered for approximately 10 minutes. Data were analyzed using descriptive and inferential statistics with a significance level of p < 0.05. Results: The mean pain intensity score decreased from 6.00 before the intervention to 4.77 after Benson relaxation therapy, indicating a reduction of 1.23 points. Breast milk production increased from an average of 40.2 ml to 94.8 ml after the intervention, with an average increase of 54.6 ml. Statistical analysis showed significant differences in pain intensity and breast milk production before and after the intervention (p < 0.05). Conclusions: Benson relaxation therapy was effective in reducing pain intensity and increasing breast milk production among post-caesarean section mothers. This therapy can be considered a simple, safe, and cost-effective complementary intervention to support postoperative recovery and promote successful breastfeeding.

MIDWIFERY CARE MANAGEMENT FOR 27-YEAR-OLD Mrs. G4P1A2 WITH NORMAL LABOR AT THE PRIMARY CLINIC SITI KHOLIJAH HASIBUAN

2026-07-20T12:25:08+07:00

Background: Safe childbirth requires comprehensive and evidence-based midwifery care to ensure optimal maternal and neonatal outcomes. This case study aimed to describe the implementation of midwifery care management for a 27-year-old woman (G4P1A2) with normal labor at Siti Kholijah Hasibuan Primary Clinic. Methods: A descriptive case study design was used, applying Varney’s Seven-Step Midwifery Management Process with SOAP documentation. Data were collected through interviews, physical examinations, observations, and medical record reviews, then analyzed descriptively according to current midwifery standards. Results: The mother experienced normal labor with stable maternal and fetal conditions throughout all stages of labor, resulting in a spontaneous vaginal delivery of a healthy newborn without complications. Comprehensive care, including continuous monitoring, emotional support, active management of the third stage of labor, early breastfeeding initiation, and postpartum counseling, contributed to positive outcomes. Conclusion: The application of evidence-based midwifery care and continuous monitoring effectively supported a safe, uncomplicated labor and favorable maternal and neonatal outcomes, highlighting the importance of standardized midwifery management in improving maternity care quality.

CORRELATING HEALTH KNOWLEDGE AND ATTITUDES WITH FIBROADENOMA MAMMAE PREVENTION AWARENESS IN ADOLESCENTS

2026-06-23T16:57:20+07:00

Background: Breast Fibroadenoma (FAM) is the most common benign breast tumor found among adolescent girls due to hormonal fluctuations during growth. Despite its benign nature, the tumor causes significant psychological anxiety and carries a high risk of delayed medical intervention due to a profound lack of early preventive awareness within the school environment. Objectives: This study aimed to analyze the relationship between health knowledge and attitudes with the awareness of Breast Fibroadenoma prevention among adolescent girls at SMAN 5 Seluma. Methods: A descriptive-analytic study with a cross-sectional design was conducted, involving 30 respondents selected through purposive sampling. Data were collected using structured questionnaires and analyzed quantitatively through univariate and bivariate analyses using Fisher’s Exact Test. Results: Univariate analysis revealed that although the majority of respondents possessed good knowledge (70%) and positive attitudes (60%), 56.7% had not taken any actual preventive actions against FAM. Bivariate analysis demonstrated a significant association between knowledge and preventive awareness (p-value = 0.042), as well as a significant association between health attitudes and preventive awareness (p-value = 0.002). Conclusions: Adequate knowledge and positive health attitudes are critical factors that play an essential role in improving adolescents' awareness toward the prevention and early detection of breast abnormalities through Breast Self-Examination (BSE/SADARI). Routine reproductive health education programs and integrated media interventions in schools are urgently required to optimize adolescents' preventive behaviors.

THE EFFECT OF PREGNANT WOMEN'S NUTRITIONAL STATUS ON PREGNANCY OUTCOMES IN THE PMB BD. WIWIN INDAWATI, LIMAPULUH DISTRICT, BATU BARA REGENCY IN 2025

2026-08-06T11:23:28+07:00

The nutritional status of pregnant women is a key determinant of successful pregnancy outcomes and fetal growth, as poor nutritional status increases the risk of anemia, preterm labor, postpartum hemorrhage, low birth weight, and fetal abnormalities. Anemia during pregnancy is known as a “Potential Danger to Mother and Child,” with a prevalence rate of 37.1% in Indonesia according to the 2018 Basic Health Research and reaching 100% based on preliminary data at the Private Midwifery Practice of Bd. Wiwin Indawati, Limapuluh Subdistrict, Batu Bara Regency in 2025. This issue is closely linked to Sustainable Development Goal (SDG) target 3.1, which aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. This study was designed following the PACER principles: Professional in data collection and processing, Accountable at every stage of the research, Collaborative with health workers and related stakeholders, and Reliable in the results and conclusions presented. Using an analytical survey design with a cross‑sectional approach, the study involved 30 third‑trimester pregnant women who served as both the population and sample. Data were collected through interviews, hemoglobin level examinations, mid‑upper arm circumference measurements, and medical record reviews, then analyzed using univariate and bivariate methods with the Chi‑Square test at a significance level of p < 0.05. The findings show that most pregnant women had poor nutritional status and anemia, and there was a significant relationship between maternal nutritional status and the occurrence of anemia as well as pregnancy outcomes. It is concluded that better nutritional status in pregnant women reduces the risk of anemia and improves fetal health and birth weight; thus, efforts to improve maternal nutrition represent a strategic step in supporting the achievement of the SDGs and ensuring quality health services.

The MIDWIFERY CARE MANAGEMENT FOR MRS. H, A 25-YEAR-OLD PRIMIGRAVIDA AT 9 WEEKS OF GESTATION WITH MORNING SICKNESS AT CITRA PRIMARY CLINIC IN 2026

2026-07-21T16:04:55+07:00

Background: Morning sickness or nausea and vomiting of pregnancy (NVP) is a common physiological condition occurring in the first trimester due to hormonal changes, particularly increased levels of human chorionic gonadotropin (hCG), estrogen, and progesterone. Globally, approximately 50–80% of pregnant women experience nausea and vomiting with varying severity, which may affect maternal quality of life and nutritional status if not properly managed. Methods: This study used a descriptive case study design on Mrs. H, a 25-year-old G1P0A0 woman at 9 weeks of gestation at Pratama Citra Clinic in 2026. Data were collected through anamnesis, physical examination, and documentation using the Varney midwifery management approach Results: The patient experienced mild nausea and vomiting, especially in the morning, without signs of dehydration and with normal vital signs, indicating physiological morning sickness. The care provided included education about pregnancy conditions, recommendations for small frequent meals, adequate fluid intake, and emotional support from the family.Conclusions: Morning sickness in this case is a physiological condition that can be effectively managed through comprehensive midwifery care based on education and non-pharmacological approaches to prevent complications.

Keywords: Morning sickness, first trimester pregnancy, midwifery care, nausea and vomiting.

MIDWIFERY CARE MANAGEMENT FOR INTRAUTERINE FETAL DEATH DURING PREGNANCY: CASE REPORT 2025

2026-07-23T10:03:19+07:00

ABSTRACT

Intrauterine fetal death (IUFD) is a serious pregnancy complication and an important indicator in assessing the quality of obstetric and perinatal health services. Comprehensive midwifery care is essential, both to maintain the mother's physical condition and to provide adequate psychological support, especially in primary healthcare facilities. Objective : To describe and analyze the implementation of midwifery care management for Mrs. Y, 29 years old, G6P5A0, diagnosed with IUFD at the Nirmala Sapni Primary Clinic. Objective: This study used a qualitative method with a clinical case study approach. Midwifery care was implemented based on Varney's seven steps and documented using the SOAP format. Data were collected through history taking, a thorough physical examination, and supporting examinations to confirm the diagnosis.Result : Mrs. Y presented with complaints of decreased fetal movement for the past week, which then became absent in the morning, accompanied by lower abdominal pain. Objective examination results showed the mother's general condition was stable with a blood pressure of 110/70 mmHg. However, a fetal heart rate was not detected by ultrasound and was confirmed by intrauterine fetal distress (IUFD) at 31 weeks and 4 days of gestation. Treatment included comprehensive communication, information, and education (IEC), early psychological support for the mother, coordination with referral facilities, and safe referral to the hospital for termination of pregnancy. Conclusion: The midwifery care provided to Mrs. Y complied with applicable standard operating procedures. Early identification of decreased fetal movement and expedited referral were crucial in preventing maternal complications, such as coagulation disorders and systemic infections.

Keywords : High-risk pregnancy, Intrauterine Fetal Death (IUFD), Midwefery Care

FACTORS RELATED TO KNOWLEDGE OF EARLY MOBILIZATION AMONG POST SECTIO CAESAREA MOTHERS AT RSUD ISKANDAR MUDA IN 2024

2026-08-04T11:41:30+07:00

This study aimed to determine the factors associated with the knowledge of post-cesarean section mothers regarding early mobilization at Iskandar Muda Regional General Hospital in 2024. Early mobilization is an essential component of postpartum care following cesarean section, as it helps accelerate recovery, improve blood circulation, reduce the risk of postoperative complications, and support the restoration of normal body functions. This research employed a descriptive cross-sectional design. The population and sample consisted of all post-cesarean section mothers treated at Iskandar Muda Regional General Hospital in 2024. Samples were selected using an accidental sampling technique. Data were collected through structured questionnaires and analyzed using univariate and bivariate statistical methods. The Chi-Square test was used to determine the relationship between independent variables and the level of maternal knowledge regarding early mobilization. The findings revealed that age, educational level, and access to information were significantly associated with mothers' knowledge of early mobilization. Mothers with higher educational backgrounds, greater access to health information, and mature age groups tended to demonstrate better knowledge compared to others. Adequate knowledge regarding early mobilization can encourage mothers to perform movement activities earlier, thereby enhancing the recovery process, preventing complications such as thrombosis and delayed wound healing, and improving overall postpartum outcomes. In conclusion, age, education, and information are important factors influencing the knowledge of post-cesarean section mothers regarding early mobilization. Strengthening health education and providing comprehensive information by healthcare professionals are recommended to improve maternal knowledge and promote the successful implementation of early mobilization after cesarean delivery.

COMPREHENSIVE MIDWIFERY CARE FOR MRS. M AT TRI HASANAH INDEPENDENT MIDWIFERY PRACTICE, SUBULUSSALAM CITY IN 2026

2026-07-17T16:26:29+07:00

Maternal and neonatal mortality rates remain critical indicators of healthcare quality, posing a significant challenge in Subulussalam City, where 18 maternal and 25 neonatal deaths were recorded in 2023. As a preventive measure, comprehensive midwifery care (Continuum of Care) is essential to systematically detect risks and minimize complications from pregnancy through family planning. This descriptive case study aimed to provide continuous, high-quality midwifery care using Varney's management method and SOAP documentation for Mrs. M (28 years old, G2P1A0) at PMB Tri Hasanah, Subulussalam City, from March to July 2026. Primary data were gathered through continuous interviews, physical examinations, and clinical observations. The results showed that third-trimester pregnancy progressed normally with appropriate management of physiological discomforts. Delivery was spontaneous and smooth, resulting in a healthy male infant weighing 3,800 grams and an intact maternal perineum with no lacerations. The postpartum period, neonatal care, and family planning services, which resulted in selecting a breastfeeding-safe contraceptive method, were successfully completed without pathological complications. In conclusion, the application of comprehensive midwifery care is proven effective in ensuring maternal and newborn safety, preventing fatal complications such as postpartum hemorrhage, and boosting family planning engagement.

RISK FACTORS ASSOCIATED WITH THE INCIDENCE OF NEONATORUM ASPHYXIA IN NEWBORNS: A LITERATURE REVIEW

2026-07-21T15:38:49+07:00

Background: Neonatal asphyxia remains one of the leading causes of neonatal morbidity and mortality worldwide, particularly in developing countries. The occurrence of neonatal asphyxia is influenced by various maternal, obstetric, and neonatal factors, with inconsistent findings reported across studies. Therefore, a comprehensive synthesis of the available evidence is needed to identify the most significant risk factors and support evidence-based prevention strategies. Objective: This study aimed to identify and analyze the risk factors associated with neonatal asphyxia based on published scientific literature. Methods: This study employed a literature review design by analyzing ten national and international scientific articles published between 2020 and 2025. The reviewed studies included case-control, cross-sectional, systematic review, and meta-analysis designs. Articles were selected based on predetermined inclusion and exclusion criteria. Data were extracted according to study characteristics, research design, sample size, and reported risk factors, and subsequently synthesized using a narrative approach. Results: The findings demonstrated that the most consistently reported risk factors for neonatal asphyxia were prematurity, low birth weight (LBW), premature rupture of membranes (PROM), meconium-stained amniotic fluid, prolonged labor, abnormal gestational age, maternal hypertension, maternal anemia, fetal malpresentation, and delivery interventions such as cesarean section, labor induction, and instrumental delivery. Several studies also identified primiparity, advanced maternal age, placental abnormalities, fetal distress, and umbilical cord complications as contributing factors. Among these, prematurity, LBW, PROM, and meconium-stained amniotic fluid were the most frequently reported determinants across the reviewed studies. Conclusion: Neonatal asphyxia is a multifactorial condition resulting from the interaction of maternal, obstetric, and neonatal factors. Early identification of high-risk pregnancies through comprehensive antenatal care, appropriate intrapartum management, and timely neonatal resuscitation are essential strategies to reduce the incidence of neonatal asphyxia and improve neonatal survival outcomes.

EFFECTIVENESS OF CONTINUITY MIDWIFERY CARE COMBINED WITH GINGER THERAPY AND NUTRITIONAL EDUCATION IN IMPROVING HYPEREMESIS GRAVIDARUM SYMPTOMS: A COMMUNITY-BASED CASE STUDY IN INDONESIA

2026-07-29T12:58:27+07:00

Background:Hyperemesis gravidarum is a severe pregnancy-related condition characterized by persistent nausea and vomiting that may lead to dehydration, nutritional imbalance, reduced maternal well-being, and adverse pregnancy outcomes. Effective and continuous midwifery management is essential to prevent disease progression and improve maternal health. Objectives:This study aimed to describe the effectiveness of continuity midwifery care combined with ginger therapy and nutritional education in improving symptoms of hyperemesis gravidarum in a pregnant woman.Methods: A community-based case study was conducted on a 21-year-old primigravida woman diagnosed with Grade I hyperemesis gravidarum in Bangun Rejo Village, Deli Serdang Regency, Indonesia. Midwifery care was implemented through four home visits using the Helen Varney midwifery management approach. Interventions included nutritional counseling, hydration education, lifestyle modification, monitoring of maternal condition, and complementary ginger therapy. Clinical outcomes were assessed through symptom progression, maternal condition, hydration status, appetite, and frequency of nausea and vomiting. Results: The patient initially presented with persistent nausea and vomiting, reduced appetite, fatigue, mild dehydration, decreased urinary frequency, and difficulty maintaining adequate food intake. Following four continuity-of-care visits, gradual clinical improvement was observed. The frequency of nausea and vomiting decreased, appetite improved, oral intake increased, urinary frequency normalized, oral mucosa became moist, and maternal general condition improved. The patient reported that ginger consumption contributed to symptom reduction and increased eating tolerance. Conclusions: Continuity midwifery care integrating nutritional education, hydration management, and ginger therapy contributed to the gradual improvement of Grade I hyperemesis gravidarum symptoms and supported maternal well-being during pregnancy.

COMPREHENSIVE MIDWIFERY CARE FOR MRS. E USING THE CONTINUITY OF CARE APPROACH AT TRI HASANAH INDEPENDENT MIDWIFERY PRACTICE, SUBULUSSALAM CITY

2026-07-31T11:47:53+07:00

Iron deficiency anemia and lack of continuity in midwifery care are critical health issues during pregnancy thatsignificantly increase the risk of maternal and neonatal complications. This study aims to evaluate the implementationof a comprehensive Continuity of Care (CoC) approach for Mrs. E at the Tri Hasanah Independent MidwiferyPractice in Subulussalam City, covering the third trimester of pregnancy, childbirth, newborn care, postpartum, and family planning services. The research method utilized a descriptive case study design with Varney's 7-step midwifery management and SOAP documentation. The results showed that Mrs. E's pregnancy progressed physiologically at 34weeks and 3 days of gestation. Her complaint of mild fatigue was effectively resolved through structured education on adequate rest and balanced nutrition. She demonstrated high compliance with regular iron (Fe) supplement consumption, maintaining a normal hemoglobin level of 11 g/dL. Childbirth, newborn adaptation, the postpartum period, and family planning choices all proceeded safely without complications. In conclusion, providing structured comprehensive midwifery care is highly effective in maintaining maternal health stability and preventing obstetric complications at the community level.

MANAGEMENT OF MIDWIFERY CARE IN TRANSVERSE LIE PREGNANCY AT SARFINA CLINIC IN 2026

2026-07-21T17:46:24+07:00

Background: Transverse lie is one of the abnormal fetal presentations that may increase the risk of maternal and neonatal complications during labor, including obstructed labor, umbilical cord prolapse, uterine rupture, and postpartum hemorrhage. Early detection and appropriate management are essential to prevent adverse outcomes. Objectives: This study aimed to describe the implementation of midwifery care for Mrs. S with a transverse lie pregnancy at Sarfina Sembiring Clinic in 2026. Methods: A case study design was employed using Varney’s Midwifery Management Approach. Data were collected through anamnesis, physical examination, obstetric examination using Leopold maneuvers, observation, and medical record review. Results: The examination revealed that the fetal head and buttocks were located on opposite sides of the maternal abdomen, with no presenting part entering the pelvic inlet, indicating a transverse lie presentation. Midwifery care included maternal and fetal monitoring, health education, counseling regarding pregnancy danger signs, psychological support, and referral for delivery management. The patient and family demonstrated a good understanding of the pregnancy condition and agreed to the referral recommendation. Conclusions: Comprehensive midwifery care enabled early identification of transverse lie presentation and facilitated timely referral for appropriate delivery management. Early detection, effective counseling, and referral are important strategies to reduce the risk of complications and improve maternal and neonatal outcomes.

MIDWIFERY CARE MANAGEMENT OF THIRD TRIMESTER PREGNANT WOMEN WITH HYPERTENSION: A CASE STUDY OF MRS. S

2026-08-04T10:23:28+07:00

Hypertension during pregnancy remains one of the leading causes of maternal and perinatal morbidity and mortality worldwide. The condition frequently occurs during the third trimester when maternal physiological demands increase significantly. This study aimed to describe midwifery care management for third-trimester pregnant women with hypertension through a case study of Mrs. S. The study employed a descriptive case study approach using the Helen Varney Midwifery Management Process. Data were collected through history taking, physical examination, observation, and documentation. The findings revealed that the client experienced elevated blood pressure during the third trimester and required comprehensive monitoring to prevent complications. Midwifery management included assessment, diagnosis, identification of potential problems, immediate actions, planning, implementation, and evaluation. Continuous antenatal care, blood pressure monitoring, nutritional counseling, health education, and fetal well-being assessment were provided. The evaluation showed that maternal and fetal conditions remained stable and no severe complications occurred. Comprehensive and continuous midwifery care plays an important role in preventing complications associated with hypertensive disorders during pregnancy.

MIDWIFERY CARE MANAGEMENT FOR MRS. S WITH SECOND DEGREE PERINEAL TEAR AT SAM CLINIC 2026

2026-07-21T19:48:18+07:00

Background: Midwifery care for pregnant women is essential to maintain maternal and fetal health and to prevent complications during pregnancy. During pregnancy, women experience various physiological and psychological changes that may cause discomfort, such as nausea and vomiting, fatigue, back pain, and sleep disturbances. If these conditions are not properly managed, they can reduce the quality of life and increase the risk of complications. In practice, not all pregnant women receive comprehensive and continuous midwifery care according to established standards. This can result in suboptimal management of complaints and delayed detection of complications. The problem in this study is how midwifery care is implemented in managing physiological complaints and preventing complications in pregnant women.Objective: This study aims to describe the implementation of midwifery care for pregnant women at SAM Primary Clinic based on standard care guidelines.Methods: This study used a case study method with a descriptive approach. The subject was a pregnant woman who received care at SAM Primary Clinic. Data were collected through assessment, interviews, physical examinations, and documentation. The care included health education, nutritional counseling, recommendations for adequate rest, and routine antenatal examinations. Data analysis was conducted descriptively to explain the care process and outcomes.Results: The results showed that pregnant women experienced common physiological complaints such as nausea and vomiting, fatigue, back pain, and sleep disturbances, especially in the first and second trimesters. These complaints were managed through health education, balanced nutrition, adequate rest, and regular antenatal care. Monitoring of maternal and fetal conditions showed normal results with no complications during the observation period.Conclusion: Comprehensive and continuous midwifery care using a case study approach is effective in improving maternal and fetal health, managing discomfort, and preventing pregnancy complications.

MIDWIFERY CARE MANAGEMENT FOR A LADY IN LABOR WITH BREAST PRESENTATION IN MRS. Y AT THE PRATAMA SARFINA SEMBIRING CLINIC 2025

2026-08-08T09:46:32+07:00

Latar Belakang: Presentasi sungsang adalah malposisi janin yang terjadi pada sekitar 3–4% kehamilan cukup bulan dan membawa risiko komplikasi bagi ibu dan bayi. Di Indonesia, insiden presentasi sungsang sekitar 3,8–4% dari semua kehamilan cukup bulan. Kondisi ini dapat meningkatkan risiko asfiksia neonatal, prolaps tali pusat, trauma persalinan, dan perdarahan postpartum, sehingga memerlukan manajemen perawatan kebidanan yang tepat dan komprehensif. Metode: Tujuan studi kasus ini adalah untuk menerapkan manajemen perawatan kebidanan pada ibu yang melahirkan dengan presentasi sungsang menggunakan pendekatan manajemen kebidanan Helen Varney dan dokumentasi SOAP. Subjek dalam studi kasus ini adalah Ibu Y, 32 tahun, G3P2A0, usia kehamilan 38–39 minggu yang melahirkan di Klinik Primer Sarfina Sembiring pada tahun 2025. Metode yang digunakan adalah studi kasus dengan pengumpulan data melalui pengambilan riwayat, pemeriksaan fisik, observasi, dan dokumentasi selama proses persalinan. Hasil: Hasil perawatan menunjukkan bahwa kondisi ibu dan janin baik selama proses persalinan. Pemantauan dilakukan secara berkala pada tanda-tanda vital, detak jantung janin, kontraksi uterus, dan kemajuan persalinan menggunakan partograf. Persalinan berjalan lancar tanpa komplikasi. Bayi lahir dengan berat 3.400 gram, panjang badan 49 cm, menangis keras, bergerak aktif, memiliki warna kulit kemerahan, dan memperoleh skor APGAR 10 pada menit pertama dan kelima. Tahap III dan IV berlangsung normal tanpa perdarahan atau trauma pada jalan lahir. Penerapan manajemen perawatan kebidanan yang sistematis, komprehensif, dan terstandarisasi dapat mendukung keberhasilan persalinan dan mencegah komplikasi pada ibu dan bayi. Kesimpulan: Petugas kesehatan diharapkan dapat meningkatkan deteksi dini presentasi sungsang melalui pemeriksaan antenatal rutin, melakukan pemantauan ketat selama persalinan, dan memberikan edukasi kepada ibu hamil dan keluarga tentang tanda-tanda bahaya kehamilan dan persalinan untuk meminimalkan risiko komplikasi ibu dan bayi.

Midwifery Care Management for Hemorrhagic Stroke Patients at Risk of Ineffective Cerebral Perfusion

2026-07-30T15:16:59+07:00

Background: Hemorrhagic stroke is a neurological emergency caused by the rupture of cerebral blood vessels, resulting in intracranial bleeding, increased intracranial pressure, and impaired cerebral perfusion. This condition contributes significantly to disability and mortality worldwide. Patients with hemorrhagic stroke are at high risk of developing ineffective cerebral tissue perfusion due to reduced blood flow and oxygen delivery to brain tissue. Early identification, continuous monitoring, and comprehensive care are essential to prevent further neurological deterioration and improve patient outcomes.Objectives: To describe the implementation of midwifery care management in a patient with hemorrhagic stroke who was at risk of ineffective cerebral perfusion and to evaluate the patient's response to the interventions provided.Methods: This study employed a descriptive case study design conducted in a hospital setting. Data were collected through interviews, direct observation, physical examination, neurological assessment, review of medical records, and documentation of care. Midwifery management was carried out using a systematic care process that included assessment, diagnosis, planning, implementation, and evaluation.Results: Assessment findings showed decreased level of consciousness, elevated blood pressure, headache, weakness, and neurological deficits indicating a risk of ineffective cerebral perfusion. Midwifery interventions included regular monitoring of vital signs and neurological status, positioning to promote cerebral circulation, maintaining oxygenation, ensuring adequate fluid balance, preventing complications, and collaborating with physicians and other healthcare professionals. Evaluation demonstrated stable vital signs, no evidence of worsening neurological status, and improved patient comfort during the observation period.Conclusions: Comprehensive midwifery care management is essential in patients with hemorrhagic stroke who are at risk of ineffective cerebral perfusion. Continuous assessment, timely interventions, and interdisciplinary collaboration can contribute to maintaining cerebral perfusion, preventing complications, and supporting optimal patient recovery.

MIDWIFERY CARE MANAGEMENT FOR NN.K, A 12-YEAR-OLD WITH ACUTE GASTROENTERITIS IN MUZDALIFAH WARD, HAJI GENERAL HOSPITAL MEDAN, NORTH SUMATRA, 2025

2026-07-21T12:02:12+07:00

Backgroud: Acute gastroenteritis is one of the most common gastrointestinal diseases in children and may lead to fluid loss and electrolyte imbalance, which can result in serious complications if not managed properly(Utami, n.d.). Objective: This article aimed to describe the implementation of comprehensive midwifery care management for patients with acute gastroenteritis using Helen Varney’s seven-step approach and SOAP documentation. Methods: This study employed a descriptive method with a case study approach involving one patient, Ms. K, an 11-year-old girl diagnosed with acute gastroenteritis with mild dehydration, who was treated in the Muzdalifah Ward of UPTD Khusus RSU Haji Medan, North Sumatra Province, in 2025. Data were collected through history taking, physical examination, observation, and documentation of the patient's progress. Results: The patient presented with complaints of watery diarrhea occurring more than five times a day, accompanied by vomiting, abdominal pain, weakness, and decreased appetite. Midwifery care focused on monitoring vital signs, hydration status, fluid replacement according to the patient's needs, and providing education to the family. After five days of continuous care, the patient's condition improved, as evidenced by a reduced frequency of diarrhea, cessation of vomiting, improved hydration status, and stable general condition. Conclusion: The implementation of comprehensive midwifery care using Helen Varney’s seven-step approach and SOAP documentation was effective in supporting the recovery process of patients with acute gastroenteritis and preventing complications.

THE EFFECTIVENESS OF NATURAL TOPICAL INTERVENTIONS IN REDUCING STRIAE GRAVIDARUM AMONG PREGNANT WOMEN: A LITERATURE REVIEW

2026-07-27T10:26:46+07:00

Background:Striae gravidarum (SG) is a common physiological skin change during pregnancy, affecting approximately 90% of expectant mothers. These lesions often cause physical discomfort, such as itching, and significant emotional distress. Objectives: This study aimed to evaluate the clinical effectiveness of topical olive oil application in reducing the severity of striae gravidarum in third-trimester pregnant women.Methods: A quasi-experimental study with a one-group pretest-posttest design was conducted. Fifteen pregnant women in their third trimester were treated with 1 ml of olive oil applied topically to the abdomen twice daily for 14 days. Severity was assessed using the Davey Score. Results: Observations indicated a significant reduction in the color intensity, width, and overall severity of striae after two weeks of consistent intervention. Olive oil, rich in vitamin E, antioxidants, and unsaturated fatty acids, successfully increased skin elasticity and promoted tissue regeneration.Conclusions: Topical application of olive oil is an effective, safe, and affordable non-pharmacological intervention to accelerate skin recovery and improve the aesthetic appearance of striae gravidarum in pregnant women.

COMPREHENSIVE MIDWIFERY CARE FOR RETAINED PLACENTA : A CASE STUDY IN 2026

2026-07-27T10:21:38+07:00

Background: Retained placenta is a common obstetric complication during the third stage of labor and a major cause of postpartum hemorrhage, contributing significantly to maternal morbidity and mortality worldwide. It is defined as the failure of placental delivery within 30 minutes after fetal birth. Delayed management may lead to severe hemorrhage, hypovolemic shock, puerperal infection, disseminated intravascular coagulation, and maternal death. Therefore, comprehensive evidence-based midwifery care is essential to improve maternal outcomes. Objectives: This study aimed to describe the implementation of comprehensive midwifery care for Mrs. M, G3P1A1, diagnosed with retained placenta at T. Hutapea Independent Midwifery Practice (TPMB), Pematangsiantar City, Indonesia.Methods: A descriptive case study design was employed. Data were collected through history taking, physical examination, direct observation, medical record review, and clinical documentation. Midwifery care was provided using Varney's Seven-Step Midwifery Management Process and documented using the Subjective, Objective, Assessment, and Plan (SOAP) format. Data were analyzed descriptively by comparing clinical findings with current evidence and national midwifery practice standards. Results: Mrs. M experienced retained placenta, indicated by failure of placental delivery more than 30 minutes after childbirth. Management included monitoring maternal vital signs, active management of the third stage of labor, assessment of uterine contractions and postpartum bleeding, preparation for manual placental removal, and collaboration with other healthcare professionals when indicated. Timely intervention resulted in successful placental delivery, adequate uterine contraction, controlled postpartum bleeding, and a stable maternal condition without complications. Conclusions: Comprehensive midwifery management based on clinical standards is essential for the early identification and effective management of retained placenta. Prompt intervention, continuous monitoring, and interdisciplinary collaboration contribute to preventing maternal complications and improving maternal safety.

EFFECTS OF PRENATAL YOGA ON MATERNAL BLOOD GLUCOSE IN WOMEN WITH GESTATIONAL DIABETES MELLITUS: LITERATUR REVIEW

2026-06-24T07:40:50+07:00

Gestational diabetes mellitus (GDM) is a growing public health concern that affects approximately 4–5% of pregnancies in the United Kingdom and may lead to adverse outcomes for both mothers and their infants if not properly managed. Various non-pharmacological interventions have been explored to improve glycemic control during pregnancy, including yoga, which has been shown to provide physical and psychological benefits in low-risk pregnancies. This systematic review aimed to evaluate the effectiveness of yoga in reducing blood glucose levels among pregnant women diagnosed with GDM. A comprehensive literature search was conducted using Ovid databases, PubMed, and CINAHL to identify randomized controlled trials comparing yoga interventions with standard care or control groups, with blood glucose levels measured before and after the intervention. Three studies met the inclusion criteria and were included in the analysis. Overall, the findings demonstrated that participants who engaged in yoga experienced a greater reduction in blood glucose levels compared to those in the control groups. These results suggest that yoga may serve as a safe and beneficial complementary exercise for pregnant women with GDM. However, further studies, particularly in the Indonesia, are required to assess the clinical feasibility, long-term effectiveness, and broader implementation of yoga interventions in pregnancies complicated by gestational diabetes mellitus.

The ASSOCIATION OF SMOKING HISTORY WITH TREATMENT DURATION IN PATIENTS WITH PULMONARY TUBERCULOSIS IN INPATIENT WARD AT GENERAL HOSPITAL EAST JAKARTA INDONESIA 2025

2026-06-24T09:27:20+07:00

Background: Pulmonary tuberculosis (TB) is a contagious infectious disease that remains a global and national health problem. Indonesia is among the eight countries with the highest TB burden in the world. The success of pulmonary TB treatment is greatly influenced by patient adherence to the 6–9-month therapy regimen. One factor associated with influencing the duration of treatment is smoking. Smoking can damage the lungs’ defense mechanisms, impair mucociliary function, and weaken the immune system, potentially slowing the healing process and increasing the risk of treatment discontinuation. The high prevalence of smokers in Indonesia makes this factor important to study, particularly among pulmonary TB patients undergoing inpatient care.

Objective: This study aims to determine the relationship between smoking history and treatment duration among pulmonary TB patients in the Edelweis Barat inpatient ward at Budhi Asih Regional General Hospital, East Jakarta, in 2025.

Methods: This study employed a cross-sectional design with a quantitative correlational approach. Sampling was conducted using probability sampling via simple random sampling, involving 76 respondents. Data were collected via a questionnaire and analyzed using the Chi-Square statistical test.

Results: The results of the study showed that respondents with moderate and high smoking behavior were equally represented, with 38 respondents (50%) in each group. The most common duration of treatment was >9 months, with 28 respondents (36.8%), followed by 6–9 months

with 25 respondents (32.9%), and 0–6 months with 23 respondents (30.3%). Most respondents with high smoking behavior had a treatment duration of >9 months, totaling 28 respondents (73.7%). The Chi-Square test results showed a p-value of 0.001, indicating a significant association between smoking history and treatment duration in pulmonary TB patients.

Conclusion: There is a significant association between smoking history and treatment duration in pulmonary TB patients. High smoking behavior tends to be associated with longer treatment duration.

MANAJEMENT OF MIDWIFERY CARE DURING THE POSTPARTUM PERIOD WITH PRE-ECLAMSIA IN CLINIK PRATAMA KASIH BUNDA 2026

2026-07-30T09:17:30+07:00

Background: The postpartum period is the period after childbirth until the reproductive organs return to their pre-pregnancy condition and is a phase that is vulnerable to various complications, one of which is postpartum preeclampsia. Continuity of midwifery care emphasizes promotive and preventive efforts, early detection of complications, and counseling to improve maternal and child health (Munthe et al., 2019). Objectives: This paper aims to identify and understand the management of midwifery care for postpartum mothers with preeclampsia, including risk factors, signs and symptoms, diagnosis, management, and the role of midwives in early detection and prevention of complications. Methods: The method used was a literature review by examining various relevant scientific sources, including midwifery textbooks, research articles, and clinical practice guidelines related to postpartum preeclampsia. Results: The review findings indicate that postpartum preeclampsia requires close monitoring of blood pressure, proteinuria, and signs of organ dysfunction. Midwifery care management includes comprehensive assessment, problem identification, maternal condition monitoring, health education, collaboration with other healthcare professionals, and the application of Varney’s seven-step midwifery management process to prevent complications. Conclusions: Comprehensive, continuous, and evidence-based midwifery care plays an important role in improving the safety of postpartum mothers with preeclampsia, preventing complications, and supporting maternal recovery during the postpartum period.

THE EFFECT OF OXYTOCIN MASSAGE ON THE IMPROVEMENT OF BREAST MILK PRODUCTION IN POSTPARTUM MOTHERS AT SURYANI CLINIC, MEDAN JOHOR, KWALA BEKALA, MEDAN CITY

2026-08-04T16:34:32+07:00

Background: The 2023 Indonesian Health Survey (SKI) recorded exclusive breastfeeding coverage of 68.6% among infants aged 0–5 months, but only 55.5% of infants were still exclusively breastfed at six months well short of the 80% national target. Globally, WHO and UNICEF reported an exclusive breastfeeding rate of 48% in 2023. A recurring barrier is insufficient milk output during the first days after delivery, which stems from inadequate stimulation of oxytocin and prolactin, the two hormones that govern milk synthesis and ejection. Oxytocin massage is a non-pharmacological measure intended to trigger this hormonal response. Objective: To determine the effect of oxytocin massage on the smoothness of breast milk production in postpartum mothers at Suryani Clinic, Medan Johor, Kwala Bekala, Medan City, in 2024. Methods: A quasi-experimental study with a two-group pre-test and post-test design was conducted on 44 postpartum mothers selected by purposive sampling and allocated into an intervention group (n = 22) and a control group (n = 22). Milk production was measured with a 16-item observation sheet before the intervention and again after three consecutive days of oxytocin massage. Univariate analysis described respondent characteristics; the independent samples t-test compared the change in observation scores between groups. Results: Most respondents were 19–25 years old (22; 50.0%), primiparous (25; 56.8%), senior high school graduates (32; 72.7%), and not employed (23; 52.3%). Before the intervention, 36 respondents (81.8%) had unsatisfactory milk production. Following oxytocin massage, 30 respondents (68.2%) achieved smooth milk production. Within the intervention group the proportion with smooth production rose from 3 mothers (13.6%) to 21 mothers (95.5%), whereas the control group moved from 5 mothers (22.7%) to 9 mothers (40.9%). The independent samples t-test yielded p = 0.000 (p < α = 0.05). Conclusion: Oxytocin massage significantly improves the smoothness of breast milk production in postpartum mothers. Midwives are encouraged to incorporate the technique into routine postnatal care and to teach it to husbands and family members as lactation support.

MIDWIFERY CARE FOR MRS. A, 27 YEARS OLD, WITH BREAST CANCER (CA MAMMAE) AT HAJI GENERAL HOSPITAL MEDAN IN 2025

2026-06-24T10:49:51+07:00

Background: Breast cancer (Carcinoma Mammae) is one of the most common malignancies
affecting women and remains a leading cause of cancer-related mortality worldwide. Patients
diagnosed with breast cancer often experience physical and psychological problems, especially
anxiety before undergoing surgical procedures. Comprehensive midwifery care is needed to
support patients physically and emotionally before surgery. Objective: This case study aimed
to describe the implementation of midwifery care for a 27-year-old woman with Carcinoma
Mammae through the application of the PACER principles (Professional, Accountable,
Collaborative, Empathy, and Reliability) in preparing the patient for Modified Radical
Mastectomy (MRM) surgery at RSU Haji Medan. Methods: This study used a descriptive case
study approach. Data were collected through interviews, observation, physical examination,
medical record review, and documentation using the Varney Midwifery Management Process
and SOAP documentation. The patient was observed during the preoperative period in the
Shafa Marwah ward of RSU Haji Medan in December 2025. Results: Assessment findings
revealed that the patient had a breast lump in the left breast and experienced anxiety related to
the upcoming MRM procedure. Vital signs were within normal limits, indicating stable
physical condition. Midwifery interventions included therapeutic communication,
psychological support, health education regarding the surgical procedure, monitoring of vital
signs, and collaboration with the multidisciplinary healthcare team. Following the
interventions, the patient demonstrated improved understanding of her condition, reduced
anxiety, increased confidence, and readiness to undergo surgery. Conclusion: The
implementation of comprehensive midwifery care based on the PACER approach effectively
supported the physical and psychological preparation of a patient with Carcinoma Mammae
before surgery. Professional, accountable, collaborative, empathetic, and reliable care
contributed to reducing anxiety and improving patient readiness for surgical treatment.

MIDWIFERY CARE MANAGEMENT OF MORNING SICKNESS IN FIRST TRIMESTER PREGNANCY

2026-07-18T15:52:09+07:00

Morning sickness or emesis gravidarum is one of the most common complaints experienced during the first trimester of pregnancy, affecting approximately 70–80% of pregnant women worldwide. Although generally considered a physiological condition, persistent nausea and vomiting can interfere with nutritional intake, daily activities, and maternal quality of life. If not managed appropriately, the condition may progress to hyperemesis gravidarum, which can lead to dehydration, electrolyte imbalance, and weight loss. Therefore, appropriate and evidence-based midwifery care is needed to reduce symptoms and prevent complications. According to Ervin Hariyani and Rizka Esty Safriana (2024), non-pharmacological management such as ginger and mint leaves can effectively reduce emesis gravidarum in first-trimester pregnant women. The purpose of this case report was to provide midwifery care management for Mrs. S, G1P0A0, at 11 weeks and 4 days of gestation with morning sickness at Niar Maternity Clinic in 2026. The method used was a case study approach based on the 7 steps of Varney’s midwifery management, including assessment, identification of diagnosis and problems, identification of immediate needs, planning, implementation, and evaluation. The assessment results showed that the patient experienced nausea and vomiting 2–3 times in the morning without signs of dehydration, with good general condition and normal vital signs. The midwifery care provided included education about morning sickness, recommendations for small frequent meals, adequate rest, nutritional fulfillment, administration of vitamin B complex and vitamin B6, and counseling regarding danger signs during pregnancy. In addition, non-pharmacological therapy such as consuming ginger drinks was recommended because previous studies reported that ginger is effective in reducing emesis gravidarum among first-trimester pregnant women. After the implementation of midwifery care, the patient understood how to manage nausea and vomiting and was willing to attend follow-up visits if complaints worsened. The conclusion of this case report is that appropriate midwifery care management can help reduce discomfort caused by morning sickness and prevent complications in first-trimester pregnant women.

CASE STUDY MIDWIFERY MANAGEMENT FOR POSTPARTUM BREAST MILK CONTAINMENT AT PMB RIMENDA

2026-07-22T08:34:35+07:00

Background: Based on the third Sustainable Development Goal (SDGs) target and the World Health Organization (WHO) recommendation, exclusive breastfeeding for the first six months is an important intervention to reduce infant mortality, but its success is often hampered by lactation problems such as breast engorgement experienced by approximately 31% of postpartum mothers. Breast engorgement due to suboptimal emptying causes pain, hard breasts, and obstructed milk flow which if not treated immediately can trigger mastitis complications. Objective: This case study aims to implement comprehensive midwifery care management for postpartum mothers with breast involvement at PMB Rimenda Br Tarigan in 2026. Method: The research method used is a descriptive case study with the Helen Varney 7-Step Midwifery Management approach on Mrs. S, 34 years old, P3A0, fifth day postpartum. Data were collected through assessment, physical lactation examination (inspection and palpation), and clinical observation. Results: The assessment showed that the patient complained of right breast engorgement, tension, hardness, tenderness, and low milk flow. Non-pharmacological management included breast care, lactation massage stimulation, education on proper breastfeeding attachment techniques, and the application of a combination of warm and cold compresses. Final evaluation showed significant improvement, with softer breast texture, better milk flow, reduced pain, and resolved maternal anxiety. Conclusion: Implementation of evidence-based midwifery care effectively addresses breast involvement, prevents serious complications, and supports successful lactation in postpartum mothers.

MIDWIFERY CARE MANAGEMENT FOR MRS. P, G1P0A0, AT 10 WEEKS OF GESTATION WITH MORNING SICKNESS AT HANNA SIMBOLON MATERNITY CLINIC IN 2026

2026-07-28T21:26:42+07:00

Morning sickness is a frequently occurring condition during early pregnancy, characterized by nausea and vomiting resulting from hormonal fluctuations, particularly elevated levels of Human Chorionic Gonadotropin (hCG), estrogen, and progesterone. While it is generally considered a normal physiological response to pregnancy, inadequate management may negatively affect maternal nutritional status, daily functioning, and overall quality of life. This case study aimed to describe the implementation of midwifery care management for Mrs. P, G1P0A0, at 10 weeks of gestation experiencing morning sickness at Hanna Simbolon Maternity Clinic in 2026. A descriptive case study design was employed using Helen Varney’s seven-step midwifery management approach, which includes assessment, diagnosis, planning, implementation, and evaluation. Assessment findings revealed that Mrs. P, a 25-year-old primigravida, experienced nausea and vomiting two to three times per day, accompanied by reduced appetite and feelings of weakness. Physical examination indicated that her general condition was stable and her vital signs were within normal limits. The midwifery interventions provided consisted of health education about morning sickness, dietary adjustments, hydration management, nutritional guidance, adequate rest, emotional support, and recommendations for follow-up visits. Following the implementation of care, the patient demonstrated an improved understanding of her condition and was able to adopt appropriate self-care measures to alleviate nausea and vomiting. The study concludes that comprehensive and individualized midwifery care is effective in minimizing discomfort associated with morning sickness and reducing the risk of complications during the first trimester of pregnancy.

VIRTUAL NURSING DIAGNOSIS AS AN E-MOBILE LEARNING STRATEGY TO IMPROVE MEDICAL-SURGICAL NURSING COMPETENCY EXAMINATION OUTCOMES

2026-06-24T12:50:08+07:00

Medical-Surgical Nursing is a core competency in nursing education that is directly related to mastery of clinical reasoning, the nursing process, and case-based decision-making. Student competency test performance still faces challenges, particularly in clinical vignette-based questions that require accuracy in identifying data, establishing nursing diagnoses, and prioritizing interventions. The integration of Virtual Nursing Diagnosis based on e-mobile learning has the potential to be a learning innovation that supports strengthening students' understanding of nursing diagnoses and preparing them for the Medical-Surgical Nursing competency test. This study aimed to analyze the effect of Virtual Nursing Diagnosis as an Augmented Reality-based e-mobile learning strategy on Medical-Surgical Nursing competency examination outcomes among Diploma III nursing students. This quasi-experimental study involved 80 final-year Diploma III nursing students selected using purposive sampling, consisting of 40 students in the intervention group and 40 students in the control group. The intervention group received Virtual Nursing Diagnosis using Augmented Reality-based e-mobile learning via smartphone, while the control group received intensive conventional learning. The instrument used was a 20-question Medical-Surgical Nursing competency exam, then the data were analyzed using the Mann-Whitney test. The intervention group achieved higher post-test scores than the control group, with median scores of 85.00 and 60.00, respectively. The Mann-Whitney test showed a significant difference between the two groups with a p-value of 0.000 (<0.05) and an effect size of 0.84. Virtual Nursing Diagnosis as an Augmented Reality-based e-mobile learning strategy effectively improved students’ Medical-Surgical Nursing competency examination outcomes.

MANAGEMENT OF BREAST ENGORGEMENT IN EARLY POSTPARTUM:A MIDWIFERY CASE REPORT

2026-06-24T14:25:16+07:00

Background: The postpartum period is a vital phase in a mother’s recovery process after giving birth, involving both physical restoration and psychological adaptation. In this period, breastfeeding plays a fundamental role in meeting the nutritional needs of the newborn, enhancing immunity, and strengthening the bond between mother and infant. However, breastfeeding is often accompanied by several difficulties, one of which is breast engorgement. This condition is characterized by breast fullness, hardness, swelling, and pain resulting from ineffective milk drainage in the early lactation period. If not treated appropriately, breast engorgement may cause maternal discomfort, disrupt breastfeeding practices, and lead to complications such as milk stasis, blocked ducts, or mastitis. Therefore, early recognition and effective intervention are necessary to support optimal breastfeeding outcomes.Objectives: This study aimed to illustrate the implementation of midwifery care management for a postpartum mother experiencing breast engorgement by applying Helen Varney’s Seven-Step Midwifery Management Model.Methods: This research employed a descriptive case study approach conducted at Vina Primary Clinic in 2025. The participant was Mrs. D, a 24-year-old primiparous woman on the fourth day after delivery who experienced breast engorgement. Data were collected through interviews, direct observation, physical assessment, and examination of medical records. The care management process was carried out systematically following Helen Varney’s framework, including data collection, diagnosis, planning, intervention, and evaluation.Results: The assessment showed delayed milk production with bilateral breast swelling, firmness, and pain. Physical examination confirmed that the mother was in stable condition, with normal vital signs and a body temperature of 37.5°C. The care provided included education regarding breast engorgement, breast care practices, warm compress application, breastfeeding support, nutritional guidance, and psychological assistance. Evaluation demonstrated better maternal knowledge, improved confidence, and greater ability to manage the condition effectively.Conclusions: Timely, comprehensive, and evidence-based midwifery care proved effective in overcoming breast engorgement, minimizing discomfort, preventing further complications, and supporting the achievement of exclusive breastfeeding.

MIDWIFERY CARE MANAGEMENT FOR A 12-YEAR-OLD PANT WITH POST-OP PENOSCROTOL HYPOSPADIA IN THE MUSDALIFAH WARD MEDAN HAJI HOSPITAL IN 2025

2026-08-05T17:00:58+07:00

Background: Hypospadias is one of the most common congenital abnormalities in male children and requires surgical management. Postoperative conditions often lead to problems such as pain and risk of infection, thus requiring comprehensive midwifery care to support patient recovery. At RSU Haji Medan, cases of hypospadias in children are still found and require optimal follow-up care. Objective: This study aims to describe the implementation of midwifery care in children with post-operative penoscrotal hypospadias in managing pain and preventing complications. Methods: This study used a descriptive case study design with a subject of An. P, a 12-year-old male with post-operative penoscrotal hypospadias. Data were collected through anamnesis, observation, physical examination, and medical record documentation. Results: The assessment results showed that the patient experienced acute pain with a pain scale of 6 after surgery and had a risk of infection. Interventions provided included pain management, wound care, monitoring of vital signs, and education for the patient and family. After continuous care was provided, the pain scale decreased from 6 to 0 within a few days of treatment, and no signs of infection were found in the surgical wound. Conclusion: Comprehensive and continuous midwifery care is effective in reducing pain, preventing complications, and supporting the healing process in patients with post-operative hypospadias.

COMPREHENSIVE MIDWIFERY CARE FOR MRS. L AT THE INDEPENDENT MIDWIFERY PRACTICE OF MIDWIFE Bd. MAULIDA WINANDA, S.Keb SUBULUSSALAM CITY IN 2026

2026-07-21T12:45:43+07:00

Background: Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are key indicators of a nation's welfare. The Continuity of Care (CoC) approach, or continuous midwifery care from pregnancy, labor, postpartum, newborn, to family planning (KB) services, is essential for the early detection of pathological risks and the reduction of MMR/IMR. Objective: To provide comprehensive and continuous midwifery care using the SOAP documentation midwifery management approach for Mrs. L at PMB Bd. Maulida Winanda, S.Keb, Subulussalam City. Methods: This report utilizes a comprehensive longitudinal case study design, following the subject from the third trimester of pregnancy through contraceptive services. The care was provided from March to June 2026. Data were collected through interviews, physical examinations, direct observation, and documentary studies. Results:Antenatal care (ANC) was provided to Mrs. L, 28 years old, G3P2A0, at 39 weeks and 2 days of gestation, presenting with the physiological complaint of lower back pain. On May 31, 2026, at 23:00 WIB, the mother gave birth spontaneously with an occiput anterior presentation; the infant was born healthy and normal. Postnatal care (PNC) was conducted up to the 20th-day postpartum visit, demonstrating a normal uterine involution process, unpalpable uterine fundal height (TFU), well-approximated perineal wound, and smooth lactation. Neonatal care was well-monitored. At the end of the postpartum period, family planning counseling was provided to determine a contraceptive method suitable for a breastfeeding mother. Conclusion: The implementation of comprehensive midwifery care (Continuity of Care) for Mrs. L was proven to proceed physiologically and effectively in monitoring maternal and infant health as well as preventing complications.

DETERMINANTS AND CLINICAL OUTCOMES OF CHRONIC ENERGY DEFICIENCY AMONG PREGNANT

2026-08-05T11:00:46+07:00

Background: Chronic Energy Deficiency (CED) remains a major nutritional issue among pregnant women in Indonesia, leading to various adverse maternal, prenatal, and neonatal outcomes. Despite targeted interventions, the prevalence of CED remains high in several sub regions due to complex socio-demographic, cultural, and healthcare access-related determinants. Objectives: This study aimed to systematically synthesize and analyze the multidimensional determinants of CED among pregnant women and its subsequent clinical outcomes on both mothers and offspring. Methods: A systematic review and meta-synthesis
of 15 high-quality studies published in Indonesia between 2021 and 2025 were conducted. A total pooled sample of 1,514 pregnant women and postpartum dyads was analyzed. Strategic outcomes including regression metrics, chi-square correlations, and descriptive variables were systematically tabulated. Results: The synthesized evidence revealed a maternal KEK/CED prevalence ranging from 15.9% to 66.2% across multiple regions. The most critical risk factors identified include a short interpregnancy interval of <24 months (OR: 5.35–7.30), low socioeconomic/income status (p < 0.05), low nutritional knowledge (p < 0.01), high parity, and low macronutrient/protein-energy intake. Clinical sequelae significantly linked to maternal CED include maternal anemia (p < 0.001), low birth weight (LBW/BBLR) (p = 0.026), and a highly elevated risk of childhood stunting (p = 0.016). Conclusions: Maternal CED in Indonesia is a multifaceted clinical and social issue. Targeted strategies must integrate intensive maternal nutritional education, economic support, family planning spacing compliance, and comprehensive antenatal care screening.

THE RELATIONSHIP BETWEEN POSTPARTUM FATIGUE AND BREASTFEEDING MOTIVATION IN EAST ACEH PROVINCE IN 2024

2026-07-20T21:54:16+07:00

Postpartum fatigue is a common condition experienced by mothers after childbirth due to physical, physiological, and psychological changes during the postpartum period. Excessive fatigue may affect a mother's ability to care for her infant and can reduce her motivation to breastfeed. Breastfeeding motivation is an important factor in the success of exclusive breastfeeding and contributes significantly to infant health and development. This study aimed to determine the relationship between postpartum fatigue and breastfeeding motivation among postpartum mothers in the service area of Leubok Pempeng Community Health Center, Peureulak Subdistrict, East Aceh Regency, Aceh Province, in 2024. This study employed a quantitative correlational design. The population consisted of 56 postpartum mothers, and all participants were selected using a total sampling technique. Data were collected using the Postpartum Fatigue Scale (PFS) to assess fatigue levels and the Breastfeeding Motivational Instructional Measurement Scale (BMIMS) to measure breastfeeding motivation. Data were analyzed using univariate and bivariate analyses with the Spearman Rank correlation test at a significance level of 0.05. The results indicated that most respondents experienced moderate levels of postpartum fatigue and moderate breastfeeding motivation. Statistical analysis showed a significant relationship between postpartum fatigue and breastfeeding motivation. Higher levels of fatigue were associated with lower motivation to breastfeed. Therefore, efforts to reduce postpartum fatigue may contribute to improving breastfeeding motivation among postpartum mother.

MIDWIFERY MANAGEMENT OF NORMAL LABOR IN MRS. W, G1P0A0, WITH A 39-WEEK GESTATION AT NIAR PRATAMA CLINIC, TIMBANG DELI, MEDAN AMPLAS DISTRICT, MEDAN CITY, NORTH SUMATRA 2025

2026-07-18T15:46:43+07:00

Background: Normal labor is a physiological process that occurs at the end of pregnancy, involving the delivery of the fetus, placenta, and fetal membranes through the birth canal. Although labor is a natural event, primigravida mothers often require more intensive observation and support because they have no prior childbirth experience. Appropriate and comprehensive midwifery care during labor is essential to ensure maternal and fetal well-being, support the normal progress of labor, prevent complications, and provide a safe and positive childbirth experience.Objective: This case study aims to describe the implementation of comprehensive midwifery care in a woman with normal labor and to evaluate the outcomes of the interventions provided during the first stage of labor. Method: This study used a case study method with a midwifery care management approach. The subject of this case study was Mrs. W, a 20-year-old woman, G1P0A0, with a gestational age of 39 weeks, who came to Klinik Pratama Niar Timbang Deli on April 28, 2026, with complaints of lower abdominal tightening that had been occurring for several hours and was becoming more frequent. Data were collected through history taking, observation, physical examination, obstetric examination, and documentation using the SOAP method. Results: The assessment results showed that Mrs. W was in the latent phase of the first stage of labor with good general condition, vital signs within normal limits, and a fetal heart rate of 150 beats per minute. Obstetric examination revealed a single live intrauterine fetus in cephalic presentation, with the fetal head having entered the pelvic inlet. The midwifery care provided included informing the mother about the examination results, teaching relaxation and breathing techniques during contractions, encouraging rest between contractions, ensuring adequate nutritional and fluid intake, providing communication, information, and education about the signs of labor, and giving emotional support to the mother and her family. Conclusion: Comprehensive midwifery care is effective in supporting normal labor, especially in primigravida mothers, by improving maternal comfort, maintaining maternal and fetal stability, and promoting safe labor progress.

MIDWIFERY CARE MANAGEMENT FOR A 25-YEAR-OLD PREGNANT WOMAN (G1P0A0) WITH PREMATURE RUPTURE OF MEMBRANES (PROM) AT KLINIK PRATAMA SITI KHOLIJAH IN 2026

2026-08-01T12:38:44+07:00

Background: The Maternal Mortality Rate (MMR) in Indonesia remains high, recorded at 189 per 100,000 live births in 2025, placing Indonesia among the countries with the highest MMR in Southeast Asia. One of the major causes of pregnancy and childbirth complications is Premature Rupture of Membranes (PROM), which can increase the risk of infection, preterm labor, and maternal and neonatal mortality. Therefore, appropriate midwifery care is essential to prevent further complications in PROM cases. Objective: This case study aims to analyze the management of midwifery care for a 25-year-old pregnant woman, Ny. R, G1P0A0, with Premature Rupture of Membranes (PROM) at Klinik Pratama Siti Kholijah. Methods: This study used a descriptive case study approach. The subject was one pregnant woman diagnosed with PROM. Data were collected through interviews, observation, physical examination, and medical record documentation. The analysis was conducted by reviewing the mother’s characteristics, pregnancy history, obstetric history, and medical history, and then comparing them with relevant theories and midwifery care standards. Results: The case study showed that the management of midwifery care for a woman with PROM was carried out through comprehensive assessment, monitoring of maternal and fetal conditions, and collaborative management according to medical indications to prevent further complications. Conclusion: Midwifery management in pregnant women with Premature Rupture of Membranes (PROM) must be performed promptly, appropriately, and comprehensively to prevent the risk of infection and complications for both mother and fetus.

EARLY INITIATION OF BREASTFEEDING AS A PROTECTIVE STRATEGY AGAINST NEONATAL SEPSIS : A REVIEW OF CURRENT EVIDANCE

2026-06-24T23:13:00+07:00

Background:Neonatal sepsis remains one of the leading causes of neonatal morbidity and mortality worldwide. Early Initiation of Breastfeeding (EIBF), defined as breastfeeding within the first hour after birth, has been recognized as a simple, effective, and cost-efficient intervention that may reduce the risk of neonatal infections. Through the provision of colostrum and the enhancement of neonatal immune function, EIBF plays a crucial role in improving neonatal health outcomes and survival.Objective:
To review current evidence regarding the role of Early Initiation of Breastfeeding (EIBF) as a protective strategy against neonatal sepsis.Methods:A literature review was conducted using articles retrieved from PubMed, Scopus, ScienceDirect, Google Scholar, and SpringerLink. The search included studies published between 2021 and 2025 using keywords related to early initiation of breastfeeding, colostrum, neonatal sepsis, and neonatal health outcomes. Eligible articles were selected based on their relevance and analyzed using a thematic approach to identify key findings regarding the relationship between EIBF and neonatal sepsis prevention.Results:The reviewed literature demonstrated that EIBF contributes significantly to reducing the risk of neonatal infections, including neonatal sepsis. This protective effect is primarily attributed to the immunological benefits of colostrum, which contains antibodies, immune cells, and bioactive components that enhance neonatal immunity. EIBF also supports the establishment of healthy intestinal microbiota and improves overall neonatal adaptation after birth. Furthermore, studies reported that EIBF is associated with lower rates of neonatal morbidity and mortality. However, several barriers to EIBF implementation were identified, including cesarean delivery, inadequate breastfeeding support from healthcare providers, and limited maternal knowledge regarding the benefits of early breastfeeding initiation.Conclusion:Early Initiation of Breastfeeding is an effective strategy for preventing neonatal sepsis and improving neonatal health outcomes. Strengthening EIBF practices through health education, supportive healthcare policies, and enhanced breastfeeding support should be prioritized as part of comprehensive neonatal healthcare programs to reduce neonatal morbidity and mortality.

Family Centered Care Midwifery Intervention to Overcome Vaccine Hesitancy: A Case Study of Incomplete Immunization in Tanjung Morawa

2026-07-21T10:14:33+07:00

Background: Immunization is a critical global health intervention, yet incomplete coverage remains a significant challenge due to parental anxiety regarding adverse events.Although immunization is proven to save lives, global childhood vaccination coverage has stagnated due to growing parental anxiety. This anxiety is deeply rooted in love, driven by an overwhelming fear of Adverse Events Following Immunization (AEFI) such as high fevers, seizures, or other unpredictable side effects. This fear is amplified by the influx of negative stories on social media, making extremely rare medical risks feel like immediate threats that will inevitably harm their own child. Consequently, parents are trapped in a painful emotional dilemma: they desperately want to protect their child from future diseases, yet they dread that a medical procedure today might inadvertently harm their little one. This article explores how healthcare communication must evolve—shifting away from merely presenting cold statistics toward embracing and validating parental fears with deeper empathy and humanity Objectives: To evaluate the effectiveness of family-centered midwifery protocols in improving immunization compliance for a 1-year-old child with an incomplete vaccination status. Methods: A qualitative community midwifery approach using the 7-step Varney management framework was conducted from February to May 2026 in Bangun Rejo Village, Deli Serdang. The intervention utilized a family-centered educational protocol focusing on the management of Adverse Events Following Immunization (AEFI). Results: Initial assessments revealed the child missed the first measles dose due to parental trauma over previous post-immunization fever. Following targeted family-centered education, parental knowledge regarding AEFI management significantly improved. Consequently, the mother proactively brought the child to the integrated health post (Posyandu) to receive the measles vaccine. Subsequent monitoring showed normal physiological responses with managed mild fever, eliminating parental anxiety. Conclusions: Family-centered midwifery care effectively addresses vaccine hesitancy by empowering parents with knowledge and practical AEFI management skills. Continuous educational support is vital for maintaining complete immunization coverage.

PREGNANT WOMEN'S INTEREST IN PARTICIPATING IN PREGNANCY EXERCISES AT MITRA PARAMEDIKA SLEMAN

2026-06-24T23:34:29+07:00

Background: Gymnastics pregnancy is one step that can prevent the occurrence of maternal death and infant mortality at the time of delivery. Pregnancy gymnastics is a motion exercise therapy given to pregnant women to prepare themselves, both physical and mental preparation to face and prepare for a fast, safe and spontaneous labor. From the result of preliminary study at Mitra Paramedika Hospital, got data that 5 (16,13%) mother never do gymnastics pregnant, while 2 (6,45%) pregnant women ever do gymnastic pregnant only just once. When asked about the desire to do pregnancy exercises again, the answer from the 7 thousand pregnant is known 4 (12,90%) mother no intention at all pregnancy gymnast while 3 (9,68%) mother answer still think.

Objective: To know the description of interest of pregnant mother in following pregnancy gym at Mitra Paramedika Hospital 2025.

Methods: Descriptive research method. The total population in this study was 32 mothers. The sample method is the total sampling. The analysis uses descriptive frequencies.

Results: Most of the respondents are still in healthy reproduction category (20 years - 35 years), which is 75.1%, with the last education up to middle level as much as 46.9%, with job status of housewife (not working) as much as 56, 3%, are mothers with interest of pregnant women in following low grade ham exercises (37,5%).

Conclusion: Most respondents are still in healthy reproduction category (20 years - 35 years), that is 75.1%, with the last education to middle level as much as 46.9%, with job status of housewife (not working) as much as 56, 3%, are mothers with interest of pregnant women in following low grade ham exercises (37,5%).

Keywords: Interest, Gymnastic Pregnant

COMPREHENSIVE MIDWIFERY CARE FOR Mrs. M IN THE INDEPENDENT MIDWIFE PRACTICE OF HUTRI PRAWITA BANCIN AM.Keb PENANGGALAN DISTRICT SUBULUSSALAM CITY 2026

2026-08-06T10:46:49+07:00

Midwifery care delivered on a continuity basis means that one woman is accompanied without interruption across the antenatal, intrapartum, postnatal, neonatal and contraceptive phases of a single reproductive episode, so that the health of mother and infant is protected throughout. This report set out to deliver that form of care to Mrs. M at the Independent Midwifery Practice of Hutri Prawita Bancin, A.Md.Keb, in Subulussalam City during 2026, and then to appraise it. A case report design was used; clinical reasoning followed the Varney management framework and every contact was recorded in SOAP format. The woman studied was 27 years old with an obstetric history of G2P1A0. She was followed from the third trimester onward, through labour and delivery, the puerperium, the care of her newborn, and counselling on contraception. Interview, direct observation, physical examination and inspection of her written records supplied the material. Care at each stage met the applicable standards. Her antenatal course showed no complication of consequence; labour advanced normally and ended in the birth of a healthy infant; the puerperal and neonatal courses alike stayed within physiological limits; and counselling on contraception was completed. Repeated surveillance combined with health education helped preserve the health status of both mother and child. Care given to Mrs. M, running from her third trimester through to the uptake of a contraceptive method, was therefore carried out in line with midwifery standards and contributed both to the avoidance of complications and to more favourable maternal and neonatal outcomes.

STRENGTHENING MULTI-STAKEHOLDER COLLABORATION FOR COMMUNITY-BASED STUNTING PREVENTION IN ACEH

2026-06-25T01:24:46+07:00

Latar Belakang: Stunting merupakan tantangan kesehatan global dan nasional yang signifikan. Pada tahun 2023, prevalensi stunting di Provinsi Aceh mencapai 29,3%, melebihi target nasional sebesar 14% dan ambang batas Organisasi Kesehatan Dunia (WHO) sebesar 20%. Mengatasi stunting memerlukan pendekatan konvergen, karena tidak dapat dikelola secara efektif melalui intervensi sektoral yang terisolasi.

Tujuan: Studi ini bertujuan untuk mengeksplorasi pengalaman kolaborasi multi-pemangku kepentingan dalam mencegah dan mengatasi stunting pada balita di tingkat gampong (desa) di Aceh.

Metode: Penelitian ini menggunakan pendekatan fenomenologi kualitatif, yang dilakukan di dua desa di Kecamatan Kutaradja, Kota Banda Aceh. Data dikumpulkan melalui Diskusi Kelompok Terfokus (FGD) dan wawancara mendalam dengan 10 partisipan, termasuk pejabat desa, pemimpin masyarakat, kader Posyandu, petugas kesehatan, dan ibu-ibu balita. Data dianalisis secara tematik.

Hasil: Temuan menunjukkan bahwa masyarakat memandang stunting sebagai tanggung jawab bersama ( ko-tanggung jawab ). Implementasi pendekatan bottom-up berhasil menumbuhkan rasa kepemilikan di tingkat lokal, yang sangat penting untuk keberlanjutan intervensi. Kepala Desa ( Geuchik ) berperan sebagai pihak yang bertanggung jawab utama, motivator, dan penyedia dukungan keuangan, sementara kader Posyandu bertindak sebagai pelaksana teknis, didukung oleh organisasi masyarakat desa seperti TP-PKK dan Karang Taruna.

Kesimpulan: Kolaborasi dan konvergensi multi-pemangku kepentingan yang terintegrasi, ditambah dengan pendekatan dari bawah ke atas, sangat penting untuk pencegahan stunting yang efektif dan berkelanjutan di tingkat desa. Model ini memperkuat struktur sosial, memastikan kesehatan dan kesejahteraan jangka panjang generasi mendatang di Aceh.

BACTERIAL PNEUMONIA CHARACTERISTICS AS A COMPLICATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2026-07-21T08:49:52+07:00

Background:The management of respiratory diseases and infectious complications requires an integrative approach that connects community epidemiology, critical care risk stratification, functional interventions, and the management of multidrug-resistant pathogens. Objective: This literature review aims to critically synthesize four major scientific articles (published between 2023 and 2024) that document significant clinical phenomena in the post-pandemic era, predictors of critical mortality, functional ventilation adaptations, and the growing threat of antimicrobial resistance Methods: A systematic review was conducted by evaluating the methodologies, key findings, and limitations of four independent studies, including an epidemiological analysis from Shanghai (n = 494), a retrospective ICU cohort study from Turkey (n = 416), a rapid review on bulbar function, and a multivariable survival analysis of solid organ transplant recipients in the United States (n = 897).

Results: The synthesis revealed that the post-COVID-19 immunity debt phenomenon contributed to a surge in pediatric respiratory infections accompanied by a high rate of macrolide resistance (80%). In the ICU setting, the C-reactive protein-to-albumin ratio (CAR) and neutrophil-to-lymphocyte ratio (NLR) were identified as significant predictors of mortality among patients with severe COPD complicated by pneumonia or sepsis. Optimization of non-invasive ventilation (NIV) through mouthpiece ventilation (MPV) was shown to improve respiratory-swallowing coordination disorders in patients with neuromuscular diseases. Meanwhile, bloodstream infections caused by carbapenem-resistant Enterobacterales (CRE-BSI) increased the mortality hazard ratio among transplant recipients by up to 2.85 times.

Keywords: Mycoplasma pneumoniae; Chronic Obstructive Pulmonary Disease (COPD); Non-Invasive Ventilation; CRE Bloodstream Infection; Contemporary Thematic Anal

ysi

MANAGEMENT OF COMMUNITY MIDWIFERY CARE FOR ANTENATAL CLIENTS WITH BREECH PRESENTATION AT HANNA SIMBOLON CLINIC MEDAN

2026-08-01T09:57:29+07:00

Background: Breech presentation is an obstetrical variation where the fetus lies longitudinally with the buttocks or feet facing the birth canal. Early detection and structured midwifery monitoring in the third trimester are essential to reduce maternal and neonatal risks. Objectives: This study aimed to implement and analyze comprehensive management of antenatal midwifery care for a primigravida with a breech presentation. Methods: A descriptive qualitative case study approach was used to document the care of Ms. A, a 21-year-old primigravida (G1P0A0) at 31 weeks of gestation at the Hanna Simbolon Clinic, Medan. Data collection involved physical and obstetric examinations (Leopold maneuvers) and dynamic assessment through consecutive follow-ups. Results: Physical parameters and vital signs remained within normal limits. Leopold examinations confirmed a fundal head position and a soft, non-ballottable breech presentation at the lower uterine segment, consistent with a breech presentation before pelvic engagement. Care management involved specific communication, information, and education (CIE) with targeted physiological interventions, including structured knee-chest exercises. Conclusions: Standardized antenatal tracking paired with family-centered education empowers pregnant women, reduces anxiety, and effectively supports internal rotation efforts for safe maternal outcomes.

COMPREHENSIF OF MIDWIFERY CARE FOR MRS. N AT THE INDEPENDENT MIDWIFERY PRACTICE OF MIDWIFE HUTRI PRAWITA BANCIN, AM.Keb SUBULUSSALAM CITY IN 2026

2026-07-22T08:49:46+07:00

Maternal and neonatal mortality remain major public health concerns globally and in Indonesia. Comprehensive midwifery care through the Continuity of Care (COC) approach is one strategy to improve maternal and neonatal health outcomes. This study aimed to describe comprehensive midwifery care provided to Mrs. N, a 27-year-old primigravida, from pregnancy, childbirth, postpartum, newborn care, and family planning services at PMB Hutri Prawita Bancin, Subulussalam City. A descriptive case study design was employed using the Varney Midwifery Management approach and SOAP documentation. Data were obtained through interviews, observation, physical examination, and review of maternal health records. The findings showed that comprehensive and continuous care enabled early detection of potential complications, increased maternal knowledge, and supported positive maternal and neonatal outcomes. Mrs. N experienced a physiological pregnancy, spontaneous vaginal delivery, normal postpartum recovery, healthy neonatal adaptation, and successful family planning counseling. Comprehensive midwifery care is essential for improving maternal and newborn health and reducing maternal and neonatal mortality.

THE RELATIONSHIP BETWEEN SOCIAL MEDIA EXPOSURE AND SEXUAL BEHAVIOR AMONG FEMALE ADOLESCENTS AT MAN 1 INOVASI SUBULUSSALAM IN 2025

2026-07-21T12:09:49+07:00

Social media has become an inseparable part of adolescents' daily lives. The ease of access to information through social media provides numerous benefits; however, it also increases exposure to sexual content that may influence adolescents' sexual behavior. Female adolescents constitute a particularly vulnerable group to the adverse consequences of risky sexual behavior. This study aimed to analyze the relationship between social media exposure and sexual behavior among female adolescents at MAN 1 Inovasi Subulussalam in 2025. Methods: This study employed a correlational analytical design with a cross-sectional approach. The research was conducted in August 2025 at MAN 1 Inovasi Subulussalam. The study population consisted of all female students in Grade X, totaling 47 individuals. A purposive sampling technique was used, resulting in a sample of 47 respondents. Data were collected using a social media exposure questionnaire and an adolescent sexual behavior questionnaire. Data analysis was performed using the Chi-Square statistical test with a significance level of α = 0.05. Results: The analysis revealed a p-value of < 0.05, indicating that adolescents with high levels of social media exposure were more likely to exhibit riskier sexual behaviors compared to those with lower levels of social media exposure. Conclusion: The findings demonstrate a significant relationship between social media exposure and sexual behavior among female adolescents at MAN 1 Inovasi Subulussalam in 2025. Uncontrolled use of social media may increase the risk of engaging in sexual behavior among adolescents. Therefore, reproductive health education, digital literacy programs, and supervision from parents and schools are essential to minimize the negative impacts of social media use.

SOCIAL SUPPORT AND DIGNITY AS DETERMINANTS OF QUALITY OF LIFE IN PATIENTS WITH HEART DISEASE IN MEDAN CITY, INDONESIA

2026-07-11T10:32:49+07:00

Heart disease remains a major global health burden and significantly affects patients’ quality of life. This study aims to examine the role of social support and dignity as determinants of health-related quality of life (HRQoL) among patients with heart disease in Medan City, Indonesia. A cross-sectional design was applied involving 271 respondents selected through structured sampling procedures. Data were collected using validated questionnaires measuring social support, dignity (dignity-related distress), and HRQoL. Descriptive statistics were used to characterize respondent characteristics, while bivariate analyses employed Gamma and Somers’d correlations to assess relationships among variables. Multivariate analysis was conducted using ordinal regression to identify dominant predictors of HRQoL. The results show that most respondents were male (51.3%), aged 55–64 years (27.7%), and married (83.0%). More than half of the participants reported high social support (56.1%) and good HRQoL (53.9%). Bivariate analysis indicated significant positive relationships between social support and HRQoL (p = 0.001) and between dignity and HRQoL (p < 0.001). Ordinal regression analysis revealed that both social support and dignity significantly influenced HRQoL simultaneously (p < 0.001), with a model explanatory power of 52.4% (Nagelkerke R² = 0.524). Social support emerged as the strongest predictor of HRQoL, compared with dignity.

In conclusion, social support and dignity are significant determinants of HRQoL in patients with heart disease in Medan. Strengthening psychosocial support systems and maintaining patient dignity should be prioritized in cardiac care interventions to improve overall quality of life.

COMMUNITY MIDWIFERY CARE WITH ANTI-CORRUPTION VALUES EDUCATION IN ADOLESCENTS

2026-06-26T09:06:22+07:00

Background: Corruption remains a major social problem that weakens public trust and the quality of public services. In Indonesia, anti-corruption behavior still needs improvement, as reflected by the 2024 Anti-Corruption Behavior Index of 3.85, which declined from the previous year. Anti-corruption education has been widely promoted as a preventive strategy, especially for adolescents who are in a critical stage of character development. Objectives: This study aimed to describe community midwifery care through anti-corruption behavior education for a 13-year-old adolescent in Dusun V, Bangun Rejo Village, Tanjung Morawa District, in 2026. Methods: A community midwifery case study was conducted through family assessment, Hanlon problem prioritization, direct education, motivational communication, family involvement, and four home visits from 15 to 19 February 2026. The adolescent’s knowledge and behavior regarding anti-corruption values were assessed before and after the intervention. Results: The main problem identified was limited understanding of anti-corruption values, with a Hanlon score of 144. After the intervention, the adolescent showed better understanding of corruption, could mention anti-corruption values, and began applying honest, disciplined, and responsible behavior in daily life. Family support also improved during the process. Conclusions: Community midwifery care combined with anti-corruption education and family support improved the adolescent’s knowledge and behavior. This approach may be useful as a community-based character education strategy.

IMPLEMENTATION OF EARLY INITIATION OF BREASTFEEDING IN NEWBORNS FOR THE PREVENTION OF HYPOTHERMIA IN THE WORKING AREA OF PAKKAT COMMUNITY HEALTH CENTER, PAKKAT DISTRICT, HUMBANG HASUNDUTAN REGENCY, NORTH SUMATRA PROVINCE, 2024

2026-07-30T11:51:44+07:00

Background: Hypothermia is one of the leading causes of morbidity and mortality in newborns due to the inability of neonates to maintain body temperature. One effective effort to prevent hypothermia is through Early Initiation of Breastfeeding (EIBF) using skin-to-skin contact between mother and baby immediately after birth. Objective: This study aims to determine the effect of Early Initiation of Breastfeeding on the prevention of hypothermia in newborns within the working area of the Pakkat Public Health Center, Pakkat District, Humbang Hasundutan Regency, North Sumatra Province, in 2024. Methods: This study utilized a quasi-experimental design with a One Group Pretest-Posttest Design. The research population consisted of all normal newborns in the working area of Pakkat Public Health Center, totaling 20 infants, with a sample of 12 infants who met the inclusion criteria selected via the total sampling technique. Body temperature measurements were taken before and after EIBF implementation using a digital thermometer. Data analysis was conducted using the Paired Samples T-Test with a 95% confidence level (alpha = 0.05). Results: The average body temperature of the infants increased by 0.68°C after EIBF. The results of the Paired Samples T-Test showed a p-value = 0.000 (p < 0.05), indicating a significant effect of EIBF implementation on increasing the body temperature of newborns. Conclusion: The implementation of Early Initiation of Breastfeeding is effective in increasing newborn body temperature, making it a viable routine intervention in essential neonatal services to prevent hypothermia.

Effectiveness of LI4 and SP6 Acupressure on Labor Pain Reduction and Positive Childbirth Experience During the Active Phase of the First Stage of Labor

2026-08-01T12:03:31+07:00

ABSTRACT

Background: Labor pain is a major challenge during childbirth that can negatively affect maternal satisfaction and labor outcomes. Acupressure is a sustainable complementary therapy that can be integrated into midwifery practice to support positive childbirth experiences. Objectives: This study aimed to examine the effectiveness of acupressure at LI4 and SP6 sites in reducing labor pain and enhancing positive childbirth experiences during the active phase of first-stage labor. Methods: A one-group pretest-posttest quasi-experimental study was conducted in Medan involving 30 laboring women selected through purposive sampling. Pain severity was measured using the Numeric Rating Scale (NRS), and childbirth experiences were evaluated using a structured questionnaire. Data were analyzed using the Wilcoxon Signed Rank Test. Results: The mean labor pain score significantly decreased from 8.10 ± 0.85 before intervention to 5.30 ± 1.04 after intervention. Concurrently, maternal satisfaction and childbirth experience scores significantly increased after acupressure therapy ($p < 0.001$). Conclusions: Acupressure at LI4 and SP6 points effectively reduces labor pain and improves childbirth experiences. As a low-cost and sustainable intervention, it should be integrated into routine maternity care to support positive childbirth experiences.

MCH HANDBOOK UTILIZATION AND PREGNANCY COMPLICATION PREVENTION BEHAVIOR: A LITERATURE REVIEW

2026-07-30T15:46:19+07:00

Background: Pregnancy complications remain a leading cause of maternal mortality in Indonesia. The Maternal and Child Health (MCH) Handbook has been identified as an important instrument with the potential to shape preventive behaviors against pregnancy complications; however, its utilization in practice remains suboptimal. Objectives: This review aimed to examine scientific evidence regarding the utilization of the MCH Handbook and its association with preventive behaviors against pregnancy complications. Methods: A systematic literature review was conducted on 15 research articles published between 2021–2026, retrieved from PubMed, Google Scholar, and Portal Garuda, using the keywords “MCH Handbook,” “utilization of MCH Handbook,” “pregnancy complications,” “pregnancy prevention behavior,” and “antenatal care.” Results: Optimal utilization of the MCH Handbook was significantly associated with improved knowledge of pregnancy danger signs (p<0.05), the formation of positive attitudes toward antenatal examinations, and enhanced compliance with complication prevention measures. Correlation coefficients between MCH Handbook utilization and pregnancy complication prevention behavior ranged from r=0.500 to r=0.721. Conclusions: The MCH Handbook plays an essential role in shaping preventive behaviors against pregnancy complications. Optimization of MCH Handbook utilization through active education by healthcare professionals is needed to reduce the incidence of complications and maternal mortality.

LITERATURE REVIEW: ANALYSIS OF FACTORS THAT CAUSE HIGH RISK OF COMPLICATIONS IN PREGNANT WOMEN

2026-06-26T23:36:44+07:00

Contains a brief description of the problem and research objectives, methods, results, and Pregnancy is a physiological condition fraught with the risk of complications for both the mother and the fetus if managed in the same way as a normal pregnancy. This can have serious consequences, including increased rates of morbidity and mortality among mothers and fetuses. The purpose of this study was to identify the main risk factors for complications, including maternal age that is too young (<20 years) or too old (>35 years) and inadequate nutritional status. The method used in this study was to analyze risk factors through a literature review by searching for journals related to complications in pregnant women. The review sources utilized electronic media from various databases, including Google Scholar, covering the period from 2021 to 2026. The results of reviewing several journals identified several high-risk factors in pregnancy and strategies for preventing pregnancy complications. In conclusion, high-risk pregnancies can be influenced by age, parity, history of miscarriage, a gestational age of less than 2 years, and a height of less than 145 cm. In addition, other high-risk factors are also influenced by education and occupation. Therefore, it is necessary to improve risk assessment through early detection of complications and by utilizing available technology to support the well-being of mothers and infants during pregnancy.

MIDWIFERY CARE MANAGEMENT FOR A NEONATE WITH CONGENITAL MALARIA AT PMB NIAR, MEDAN AMPLAS DISTRICT, 2026

2026-07-18T14:59:38+07:00

Background: Congenital malaria is a rare neonatal infection caused by vertical transmission of Plasmodium parasites from mother to fetus during pregnancy or delivery. The disease remains a significant health problem in malaria-endemic countries because its clinical manifestations often resemble neonatal sepsis, resulting in delayed diagnosis and treatment. Early detection and comprehensive management are essential to prevent severe complications and improve neonatal outcomes. According to the World Health Organization, (2024), malaria continues to contribute substantially to maternal and neonatal morbidity worldwide. Objective: This case report aimed to describe the implementation of comprehensive midwifery care management for a neonate with congenital malaria at PMB Niar, Medan Amplas District, in 2026. Methods: This study employed a descriptive case report design using a Continuity of Care approach. Data were collected through interviews, observation, physical examination, review of medical records, and laboratory findings. Midwifery care was provided using Varney’s Seven Steps of Midwifery Management and documented through the SOAP method. Results: A male neonate aged seven days presented with fever, lethargy, decreased breastfeeding frequency, mild jaundice, and reduced activity. Maternal history revealed recurrent fever during pregnancy, suggesting possible transplacental transmission of malaria parasites. Laboratory examination confirmed Plasmodium vivax infection. Midwifery interventions included comprehensive neonatal assessment, monitoring of vital signs, breastfeeding support, maternal education regarding neonatal danger signs, infection prevention measures, collaborative management with physicians, and regular follow-up visits. The neonate showed progressive clinical improvement characterized by normalization of body temperature, increased feeding frequency, and improved activity. Conclusion: Comprehensive midwifery care through a Continuity of Care approach contributed to the early identification, monitoring, and successful management of congenital malaria. Collaboration among midwives, physicians, and family members played an important role in improving neonatal health outcomes and preventing complications.

REGRESSION ANALYSIS OF NURSING AGENCY, SELF-CARE DEMAND, AND SELF-CARE AGENCY ON QUALITY OF LIFE AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE

2026-07-11T10:40:31+07:00

Background: Chronic Kidney Disease (CKD) is a progressive condition that significantly reduces patients’ quality of life (QoL) in physical, psychological, and social aspects. Nursing agency, self-care demand, and self-care agency are considered important determinants influencing patient outcomes. Objective: This study aimed to analyze the effects of nursing agency, self-care demand, and self-care agency on QoL among CKD patients, including the mediating role of self-care agency. Methods: A quantitative cross-sectional study with correlational, multiple linear regression, and mediation analysis was conducted among 223 CKD patients at Haji Medan Public Hospital. Data were collected using validated instruments: Nursing Agency Scale, Self-Care Demand Scale, Self-Care Agency Instrument, and WHOQOL-BREF. Statistical analysis was performed using SPSS. Results: The mean scores were 4.17 ± 0.49 for nursing agency, 3.06 ± 0.71 for self-care demand, 3.26 ± 0.67 for self-care agency, and 3.02 ± 0.67 for quality of life. Nursing agency showed a significant positive correlation with QoL (r = 0.214; p = 0.001), as did self-care agency (r = 0.238; p < 0.001). Self-care demand was not significantly associated with QoL (r = 0.061; p = 0.361). Regression analysis confirmed nursing agency (β = 0.1733; p = 0.004) and self-care agency (β = 0.1810; p = 0.001) as significant predictors of QoL, while self-care demand was not significant (β = -0.0200; p = 0.798). Conclusion: QoL in CKD patients is primarily influenced by nursing agency and self-care agency, while self-care demand has no significant effect. Strengthening nursing support and patient self-management capacity is essential to improving outcomes.

ANALYSIS OF FACTORS INFLUENCING THE HIGH INCIDENCE OF ANEMIA IN PREGNANT WOMEN BASED ON EVIDENCE-BASED PRACTICE

2026-08-04T09:23:10+07:00

Background: Anemia during pregnancy remains a critical global and national public health concern with profound maternal and neonatal health implications. Objectives: This study aims to systematically synthesize and analyze the predominant factors influencing the incidence of anemia among pregnant women based on a comprehensive literature review of contemporary research articles. Methods: A comprehensive literature review design was implemented, evaluating ten primary scientific articles published between 2021 and 2024 from accredited databases. Analytical extraction matrices were utilized to evaluate clinical and non-clinical risk factors. Results: The synthesis demonstrates that maternal age (particularly high-risk groups <20 and >35 years), elevated parity, short pregnancy intervals, low socio-economic status, low educational attainment, inadequate knowledge, poor nutritional status (chronic energy malnutrition/mid-upper arm circumference <23.5 cm), and non-compliance with iron (Fe) tablet supplementation are significantly associated with anemia. Conclusions: Eliminating maternal anemia requires holistic multidimensional interventions combining clinical optimization, strategic health education, and the systematic implementation of professional midwifery core values.

FORMULATION OF HONEY AND DATES FOR NUTRITIONAL SUPPORT IN PREGNANT WOMEN 2024

2026-08-03T16:09:22+07:00

Background :Anemia in pregnancy remains one of the major contributors to the high Maternal Mortality Rate (AKI) in Indonesia requiring proper management, one of which is through nutritional approach alternatives with dates and honey rich in iron, vitamin C, and other nutrients supporting red blood cell formation. Objectives : This study aims to explore and determine the significant effect of providing dates and honey on the increase of hemoglobin levels in pregnant women in the third trimester in the working area of Gunungtua Health Center, Mandailing Natal in 2024. Methods : The research method implemented is a quantitative approach with a quasi-experimental design of pretest-posttest with control group. Sampling technique used is total sampling involving a total population of 32 pregnant respondents meeting inclusion criteria, then evenly divided into 16 respondents for the intervention group (given treatment) and 16 respondents for the control group (not given treatment). Results : Based on observations before intervention (pre-test), all respondents (100%) in the intervention group and 66.7% of respondents in the control group were identified as having anemia. However, after intervention with dates and honey (post-test), there was a very significant improvement where 100% of pregnant women in the intervention group were free from anemia, while the control group still had 53.3% with anemia. Hypothesis testing through bivariable statistical analysis using Chi-Square test yielded a p-value of 0.002 (p < 0.05), which statistically confirms a positive and significant effect of consuming dates and honey on the occurrence of anemia. Also supported by a Relative Risk (RR) value of 3.14 indicating that pregnant women who do not consume dates and honey are 3.14 times more likely to remain anemic than those who regularly consume them. Conclusions : In conclusion, the intervention of giving dates and honey proved effective to be applied as a nutritional supplement for pregnant women to naturally raise hemoglobin levels and reduce complications due to iron deficiency anemia in the community.

EXCELLENT FAMILY NURSING CARE FOR MRS. N WITH HYPERTENSION NORTH SUMATRA 2026

2026-08-06T11:58:18+07:00

Objective: This study aimed to describe the implementation of family nursing care in managing health problems within a foster family, particularly uncontrolled hypertension, the risk of recurrent urinary tract stones, and environmental health issues. Family-centered interventions were conducted to improve the family’s ability to recognize, manage, and prevent health problems.Methods: This study employed a descriptive case study design using the family nursing process, which included assessment, nursing diagnosis, planning, implementation, and evaluation. Data were collected through interviews, direct observation, physical examination, and home environmental assessment during three home visits. Nursing interventions focused on health education, medication adherence, adequate fluid intake, family participation, and environmental health improvement. Subject: The subjects were members of a foster family consisting of elderly and adult individuals. The primary health concern was uncontrolled hypertension in Mrs. N, evidenced by a blood pressure of 150/110 mmHg and limited knowledge regarding hypertension management. Additional concerns included the risk of recurrent urinary tract stones in Mr. A due to inadequate fluid intake and environmental health risks associated with poor ventilation and sanitation. Results: The nursing interventions improved the family’s knowledge of hypertension management, treatment adherence, fluid consumption, and environmental health practices. Following three home visits, Mrs. N reported no dizziness or neck pain, and her blood pressure decreased to 140/80 mmHg. Mr. A increased his daily water intake, while household ventilation and cleanliness improved. Family participation in maintaining health and preventing complications also increased.Conclusion: Family-centered nursing care effectively enhanced family health management, disease prevention behaviors, and environmental health. Continuous education, active family involvement, and regular monitoring are essential to sustain positive health outcomes and prevent future complications.

Artikel SERVICE EXCELLENT PSYCHIATRIC NURSING VIA ECO EDUCATION FOR Mr. M WITH AUDITORY HALLUCINATIONS

2026-07-31T09:41:20+07:00

Background: Auditory hallucinations are among the most common mental health nursing problems experienced by patients with schizophrenia and may affect emotional responses, behavior, social interaction, and daily functioning. These symptoms can reduce quality of life and hinder recovery if not managed appropriately. Objectives: This study aimed to describe the implementation of Service Excellent Psychiatric Nursing through Eco-Education and to evaluate the outcomes of nursing care provided to Mr. M, a patient with paranoid schizophrenia experiencing auditory hallucinations. Methods: A descriptive case study was conducted in Mawar 1 Ward at Prof. Dr. Muhammad Ildrem Mental Hospital, North Sumatra Province. The nursing process included assessment, nursing diagnosis, planning, implementation, and evaluation. The primary nursing diagnosis was sensory perception disturbance related to auditory hallucinations. Nursing interventions were implemented using the Four Implementation Strategies (SP), including identifying hallucination characteristics, teaching techniques to control hallucinations, improving medication adherence, encouraging communication with others, and arranging structured daily activities. The Eco-Education approach was integrated to enhance the patient's knowledge, self-management abilities, and sustainable healthy behaviors. Results: After 3 × 24 hours of nursing care, the patient demonstrated a reduction in the frequency and intensity of auditory hallucinations, improved ability to control symptoms independently, increased medication adherence, and enhanced social interaction. Conclusions: Service Excellent Psychiatric Nursing integrated with Eco-Education was effective in supporting recovery and improving the quality of mental health care for patients with auditory hallucinations.

COMMUNITY MIDWIFERY CARE FOR 16-YEAR-OLD NN. Z WITH OBESITY IN HALL II, BANGUN VILLAGE, REJO, TANJUNG MORAWA DISTRICT, DELI SERDANG REGENCY, 2026

2026-07-06T17:33:27+07:00

Obesity in adolescence is a serious global health challenge due to the long-term risk of degenerative diseases and decreased psychosocial quality of life. This study aims to describe the implementation of family-based community midwifery care in adolescents with obesity to increase independence in healthy lifestyle management. This case study uses a comprehensive midwifery care approach through Varney's steps, including assessment, problem identification, planning, implementation, and evaluation. The subject of the study was Ms. Z (16 years old) in Dusun II, Bangun Rejo Village, who was obese with a Body Mass Index (BMI) of 33.45 kg/m² and chief complaints of fatigue and frequent sweating. The intervention provided focused on education on balanced diet management, increasing daily physical activity, and regulating adequate rest patterns. During the mentoring period from February 12 to May 2, 2026, regular monitoring of client behavior changes was conducted. The evaluation results showed significant behavioral improvements, where the client became more disciplined in managing nutritional intake, exercising regularly, and reported a fitter and lighter body condition compared to before the intervention. The success of this care program confirms that a structured, educational, and persuasive community midwifery approach is highly effective in increasing adolescent awareness and independence in weight management. It is hoped that the results of this care program can serve as a reference for health workers in optimizing their promotive and preventive roles in adolescents at the community level to prevent future complications of degenerative diseases, while also emphasizing the importance of family support as a determining factor in the success of sustainable healthy lifestyle modifications in adolescents.

LITERATURE REVIEW FACTORS RELATED TO THE INCIDENCE OF PERINEAL RUPTURE IN NORMAL CHILDBIRTH

2026-07-20T15:01:31+07:00

Perineal rupture is a common complication during normal childbirth that can increase maternal morbidity, including postpartum hemorrhage, infection, prolonged perineal pain, dyspareunia, and reduced quality of life. This literature review analyzed ten research articles published between 2020 and 2025 to identify factors associated with perineal rupture. The review found that parity was the most dominant factor, with primiparous women experiencing a higher risk due to limited perineal tissue adaptation. Other important factors included high birth weight (≥4,000 grams), maternal age, fetal head circumference, prolonged second stage of labor, ineffective pushing techniques, perineal elasticity, and the skills of birth attendants. The findings suggest that prevention of perineal rupture requires antenatal education, early identification of risk factors, proper labor management, and the application of evidence-based perineal protection techniques by skilled healthcare providers.

MIDWIFERY CARE OF POSTPARTUM BREAST ENGORGEMENT DAY THREE USING VARNEY APPROACH: A CASE STUDY

2026-07-29T11:28:43+07:00

Background: Breast engorgement is one of the most common breastfeeding problems experienced during the early postpartum period, particularly between the third and fifth days after childbirth. If not managed appropriately, breast engorgement may interfere with breastfeeding, cause maternal discomfort, and increase the risk of mastitis. Midwives play a crucial role in providing evidence-based care to support successful breastfeeding. Objectives: This study aimed to describe the implementation of midwifery care for a mother with breast engorgement on the third day postpartum using Helen Varney’s seven-step approach. Methods: A descriptive case study design was employed. Data were collected through interviews, observation, physical examination, and documentation. Midwifery management was conducted according to Helen Varney’s seven-step approach, including assessment, diagnosis, identification of potential problems, immediate intervention, planning, implementation, and evaluation. Results: Mrs. R, a 28-year-old multiparous mother, experienced breast engorgement on the third postpartum day, characterized by breast swelling, pain, firmness, and difficulty breastfeeding. Interventions included breastfeeding education, correction of infant positioning and latch, breast care, cold compress application, and family support. Evaluation showed a reduction in pain intensity, decreased breast swelling, improved milk flow, and more effective breastfeeding. Conclusions: The application of Helen Varney’s seven-step approach effectively reduced symptoms of breast engorgement and improved breastfeeding outcomes. Early identification and appropriate midwifery interventions are essential to prevent complications and promote exclusive breastfeeding.

ELEVATING STUDENT LEADERSHIP THROUGH EXCELLENT SERVICE IN THE OBSTETRIC CARE OF HYPERMESIS GRAVIDARUM IN MRS. N FOR INDONESIA SDGs 2030

2026-08-01T10:03:23+07:00

ABSTRACT
Background: Hyperemesis gravidarum (HG) affects 12.5% of pregnancies globally and 14.8% in Indonesia, posing risks of severe dehydration and maternal-fetal complications. Integrating student leadership and service excellence in midwifery care is pivotal to address this clinical challenge. Objectives: This study aimed to implement comprehensive midwifery care management using Varney's seven-step method for Mrs. N, a 27-year-old G2P1A0 with Grade 2 Hyperemesis Gravidarum, while elevating student leadership to support 2030 SDGs. Methods: A descriptive case study approach was conducted at Prtek Mandiri Bidan (PMB) Pera in March 2024. Primary data were gathered through anamnesis and physical examinations, while secondary data were obtained from medical records. Results: The patient presented progressive nausea and vomiting (>5 times/day), extreme weakness, acetone in urine, and decreased skin turgor. Care management involved interprofessional collaboration for parenteral fluid rehydration (RL + Dextrose 5%), antiemetic therapy (Ondansetron, Ranitidine), communication therapy, and non-pharmacological ginger aromatherapy. Within short-term monitoring, the patient's turgor improved, and nausea decreased. Conclusions: Comprehensive management and early detection through clinical leadership effectively mitigated severe dehydration and complications. Responsive service excellence directly aligns with reducing maternal mortality rates under SDG targets.

SOCIAL EMOTIONAL DEVELOPMENT OF SIXTH GRADE STUDENTS DURING LEARNING INTERACTIONS IN AN ELEMENTARY SCHOOL

2026-07-23T15:35:10+07:00

Background: Social emotional development is an important aspect of the learning process in elementary schools because it influences students' ability to interact with others, regulate their emotions, and participate effectively in learning activities. Objectives: This study aimed to describe the social-emotional development of sixth-grade students in the context of learning interactions at State Elementary School 1 Toyareka. Methods: This study employed a quantitative approach with a descriptive research design. The study participants consisted of 51 sixth-grade students. Data were collected using a social-emotional development questionnaire covering six dimensions: self-awareness and emotional security, emotional regulation skills, the need for social support and attachment, empathy and social concern, independence and responsibility, and student–teacher relationships. Data were analyzed descriptively using mean, standard deviation, median, and categorical assessment scores. Results: The results indicated that the overall social-emotional development of sixth-grade students was categorized as good, with a mean score of 74.55. The dimensions of student–teacher relationships and the need for social support and attachment demonstrated the highest achievement levels. Meanwhile, the dimensions of self-awareness, emotional regulation, and empathy were categorized as moderate, with a tendency toward good performance. Conclusions: In conclusion, supportive learning interactions and positive teacher–student relationships are essential factors in promoting the social-emotional development of elementary school students. Therefore, creating a positive and supportive classroom environment should be prioritized to enhance students' social and emotional competencies.

THE EFFECT OF EARLY MOBILIZATION ON REDUCING THE RISK THROMBOSIS INMOTHERS AFTER CESAREAN SURGERY

2026-07-21T14:14:05+07:00

Background: A cesarean section (C-section) is a surgical procedure performed to deliver a baby through an incision in the mother’s abdomen and uterus. As the number of deliveries via this method increases, attention to the postoperative wound healing process has become increasingly crucial. In Indonesia, according to the 2023 Basic Health Research (Riskesdas), the rate of cesarean section (CS) deliveries has increased compared to previous years. This increase indicates the need for greater attention to aspects of postoperative care, including early mobilization. The objective of this study is to analyze the effect of early mobilization on reducing the risk of thrombosis in mothers following cesarean section at Citra Medika Tembung Hospital, Deli Serdang Regency, in 2025. Research Methodology: This study employed a qualitative-analytical approach with a cross-sectional design. The study population consisted of 32 participants. Data were collected through direct observation using an observation sheet and analyzed using the Chi-Square test at a 95% confidence level. The results indicate a significant association between early mobilization and a reduced risk of thrombosis (p-value < 0.05). Mothers who underwent early mobilization experienced faster wound healing and exhibited a reduction in clinical symptoms associated with thrombosis risk compared to those who did not undergo early mobilization. The conclusion of this study is that early mobilization has a significant effect on reducing the risk of thrombosis in mothers following cesarean section.

The Effectiveness of Endorphin Massage on Back Pain in Third Trimester Pregnant Women at Gumpang Community Health Center in 2025

2026-07-18T13:28:07+07:00

Back pain is one of the complaints often experienced by pregnant women in the third trimester due to physiological changes during pregnancy, such as weight gain, changes in body posture, and the influence of the hormone relaxin that can interfere with daily activities. One non-pharmacological effort that can be done to reduce back pain is endorphin massage , which is a light massage technique that can stimulate the release of endorphins as a natural pain reliever. This study aims to determine the effectiveness of endorphin massage on reducing the intensity of back pain in pregnant women in the third trimester at the Gumpang Community Health Center in 2025. This study used a quantitative method with a pre-experimental design using a one group pretest-posttest design approach . The study sample consisted of 30 pregnant women in the third trimester who experienced back pain with an accidental sampling technique. Measurement of pain intensity was carried out before and after the Endorphin Massage intervention using a pain scale. The results showed that before the intervention, most respondents experienced moderate to severe pain, while after the intervention, the majority experienced a decrease in pain intensity to mild. The results of statistical tests showed a p-value <0.05, which means there is a significant effect of endorphin massage on reducing the intensity of back pain in pregnant women in the third trimester. The conclusion of this study shows that endorphin massage is effective as a non-pharmacological therapy to help reduce back pain in pregnant women in the third trimester.

MIDWIFERY CARE MANAGEMENT OF PREGNANT WOMEN WITH HEMORRHOIDS AT HAJI MEDAN HOSPITAL 2025

2026-07-28T10:05:52+07:00

Background: Hemorrhoids are one of the most common anorectal disorders experienced during pregnancy, particularly in the third trimester. Physiological and hormonal changes during pregnancy increase the risk of constipation, which contributes to the development of hemorrhoids. This condition may cause pain, rectal bleeding, discomfort, and decreased quality of life in pregnant women. Early detection and appropriate management are important to prevent complications and improve maternal well-being. Objectives: To describe the management of midwifery care for a pregnant woman with hemorrhoids at Haji General Hospital Medan in 2025. Methods: This study employed a descriptive case study approach. Data were collected through interviews, physical examinations, observation, and review of medical records. Midwifery management was carried out using the Varney Midwifery Management Process. Results: Mrs. M, 32 years old, G2P1A0, at 34 weeks of gestation, presented with complaints of rectal bleeding, anal pain, constipation, and weakness. Physical examination showed blood pressure 90/70 mmHg, pulse 96 beats/minute, respiratory rate 20 breaths/minute, and temperature 36°C. A hemorrhoidal mass with fresh rectal bleeding was observed. Midwifery care included assessment of maternal condition, monitoring of vital signs, pain management, observation of bleeding, health education regarding hemorrhoids, dietary counseling with increased fiber and fluid intake, and collaboration with physicians for further management. Conclusions: Comprehensive midwifery care and collaborative management are essential in reducing symptoms, preventing complications, and improving the quality of life of pregnant women with hemorrhoids.

ANALYSIS OF PREGNANT WOMEN’S ANXIETY FACTORS ON HYPEREMESIS GRAVIDARUM IN MUARASIPONGI HEALTH CENTER, MANDAILING NATAL DISTRICT, NORTH SUMATRA PROVINCE 2025

2026-07-18T16:30:04+07:00

Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that can lead to dehydration, weight loss, and a reduced quality of life. Psychological factors, particularly anxiety, can exacerbate this condition. This study aims to analyze the factors associated with anxiety levels in pregnant women with hyperemesis gravidarum, including age, number of births, and spousal support. This study employed a quantitative cross-sectional design with 48 respondents selected through a convenience sample. Data were collected using a checklist and the Perinatal Anxiety Screening Scale (PASS), then analyzed using the chi-square test (p < 0.05). The results showed that the majority of respondents were aged 20–35 years (70.8%), were primigravidas (56.3%), received low levels of spousal support (66.7%), and experienced severe anxiety (56.3%). There was a significant association between age (p=0.006) and number of births (p=0.002) and anxiety levels. Low spousal support was also associated with higher anxiety levels. In conclusion, age, number of births, and spousal support are significantly associated with anxiety levels in pregnant women with hyperemesis gravidarum. Strengthening family support and providing adequate education during pregnancy are crucial for reducing anxiety.

MANAGEMENT OF OBSTETRIC CARE WITH PLACENTAL RETENTION DURING THE THIRD STAGE OF LABOR IN MRS. Y AT TUTUN-SEHATI CLINIC 2025

2026-07-22T15:37:23+07:00

Retained placenta is an obstetric emergency that occurs when the placenta fails to be expelled within 30 minutes after delivery despite Active Management of the Third Stage of Labor (AMTSL). The incidence of retained placenta is estimated at 0.5–3% of all vaginal deliveries worldwide and remains one of the leading causes of postpartum hemorrhage, contributing substantially to maternal morbidity and mortality, particularly in low- and middle-income countries. Although retained placenta has been widely investigated, limited evidence is available regarding the practical implementation of Helen Varney's seven-step midwifery management approach integrated with WHO and FIGO recommendations in primary maternity care settings. This study provides clinical evidence from a primary healthcare facility to support evidence-based midwifery practice. Objective: This study aimed to analyze the application of Helen Varney’s seven-step midwifery management approach in managing retained placenta during the third stage of labor in a multiparous woman. Methods: A descriptive case study design was employed. Data were collected through anamnesis, direct observation, physical examination, abdominal palpation, genital tract exploration, and review of medical records. Data were analyzed descriptively by comparing clinical findings and interventions with recommendations from the World Health Organization (WHO), the International Federation of Gynecology and Obstetrics (FIGO), and evidence-based midwifery literature. Results: Mrs. Y, a 32-year-old multiparous woman (P2A0), experienced retained placenta 30 minutes after spontaneous vaginal delivery. Clinical findings included continuous vaginal bleeding, inadequate uterine contractions, blood pressure of 100/70 mmHg, pulse rate of 92 beats per minute, and respiratory rate of 24 breaths per minute. Emergency management consisted of fluid resuscitation, bladder catheterization, manual placental removal, uterotonic administration, and close monitoring. The placenta was successfully removed without complications, uterine contractions improved, bleeding was controlled, and the maternal condition stabilized. Conclusion: Helen Varney’s seven-step management approach provided a systematic framework for the early diagnosis, emergency intervention, and evaluation of retained placenta. The implementation of evidence-based midwifery care contributed to successful maternal outcomes and the prevention of severe postpartum hemorrhage.

DESCRIPTION OF POST-PARTUM VISITS (KF1-KF4) FOR POSTPARTUM MOTHERS AT PAGEDONGAN COMMUNITY HEALTH CENTER IN 2025

2026-08-06T10:25:19+07:00

Background: The postpartum period is a recovery phase after childbirth that requires continuous monitoring through postpartum visits to detect complications early and ensure maternal well-being. According to health service standards, postpartum visits are conducted four times, namely KF1, KF2, KF3, and KF4. These visits aim to monitor maternal health, support the recovery process, and provide health education and services during the postpartum period. Objective: To describe the coverage of postpartum visits (KF1–KF4) among postpartum mothers at the Pagedongan Community Health Center in 2025. Method: This study employed a quantitative descriptive design with a retrospective approach. The sample consisted of 410 postpartum mothers selected using a total sampling technique. Data were obtained from Maternal and Child Health (KIA) reports and maternal cohort registers. Data analysis was conducted using univariate analysis and presented as frequency distributions and percentages. Results: Most postpartum mothers were of healthy reproductive age (20–35 years), accounting for 313 respondents (76.3%), while 97 respondents (23.7%) were of unhealthy reproductive age (<20 years and >35 years). Based on parity, the majority were multiparous mothers (65.1%), followed by primiparous (24.1%) and grandemultiparous mothers (10.7%). Regarding education level, most respondents had primary education (62.9%), followed by secondary education (31.0%) and higher education (6.1%). The coverage of postpartum visits was very high, with KF1 attended by 410 mothers (100%), KF2 by 404 mothers (98.5%), KF3 by 403 mothers (98.3%), and KF4 by 400 mothers (97.6%). Conclusion: The coverage of postpartum visits among postpartum mothers at the Pagedongan Community Health Center in 2025 was classified as very good. High participation was observed at every stage of postpartum visits (KF1–KF4), indicating strong utilization of postpartum health services.

OVERVIEW OF THE INCIDENCE OF SIDE EFFECTS AMONG IMPLANT CONTRACEPTIVE USERS AT THE PURWANEGARA I COMMUNITY HEALTH CENTER, BANJARNEGARA REGENCY

2026-07-23T16:28:57+07:00

Background: Implant contraception is one of the most effective long-term contraceptive methods and is widely used by women of reproductive age. Despite its effectiveness, implant use may cause several side effects due to the influence of progestin hormones, including menstrual disorders, weight gain, and acne. Side effects that are not managed appropriately may reduce user satisfaction and increase the risk of discontinuation. Objectives: This study aimed to describe the incidence of side effects among implant contraceptive acceptors based on age, parity, and duration of use at Purwanegara I Public Health Center, Banjarnegara Regency. Methods: This study employed a quantitative descriptive design with a cross-sectional approach. The population consisted of 179 implant contraceptive acceptors, and 45 respondents were selected using purposive sampling. Data were collected through medical records and observation sheets. Data analysis was performed using univariate analysis to obtain frequency distributions and percentages. Results: The study results indicate that the most common side effect experienced by contraceptive implant users was weight gain (reported by 24 respondents or 53.3%), followed by spotting (19 respondents or 42.2%) and menorrhagia (14 respondents or 31.1%). Weight gain was most frequently observed among respondents aged 20–35 years, multiparous women, and those with a duration of use exceeding two years. Conclusions: Implant contraceptive use may result in various side effects, particularly weight gain and menstrual disorders. Proper counseling, education, and routine monitoring by healthcare providers are important to improve user comfort and continuation of implant contraceptive use.

FACTORS THAT AFFECT THE OCCURRENCE OF HYPEREMESIS IN PREGNANT WOMEN WITH TEMPOSTRSSION IN PMB ANITAKIRAN, PLAKATTING DISTRICT, REGENCY MUSIBANYUASIN, SUMATRA SOUTH PROVINCE IN 2025

2026-07-18T17:46:31+07:00

Background: Hyperemesis gravidarum is a condition of excessive hyperemesis that occurs in the first trimester of pregnancy and can negatively impact the health of the mother and fetus. Some of the factors that are suspected to contribute to the occurrence of hyperemesis include employment status, parity, and family support. This study aims to analyze the factors that affect the occurrence of hyperemesis in pregnant women in the first trimester at PMB Anita Kirana, Plakat Tinggi District, Musi Banyuasin Regency. This study uses a quantitative method with a descriptive design and a cross sectional approach. A sample of 30 pregnant women in the first trimester was selected using purposive sampling techniques. Data analysis was carried out univariate and bivariate with the Chi-Square test. There was a significant influence between employment status (p=0.008), parity (p=0.006), and family support (p=0.026) on the incidence of hyperemesis. Working mothers, primigravida, and those who do not have family support have a higher risk of developing hyperemesis. Employment status, parity, and family support are factors that affect the occurrence of hyperemesis gravidarum in pregnant women in the first trimester.

MIRROR THERAPY FOR POST STROKE ELDERLY WITH PHYSICAL MOBILITY IMPAIRMENT AT UPTD PUSKESMAS RAMBUNG BINJAI CITY

2026-07-18T17:55:59+07:00

Background: Non-hemorrhagic stroke often leads to physical mobility impairment in elderly patients, limiting their daily activities. Mirror Therapy is a non-pharmacological rehabilitation intervention that uses visual mirror feedback to stimulate motor function recovery. Objectives: The purpose of this case study is to describe the application of Mirror Therapy in elderly patients with post non-hemorrhagic stroke experiencing the nursing problem of impaired physical mobility at UPTD Puskesmas Rambung, Binjai City, in 2026. Methods: This descriptive case study design involved 3 elderly respondents (Mr. J, Mrs. R, and Mrs. E) diagnosed with non-hemorrhagic stroke. Data were collected through interviews, physical examinations, and documentation studies. Nursing care was provided over 3 days, covering assessment, diagnosis, intervention, implementation, and evaluation. Results: The results showed that all three respondents experienced impaired physical mobility with hemiparesis, decreased muscle strength, and limited range of motion (ROM). After 3 days of Mirror Therapy, all three clients showed gradual improvement in muscle strength, range of motion, and daily activity ability, although the problem had not been fully resolved. Conclusions: It was concluded that Mirror Therapy is effective as a non-pharmacological nursing intervention to improve physical mobility in elderly post non-hemorrhagic stroke patients and should be continued with family support.

FACTORS OF BASIC IMMUNIZATION COMPLETENESS IN 12-MONTH-OLD INFANTS IN BANDAR SETIA VILLAGE IN 2022

2026-08-04T17:17:31+07:00

Background: Complete basic immunization in infants is an important indicator in improving child health and preventing diseases that can be prevented through immunization. Immunization plays an important role in reducing morbidity and mortality among infants. However, complete basic immunization coverage has not reached the expected target in several areas. This condition indicates that factors affecting immunization completeness still exist, including maternal knowledge about the importance, benefits, and schedule of immunization. Therefore, it is important to identify factors related to complete basic immunization. Objective: This study aims to analyze the relationship between maternal knowledge level and completeness of basic immunization in 12-month-old infants in Bandar Setia Village in 2022.
Methods: This study used an analytical design with a cross-sectional approach. The population consisted of primipara mothers who had babies aged ≥10–36 months, with a total of 50 respondents. The sampling technique used was total sampling. Data were collected through questionnaires to measure maternal knowledge and immunization cards/KMS to assess infant immunization completeness. Data analysis was performed using univariate and bivariate analysis with the Chi-Square test at a 95% confidence level (α = 0.05). Results:
The results showed that most respondents had sufficient knowledge, with 47 people (52.8%), followed by good knowledge with 33 people (37.1%), and poor knowledge with 9 people (10.1%). A total of 34.8% of infants had complete basic immunization, while 65.2% had incomplete immunization. The Chi-Square test showed a significant relationship between maternal knowledge level and immunization completeness (p = 0.009). Conclusion:
Maternal knowledge is significantly related to complete basic immunization in infants. Improving knowledge through education and counseling can increase immunization coverage. Health workers are expected to provide information through posyandu activities, counseling, and educational media.

MIDWIFERY CARE FOR MRS. R WITH IUFD AT KLINIK PRATAMA SAM

2026-07-19T22:05:25+07:00

Background: Maternal and fetal health is an important aspect of reproductive health services. Pregnancy complications may lead to adverse outcomes, including intrauterine fetal death (IUFD), which has significant physical and psychological effects on the mother. Therefore, comprehensive midwifery care is required to ensure proper management and emotional support. Objectives: This study aimed to provide midwifery care for Mrs. R with Intrauterine Fetal Death (IUFD) at Klinik Pratama Sam in 2026 using the seven-step Varney midwifery management approach and SOAP documentation. Methods: The research method used was a descriptive study with a case study approach. Data were collected through interviews, observations, physical examinations, obstetric examinations, and medical record review. Results: Mrs. R was a 38-year-old woman with obstetric status G2P1A0 at 23 weeks and 3 days of gestation. She was diagnosed with IUFD based on the absence of fetal movement, fundal height not matching gestational age, and no fetal heart sounds. The midwifery interventions included maternal monitoring, intravenous Ringer Lactate administration, preparation for delivery management, and psychological support. The patient’s condition remained stable and she showed acceptance of her condition with strong family support. Conclusions: the implementation of comprehensive midwifery care using Varney’s seven-step approach is effective in managing IUFD cases and providing both physical and psychological support to the mother.

CASE STUDY OF MIDWIFERY CARE FOR COMPLETE ABORTION AT 10 WEEKS GESTATION

2026-07-21T14:53:22+07:00

Background: Early pregnancy loss remains a significant contributor to maternal morbidity and has the potential to cause complications, including excessive bleeding, infection, anemia, and psychological problems when appropriate management is not provided. Therefore, comprehensive and prompt midwifery care is essential to promote maternal recovery and minimize the risk of further complications (Shimels et al. 2023) Objectives: This study aimed to describe the implementation of comprehensive midwifery care in Mrs. I, a 24-year-old G1P0A1 woman with a gestational age of 10 weeks who experienced complete abortion at Pratama Vina Clinic, North Sumatra. Methods: A descriptive case study design was used with Varney’s seven-step midwifery management approach. Data were obtained through interviews, physical examinations, observations, and documentation. The care provided was documented using the SOAP format. Results: The patient presented with complaints of lower abdominal cramps accompanied by vaginal bleeding and expulsion of tissue. Examination findings showed blood pressure of 110/80 mmHg, pulse rate of 100 beats/minute, respiratory rate of 20 breaths/minute, body temperature of 36.5°C, and ultrasonography findings indicating an empty uterine cavity. Midwifery management included monitoring vital signs, providing health education, recommending adequate rest and genital hygiene, administering iron tablets, folic acid, and vitamin C, providing counseling regarding temporary pregnancy postponement, offering psychological support, and recommending follow-up visits. Evaluation results showed that the patient and her husband understood the information provided, anxiety decreased, and the patient's physical condition improved without complications. Conclusions: The implementation of comprehensive midwifery care using Varney’s seven-step approach was carried out effectively and contributed to improving the patient's condition, accelerating recovery, and preventing complications following pregnancy loss.

MIDWIFERY CARE MANAGEMENT FOR MR. Z WITH HYPERTENSION IN STROKE UNIT

2026-07-28T20:23:04+07:00

Hypertension is a chronic disease and a major risk factor for stroke and other cardiovascular complications. It is often referred to as the “silent killer” because it can develop without noticeable symptoms and may lead to severe health consequences if not properly managed.Objectives: This study aimed to evaluate the implementation of midwifery care management for a patient with hypertension treated in the Stroke Care Unit (SCU) of Haji General Hospital Medan in 2025. Methods: This study employed a case study design using a midwifery care management approach. Data were collected through patient assessment, physical examination, observation, medical records, and collaboration with the healthcare team. The subject of the study was Mr. Z, a 57-year-old patient diagnosed with hypertension and stroke.Results: The patient presented with decreased consciousness, headache, vomiting, right-sided limb weakness, and a blood pressure of 193/135 mmHg. A CT scan revealed lacunar infarction. Comprehensive care included monitoring vital signs, assessing neurological status, collaborating with physicians, administering prescribed therapy, and providing health education. The interventions contributed to the stabilization of the patient’s condition and helped prevent further complications.Conclusions: Comprehensive and collaborative midwifery care management plays an important role in controlling hypertension, supporting patient recovery, and preventing complications in patients treated in intensive care settings.

EARLY CHILDHOOD DEVELOPMENT SCREENING USING KPSP IN COMMUNITY MIDWIFERY CARE

2026-08-03T11:54:19+07:00

Background: Early childhood development screening is essential for identifying developmental delays during the critical period of child growth. Community midwives play an important role in providing developmental surveillance and family-centered education using the Indonesian Pre-Screening Developmental Questionnaire (KPSP). Objectives: This study aimed to describe the implementation of community midwifery care for early childhood development screening using the KPSP and to evaluate the outcomes of family-based developmental stimulation. Methods: A descriptive case study was conducted involving a 34-month-old child in Bangun Rejo Village, Deli Serdang Regency, Indonesia. Data were collected through interviews, direct observation, physical examination, KPSP assessment, documentation review, and home visits. Interventions included developmental screening, parental education, language stimulation, educational play activities, and follow-up evaluation. Results: Initial KPSP assessment indicated a doubtful developmental status (score = 8), primarily in the language domain. Following two weeks of family-based language stimulation and continuous parental education, the child demonstrated improved communication skills, including the ability to produce simple sentences, respond to verbal instructions, and engage in more active social interaction. Increased family participation supported the child's developmental progress. Conclusions: Community midwifery care using the KPSP effectively facilitated the early identification of developmental concerns and strengthened parental involvement in developmental stimulation. Integrating routine developmental screening with family-centered interventions may contribute to optimizing child development and preventing long-term developmental delays.

MATERNAL KNOWLEDGE AND TRIPLE ELIMINATION SCREENING ADHERENCE: A CASE STUDY AT DR. DJASMEN SARAGIH HOSPITAL

2026-07-30T16:37:39+07:00

Background: The Triple Elimination program was initiated to reduce the transmission rates of HIV, syphilis, and hepatitis B from mother to infant. The program's success relies heavily on the compliance of pregnant women, which is driven in part by their understanding of the importance of such screening. Objective: To analyze the correlation between the level of knowledge among pregnant women and their compliance with Triple Elimination screening at Dr. Djasamen Saragih Regional General Hospital (RSUD), Pematang Siantar, in 2023. Methods: This observational analytic study employed a cross-sectional design involving 40 pregnant women selected via probability sampling. Data were collected using a knowledge questionnaire and a compliance observation sheet, then analyzed using the Chi-Square test. Results: The majority of respondents (72.5%) possessed poor knowledge, while 27.5% had good knowledge. Regarding compliance, 80% of respondents were classified as compliant with the screening. Statistical analysis yielded a p-value of 0.013 (p < 0.05), indicating a significant relationship between maternal knowledge and screening compliance. Conclusion: here is a significant association between the knowledge of pregnant women and compliance with Triple Elimination screening. Therefore, more intensive health education strategies are needed to improve maternal literacy and participation in the program.

MIDWIFERY CARE MANAGEMENT OF MR. T WITH INTRACRANIAL TUMOR AT RSU HAJI MEDAN

2026-07-21T17:07:10+07:00

Background: Intracranial tumors are abnormal tissue growths inside the skull that can increase pressure in the brain and affect neurological function. Patients often experience headaches, visual disturbances, weakness of the arms and legs, seizures, and decreased consciousness. Delayed diagnosis and lack of understanding about the disease can worsen the patient's condition. Therefore, comprehensive care is needed to support recovery and improve quality of life. Objective: This study aimed to describe the implementation of midwifery care management for a patient with an intracranial tumor at RSU Haji Medan in 2025. Methods: This study used a descriptive case study approach. Data were collected through interviews, direct observation, physical examination, neurological assessment, monitoring of vital signs, and review of medical records. Midwifery care was provided using Helen Varney’s 7-step management approach, and the data were analyzed descriptively. Results: The patient experienced persistent headache, weakness of the arms and legs, visual disturbances, and fatigue. The care provided included monitoring of neurological status and vital signs, health education, psychological support, and collaboration with other healthcare professionals. Evaluation showed improvement in neurological status, reduced symptoms, stable physical condition, and better understanding of the disease and treatment process. Conclusion: Comprehensive midwifery care management helps maintain patient stability, improve neurological outcomes, and support recovery. Continuous assessment, patient education, psychological support, and collaboration with healthcare professionals are important in caring for patients with intracranial tumors.

Ainalia lutfika rizki

2026-07-21T09:55:27+07:00

Background: Perineal rupture is a common complication of vaginal delivery and may lead to postpartum hemorrhage if not managed properly. Appropriate obstetric and midwifery care is essential to prevent complications and support postpartum recovery. Objectives: This case study aimed to describe the implementation of obstetric care for Mrs. Y, a 33-year-old woman, G2P1A0, at 38 weeks of gestation with a second-degree perineal rupture at the Tutun Sehati Primary Inpatient Clinic in 2026. Methods: A descriptive case study design was used, applying Varney’s seven-step obstetric management approach, including assessment, diagnosis and problem identification, anticipation of potential complications, immediate intervention, planning, implementation, and evaluation. Data were collected through interviews, observations, physical examinations, and medical record reviews. Results: The assessment showed that the patient was in the active phase of the first stage of labor with 5 cm cervical dilatation and stable maternal and fetal conditions. A healthy male infant was delivered spontaneously at 19:15 WIB, weighing 3,875 grams and measuring 51 cm in length, with an APGAR score of 10/10. During the fourth stage of labor, a second-degree perineal rupture with an estimated blood loss of 200 cc was identified. Management included perineal suturing, monitoring of vital signs, uterine contractions, postpartum bleeding, and ensuring adequate nutrition and rest. Evaluation indicated that the mother's condition remained stable, bleeding was within normal limits, the perineal wound was successfully managed, and no complications occurred. Conclusions: Varney’s obstetric management approach was effective in managing second-degree perineal rupture, preventing postpartum complications, and promoting optimal maternal recovery.

THE RELATIONSHIP BETWEEN NUTRITIONAL STATUS OF PREGNANT WOMEN AND FETALGROWATH: A LITERATURE REVIEW

2026-07-21T16:32:49+07:00

Background: Pregnancy is a crucial period that determines maternal health and fetal growth. Energy and nutrient needs increase significantly to support the mother's physical changes and the development of fetal organs. Nutritional problems such as Chronic Energy Deficiency (CED) with a Mid-Upper Arm Circumference (MUAC) <23.5 cm, anemia, and low nutritional knowledge are still common. These conditions carry the risk of complications, stunted fetal growth, low birth weight (LBW), and even stunting, which have long-term impacts. Objectives: To examine the relationship between nutritional status of pregnant women and fetal growth and pregnancy outcomes.(Maslikhah, Prajayanti and Baroroh, 2023) Methods: This study employed a systematic literature review. Sources were searched through Google Scholar and health journal databases, covering publication years 2019–2025. A total of 13 relevant articles were selected and analyzed, encompassing cross-sectional, cohort, and experimental designs. The variables studied included MUAC, hemoglobin levels, nutritional intake, and fetal growth and birth weight parameters. Result: Maternal nutritional status is significantly related to fetal growth. Mothers with a mid-birth weight (MULA) ≥ 23.5 cm have a 2–3 times lower risk of giving birth to a low-birth-weight (LBW) baby. Conversely, CED and anemia increase the risk of fetal growth restriction and stunting by up to 3.7 times. Providing supplemental food, iron supplements, and nutrition education have been shown to be effective in improving maternal nutritional status. Conclusions: The better the mother's nutritional status, the more optimal the fetus's growth. Regular monitoring, balanced nutrition, and counseling from early pregnancy are essential to ensure a successful pregnancy outcome.

INTEGRATING BASIC SCIENCE AND CLINICAL SKILLS IN MIDWIFERY CARE OF THIRD TRIMESTER PREGNANT WOMEN WITH BREECH MALPRESENTATION

2026-07-22T10:44:43+07:00

Breech malpresentation in the third trimester of pregnancy represents a significant obstetric complication that contributes to elevated perinatal morbidity and mortality. This study aims to evaluate the implementation of evidence-based comprehensive midwifery care by integrating basic biomedical sciences (Basic Midwifery Science II and III) and Fundamental Midwifery Clinical Skills (KDPK). The method employed is a clinical case study of Mrs. A, a 26-year-old primigravida (G1P0A0) at 34 weeks of gestation, managed at the Healthcare Facility (Faskes) of PT Panca Surya Agrindo. Clinical data collection involved anamnesis, abdominal palpation via Leopold maneuvers, and fetal hemodynamic monitoring using a Doppler transducer. Physical examination confirmed a breech presentation with a fundal height of 30 cm and a normal fetal heart rate of 140 beats per minute. A non-invasive, conservative positional intervention was applied, instructing the patient to perform the knee-chest position. This posture elevates the maternal pelvis above the thoracic cavity, leveraging gravitational forces to create mechanical space within the uterine cavity, thereby encouraging spontaneous cephalic version toward the pelvic inlet. Post-intervention clinical evaluation demonstrated excellent patient comprehension and adherence, with the patient correctly executing the posture independently and safely. The structured integration of fundamental biomedical principles and procedural clinical skills centered on patient safety effectively optimizes antenatal care outcomes and early malpresentation management in primary healthcare settings.

CONTINUITY OF MIDWIFERY CARE FOR PREGNANT WOMEN WITH GRADE 1 HYPEREMESIS GRAVIDARUM FOR MRS. S AT THE SARFINA PRIMARY CARE CLINIC

2026-07-22T10:17:14+07:00

Background: Hyperemesis gravidarum is a pregnancy complication characterized by persistent nausea and vomiting that can lead to dehydration, electrolyte imbalance, nutritional deficiencies, and psychological distress. If not managed appropriately, this condition may adversely affect both maternal and fetal health. Comprehensive Continuity of Care (CoC) allows early detection, appropriate intervention, and continuous monitoring throughout pregnancy.Objectives: This study aimed to describe the implementation of comprehensive Continuity of Care (CoC) midwifery services for a pregnant woman with Grade I hyperemesis gravidarum using Helen Varney's Seven Steps of Midwifery Management and SOAP documentation.Methods: A descriptive observational case study was conducted involving Mrs. S, a 28-year-old pregnant woman diagnosed with Grade I hyperemesis gravidarum at Sarfina Primary Care Clinic, Medan, in 2026. Data were collected through interviews, physical examinations, observation, documentation, and evaluation of maternal progress during antenatal care.Results: At 8 weeks and 1 day of gestation, the patient experienced nausea and vomiting more than nine times daily, decreased appetite, weakness, weight loss, and anxiety regarding her pregnancy. Comprehensive management consisting of vitamin B6, folic acid supplementation, nutritional counseling, psychological counseling, relaxation techniques, and husband involvement resulted in substantial improvement. At 11 weeks and 6 days of gestation, nausea and vomiting had decreased significantly, appetite improved, body weight increased by 1 kg, and maternal anxiety was reduced.Conclusions: Comprehensive Continuity of Care effectively improved both the physical and psychological conditions of pregnant women with Grade I hyperemesis gravidarum. Integrating medical management with psychosocial support and family involvement contributes to better maternal outcomes during early pregnancy.

CONTINUITY OF MIDWIFERY CARE FOR MRS. P WITH GESTATIONAL HYPERTENSION DURING PREGNANCY, CHILDBIRTH, POSTPARTUM, NEWBORN, AND FAMILY PLANNING AT PMB HANNA SIMBOLON, MEDAN 2026

2026-07-28T10:54:52+07:00

Background: Continuity of care (CoC) is a continuous healthcare service between midwives and patients provided to women from early pregnancy, labor, postpartum, newborn, through to family planning. Gestational hypertension is a condition where a pregnant woman experiences blood pressure of 140/90 mmHg during pregnancy.Objectives: This study aims to expand knowledge in providing midwifery care for pregnancy, labor, postpartum, newborn, and family planning using Helen Varney’s 7-step midwifery management approach and SOAP notes.Methods: This study used a descriptive observational case study method to obtain a comprehensive overview of health phenomena within a specific population and individual in pregnant women starting from pregnancy with Gestational Hypertension, Labor, Postpartum, Newborn, and contraception in PMB Hanna Simbolon, Medan Labuhan District, Medan City, 2026.Results: During pregnancy, the mother experienced gestational hypertension at 21 weeks of gestation, requiring treatment and 6 antenatal care (ANC) visits. The labor was a normal vaginal delivery on February 10, 2026, delivering a female infant. Postpartum care from the 2nd to the 4th visit (KF 2 to KF 4) was conducted appropriately without complications. Neonatal visits from the 2nd to the 3rd visit (KN 2 to KN 3) proceeded well without issues. The mother opted for an implant contraceptive method, and no problems were found.Conclusions: Care was provided continuously, and no gaps were found between theory and practice in the case of Mrs. P at PMB Hanna Simbolon, Medan Labuhan District, Medan City, 2026.

CONTINUITY OF CARE MIDWIFERY MANAGEMENT FOR MRS. V: HYPEREMESIS GRAVIDARUM (GRADE I), CHILDBIRTH, POSTPARTUM PERIOD, NEWBORN CARE, AND FAMILY PLANNING AT ANITA PERA PRIMARY CLINIC, MEDAN CITY, 2026

2026-07-28T16:55:16+07:00

Hyperemesis gravidarum is a pregnancy complication characterized by excessive nausea and vomiting that may lead to dehydration, electrolyte imbalance, and nutritional deficiencies if not managed appropriately. Continuity of Care (COC) is a comprehensive midwifery approach that provides continuous care from pregnancy to family planning to improve maternal and neonatal outcomes. This study aimed to describe the implementation of Continuity of Care midwifery services for a pregnant woman with Grade I Hyperemesis Gravidarum at Anita Pera Primary Clinic, Medan. This study employed a descriptive case study design using the Continuity of Care approach. Data were collected through interviews, observations, physical examinations, and supporting medical records, and were documented using Helen Varney’s midwifery management and the SOAP method. The results showed that the mother's nausea and vomiting gradually improved following education, nutritional counseling, therapy, and routine monitoring. Labor occurred normally without complications, postpartum recovery was physiological, the newborn was healthy with normal adaptation, and the mother selected the Lactational Amenorrhea Method (LAM) after receiving family planning counseling. It can be concluded that the implementation of Continuity of Care effectively supports early detection, appropriate management, and continuous monitoring, resulting in favorable maternal and neonatal outcomes.

EFFECTIVENESS OF COLD COMPRESS METHOD ON BREAST PAIN IN POST-POST MOTHERS IN PMB RITA 2025

2026-07-31T10:14:26+07:00

Background: The postpartum period is a crucial time for maternal recovery, especially related to breastfeeding. Breast pain due to breast engorgement is a common complaint that can hinder exclusive breastfeeding. One of the safe and effective non-pharmacological interventions is the cold compress method. Objective: This study aims to determine the effectiveness of cold compress therapy in reducing breast pain among postpartum mothers at PMB Rita, Kampung Mesjid, North Labuhanbatu Regency, North Sumatra Province. Methods: This is a quantitative experimental study using a one group pretest-posttest design. The sample consisted of 30 postpartum mothers selected through total sampling. Breast pain intensity was measured using the Numeric Rating Scale (NRS) before and after applying cold compresses. Data were analyzed using univariate and bivariate statistics. Conclusions: The study showed that prior to the cold compress intervention, the majority of respondents experienced severe pain (33.3%), whereas post-intervention, most reported mild pain (50%). The average pain score decreased from 1.83 to 0.63. The statistical test yielded a p-value of 0.000, indicating a significant difference before and after the intervention. Cold compress therapy is proven effective in reducing breast pain among postpartum mothers. This method can be a cost-effective, simple, and safe non-pharmacological treatment option

ECO-EDUCATION TRANSFORMATION TOWARDS GREEN HUMAN RESOURCES FOR HEALTH: INTEGRATING ECOLOGICAL LITERACY, ENVIRONMENTAL ETHICS, CRITICAL THINKING, AND MENTAL HEALTH RESILIENCE FOR SUSTAINABLE HEALTHCARE

2026-06-23T12:18:11+07:00

Background: Climate change, environmental degradation, pandemics, and humanitarian crises have significantly affected healthcare systems worldwide. These challenges require healthcare professionals who possess not only clinical competencies but also sustainability-oriented skills, ecological awareness, and psychological resilience. However, environmental literacy and resilience competencies remain insufficiently integrated into health professional education.. Objectives: This study aimed to explore the role of eco-education in transforming health professional education and to propose a Green Human Resources for Health (GHRH) framework that integrates ecological literacy, environmental ethics, critical thinking, and mental health resilience. Methods: A narrative literature review was conducted using publications from 2020–2025 obtained from Scopus, Web of Science, PubMed, ScienceDirect, SpringerLink, and Google Scholar. Relevant literature related to eco-education, sustainability, environmental ethics, climate-health education, resilience, and workforce development was analyzed thematically. Results: The review identified four essential competencies required for future healthcare professionals: ecological literacy, environmental ethics, critical thinking, and mental health resilience. Eco-education was found to be an effective approach for strengthening these competencies. The proposed GHRH framework positions eco-education as the foundation for developing environmentally responsible, critically reflective, and resilient healthcare professionals capable of supporting sustainable healthcare systems. Conclusions: Eco-education provides a strategic pathway for transforming health professional education. Integrating ecological literacy, environmental ethics, critical thinking, and mental health resilience can contribute to the development of Green Human Resources for Health and support sustainable healthcare systems and global recovery efforts.

COMMUNITY MIDWIFERY CARE FOR MRS. S, A 34-YEAR-OLD WOMAN, THROUGH EDUCATION ON THE THREE-MONTH INJECTABLE CONTRACEPTIVE IN DUSUN I, BANGUN REJO VILLAGE, TANJUNG MORAWA DELI SERDANG REGENCY 2026

2026-06-23T10:53:45+07:00

Family planning is an essential component of reproductive health services aimed at regulating
pregnancy, birth spacing, and improving family welfare. However, limited knowledge and
misconceptions regarding contraceptive methods often become barriers for women in choosing
appropriate family planning methods. This community midwifery care report describes the
implementation of family-guided assistance (Keluarga Binaan) for Mrs. S, a 34-year-old
woman living in Dusun I, Bangun Rejo Village, Tanjung Morawa District, Deli Serdang
Regency, in 2026. The purpose of this community midwifery care was to improve the client’s
knowledge and readiness to use a suitable contraceptive method through education and
counseling regarding the three-month injectable contraceptive. The care was carried out from
February 9 to May 2, 2026, using the seven-step midwifery management approach developed
by Helen Varney, including assessment, diagnosis, identification of potential problems,
immediate actions, planning, implementation, and evaluation. Data collection was conducted
through interviews, observations, physical examinations, and home visits. The initial
assessment revealed that Mrs. S had never used modern contraception and experienced fear
and anxiety about possible side effects due to insufficient information and limited family
support. Interventions focused on providing comprehensive counseling regarding
contraceptive options, mechanisms of action, indications, contraindications, advantages,
disadvantages, and possible side effects. Educational media, including posters and visual aids,
were utilized to enhance understanding. After several counseling sessions and continuous
support, Mrs. S demonstrated improved knowledge, reduced anxiety, and increased confidence
in making decisions regarding family planning. Ultimately, she chose and successfully became
a new acceptor of the three-month injectable contraceptive. The results indicate that continuous
community-based midwifery care and family-centered counseling effectively improve
knowledge, reduce fear, and support informed decision-making regarding contraceptive use.
This approach can contribute to increasing family planning participation and promoting
reproductive health among women of reproductive age.

CASE STUDY COMMUNITY MIDWIFERY CARE FOR WOMEN WITH OLIGOMENORRHEA

2026-06-23T16:14:13+07:00

Background: Oligomenorrhea is a menstrual disorder characterized by menstrual cycles lasting more than 35 days and commonly occurs in adolescents due to hormonal imbalance. This condition may be influenced by several factors, including stress, irregular sleep patterns, excessive physical activity, poor nutritional status, and unhealthy lifestyle habits. Menstrual disorders in adolescents require special attention because they can negatively affect reproductive health, psychological well-being, daily activities, and future quality of life. Based on an assessment conducted on Ms. A, a 14-year-old adolescent living in Dusun I, Bangun Rejo Village, Tanjung Morawa District, Deli Serdang Regency, irregular menstruation with prolonged cycles was identified, requiring comprehensive community midwifery care. Objective: This case study aimed to provide community midwifery care to an adolescent experiencing oligomenorrhea and to improve her knowledge, attitudes, and behaviors related to reproductive health.Method: A case study design was applied using a midwifery care management approach consisting of assessment, diagnosis and problem identification, planning, implementation, and evaluation. The interventions included counseling regarding oligomenorrhea, health education on balanced nutrition, recommendations for adequate rest, stress management strategies, regular light physical exercise, and psychological support for both the client and her family. Results: The interventions demonstrated positive outcomes. The client experienced reduced anxiety, improved sleep quality, more regular physical activity, and healthier dietary habits. At the final evaluation, the client reported that her menstrual cycle had returned to normal, menstruation lasted six days, and her overall physical and psychological condition had improved. Conclusion: Community midwifery care was effective in managing oligomenorrhea through health education, lifestyle modification, stress management, and family support, resulting in improved reproductive health knowledge and healthier behaviors among adolescents.

OBSTETRIC HEMORRHAGE IN MATERNAL EMERGENCIES : RISK FACTORS, CLINICAL MANAGEMENT, AND PREVENTION STRATEGIES

2026-08-06T09:14:18+07:00

Obstetric hemorrhage remains one of the most significant maternal emergencies and continues to be a leading cause of maternal morbidity and mortality worldwide. Despite advances in maternal healthcare, hemorrhage during pregnancy, childbirth, and the postpartum period remains a major challenge, particularly in low- and middle-income countries.This study aimed to review the current evidence on risk factors, clinical management, and prevention strategies for obstetric hemorrhage, with the goal of improving maternal health outcomes. A literature review was conducted using articles published between 2023 and 2025 retrieved from PubMed, Scopus, ScienceDirect, Google Scholar, and Wiley Online Library. Relevant studies discussing obstetric hemorrhage, maternal emergencies, risk factors, clinical management, and prevention strategies were selected and analyzed through thematic content analysis. The review found that postpartum hemorrhage is the most common form of obstetric hemorrhage and a major contributor to maternal mortality. Uterine atony was identified as the leading cause, followed by retained placenta, genital tract trauma, and coagulation disorders. Major risk factors included maternal anemia, advanced maternal age, multiparity, prolonged labor, cesarean section, placenta previa, and hypertensive disorders. Evidence-based interventions such as active management of the third stage of labor, uterotonic administration, tranexamic acid therapy, blood transfusion, and multidisciplinary emergency care significantly improved maternal outcomes. Most obstetric hemorrhage-related maternal deaths are preventable through early identification of risk factors, timely diagnosis, effective clinical management, and strengthened maternal healthcare systems.

THE RELATIONSHIP BETWEEN NURSES’ THERAPEUTIC COMMUNICATION AND THE IMPLEMENTATION OF PATIENT EDUCATION FOR DIABETES MELLITUS AT BEKASI DISTRICT HOSPITAL IN 2025

2026-07-17T23:40:02+07:00

Background: Diabetes mellitus is a chronic condition that necessitates long-term care and
continual education to enable individuals to take the best possible care of themselves. In order
to effectively provide instruction through therapeutic communication, nurses are essential.
Patients' comprehension, compliance, and capacity to control their illness can all be enhanced
by effective therapeutic communication.
Methods: A cross-sectional design was employed in this investigation. Patients with diabetes
mellitus at RSUD Kabupaten Bekasi made up the study's population. Purposive sampling was
used to pick 117 respondents for the sample. Questionnaires on nurses' therapeutic
communication and patient education implementation were utilized as research tools. The Chi
Square test was used for both univariate and bivariate analysis of the data at a significance level
of 0.05.
Results: According to the findings, the majority of nurses' therapeutic communication fell into
two categories: adequate (44 respondents, 37.6%) and good (73 respondents, 62.4%). Patient
education for diabetes mellitus was mostly implemented in three categories: sufficient (61
respondents, 52.1%), good (54 respondents, 46.2%), and poor (2 respondents, 1.7%). The
results of the Chi-Square test showed a significant correlation between the implementation of
education for patients with diabetes mellitus at RSU Kabupaten Bekasi in 2025 and the
therapeutic communication of nurses, with a p-value of 0.003 (<0.05).
Conclusions: The implementation of education for patients with diabetes mellitus at RSUD
Kabupaten Bekasi is significantly correlated with the therapeutic communication skills of
nurses. The more effectively nurses communicate therapeutically, the more effectively patient
education is implemented. It is anticipated that improved patient comprehension, therapy
adherence, and nursing service quality will result from effective therapeutic communication.

POWERLESSNESS OF PREGNANT WOMEN IN THE FAMILY IN MEDAN BELAWAN DISTRICT

2026-06-23T16:02:16+07:00

This study aims to explore the powerlessness of pregnant women within the family in Medan Belawan District, Medan City. The method used is participatory action research with a qualitative approach through in-depth interviews, Focus Group Discussion (FGD), and field observations. Participants consisted of 34 people including pregnant women, families, health workers, cadres, and community leaders selected by purposive sampling. The results revealed four dimensions of powerlessness experienced by pregnant women: (1) Economic powerlessness, wherein pregnant women are fully financially dependent on their husbands’ unpredictable fishing income, creating a chronic food insecurity cycle; (2) Relational powerlessness, in which pregnant women occupy subordinate positions in family decision-making, including in food selection and preparation, thus inhibiting them from demanding fulfillment of their nutritional needs; (3) Informational powerlessness, where access to meaningful health information is limited—pregnant women routinely attended posyandu but lacked substantial understanding, to the extent that severe anemia went unrecognized; and (4) Cultural powerlessness, where cultural norms prohibiting pregnant women from asking too much and food taboos—including a ban on consuming crab (baby crab)—structurally hinder access to the best local iron sources available in their environment. These findings confirm that anemia in pregnant women in coastal communities is not merely a nutritional problem, but a multidimensional social and structural phenomenon that requires an empowerment-based intervention approach.

NURSING CARE FOR PATIENTS WITH CONGESTIVE HEART FAILURE AT RSUP HAJI ADAM MALIK

2026-06-23T17:00:11+07:00

Background: Congestive Heart Failure (CHF) remains a critical global health problem characterized by rising incidence rates and poor prognosis. Objectives: This study aimed to execute a comprehensive nursing care process for Mrs. S, a patient diagnosed with CHF in the RA3 Inpatient Ward at RSUP Haji Adam Malik Medan. Methods: A descriptive case study approach was utilized to document the 3x24-hour nursing process, including holistic assessment, diagnosis, intervention planning, implementation, and clinical evaluation. Results: The initial assessment revealed severe dyspnea, extreme fatigue, peripheral edema, and compromised activity tolerance. Five core nursing diagnoses were formulated: decreased cardiac output, activity intolerance, hypervolemia, impaired skin integrity, and impaired gas exchange. Tailored interventions included intensive cardiovascular monitoring, strict fluid restriction (1000–1200 ml/day), energy management with gradual mobilization, and a 2-hour turning protocol to prevent pressure ulcers. After three days of implementation, the clinical evaluation demonstrated significant improvements: marked reduction in dyspnea, stabilized vital signs, complete resolution of peripheral edema, and enhanced functional activity tolerance. Conclusions: Structured, evidence-based nursing care plays a pivotal role in optimizing cardiac performance, managing fluid overload, preventing skin breakdown, and improving the overall clinical outcomes and quality of life for advanced CHF patients

Leave blank MIDWIFERY CARE MANAGEMENT IN MR. M WITH ACTIVE PULMONARY TUBERCULOSIS AND DYSPNEA AT RUMAH SAKIT HAJI MEDAN IN 2025

2026-08-01T13:19:43+07:00

Pulmonary tuberculosis (TB) remains a major public health problem in Indonesia and can lead to respiratory impairment accompanied by dyspnea, which may worsen the patient's condition and quality of life. This case report aimed to describe the implementation of midwifery care management for Mr. M, a 61-year-old patient with active pulmonary tuberculosis accompanied by dyspnea in the Ar'Rijal ward of Haji General Hospital, Medan, North Sumatra, in 2025. The method used was a case study approach employing Helen Varney’s midwifery management process, which included data collection, identification of diagnoses and problems, potential diagnoses, immediate actions, planning, implementation, and evaluation. Subjective findings revealed productive cough for one month, hemoptysis during the last week, intermittent fever, weight loss, and dyspnea. Objective examination showed blood pressure of 158/94 mmHg, pulse rate of 101 beats/minute, respiratory rate of 24 breaths/minute, body temperature of 38.9°C, and oxygen saturation of 98–99%. Midwifery care included monitoring vital signs, positioning the patient in semi-Fowler’s position, providing nutritional and fluid support, health education, psychological support, and collaboration with pulmonologists for medical treatment and further examinations. Evaluation results indicated improvement in the patient’s general condition, increased understanding of the disease and treatment, and willingness of the patient and family to comply with the recommended care. Comprehensive and collaborative midwifery management contributes to improving the condition of patients with active pulmonary tuberculosis accompanied by dyspnea and supports treatment success.

the OBSTETRIC CARE MANAGEMENT OF NEWBORNS WITH HYPOGLYCEMIA IN THE PICU NICU

2026-07-21T19:56:16+07:00

Background: Hypoglycemia in newborns is a metabolic emergency characterized by low blood glucose levels due to an imbalance between glucose production and utilization. This condition often occurs in neonates with risk factors such as babies born to mothers with diabetes mellitus, high birth weight, prematurity, or impaired metabolic adaptation after birth. Objectives: This study aims to provide an overview of the implementation of midwifery care for a 4-day-old infant with hypoglycemia in the PICU of Haji General Hospital, Medan, in 2025. Methods: The study used a case study with a midwifery care management approach based on Varney's 7 steps, which include data collection, problem identification, planning, implementation, and evaluation. Data were obtained through observation, physical examination, and measurement of the infant's blood glucose level. Results: The study showed that the infant experienced hypoglycemia with an initial glucose level of 33 mg/dL, accompanied by symptoms of weakness and a decreased sucking reflex. Management included administering a 10% glucose bolus, D10W infusion, keeping the infant warm, and gradually introducing breast milk. After intervention, the baby's condition improved, with glucose levels returning to normal (82 mg/dL), increased activity, and a good sucking reflex. Conclusions: This case demonstrates that prompt, appropriate, and continuous management of neonatal hypoglycemia can improve the baby's condition and prevent further complications. The role of healthcare workers, particularly midwives, is crucial in early detection and close monitoring of neonates at risk of hypoglycemia.

LITERATURE REVIEW ANALYSIS FACTORS RELATED TO MATERNAL PRIMIGRAVIDA ANXIETY BEFORE CHILDBIRTH

2026-07-31T17:10:46+07:00

Anxiety before childbirth is common among pregnant women, and tends to be more pronounced in primigravida mothers who have no prior delivery experience. This paper attempts to summarize the factors associated with such anxiety, based on 16 research articles published between 2020 and 2025 and obtained through Google Scholar. Several factors appear repeatedly across the articles reviewed, including maternal age, gravida status, husband support in its various forms (informational, appraisal, instrumental, emotional), family support, religiosity, maternal knowledge about childbirth, ANC visit compliance, and the effect of childbirth-related health education. Among these factors, husband support was mentioned most frequently and tended to show a consistent relationship with anxiety levels across studies. Several experimental studies also showed that health education interventions could meaningfully reduce anxiety scores. Overall, this review suggests that strengthening support from husbands and families, combined with adequate health education and ANC compliance, are important steps in helping primigravida mothers face childbirth with greater calm.

LITERATUR RIVIEW ANALYSIS OF FACTORS CONTRIBUTING TO PREECLAMPSIA IN PREGNANT WOMEN

2026-07-30T09:24:33+07:00

Preeclampsia remains one of the pregnancy complications that significantly contributes to increased maternal and fetal morbidity and mortality in various countries, including Indonesia. Numerous studies indicate that the occurrence of preeclampsia is not influenced by a single factor, but rather results from the interaction of multiple risk factors such as maternal age, parity, history of hypertension, nutritional status, obesity, and the quality of antenatal care services. This study aims to analyze the relationship between maternal age and parity with the incidence of preeclampsia based on a review of 16 national and international scientific articles published between 2007 and 2025. The method used is a literature review with a descriptive analytical approach, incorporating various research designs such as cross-sectional, case-control, retrospective descriptive, narrative review, and other literature-based studies. The findings show that most studies report a significant relationship between maternal age and preeclampsia, particularly among women aged <20 years and >35 years, who have a higher risk compared to those aged 20–35 years. Parity also demonstrates a meaningful association, where primiparous women are more frequently affected by preeclampsia than multiparous women, although some studies report inconsistent results. Overall, maternal age and parity are associated with the occurrence of preeclampsia; however, the condition is multifactorial in nature, requiring early detection and optimal pregnancy monitoring to prevent further complications.

Midwifery Care for a Third-Trimester Pregnant Woman with Moderate Anemia: A Case Study

2026-07-21T15:03:15+07:00

Anemia during pregnancy is one of the most common health problems, particularly in the third trimester, due to the increased iron requirements for fetal growth and maternal blood volume expansion. If left untreated, anemia may lead to various maternal and fetal complications. This article aims to describe midwifery care for a third-trimester pregnant woman with moderate anemia using Varney’s Midwifery Management approach. The method used was a case study of Mrs. A, a 28-year-old G2P1A0 woman at 32 weeks of gestation who presented with complaints of fatigue, dizziness, weakness, and palpitations. Physical examination revealed pale conjunctiva, and laboratory results showed a hemoglobin level of 9.8 g/dL, indicating moderate anemia. Midwifery care included health education regarding anemia, counseling on iron-rich foods, administration of iron (Fe) tablets, adequate rest, and regular antenatal monitoring. Evaluation after two weeks showed improvement in the mother's condition, reduced symptoms, and an increase in hemoglobin level to 10.8 g/dL. In conclusion, comprehensive midwifery care through education, nutritional improvement, and adherence to iron supplementation can effectively improve hemoglobin levels and help prevent maternal and fetal complications.

Midwifery Care Management for Pregnant Women with Emesis Gravidarum Case Study at Fatimah Ali Clinic in 2024

2026-07-21T16:45:50+07:00

Abstrac

Background: Emesis gravidarum is a common condition experienced by pregnant women, particularly during the first trimester, characterized by nausea and vomiting caused by hormonal changes such as increased levels of human chorionic gonadotropin (hCG), estrogen, and progesterone. Although considered physiological, persistent symptoms can negatively impact maternal health, including decreased nutritional intake, dehydration, fatigue, and limitations in daily activities. Therefore, comprehensive midwifery care is essential to prevent complications and improve maternal well-being.Objective: This case study aims to describe the implementation of comprehensive midwifery care in a pregnant woman with emesis gravidarum and to evaluate the outcomes of the interventions provided.Methods: This study used a case study approach involving a pregnant woman (Mrs. R, 26 years old, G2P1A0) at 8 weeks and 6 days of gestation who presented with complaints of frequent nausea and vomiting. Data were collected through interviews, physical examinations, and observation. Midwifery care was provided comprehensively, including assessment, education, nutritional counseling, and follow-up monitoring.Results: After the interventions were implemented, the patient showed improved understanding of her condition and adherence to recommendations. The frequency of nausea and vomiting decreased gradually, nutritional intake improved, and the patient was able to perform daily activities more comfortably. No complications such as severe dehydration were observed during follow-up.Conclusion: Comprehensive midwifery care is effective in managing emesis gravidarum during early pregnancy. Early assessment, appropriate education, nutritional support, and continuous monitoring can reduce symptoms, prevent complications, and improve maternal health outcomes.

Keywords: emesis gravidarum, midwifery care, pregnancy, nausea and vomiting, maternal health

Analysis of High-Risk Factors Among Referred Pregnant Women at Sultan Iskandar Hospital

2026-07-30T09:52:37+07:00

High-risk pregnancy is a condition that can increase the occurrence of complications in both the mother and the fetus, thus requiring appropriate management and referral. Factors such as maternal age, parity, obstetric history, and health conditions during pregnancy contribute to the increased risk of pregnancy complications. Obiective: This studv aims to analvze nigh-risk factors in pregnant women referred o RSUD Sultan Iskandar Muda, Kuala Subdistrict, Nagan Raya Regency, Acer Province in 2025Methods: This study used a quantitative method with a case-control analvtic design The study population consisted of al pregnant women referred to RSUD Sultan Iskandar Muda, with a sample of 72 respondents selected using purposive sampling technique. Data were obtained from nedical records and analyzed using the Chi-Square test with a significance level o 0.05 and Odds Ratio (OR) to determine the maanitude of risk

Results: The results showed that mos respondents were in the age group of <20 vears and >35 years (54.2%), primigravida and grandemultipara (55.6%), had a history o obstetric complications (55.6%), and had hemoalobin levels >11 a/di (73.6%). Bivariate analvsis showed a significant relation shir between maternal age and high-risk pregnancy (p=0.005; OR=4.600), parity p=0.009; OR=4.086), obstetric history (p=0.009), and hemoglobin levels (p=0.000; OR=3.118) with the occurrence of hiah-risk pregnancy in pregnant womenConclusion: Maternal age, parity, obstetric history, and hemoglobin levels are factors associated with high-risk pregnancy among women referred to RSUD Sultan Iskandar Muda, Kuala Subdistrict, Nagan Raya Regency, Aceh Province in 2025. Improving the quality of antenatal care (ANC) services and early detection of risk factors are essential to reduce maternal complications and mortality.

MANAGEMENT OF ACUTE GASTROENTERITIS WITH FLUID VOLUME DEFICIT IN ELDERLY

2026-07-21T17:22:34+07:00

Background: Acute gastroenteritis in elderly individuals poses a considerable obstacle in healthcare due to the rapid onset of fluid depletion and a heightened risk of severe dehydration resulting from diminished physical reserves. Objectives: This study aimed to explore the application of comprehensive midwifery care following Varney's seven-step management framework, focusing on the treatment of fluid loss in an elderly patient. Methods: A descriptive qualitative case study approach was employed at the Fitrah Ward of UPTD RSU Haji Medan from November 18 to 23, 2025. Primary data were collected through clinical assessments of a 75-year-old female patient (Ny. I) presenting with a fluid volume deficit, combined with secondary data from Integrated Progress Notes (CPPT). Results: Midwifery strategies prioritized continuous vital sign monitoring, fluid tracking, team-based intravenous rehydration, and family health education. Following these systematic interventions, the patient showed a significant decrease in diarrhea episodes, stabilization of vital signs (initial BP 90/70 mmHg), and notable improvement in clinical dehydration indicators such as skin elasticity and oral mucous membranes. Conclusions: he methodical application of Varney's management framework, coupled with interdisciplinary cooperation, demonstrates high effectiveness in managing acute fluid loss, preventing hypovolemic shock, and improving clinical outcomes for older adults affected by gastroenteritis.

COMMUNITY EMPOWERMENT THROUGH EDUCATION ON CLEAN AND HEALTHY LIVING TO IMPROVE PUBLIC HEALTH

2026-07-21T20:02:18+07:00

COMMUNITY EMPOWERMENT THROUGH EDUCATION ON CLEAN AND HEALTHY LIVING TO IMPROVE PUBLIC HEALTH

Kıki Rezeki Amelia', Meylissa², Tara Ramadhana³, Desi Handayani Lubis⁴, Dini Aminarti Lubis⁵

^1,2,3Prodi Pendidikan Profesi Bidan, Universitas Abulyatama, Indonesia

^4,5,Sekolah Tinggi Ilmu Kesehatan Flora, Medan, Indonesia

Email: kiki kebidanan@abulyatama.ac.id¹, meylissa fikes@abulyatama.ac.id², tararamadhana30gmail.com³, desihandayanilubis84@gmail.com⁴,aminartidini628@gmail.com⁵

ABSTRACT

Improving public health is a key effort in achieving a better quality of life. One strategy that can be implemented is the adoption of Clean and Healthy Living Practices (PHBS) at the household and educational institution levels. This initiative aims to enhance the public's knowledge, understanding, and awareness regarding the importance of implementing PHBS as a means to maintain and improve public health. The program was carried out through health education sessions, interactive lectures, practical simulations, interactive discussions, handwashing practice simulations for elementary school students, and environmental cleanup activities as a form of community empowerment. An evaluation was also conducted to assess improvements in knowledge. The results of the activity showed an increase in the knowledge of the community and students regarding PHBS, an improvement in students ability to practice proper handwashing, and increased community participation in maintaining environmental hygiene. Thus, PHBS-based health education, health promotion, and community empowerment activities can serve as an effective strategy to support the sustainable improvement of public health.

article ANALYSIS OF GERONTOLOGICAL NURSING CARE FOR ELDERLY PATIENTS WITH DEMENTIA AT THE BINJAI REGIONAL TECHNICAL IMPLEMENTATION UNIT (UPTD) FOR THE ELDERLY IN 2025

2026-07-23T09:56:12+07:00

Objective:The common problem that occurs in the elderly is dementia, which involves a decline in memory, thinking, behavior, and the ability to perform daily activities. This study aims to provide gerontic nursing care for Mrs. P with dementia at the Technical Implementation Unit (UPTD) for the Elderly in Binjai in 2025. Methods:The research method used a case study approach conducted over three days involving assessment, nursing diagnosis formulation, intervention planning, implementation, and evaluation. Results:The assessment results showed that Mrs. P (78 years old) experienced frequent forgetfulness, disorientation of time, and difficulty recognizing new people. Cognitive assessment using the MMSE scored 18 (moderate cognitive impairment) and the SPMSQ scored 4 (mild intellectual impairment). Based on these data, three nursing diagnoses were established: memory impairment, communication impairment, and acute confusion. Nursing interventions were implemented using memory training and brain gym therapy. The evaluation after three days of care indicated that all three nursing problems were partially resolved, characterized by the patient's ability to concentrate, perform some brain gym movements, and recall the nurse's name. Conclusion: Brain gym therapy can be utilized as an effective intervention to improve cognitive function in elderly patients with dementia.

(STUDENTS' KNOWLEDGE LEVEL OF BASIC LIFE SUPPORT (BLS) IN SCHOOLS KARTIKA 1-2 PRIVATE SENIOR HIGH SCHOOL MEDAN)

2026-07-20T12:16:18+07:00

ABSTRACT

Basic Life Support (BLS) is a crucial first aid measure in emergencies such as cardiac arrest and respiratory arrest. Lack of public knowledge, particularly among students, regarding basic life support (BLS) can result in delayed treatment, which can endanger the victim's safety. This study aims to determine the level of student knowledge about basic life support (BLS) at Kartika 1-2 Private High School in Medan in 2026. The research used a descriptive method with a univariate approach. The population was all 48 ninth-grade science students, using a total sampling technique. Data collection was conducted using a questionnaire containing 20 multiple-choice questions. Data were analyzed descriptively in the form of frequency distributions and percentages. The results of the study showed that of the 48 respondents, the majority (28 respondents) had a good level of knowledge, 58.3% (28 respondents), a fair level of knowledge (12 respondents) (25.0%), and a poor level (8 respondents) (16.7%). This indicates that the majority of students already have a good understanding of basic life support (BLS), although some still need to improve their knowledge. The conclusion of this study is that students' knowledge of basic life support (BLS) at Kartika 1-2 Private High School in Medan is considered good. It is recommended that educational institutions and healthcare professionals regularly improve basic life support (BLS) education and training to enhance student preparedness in emergency situations.

COMPREHENSIVE MIDWIFERY CARE FOR Mrs. D IN THE INDEPENDENT MIDWIFE PRACTICE OF HUTRI PRAWITA BANCIN AM.Keb PENANGGALAN DISTRICT SUBULUSSALAM CITY 2026

2026-06-23T23:27:17+07:00

Continuity of Care (CoC) is a comprehensive and continuous midwifery service provided to women during pregnancy, childbirth,postpartum, newborn care, and family planning. The purpose of this study was to provide comprehensive midwifery care to a pregnant woman from the third trimester through postpartum, newborn care, and family planning services using a continuity of careapproach. This study used a case study method conducted on one pregnant woman with a gestational age of weeks. Data were collected through interviews, physical examinations, observations, and documentation. The midwifery care was carried outaccording to the standards of midwifery practice and documented using the SOAP method. The results showed that the pregnancy progressed normally without complications. The labor process was spontaneous and normal, resulting in the birth of a healthy baby. The postpartum period and newborn care were conducted appropriately, and both mother and baby remained in good condition. Family planning counseling was also provided, and the mother chose a suitable contraceptive method according to her needs. Inconclusion, continuity of care midwifery services can help monitor maternal and neonatal health conditions comprehensively, detectcomplications early, and improve the quality of maternal and child health services.

COMPREHENSIVE MIDWIFERY CARE FOR MRS. R AT THE INDEPENDENT MIDWIFERY PRACTICE OF MIDWIFE IKA ASTUTI, AM,Keb SUBULUSSALAM CITY IN 2026

2026-07-31T10:58:42+07:00

Background: Maternal and infant mortality rates remain critical indicators of public health. Comprehensive midwifery care (Continuity of Care) is essential to reduce these rates through early detection of complications. Objectives: This study aimed to provide comprehensive midwifery care to Mrs. R from pregnancy, labor, postpartum, newborn, to family planning at Ika Astuti AM,Keb Independent Midwifery Practice, Subulussalam City in 2026. Methods: This research used aqualitative case study design with a Continuity of Care (CoC) approach. Data were gathered through interviews, physical examinations, observations, and documentation. Results: Mrs. R's pregnancy progressed normally with mild physiological complaints. Delivery occurred smoothly at 40 weeks of gestation without major complications. Postpartum care and newborn monitoring showed excellent health status, and the mother opted for progestin-only injection contraceptives. Conclusions: Comprehensive midwifery care provided to Mrs. R effectively maintained maternal and neonatal health, showing complete alignment between theory and standard clinical practices.

Article SERVICE EXCELLENCE NURSING CARE FOR MR. A WITH DENGUE HEMORRHAGIC FEVER AT RSU HAJI MEDAN

2026-07-23T09:34:34+07:00

Dengue Hemorrhagic Fever (DHF) is an infectious disease caused by the dengue virus and transmitted through the bite of Aedes aegypti mosquitoes. This disease remains a significant public health problem in Indonesia because it can lead to serious complications such as thrombocytopenia, hemorrhage, plasma leakage, and shock that may be life-threatening. Objective of this study is to describe the management of medical-surgical nursing care using a service excellence approach in patients with DBD at the Annisa Ward, Special UPTD RSU Haji Medan. Method employed in this study is a descriptive design with a case study approach through the nursing process stages, including assessment, diagnosis, planning, implementation, and evaluation based on data collected through interviews, observation, physical examination, and medical record documentation. Subject of this study was Mr. A, a 26-year-old male diagnosed with Dengue Fever who was treated in December 2024. Results of the assessment showed intermittent fever for five days, bone pain, headache, nausea, body temperature of 38°C, and platelet count of 64,000/mm³. Nursing diagnoses established were hyperthermia and acute pain. Nursing interventions included monitoring vital signs, managing hyperthermia and pain, monitoring fluid balance, providing health education, and collaborating in pharmacological therapy. Evaluation showed a decrease in fever and pain and improvement in the patient’s general condition. Conclusion implementation of medical-surgical nursing care with a service excellence approach in DBD patients proved effective in improving patient comfort, accelerating clinical recovery, and enhancing the quality of holistic, comprehensive, and patient-centered nursing care.

ANALYSIS OF RISK FACTORS ASSOCIATED WITH PREECLAMSIA AMONG PREGNANT WOMEN

2026-07-21T16:52:43+07:00

Background: Preeclampsia remains a major maternal health problem and is one of the leading causes of maternal and neonatal morbidity and mortality worldwide. Various maternal factors have been associated with the occurrence of preeclampsia, but the findings remain inconsistent across different studies.Objectives: This study aimed to analyze the maternal risk factors associated with preeclampsia among pregnant women.Methods: A Systematic Literature Review (SLR) was conducted using articles obtained from Google Scholar, PubMed, and ScienceDirect. Articles published between 2020 and 2025 were selected according to the PRISMA guidelines. A total of 20 articles met the inclusion criteria and were included in the review. Data were analyzed through qualitative synthesis.Results: The review identified several factors significantly associated with preeclampsia, including maternal age, obesity, history of hypertension, parity, inadequate antenatal care (ANC), maternal stress, chronic diseases, and gestational diabetes mellitus. Maternal age, obesity, and hypertension history were the most frequently reported risk factors across the included studies.Conclusions: Maternal age, obesity, hypertension history, parity, and inadequate ANC attendance are important determinants of preeclampsia. Strengthening early detection, maternal education, and antenatal care services is essential to reduce the incidence and complications of preeclampsia.

THE RELATIONSHIP BETWEEN KIE FAMILY PLANNING SERVICES TO INCREASE INTEREST IN BECOMING A FAMILY PLANNING ACCEPTOR IN THE WORKING AREA OF THE LAMPAHAN HEALTH CENTER, TIMANG GAJAH DISTRICT, BENER MERIAH REGENCY, ACEH PROVINCE

2026-07-31T16:10:33+07:00

Background The Total Fertility Rate (TFR) in 2010 increased from 2.43 people to 2.60 people. As many as 50.08% of women aged 15-49 years who are accepting birth control, 79.1% of deliveries are assisted by midwives and 92.42% of the child's weight is born alive, which is above 2.5 kg. The number of working population decreased from 7,037 people in 2019 to 6,950 people in 2020. Purpose of Research This research was conducted to determine the relationship between family planning service KIE and interest in becoming a family planning acceptor in the working area of the Lampahan Health Center, Timang Gajah District, Bener Meriah Regency, Aceh Province in 2023. Method This research method is observational/survey, namely data collected from respondents using questionnaires or questionnaires without intervening with the research subject. The type of research is descriptive analytical with cross-sectional, which is to connect risk factors with the effects of certain diseases or health statuses. Data analysis of the Majority of KIE Principles on Unclear Family Planning acceptors as many as 20 people (65%) and clear minority as many as 11 people (35%). There is a relationship between KIE and the increase in interest of family planning acceptors seen from the age of the Lampahan Health Center, Timang Gajah District, Bener Meriah Regency, Aceh Province in 2023 where the p-value is 0.035 for communication, 0.035 for information and 0.012 for education (p<0.05).

Artikel TRANSFORMING STEMI NURSING CARE THROUH SERVICE EXCELLENT FOR SUSTAINABLE HEALTCARE

2026-07-18T17:08:02+07:00

Background: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide. Patients with ST-Elevation Myocardial Infarction (STEMI) often experience severe chest pain, dyspnea, hemodynamic instability, and impaired tissue perfusion, which may result in serious complications if not managed promptly. Integrating service excellence into nursing care may improve patient outcomes and healthcare quality while supporting Sustainable Development Goal (SDG) 3. Objectives: This study aimed to describe the implementation of service excellence-based emergency nursing care for a patient with STEMI in the Cardiovascular Care Unit (CVCU) of H. Adam Malik General Hospital Medan. Methods: A descriptive case study was conducted involving a 42-year-old male patient diagnosed with STEMI. Data were collected through interviews, physical examinations, direct observations, medical record reviews, and diagnostic investigations. Nursing care was provided based on the Indonesian Nursing Diagnosis Standards (SDKI), Nursing Intervention Standards (SIKI), and Nursing Outcomes Standards (SLKI). Results: The assessment identified decreased cardiac output, acute pain, and impaired gas exchange as the primary nursing problems. Nursing interventions were implemented for three days through hemodynamic monitoring, oxygen therapy, pain management, health education, and collaborative care integrated with service excellence principles. The patient demonstrated clinical improvement, including reduced chest pain, decreased dyspnea, improved oxygenation, and enhanced comfort. Conclusions: Service excellence-based emergency nursing care contributed positively to the patient's clinical recovery and well-being. This approach may improve the quality of emergency nursing services and support sustainable healthcare outcomes.

MIDWIFERY CARE MANAGEMENT FOR AN 18-YEAR-OLD Ms. A WITH A SECOND-DEGREE PERINEAL TEARAT PMB MAIDAWATI

2026-07-18T11:01:57+07:00

Background: This critical medical emergency directly hinders the target of the United Nations' Sustainable Development Goals (SDGs), specifically Goal 3.1, which demands a drastic reduction in the global maternal mortality ratio to less than 70 per 100,000 live births. Second-degree perineal tear is one of the most common complications of vaginal delivery, especially in young primigravida. This condition is characterized by tears involving the vaginal mucosa, perineal skin, and perineal muscles without affecting the anal sphincter, thus risking postpartum hemorrhage, infection, and decreased quality of life of the mother. Objective: This case report aims to describe comprehensive midwifery care management using Varney's seven steps and SOAP documentation in Mrs. A, an 18-year-old primigravida who experienced a second-degree perineal tear at PMB Maidawati in 2025. Method: A descriptive case study was used with an obstetric management approach. The assessment was carried out through anamnesis, physical examination, and perineal examination. The results of the assessment showed that Mrs. A, an 18-year-old primigravida (G1P0A0), gave birth to a baby with a birth weight of 3,100 grams spontaneously pervaginally and was found to have a second-degree perineal tear. Management included aseptic wound suturing under local anesthesia, vital sign observation, bleeding monitoring, education on perineal wound care, vulvar hygiene, high-protein nutrition, early mobilization, and postpartum danger sign counseling. Results: The mother's condition improved, the perineal wound was healing well, and there were no signs of infection. Comprehensive, prompt, and targeted midwifery care has been shown to prevent further complications in cases of second-degree perineal tears.

MIDWIFERY CARE MANAGEMEN OF PULMONARY TUBERKULOSIS PATIENT AT RSU HAJI MEDAN 2025

2026-07-20T12:04:41+07:00

Background: Pulmonary tuberculosis remains a major public health problem, particularly among elderly individuals who are more vulnerable due to decreased immune function and the presence of chronic health conditions. Comprehensive healthcare management is essential to improve treatment adherence and support patient recovery. Objectives: This study aimed to describe the implementation of comprehensive midwifery care for a 61-year-old male patient with pulmonary tuberculosis in the Ar-Rijal Ward at Haji General Hospital Medan, North Sumatra Province. Methods: This study employed a descriptive case study design. Data were collected through interviews, physical examinations, direct observations, and medical record reviews. The care process included assessment, planning, implementation, and evaluation of comprehensive midwifery interventions. Results: The patient presented with a prolonged productive cough, weight loss, fatigue, night sweats, decreased appetite, and mild shortness of breath. Diagnostic examinations confirmed pulmonary tuberculosis. Comprehensive midwifery care focused on monitoring the patient’s condition, providing health education, supporting nutritional needs, encouraging medication adherence, and promoting infection prevention measures. Following the implementation of care, the patient demonstrated improved understanding of the disease and greater commitment to completing treatment. Conclusions: Comprehensive midwifery care contributes to improving patient knowledge, treatment adherence, and overall health outcomes in elderly patients with pulmonary tuberculosis. Continuous monitoring and family involvement are important factors in supporting successful recovery and long-term treatment compliance.

Ray Rezeki NURSING CARE MANAGEMENT EXCELLENT SERVICE IN PATIENTS WITH CONGESTIVE HEART FAILURE (CHF) IN VIP WARD OF LATERSIA BINJAI HOSPITAL IN 2025

2026-08-05T10:14:39+07:00

Congestive Heart Failure (CHF) is a clinical syndrome characterized by the inability of the heart to pump blood effectively to meet the body's metabolic needs. Patients with CHF frequently experience shortness of breath, fatigue, edema, and decreased activity tolerance. Objective: To describe nursing care management in patients with CHF. Methods: This study used a descriptive case study design conducted in the VIP ward of Latersia Binjai Hospital. Data were obtained through interviews, physical examination, observation, and documentation studies. Results: The patient complained of shortness of breath during activity, weakness, edema in both lower extremities, and difficulty performing daily activities. The priority nursing diagnosis was decreased cardiac output related to altered cardiac rhythm. Nursing interventions included monitoring vital signs, assessing cardiac status, monitoring oxygen saturation, administering oxygen therapy, positioning in semi-Fowler position, and educating the patient regarding activity management. After 3 × 24 hours of nursing care, dyspnea decreased, oxygen saturation improved, and the patient appeared more comfortable. Conclusion: Nursing care management contributed to improving patient condition and reducing symptoms associated with CHF.

MIDWIFERY CARE FOR FIRST TRIMESTER PREGNANT WOMEN WITH PAINFUL EATING DUE TO GASTRIC ACID

2026-06-24T10:54:04+07:00

Background: Gastroesophageal reflux disease (GERD) and acute gastritis affect up to 80% of pregnancies, predominantly escalating during the first trimester due to profound endocrine shifts. If left unmanaged, severe dietary intolerance leads to maternal malnutrition, dehydration, and fetal growth restriction (FGR). Objective: This study aims to criticaly analyze evidence-based midwifery clinical management for a first-trimester primigravida presenting with severe odynophagia and rice-induced dyspepsia driven by gestational acid dysregulation. Methods: A comprehensive, single-case clinical study was conducted utilizing the synchronized 7-step Helen Varney framework integrated with Basic Midwifery Sciences (Genetics, Microbiology, Biophysics, and Pharmacology). Results: Advanced pathophysiological profiling revealed that progesterone-induced lower esophageal sphincter (LES) hypotonia combined with mechanical intragastric pressure shifts precipitated severe mucosal irritation. Microbiological screening ruled out Helicobacter pylori exacerbations. Implementation of micro-portion texturized dietary substitution (replacing solid rice with thermal-stabilized soft porridge), postural anti-reflux dynamics, and cautious, calibrated administration of non-systemic antacids synchronized with Vitamin B6 successfully eradicated epigastric burning and restored optimal nutritional kinetics. Conclusion: Synergistic midwifery models combining biomolecular clinical awareness with customized non-pharmacological dietary physics demonstrate high efficacy in preventing gestational cachexia and ensuring excellent maternal-fetal outcomes.

MIDWIFERY CARE MANAGEMENT FOR A TWO-YEAR-OLD CHILD WITH TUBERCULOUS MENINGITIS

2026-07-21T09:32:39+07:00

Background: Tuberculous meningitis is a severe form of extrapulmonary tuberculosis that commonly affects children under five years of age and may lead to serious neurological complications, disability, or death if not managed appropriately.
Objective: This study aimed to describe the implementation of midwifery care management for a two-year-old child diagnosed with tuberculous meningitis in the Pediatric Intensive Care Unit (PICU) of Haji General Hospital Medan, North Sumatra Province, in 2025. Methods: A case study design was employed using Varney’s seven-step midwifery management framework, including data collection, data interpretation, identification of actual and potential problems, immediate interventions, care planning, implementation, and evaluation. Data were obtained through observation, physical examination, medical records, and collaboration with the healthcare team. Results: Assessment findings showed decreased consciousness, respiratory distress, a history of seizures, muscle rigidity, and dependence on mechanical ventilation. Midwifery interventions focused on neurological and respiratory monitoring, airway maintenance, ventilatory support, vital sign assessment, fluid balance monitoring, and multidisciplinary collaboration. Evaluation indicated stable oxygen saturation, maintained airway patency, absence of recurrent seizures, and improvement in the patient’s overall clinical condition. Conclusion: Comprehensive, systematic, and collaborative midwifery care contributed to patient stabilization, prevention of complications, and improvement of clinical outcomes in a child with tuberculous meningitis treated in the PICU.

MIKROMELIA IN NEWBORNS: MIDWIFERY MANAGEMENT AND CLINICAL IMPLICATIONS

2026-07-18T18:13:47+07:00

Background: Micromelia is a rare congenital skeletal dysplasia characterized by generalized shortening of the upper and lower extremities due to impaired endochondral ossification during fetal development. Early detection and appropriate management are essential to reduce complications and improve neonatal outcomes. Objectives: This study aimed to describe the concept of micromelia and analyze the implementation of midwifery care management in infants diagnosed with this congenital anomaly. Methods: This study employed a descriptive case study approach based on literature review and application of Varney’s seven-step midwifery management process. Data were collected through assessment, physical examination, identification of problems and needs, planning, implementation, and evaluation of care in an infant with micromelia. Results: The case assessment revealed generalized shortening of the upper and lower extremities, mild respiratory distress, weak sucking reflex, and risk of growth and developmental problems. Midwifery management included monitoring vital signs, maintaining body temperature, supporting breastfeeding, observing respiratory function, providing parental education, and collaborating with pediatric specialists for further evaluation and referral. The infant's condition remained stable, and the family demonstrated improved understanding of the condition and agreed to the referral plan. Conclusions: Comprehensive and evidence-based midwifery care plays an important role in the early detection, monitoring, referral, and family support of infants with micromelia. Multidisciplinary collaboration is essential to optimize clinical outcomes and improve the quality of life of affected infants.

EFFECTIVENESS OF COMPLEMENTARY THERAPIES ON PHYSICAL PSYCHOLOGICAL HEALTH IN PREGNANCY:LITERATURE REVIEW

2026-08-06T10:14:44+07:00

Pregnancy is a normal physiological process characterized by significant physical, hormonal, and psychological changes that may affect maternal comfort and overall well-being. During pregnancy, women commonly experience nausea and vomiting, low back pain, sleep disturbances, fatigue, stress, and anxiety. If not properly managed, these conditions may reduce quality of life and potentially impact pregnancy outcomes. In response to the need for holistic maternity care, complementary therapy has emerged as an important non-pharmacological approach to support maternal health. These interventions are generally considered safe, cost-effective, and easy to apply, with the potential to reduce reliance on pharmacological treatments during pregnancy.This literature review aimed to synthesize recent evidence on the effectiveness of complementary therapies in improving physical and psychological health outcomes among pregnant women. A systematic search was conducted in PubMed, ScienceDirect, Google Scholar, and other scientific databases for studies published between 2021 and 2025. Keywords included complementary therapy, pregnancy, prenatal yoga, aromatherapy, acupressure, maternal anxiety, low back pain, and emesis gravidarum. After applying inclusion and exclusion criteria, 20 articles were selected for analysis, consisting of randomized controlled trials, quasi-experimental studies, systematic reviews, and meta-analyses.The results show that complementary therapies provide consistent positive effects on maternal health outcomes. Prenatal yoga was frequently reported to reduce anxiety, stress, and depressive symptoms while improving relaxation, emotional stability, and sleep quality. Aromatherapy using essential oils such as lavender, peppermint, ginger, and lemon was effective in reducing nausea, vomiting, sleep disturbances, and anxiety. Acupressure also demonstrated benefits in reducing low back pain and decreasing the severity of emesis gravidarum through stimulation of specific pressure points that promote physiological relaxation. Overall, these interventions were described as safe, practical, and feasible for integration into routine antenatal care services.In conclusion, complementary therapies such as prenatal yoga, aromatherapy, and acupressure are effective in improving both physical and psychological health among pregnant women. Integrating evidence-based complementary approaches into antenatal care can provide a more holistic, patient-centered model of maternity care. This integration enhances symptom management, supports maternal well-being, and contributes to a more positive pregnancy experience.

MIDWIFERY MANAGEMENT OF A 45-YEAR-OLD WOMAN WITH UTERINE MYOMA: A CASE STUDY

2026-07-21T18:29:40+07:00

Uterine myoma is a benign tumor of the female reproductive system that may cause abnormal uterine bleeding and severe anemia. Persistent blood loss can result in hemodynamic instability and decreased quality of life. Objective: To describe the implementation of Helen Varney’s midwifery management in a patient with myoma-induced severe anemia at RSU Haji Medan. Methods: This study employed a descriptive case study design involving a 45-year-old woman diagnosed with uterine myoma complicated by severe anemia. Data were collected through anamnesis, physical examination, observation, laboratory investigations, and documentation review using Helen Varney’s seven-step management approach. Results: The patient presented with prolonged vaginal bleeding for one week, lower abdominal pain, weakness, nausea, and pallor. Physical examination revealed blood pressure of 91/62 mmHg, pulse rate of 105 beats/minute, respiratory rate of 24 breaths/minute, pain scale of 7/10, and hemoglobin level of 5.4 g/dL indicating severe anemia. Midwifery management included monitoring vital signs and bleeding, pain assessment, nutritional counseling, psychological support, patient education, and collaboration with obstetricians regarding blood transfusion and definitive treatment. Conclusion: Helen Varney’s midwifery management facilitated comprehensive assessment, early detection of complications, and collaborative interventions, contributing to stabilization of the patient's condition and prevention of further complication (Sarumpaet et al., 2025)

IMPLEMENTATION OF ELDERLY NON-COMMUNICABLE DISEASE (NCDs) SCREENING AT GPP GLORIA SEMPURNA CHURCH

2026-07-28T09:39:33+07:00

Background: Hypertension (HTN), defined as a systolic blood pressure (SBP) >140 mmHg or a diastolic blood pressure (DBP) >90 mmHg, is a major health problem that is increasing worlwide (Sembiring et al., 2024). As older adults age, their physiological function declines, which increases the risk of non-communicable diseases (NCDs) such as hypertension, diabetes mellitus, arthtritis and cardiovascular disease (Wikandari, Rosidah dan Auliya, 2025). Objective: This community service activity aims to detect and educate the elderly about non communicable diseases through health checks at the GPP Gloria Sempurna church, Jl. Sempurna Ujung No. 229 Medan, North Sumatera in 2026. Method: The activity was carried out on may 10 2026, The methods used included health checks, including the recording of personal data, blood pressure measurements, simple laboratory tests, and education. The laboratory tests included measuring blood glucose, cholesterol, and uric acid levels using the EasyTouch GCU 3-in-1 device. Education regarding non-communicable diseases was provided through outreach activities (Hikmatul Khoriyah, 2024). Results: Advancing age is one of the major risk factors for hypertension. Age related vascular changes increase blood pressure over time, making older adults more susceptible to hypertension and its associated complications (Sinaga, 2025).Approximately 45% of elderly people have high cholesterol, 50% have hypertension, and 5% have gout. Conclusion: It is hoped that the elderly can adopt a healthy lifestyle and understand the importance of information about NCDs (Non Communicable Diseases) for their health.

midwifery care management for mrs j with breast canser (ca mamae)at rsu haji medan ,north sumatra utara province in 2025

2026-06-24T16:12:19+07:00

Background: Breast cancer (Ca mammae) is a malignant condition characterized by uncontrolled and abnormal cell growth, leading to the formation of a mass in breast tissue that can spread to other parts of the body. Breast cancer remains one of the most common cancers globally, with more than 2.29 million new cases in 2022. In Indonesia, the incidence continues to increase, with approximately 65,000 new cases annually. In North Sumatra, breast cancer is also a major health problem, with 393 cases reported in 2022. Objective: This case study aims to analyze the management of midwifery care for Mrs. J with breast cancer (Ca mammae) at RSU Haji Medan, North Sumatra Province, in 2025. Methods: This study used a descriptive case study approach involving one patient diagnosed with Ca mammae. Data were collected through interviews, observation, physical examination, and medical record documentation. The data were analyzed by reviewing the patient’s condition, history, and clinical findings, and then compared with relevant midwifery care theories and standards, using the 7-step management of Helen Varney. Results: The study showed that midwifery care management was carried out through comprehensive assessment, identification of patient problems, determination of potential risks, immediate action planning, implementation of care, and continuous evaluation. Collaborative management with other health professionals was also performed to ensure optimal patient care. Conclusion: Midwifery care management for patients with Ca mammae must be conducted comprehensively, systematically, and collaboratively to improve patient outcomes and prevent further complications.

Analysis Of The Application Of Continuity Of Care To The Competence Of Midwifery Students.

2026-08-03T15:10:18+07:00

Background: Many problems still exist in maternal and child health services. The problem of low public knowledge and the improvement of students' ability in midwifery practice are the most prominent. A solution to improve the quality of service can be in the form of a continuous care approach (COC). It can also be used to teach student clinics.

Objective: Evaluate the implementation of COC in 2026 to improve the ability of midwifery practice and community knowledge of Bangun Rejo students.

Methods: This study used a cross-sectional approach as an analytical descriptive design. With a total sampling technique, the study population consisted of pregnant women (±30 people), postpartum mothers (±20 people), families of toddlers (±35 families), and health workers (±10 people). Research tools include competency checklists, observation sheets, and knowledge questionnaires (pretest-posttest). The data was tested with paired t-test and chi-square test.

Results: This study found a significant relationship between the implementation of COC and student competence (p = 0.002) and the improvement of community knowledge (p = 0.05). In addition, the implementation of COC in the good category was 65% and student competence was 68%.

Conclusion: The implementation of Continuity of Care successfully improved students' obstetric skills and their community knowledge.

Keywords: Student Ability, Midwifery Practice, and Health Education

PSYCHOSOCIAL FACTORS ASSOCIATED WITH MENTAL HEALTH ISSUES AMONG ADOLESCENTS: LITERATURE REVIEW

2026-06-24T17:23:51+07:00

Background: Adolescent mental health has become a critical global and local concern, yet it is frequently overlooked in routine community health interventions. Psychosocial development during this transition period significantly determines future productivity and quality of life. Objectives: This study aimed to review and analyze the psychosocial determinants and peer-led educational strategies associated with adolescent mental health status. Methods: This study utilized a Systematic Literature Review (SLR) design across Google Scholar, ScienceDirect, and PubMed databases, analyzing publications (2022–2026) focusing on community health education, peer counseling, and psychosocial behaviors. Out of 26 potential articles identified, 10 met the inclusion criteria and were selected for data extraction and thematic synthesis, Results: The synthesis shows that parental socioeconomic background, family support systems, and peer-to-peer interactive environments are primary drivers of adolescent psychological well-being. Peer-education frameworks demonstrate a high effectiveness level, improving self-efficacy and psychological awareness among youth by up to 3.5 times compared to generic approaches. Furthermore, structured counseling integrated within academic frameworks significantly cushions the negative impacts of social anxiety and nutritional-related stigma. Conclusions: Strengthening multi-sectoral adolescent care through peer education and family-centered psychological innovation is highly recommended to enhance mental resilience.

COMMUNITY MIDWIFERY CARE FOR MRS. H WITH LOW INTEREST IN UTILIZING LONG-ACTING REVERSIBLE CONTRACEPTION (LARC) IN BANGUN REJO VILLAGE, TANJUNG MORAWA DISTRICT, DELI SERDANG REGENCY IN 2026

2026-07-21T19:40:27+07:00

Background: Uncontrolled population growth significantly affects the quality of life and public health. Long-Acting Reversible Contraception (LARC) such as IUDs and implants are more effective and efficient in suppressing discontinuation rates than short-term methods. However, the coverage of LARC acceptors at the community level remains low due to psychological barriers, fear of side effects, and misconceptions. Objectives: This study aimed to implement community midwifery care for Mrs. H presenting with low interest in LARC utilization in Bangun Rejo Village, Tanjung Morawa District, Deli Serdang Regency in 2026. Methods: Data collection was conducted through interviews, observations, and documentation during the home-visit period from February 9 to May 2, 2026, integrating Varney's 7-step management and SOAP documentation. Results: Assessment revealed that Mrs. H (31 years old, P3A0) desired to space pregnancies but relied on natural family planning due to severe anxiety, believing LARC placement required major surgery, alongside myths regarding significant weight gain and internal organ disruption. Interventions based on the PACER value framework were implemented, focusing on Professionalism, Empathy, and Collaboration. High-quality Communication, Information, and Education (CIE) via Decision-Making Tools (ABPK) and LARC models were utilized. Post-intervention evaluation showed increased knowledge, fully reduced anxiety, and a highly positive attitude modification. Mrs. H expressed strong intent to switch to an implant after obtaining full support and informed consent from her husband (Mr. J). Conclusions: Midwifery community care incorporating empathetic and professional counseling effectively mitigates psychological barriers and optimizes LARC uptake.

MIDWIFERY CARE MANAGEMENT FOR MRS. H G2P0A1 AT 11 WEEKS OF PREGNANCY WITH HIPERMESIS GRAVIDARUM LEVEL II AT SAM CLINIC IN 2025

2026-08-05T10:43:23+07:00

Background: Hyperemesis gravidarum (HG) is a complication of excessive nausea and vomiting in early pregnancy that can lead to dehydration, weight loss, and even threaten the safety of both mother and fetus. In North Sumatra Province, particularly in Medan city, the maternal mortality rate (MMR) is still a major health challenge and remains above the national target as well as the Sustainable Development Goals (SDGs) 2030. Objectives: To carry out structured and evidence-based midwifery care management for Mrs. H with Level II hyperemesis gravidarum at SAM Primary Clinic in 2025. Methods: This care uses a descriptive case study design by applying Helen Varney's 7-step midwifery management framework. Conclusions: Initial assessment showed Mrs. H experienced severe nausea and vomiting (5-7 times per day) for 10 days, which impacted her tolerance for nutritional intake. Interventions were carried out collaboratively, including intravenous rehydration with Ringer's lactate fluid, administration of antiemetics, nutrition counseling, and therapy Ginger. After 48 hours of intervention, the clinical evaluation showed significant improvement with the frequency of nausea and vomiting reduced to 2-3 times per day.

MIDWIFERY CARE MANAGEMENT FOR MRS.U A CASE OF HYPEREMESIS GRAVIDARUM,HALL VII,BANGUN REJO VILLAGE,DISTRICT TANJUNG MORAWA,DELI SERDANG REGENCY YEAR 2026

2026-08-03T08:59:01+07:00

Background: Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy that can significantly affect maternal and fetal health. It often leads to dehydration, weight loss, and electrolyte imbalances in pregnant women, especially in the first trimester. Managing HG effectively remains a challenge in community midwifery care due to limited resources and awareness. Objectives: To deliver professional and innovative comprehensive midwifery care to pregnant women with hyperemesis gravidarum during the first trimester, to improve maternal and fetal health outcomes.Methods: A case study approach was employed involving Mrs. Uci Lestari, a 32-year-old pregnant woman diagnosed with grade I hyperemesis gravidarum at 8 weeks gestation. The study utilized comprehensive data collection through anamnesis, physical examination, and supportive assessments. Care management was conducted following Varney’s midwifery care steps: assessment, diagnosis, immediate action, planning, implementation, and evaluation. Collaboration with healthcare professionals and family involvement were integral components of care. Results: Following eight days of midwifery care and family support, Mrs. Uci showed significant clinical improvement. Nausea and vomiting frequency decreased from more than ten times daily to 1–2 times per day, appetite and general condition improved, and signs of dehydration resolved. Both the patient and her family gained understanding and confidence in managing HG at home, including awareness of danger signs requiring medical attention. Conclusions: Comprehensive family-based midwifery care incorporating psychological support, education, and evidence-based management can effectively alleviate symptoms of hyperemesis gravidarum and improve maternal well-being during the first trimester. This case underscores the importance of integrated community midwifery interventions and family engagement to support high-risk pregnancies.

A CILOK AND EAR MUSHROOM-BASED FOOD INTERVENTION FOR THE PREVENTION OF ANEMIA AMONG JUNIOR HIGH SCHOOL STUDENTS

2026-07-02T14:49:18+07:00

Background : Anemia remains a highly prevalent health problem among Indonesian adolescents, primarily due to low iron intake, imbalanced dietary patterns, and non-compliance with iron supplementation. Objectives : This study aimed to evaluate the effectiveness of a wood ear mushroom-based cilok food intervention in improving adolescents’ knowledge regarding anemia prevention at SMP Negeri 43 Batam. Methods : A community nursing approach was employed, with data collected through interviews, observations, and questionnaires involving 26 seventh-grade students aged 13–15 years. The intervention was conducted on February 5, 2026, through health education sessions and a demonstration of the cilok innovation, with pre-test and post-test assessments to measure knowledge improvement. Results : Results showed that the average pre-test score of 75.15 increased to 91.77 post-intervention, representing an improvement of 16.62 points (25.09%). Nearly all participants demonstrated increased scores, particularly those with initially low to moderate levels of knowledge. Conclusion : It is concluded that the wood ear mushroom cilok-based health education intervention effectively improved adolescents’ knowledge and interest in anemia prevention and holds potential as a sustainable health promotion strategy within school settings.

MIDWIFERY CARE MANAGEMENT OF MRS. S, G2P1A0, BREECH PRESENTATION, 38 WEEKS 5 DAY

2026-06-24T23:05:26+07:00

Background: Breech presentation where the fetal buttocks or lower extremities present to the birth canal occurs in approximately 3-4% of term pregnancies and is associated with increased maternal and neonatal morbidity and mortality. Pregnancy and childbirth complications remain leading causes of maternal and perinatal death, with a disproportionate burden in developing countries; Indonesia’s MMR was 189 per 100,000 live births . Objective: To describe the role of comprehensive midwifery care management in improving maternal and neonatal safety during breech deliveries. Methods: Case report and practice review of a care model involving continuous monitoring of maternal and fetal conditions and interventions aligned with professional midwifery standards throughout labor and postpartum observation. Results: Implementation of comprehensive, continuous midwifery management enabled a physiological vaginal birth in breech presentation with favorable maternal and neonatal outcomes and no complications during labor or postpartum observation. Conclusion: Comprehensive, continuous midwifery care delivered according to professional standards substantially contributes to maternal and neonatal safety in breech deliveries and supports progress toward SDG target 3 by improving the quality of maternal and neonatal health services.

COMHHPREHENSIVE MIDWIFERY CARE FOR MRS. N AT INDEPENDENT MIDWIFERY PRACTICE (BPM) HUTRI PRAWITA SUBULUSSALAM CITY

2026-08-08T09:59:40+07:00

Background: Pregnancy, labor, postpartum, and newborn periods are continuous physiological processes, yet they still carry risks of life-threatening complications for both mother and baby. Based on data from the Subulussalam City Health Office in 2025, maternal death cases and 25 infant death cases were recorded. The Continuity of Care (CoC) approach is an effective strategy for early detection of high-risk factors and reducing Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR).Objective: To provide comprehensive and continuous midwifery care (Continuity of Care) to Mrs. N starting from the third trimester of pregnancy, labor, postpartum period, newborn, up to family planning (KB) services using a SOAP-based midwifery management documentation approach.Method: This study uses a descriptive qualitative method with a comprehensive case study approach. The subject of the study was Mrs. N, 26 years old, G3P2A0. Primary data collection was conducted through direct observation, interviews, and physical examination (head-to-toe and Leopold's palpation). Secondary data were obtained from the Maternal and Child Health (KIA) handbook, ultrasound (USG) results, and the PMB register. Care was implemented at PMB Hutri Prawita Bancin, AM.Keb from March to July 2026.Results: Antenatal care (ANC) was provided across 2 visits at 30 weeks 2 days and 38 weeks of gestation, showing that the maternal and fetal conditions were within normal limits. On May 26, 2026, at 05:00 AM WIB, the mother entered the active phase of the first stage of labor (INC). The entire process from pregnancy to labor was well-documented.Conclusion: The implementation of comprehensive midwifery care for Mrs. N proceeded according to midwifery service standards, and no complications or pathological difficulties were found in either the mother or the fetus.

FAMILY-CENTERED COMMUNITY MIDWIFERY CARE FOR MANAGING SIBLING RIVALRY IN A PRESCHOOL CHILD: A CASE STUDY IN INDONESIA

2026-07-20T14:20:41+07:00

Background:Sibling rivalry is a common psychosocial problem among preschool children, particularly after the birth of a younger sibling. The condition may result in jealousy, emotional distress, aggressive behavior, and difficulties in family adaptation if not appropriately managed. Family-centered community midwifery care plays an important role in supporting parents and promoting healthy psychosocial development in children.Objective:To describe the implementation of family-centered community midwifery care in managing sibling rivalry among a preschool child following the birth of a younger sibling.Methods: A descriptive case study was conducted in Bangun Rejo Village, Tanjung Morawa District, Deli Serdang Regency, Indonesia, from February to May 2026. The subject was a family with two children, including a five-year-old child who demonstrated signs of sibling rivalry after the birth of a five-month-old sibling. Data were collected through interviews, direct observation, family assessment, home visits, and SOAP documentation. Interventions included parental education regarding sibling rivalry, positive parenting counseling, emotional validation techniques, quality-time activities, and involving the older child in infant care.Results: Before the intervention, the child exhibited jealousy, frequent crying, anger, dependency, and attention-seeking behaviors. Following three home visits and family-centered interventions, notable improvements were observed. The child showed reduced jealousy, improved emotional regulation, increased participation in infant care, and more positive interactions with the younger sibling. Parents also reported increased confidence in managing sibling relationshipsand supporting the emotional needs of both children.Conclusion: Family-centered community midwifery care was effective in reducing sibling rivalry behaviors and promoting healthy psychosocial adaptation among family members. Continuous parental support, education, and active involvement of the older child in family activities are important strategies for preventing and managing sibling rivalry in preschool children.

DETERMINAN OF EARLY MOBILIZATION AMON POSTCAESAREA MOTHERS IN KUTACANE HOSPITAL IN 2025

2026-07-18T16:56:33+07:00

Background: The increasing trend of childbirth via Sectio Caesarea (SC) demands optimal postoperative care. Early mobilization is critical to speed up healing and prevent complications, but post-SC mothers often experience anxiety and severe pain that limits their movement. Objectives: This study aims to determine the factors influencing maternal anxiety in performing early mobilization among post-Sectio Caesarea mothers at RSUD H. Sahudin Kutacane, Aceh Tenggara. Methods: This quantitative research utilized a cross-sectional approach. The population comprised 118 post-SC mothers, from which a sample of 52 respondents was selected using purposive sampling. Data collection was carried out through structured questionnaires, the Numeric Rating Scale (NRS) for pain levels, and the Visual Analog Scale for Anxiety (VAS-A). Data analysis was performed using the Chi-Square statistical test. Results: The findings indicated that 38.5% of the respondents experienced moderate anxiety, and 57.6% suffered from moderate postoperative pain. Bivariate analysis revealed a significant relationship between family support and maternal anxiety in conducting early mobilization ($p = 0.02$). Furthermore, a significant correlation was found between labor pain intensity and maternal anxiety ($p = 0.02$). Conclusions: Family support and the level of labor pain are vital factors significantly influencing maternal anxiety during early mobilization post-SC. Healthcare professionals are advised to provide continuous monitoring and emotional reassurance to reduce anxiety and enhance early recovery.

LITERATURE REVIEW: NUTRITIONAL STATUS OF PREGNANT WOMEN WITH LOW BIRTH WEIGHT (LBW)

2026-07-30T10:39:16+07:00

Background: Pregnancy is a critical period requiring optimal nutrition to support maternal health and fetal development. In Indonesia, Chronic Energy Deficiency (CED) remains a significant public health issue, with prevalence ranging from 13.6% to 35.9%, identified by an Upper Arm Circumference (UAC) below 23.5 cm. Poor nutritional status during this stage can lead to various adverse outcomes affecting both mother and child. Objective This study aims to examine the relationship between maternal nutritional status and the occurrence of Low Birth Weight (LBW) and stunting, as well as to identify the main factors that influence nutritional status throughout pregnancy. Methods A descriptive‑analytical literature review was conducted using secondary data sourced from scientific journals published between 2013 and 2019. Relevant information was collected, analyzed, and synthesized to draw consistent conclusions. Result The findings show that pregnant women with CED have a risk 2.2 to 4.15 times higher of giving birth to infants with LBW and children who experience stunting compared to mothers with normal nutritional status. Nutritional status is strongly influenced by maternal knowledge, attitude, and socioeconomic conditions, while factors such as education level and parity do not always demonstrate a direct effect. Furthermore, health education proves effective in improving understanding and preventing nutritional deficiencies. Conclusion Maternal nutritional status is a key determinant of successful pregnancy and long‑term child growth. Regular monitoring and early intervention are therefore necessary to improve maternal health and break the intergenerational cycle of malnutrition.

MIDWIFERY CARE MANAGEMENT FOR 30-YEAR-OLD MISS M WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) AT HAJI HOSPITAL MEDAN IN 2024

2026-07-20T15:36:36+07:00

Background: Human Immunodeficiency Virus (HIV) remains a major global health problem due to its impact on the immune system and quality of life of affected individuals. Women of reproductive age living with HIV require comprehensive health services, including midwifery care, to prevent complications and improve their quality of life. Objectives: This study aimed to describe the implementation of midwifery care management for a 30-year-old woman diagnosed with HIV at Jabal Rahmah Ward, Haji Medan Hospital. Methods: This study used a descriptive case study design with Varney’s 7-Step Midwifery Management Approach. Data were collected through interviews, physical examinations, observation, laboratory examination results, and medical record reviews. The study was conducted from 11–16 June 2024 at Jabal Rahmah Ward, Haji Medan Hospital. Results: The patient was a 30-year-old woman diagnosed with HIV stage III who presented with complaints of epigastric pain, nausea, vomiting, diarrhea five times daily, decreased appetite, dizziness, and weight loss. Physical examination showed blood pressure 100/70 mmHg, pulse 90 beats/minute, respiration 22 breaths/minute, temperature 37.5°C, and HIV reactive laboratory results. Midwifery care included infection prevention education, health monitoring, psychosocial support, nutritional counseling, and collaboration with the medical team. Evaluation showed that the patient’s condition deteriorated during hospitalization and the patient died on 16 June 2024. Conclusions: Comprehensive midwifery care is essential in managing HIV patients. Early detection, treatment adherence, psychosocial support, infection prevention, and multidisciplinary collaboration play important roles in improving patient outcomes.

RELATIONSHIP BETWEEN THE ROLES OF HEALTHCARE WORKERS AND ACCESS TO HEALTH CARE IN THE USE OF LONG-ACTING CONTRACEPTIVES

2026-07-20T22:37:10+07:00

Background the main demographic issue in Indonesia is high population growth. In order to curb the population growth rate, the government implements various development programs, one of which is Family Planning. Long-Acting Contraceptive Methods are part of the government’s efforts to curb population growth. Couples of Reproductive Age can choose a contraceptive method that suits their circumstances and needs based on information they have understood, including the advantages, disadvantages, and factors that influence contraceptive methods.Objective of this study was to determine the relationship between the role of health workers and health facilities and the selection of LCMs in the service area of the Muara Bangkahulu Community Health Center in Bengkulu City. Methods:the research used was a quantitative study with a descriptive-analytical approach employing a cross-sectional design. The sample size for this study was 96 participants, selected using accidental sampling. Analysis was performed using the chi-square test. Results: the showed that 23 respondents (23.0%) in the Muara Bangkahulu Community Health Center’s service area used Long-Acting Contraceptive Methods, support from health workers (p-value 0.000) was significantly associated with the choice of Long-Acting Contraceptive Methods (p-value < 0.05), and access to health facilities (p-value 0.590) was not associated with the choice of long-acting contraception (p-value > 0.05). Conclusions: Support from family planning service providers influences the decision regarding the level of participation in the LCM and Access to health care refers to the opportunities or ease with which people can obtain services according to their needs.

COMPREHENSIVE MIDWIFERY CARE FOR MRS. N FROM THE THIRD TRIMESTER OF PREGNANCY TO FAMILY PLANNING SERVICES AT PMB MAULIDIA WINANDA, S. Keb, SUBULUSSALAM CITY

2026-07-22T09:11:51+07:00

Maternal and neonatal mortality remain significant public health challenges in Indonesia. Comprehensive midwifery care is an essential strategy to improve maternal and newborn health outcomes through continuous care during pregnancy, childbirth, postpartum, neonatal, and family planning periods. This case study aimed to provide comprehensive midwifery care for Mrs. N from the third trimester of pregnancy until the selection of a contraceptive method at PMB Maulidia Winanda, S.Keb, Subulussalam City.The method used was a descriptive case study with continuity of care. Midwifery care was provided through assessment, diagnosis, planning, implementation, and evaluation based on the standards of antenatal care, normal delivery care, postpartum care, newborn care, and family planning services.The results showed that Mrs. N experienced a normal third-trimester pregnancy, underwent spontaneous vaginal delivery without complications, had a normal postpartum period, delivered a healthy newborn who adapted well to extrauterine life, and successfully selected an appropriate contraceptive method after counseling.Comprehensive midwifery care contributed to maintaining the health and well-being of both mother and baby and supported informed decision-making regarding family planning.

UNRAVELING STUNTING RISK FACTORS IN TODDLERS: A CASE STUDY AT KLAMPOK 1 PUBLIC HEALTH CENTER, BANJARNEGARA

2026-08-08T09:28:14+07:00

Stunting is a manifestation of chronic linear growth disorders in toddlers triggered by long-term nutritional deficiencies and recurrent infections. Preliminary data from early 2024 at the Klampok 1 Public Health Center in Banjarnegara recorded a fairly high figure, with 295 toddlers diagnosed with stunting. This study aims to map the risk factors for stunting among toddlers in the working area of the Klampok 1 Public Health Center, Banjarnegara. The research design is descriptive quantitative with a cross-sectional approach. Using a purposive sampling technique, a sample of 200 toddlers aged 0–59 months was obtained from secondary data and analyzed univariately. The analysis showed that the average age of stunted toddlers was 33.77 months, with a slightly higher proportion of boys (53.0% / 106 children). Based on the height-for-age (HAZ) indicator, the majority of toddlers were in the stunted category (84.5% / 169 children). Meanwhile, 36.7% (62 children) were underweight (WAZ), and 87.0% (147 children) of stunted toddlers had a normal weight-for-height (WHZ). Furthermore, most mothers who did not participate in the toddler-mother class program (76.3% / 129 people) had stunted toddlers. These conditions indicate that stunting is influenced not only by current nutritional status but also by the history of nutritional intake, parenting practices, and the long-term health condition of the child.

ENVIRONMENTAL DETERMINANTS AND CATARACT VULNERABILITY PROFILE AMONG RICE FARMERS IN WEST NIAS REGENCY

2026-07-03T10:26:20+07:00

Background: As a largely preventable cause of blindness, cataract places rice farmers in equatorial tropical settings among the populations most at risk, given the substantial cumulative ultraviolet exposure they sustain over their working lives. Objective: This study set out to characterise the environmental, behavioural, and metabolic determinant profile alongside the ocular health status of rice farmers in West Nias Regency, providing an empirical basis for developing a cataract risk-mitigation model. Methods: A descriptive cross-sectional design was applied to 30 purposively selected rice farmers in West Nias Regency. Information on demographic characteristics, work patterns, ocular complaints, smoking habits, comorbidities, and protective behaviour was gathered through structured interviews and examined descriptively. Results: Women made up the majority of respondents (63.3%), with a mean age of 47.6 years; 56.7% were aged 45 years or older. Most respondents worked 7–9 hours daily in open paddy fields, with a working tenure ranging from 20 to over 40 years. Ninety percent reported ocular complaints, none used any form of eye protection, and the majority displayed low risk perception. Smoking history was present in 26.7% of respondents, diabetes mellitus in 10%, and hypertension in 16.7%. Conclusions: Rice farmers in West Nias simultaneously bear a convergence of cataract risk determinants, pointing to an urgent need for a multilevel mitigation model that targets both risk perception and protective behaviour.

Keywords: cataract; environmental determinants; rice farmers; ultraviolet radiation; risk mitigation

RE-ECHO: METABOLIC SYNDROMA SCREENING PROGRAM AND LOW-INFLAMMATION DIET EDUCATION

2026-07-30T13:55:08+07:00

Background : Syndrome metabolic is gathering risk disease cardio vascular , diabetes mellitus and stroke syndrome metabolic This can occurs in adolescents , adults and the elderly . Metabolic syndrome in mothers pregnant can result in fetal disorders even childhood obesity . Hence the syndrome metabolic This can happen everywhere age . Methods: Study quantitative , pre experiment , with design one group pretest and posttest design . Population : parents PAB 8 Saentis High School students . Sample: Engineering taking sample is accidental sampling. Parents students who come to place research that is wanted become respondents study as many as 45 people. Instruments research : sheet observation results metabolic screening : Blood pressure, blood sugar levels glucose blood , levels sour urate ( purine) blood ). Questionnaire sheet For measure knowledge respondents on an anti- inflammatory diet . Data were analyzed using the Wilcoxon test for mean differences with P value P<0.05 then There is difference knowledge before and after low-fat diet education inflammation . Results: Screening results : Majority age respondents aged risky in reproduce that is age > 35 years as many as 39 people (86.7%) glucose levels blood the majority were normal , as many as 43 people ( 95.6%), the level purine in respondents is majority normal as many as 24 people (53.3%). bring score knowledge before education min - max 30-80, mean 52.78 and score knowledge after Education min- max 40-90 mean 73.33. Mean difference test The Wilcoxon test value obtained P value 0.000 (P < 0.05 ) There is difference knowledge respondents before with after given education syndrome metabolic and low diet inflammation . Conclusions: education about syndrome metabolic and inflamation low in effective respondents increase knowledge respondents

THE RELATIONSHIP BETWEEN DUAL ROLES AS MOTHERS AND WORKERS ON THE MENTAL HEALTH OF POSTPARTUM MOTHERS AT SUNDARI GENERAL HOSPITAL MEDAN

2026-06-26T16:40:15+07:00

Background: Postpartum mothers who live in dual roles as mothers and workers face the demands of physical, psychological, and social adaptation, as well as job responsibilities after childbirth. These conditions can increase the risk of stress, anxiety, emotional exhaustion, and mental health disorders if not supported by adequate adaptability and social support. Objectives: This study aims to determine the relationship between dual roles as mothers and workers on maternal mental health after childbirth at Sundari General Hospital, Medan. Methods: This study uses a quantitative method with a descriptive correlational design and a cross-sectional approach. The study population comprised 132 postpartum mothers, of whom 57 were selected based on the study criteria. Data were collected using a questionnaire and analyzed using the Spearman Rank test. Results: The results showed that respondents with dual roles in the high category were 30 people (52.6%), while respondents with mental health disorders were in the high category as many as 37 people (64.9%). The results of the statistical test showed a p-value of 0.000 (<0.05) with a correlation coefficient of 0.919. These findings suggest a significant and very strong relationship between dual maternal and worker roles and maternal postpartum mental health. Conclusions: This study concluded that the higher the demands of dual roles, the higher the risk of mental health disorders in postpartum mothers.

THE INFLUENCE OF NURSING MANAGEMENT AND LEADERSHIP ON NURSES ' JOB SATISFACTION AT SUNDARI HOSPITAL MEDAN

2026-07-11T10:37:19+07:00

Background: Nurse job satisfaction is an important indicator in determining the quality of nursing services. However, various studies show that nurse job satisfaction in Indonesia remains a challenge. Objectives: This study aims to analyze the influence of management and leadership on nurses' job satisfaction. Methods: The study employed a cross-sectional quantitative design, involving 88 nurse respondents at Sundari Hospital, Medan. The sample was selected using proportional stratified random sampling. Data collection used three structured questionnaires that had been tested for validity and reliability. Data analysis was performed univariately, bivariately using the Chi-square test, and multivariately using binary logistic regression. Results: The majority of respondents rated nursing management as good (70.5%) and leadership as good (64.8%), and reported high job satisfaction (64.8%). The Chi-square test showed a significant relationship between nursing management and job satisfaction (p=0.001), and leadership as good (p=0.001) with job satisfaction (p=0.001). The results of binary logistic regression confirmed that nursing management is the most dominant predictor, with an Odds Ratio (OR) of 6.632 (95% CI: 2.432-18.087), compared to leadership, with an OR of 4.768 (95% CI: 1.796-12.656), with a Nagelkerke R Square value of 0.412. Conclusions: This study found that nursing management and leadership are key determinants in nurse job satisfaction, with nursing management the most dominant variable. It is recommended that improving the quality of nursing management through appropriate workforce planning and fair shift scheduling be prioritized to improve nurse job satisfaction.

RISK OF TYPE 2 DIABETES MELLITUS IN RIPARIAN ZONE COMMUNITY IN LANGKAT REGENCY

2026-07-31T08:50:31+07:00

Background: Type 2 Diabetes Mellitus (T2DM) is a growing public health challenge, particularly in riparian zone communities with limited access to healthcare services. Objectives: This study aimed to describe the T2DM risk profile and dietary patterns among the population in the working area of Puskesmas Stungkit, Wampu District, Langkat Regency, situated in a riparian zone. Methods: A preliminary survey was conducted with 60 respondents using the Finnish Diabetes Risk Score (FINDRISC) for risk screening, Fasting Blood Glucose (FBG) measurement to establish diabetes status (ADA 2019 criteria), and Semi-Quantitative Food Frequency Questionnaire (SQFFQ) for dietary analysis. A qualitative approach was employed through brief interviews with five informants to explore health perceptions and family health behaviors. Results: 83.3% of respondents were classified as high risk for T2DM based on FINDRISC. FBG examination revealed that 50% were diagnosed with DM and 50% were in a prediabetes condition. SQFFQ analysis found that all DM respondents (100%) and 70% of the prediabetes group had high-risk dietary patterns. Qualitative findings revealed low perceived susceptibility, limited health literacy regarding DM, and internalization of unhealthy dietary habits as family norms. Conclusions: The study revealed a very high T2DM risk profile in the riparian zone community of Langkat Regency, underscoring the urgency of developing contextual family empowerment-based health promotion strategies.

MANAGEMENT OF CHILDBIRTH CARE FOR MRS. E, 31 YEARS OLD, G4P3A0, WITH UMBILICAL CORD PROLAPSE AT NIAR PRIMARY CLINIC IN 2026

2026-07-18T11:57:07+07:00

Background: Nuchal cord is a common complication during pregnancy and labor that occurs when the umbilical cord wraps around the fetal neck. This condition may impair placental-fetal blood circulation, increasing the risk of fetal hypoxia, fetal distress, and neonatal asphyxia. Early detection and appropriate management are essential to prevent adverse maternal and neonatal outcomes. Inadequate antenatal care (ANC) may contribute to delayed identification of such complications. Objective: To analyze the implementation of midwifery care management in a case of nuchal cord using Helen Varney’sret Seven-Step Midwifery Management Approach. Methods: This descriptive case study was conducted at Niar Primary Clinic in 2026. The subject was Mrs. E, a 31-year-old G4P3A0 woman at 39 weeks of gestation who experienced a nuchal cord during labor. Data were collected through interviews, observation, physical examination, medical record review, and documentation. Midwifery care was implemented and evaluated based on Helen Varney’s seven-step management process. Results: The assessment showed that the mother attended only two ANC visits during pregnancy. During labor, the fetal heart rate decreased from 120 to 100 beats per minute and became irregular, indicating possible fetal distress. After delivery of the fetal head, a double nuchal cord was identified around the infant’s neck. Immediate management included releasing the cord loops and closely monitoring maternal and fetal conditions. The infant was delivered safely and required initial assessment and immediate stimulation. Conclusion: Helen Varney’s Seven-Step Midwifery Management Approach enabled early identification of complications, appropriate clinical decision-making, and timely intervention. Its application contributed to the successful management of the nuchal cord case and minimized the risk of complications for both mother and newborn.

RISK FACTORS FOR ABORTION IN KELIAT PERAK HOSPITAL, DELI SERDANG REGENCY, NORTH SUMATRA PROVINCE IN 2024

2026-07-18T12:36:57+07:00

Background: Abortion is the spontaneous termination of pregnancy before reaching 20 weeks of gestation, and is a crucial reproductive health issue in Indonesia. At Keliat General Hospital, Deli Serdang Regency, there are reports of spontaneous abortion cases frequently experienced by pregnant women.Pourpose : This study aims to examine the risk factors associated with abortion incidents at Keliat General Hospital, Deli Serdang Regency, North Sumatra Province.Method: This quantitative study applies an observational analytical approach with a case-control study design. The study sample consisted of 60 respondents, divided into 30 people in the case group (mothers who experienced abortion) and 30 people in the control group (mothers who did not experience abortion). Data collection was carried out retrospectively through medical records using a structured questionnaire. Data analysis: included univariate analysis and bivariate analysis using the Chi-Square statistical test (alpha = 0.05). Result :Bivariate analysis indicated that age had a significant correlation with the incidence of abortion (p = 0.007; OR = 4.57), indicating that mothers in the high age category (35 years) were at 4.5 times higher risk of abortion. Furthermore, anemia also showed a statistically significant correlation (p = 0.018; OR = 3.59), indicating that pregnant women with anemia were more likely to experience miscarriage. On the other hand, parity (p = 0.605) and history of previous abortion (p = 0.371) showed p values > 0.05, indicating no significant association with the incidence of abortion in the study area.Conclusion: Extreme maternal age (high risk) and anemia are important risk factors directly related to the incidence of abortion at Keliat General Hospital. Therefore, it is necessary to improve the quality of antenatal care, early detection of at-risk ages, and optimization of screening programs and anemia management from the beginning of pregnancy to reduce the potential for spontaneous miscarriage in pregnant women.

FAMILY EMPOWERMENT, CAREGIVER POSITIVE FEELINGS, AND DEMENTIA QUALITY OF LIFE: A MEDIATION ANALYSIS

2026-07-11T10:27:43+07:00

Background: Dementia is a growing public health challenge that reduces the quality of life of older adults and places considerable physical, emotional, and psychological burdens on family caregivers. Although family empowerment has been recognized as an important strategy for improving dementia care, the mediating role of caregiver positive feelings remains inadequately understood. Objectives: This study aimed to examine the effect of family empowerment on dementia quality of life and to determine the mediating role of caregiver positive feelings. Methods: A quantitative cross-sectional correlational study was conducted among 150 family caregivers of older adults with dementia in Medan Amplas, Indonesia. Participants were recruited using purposive sampling. Data were collected using the Family Empowerment Scale, Dementia Caregiver Positive Feeling Scale, and Dementia Quality of Life Instrument. Pearson correlation, multiple regression, and mediation analyses were performed using SPSS version 27. Results: Family empowerment was significantly associated with caregiver positive feelings (r = 0.409, p < 0.001) and dementia quality of life (r = 0.487, p < 0.001). Caregiver positive feelings were also positively associated with dementia quality of life (r = 0.555, p < 0.001). Regression analysis showed that family empowerment (β = 0.312, p < 0.001) and caregiver positive feelings (β = 0.427, p < 0.001) significantly predicted dementia quality of life (R² = 0.389). Caregiver positive feelings partially mediated this relationship (β = 0.175, p < 0.001). Conclusions: Family empowerment improves the quality of life of older adults with dementia directly and indirectly through caregiver positive feelings. Strengthening community-based empowerment programs may enhance caregiver resilience and dementia care outcomes.

EVIDENCE-BASED GINGER COMPRESS THERAPY FOR REDUCING LOW BACK PAIN IN THIRD-TRIMESTER PREGNANT WOMEN

2026-08-04T10:06:31+07:00

Introduction: Back pain is a common problem experienced during pregnancy. Various factors contribute to this condition, including uterine growth, weight gain, the effect of the relaxin hormone on ligaments, a history of back pain, parity, and daily activities. If not managed properly, back pain may persist after childbirth and become chronic. Objective: This implementation aimed to evaluate the effectiveness of ginger compresses in reducing back pain among pregnant women. Methods: The study used a case report approach involving two third-trimester pregnant women. The intervention was conducted over four visits, with ginger compresses applied three times, each session lasting 15 minutes. Pain intensity was assessed using the Numeric Rating Scale (NRS). Pain scores were measured before and after the application of the ginger compress. Results: showed a reduction in pain intensity in both participants. The first pregnant woman had an initial pain score of 5 (moderate pain), while the second pregnant woman had an initial pain score of 6 (moderate pain). At the end of the intervention, both participants experienced a decrease in pain. Conclusions: The implementation of ginger compress to reduce back pain was effective in reducing back pain intensity among third-trimester pregnant women.

CASE STUDY: MIDWIFERY CARE FOR GENDER EQUALITY IN PREGNANCY PLANNING, DELI SERDANG

2026-08-04T09:38:46+07:00

Background: Gender equality in household role division, particularly husband involvement in pregnancy planning, plays an important role in maternal physical and psychological readiness before pregnancy. A preliminary survey in Dusun II, Bangun Rejo Village, Tanjung Morawa Subdistrict, Deli Serdang Regency, identified one family showing an imbalance in gender equality practices, where Mrs. E (32 years old) reported that decisions regarding pregnancy planning were mostly dominated by her husband, with limited involvement in determining her own readiness, causing fatigue and anxiety. Objectives: This study aimed to provide community midwifery care for Mrs. E, 32 years old, related to gender equality in pregnancy planning in Dusun II, Bangun Rejo Village, in 2026. Methods: This was a descriptive case study using the seven-step midwifery management approach by Helen Varney, covering data collection, problem identification, anticipation of potential problems, immediate action, planning, implementation, and evaluation. Data were obtained through interviews and home visits conducted from February 9 to May 2, 2026. Results: The initial assessment showed decision-making dominated by the husband and limited involvement of the wife, accompanied by anxiety. After health education and counseling were provided, three follow-up visits showed progressive improvement: communication between the couple improved, the husband became more actively involved in discussions and pre-pregnancy health checks, and by the final visit the couple had fully shared decision-making in pregnancy planning. Conclusions: Community midwifery care effectively improved the couple's understanding and practice of gender equality, strengthened communication, increased husband involvement, and created a more harmonious and supportive family relationship in preparing for pregnancy.

EXCELLENT SERVICE EMERGENCY NURSING CARE MANAGEMENT FOR MRS. R WITH STEMI

2026-08-04T10:38:16+07:00

Background: Cardiovascular disease remains the leading cause of death globally, with ST-Elevation Myocardial Infarction (STEMI) representing the most serious acute coronary syndrome that requires immediate intervention. To meet Sustainable Development Goals (SDGs) Target 3, emergency nursing care must incorporate excellent service principles to optimize clinical outcomes and lower premature mortality. Objectives: This study aimed to develop, implement, and evaluate an excellent service-based emergency nursing care management for a patient presenting with STEMI at the CVCU ward of RSUP H. Adam Malik Medan. Methods: A clinical case study approach was utilized to manage Mrs. R, a 54-year-old female with STEMI and a history of Diabetes Mellitus. Comprehensive nursing management spanning three days included rapid assessment, formulation of Indonesian Nursing Diagnoses (SDKI), application of Indonesian Nursing Interventions (SIKI), implementation, and evaluation. Results: Three primary nursing diagnoses were identified: decreased cardiac output, acute pain, and impaired gas exchange. Following three days of customized, patient-centered interventions—including intensive hemodynamic monitoring, semi-Fowler positioning, titrated oxygen therapy, and non-pharmacological pain relief—the patient showed progressive improvement. Chest pain intensity decreased from a scale of 5 to 3, respiratory distress subsided, and blood gas metrics stabilized. Conclusions: The systematic integration of excellent service nursing protocols significantly improves hemodynamic stability and pain management in acute STEMI patients, thereby contributing directly to reduced cardiovascular mortality.

DESCRIPTION OF TODDLER NUTRITIONAL STATUS BASED ON THE DURATION OF BREASTFEEDING AT WANADADI 1 HEALTH CENTER

2026-08-08T09:47:35+07:00

Background: Nutritional status is an important indicator of children's health and growth. Adequate nutrition during infancy and toddlerhood supports optimal physical growth, cognitive development, and overall well-being. Breastfeeding provides essential nutrients and immunological protection that contribute to maintaining good nutritional status. Objective: This study aimed to describe the nutritional status of toddlers based on breastfeeding duration in the working area of Wanadadi 1 Primary Health Center, Banjarnegara Regency, in 2025. Methods: A descriptive quantitative study was conducted using secondary data from the Electronic Community-Based Nutrition Recording and Reporting System (e-PPGBM). A total of 158 toddlers aged 6–24 months who met the inclusion criteria were selected through purposive sampling. The variables analyzed were breastfeeding duration and nutritional status. Data were analyzed descriptively and presented as frequencies, percentages, means, and standard deviations. Results: The mean age of respondents was 11.13 ± 3.465 months. Most respondents were male (53.2%), had normal birth weight (93.7%), and normal birth length (81.0%). The majority of toddlers received breastfeeding for six months (82.9%), while 76.6% had good nutritional status. Toddlers breastfed for six months showed a higher proportion of good nutritional status than those breastfed for less than six months. Conclusion: Most toddlers received breastfeeding for six months and had good nutritional status. Adequate breastfeeding duration may contribute to maintaining optimal nutritional status among toddlers.

ECOLOGICAL LITERACY ENHANCING ADOLESCENT MENTAL HEALTH IN THE DIGITAL ERA

2026-07-18T07:59:15+07:00

Adolescent mental health has become an increasing concern in the digital era due to excessive exposure to digital media and reduced interaction with natural environments. Ecological literacy has emerged as a potential approach to promoting psychological well-being and encouraging sustainable behaviors among adolescents. This study aimed to analyze the role of ecological literacy in enhancing adolescent mental health through a literature review of ten scientific articles published between 2021 and 2026. The selected studies included systematic reviews, integrative reviews, longitudinal studies, cross-sectional surveys, and experimental studies related to adolescent mental health, environmental health literacy, nature connectedness, and nature-based interventions. The findings indicated that excessive social media use is associated with anxiety, stress, depression, and low self-esteem among adolescents. In contrast, ecological literacy, environmental health literacy, and stronger connections with nature contribute to better emotional regulation, positive affect, life satisfaction, and pro-environmental behaviors. School-based nature interventions also demonstrated positive effects on adolescents’ physical, social, and psychological well-being. These findings suggest that ecological literacy has considerable potential as a promotive strategy for strengthening adolescent mental health and resilience in the digital era through the integration of environmental education and meaningful experiences with nature.

THE EFFECT OF HEALTH EDUCATION USING THE LEFTET METHOD ON THE ATTITUDES AND BEHAVIOR OF WOMEN OF REPRODUCTIVE AGE UNDERGOING IVA EXAMINATIONS AT BLANG PIDIE PUBLIC HEALTH CENTER, WEST ACEH REGENCY, ACEH IN 2025

2026-07-29T11:10:15+07:00

Background: VIA test coverage at the Blang Pidie Health Center remains low due to a lack of information, negative attitudes, and the reluctance of reproductive-age women (WUS) to undergo screening. Health education using leaflets is required to raise their awareness. Objective: To determine the effect of health education using the leaflet method on the attitudes and behavior of WUS in undergoing VIA tests at the Blang Pidie Health Center, Southwest Aceh Regency, in 2025. Method: This quantitative quasi-experimental study with a one-group pretest-posttest design involved 40 WUS respondents selected through purposive sampling. Data were collected via questionnaires and analyzed using the Wilcoxon Signed Rank Test. Results: Bivariate analysis showed a significant increase in the attitude variable with a p-value of 0.000 (p < 0.05) and the behavior variable with a p-value of 0.001 ($p < 0.05$) after the intervention. These results prove that health education using leaflets has a significant influence on changing respondents' attitudes and behavior. Conclusion: Health education using the leaflet method is effective in improving the positive attitudes and screening behavior of WUS toward VIA testing. The health center is advised to optimize the use of this printed medium in regular health promotion programs.

FACTORS AFFECTING THE SUCCESS OF VBAC (VAGINAL BIRTH AFTER CESAREAN) IN MOTHERS WITH A HISTORY OF CESAREAN SECTION: A LITERATURE REVIEW

2026-07-18T11:22:09+07:00

Background: Vaginal Birth After Cesarean (VBAC) is a recommended alternative to cesarean delivery for women with a history of cesarean section (CS) in order to reduce the globally rising rate of repeat CS. The VBAC success rate ranges from 60–80%, but is strongly influenced by various maternal and clinical factors. Objective: The objective of this literature review is to identify the determinants that influence VBAC success based on the latest primary literature. Methods: The method involved searching for articles in the PubMed, Google Scholar, Scopus, and ScienceDirect databases, as well as in Sinta-accredited national journals, using the keywords “vaginal birth after cesarean,” “VBAC success factors,” “TOLAC,” and “VBAC success factors.” Articles meeting the inclusion criteria were primary observational studies published between 2021 and 2026. A total of 10 articles were extracted using the PRISMA flowchart and their quality was assessed using the JBI Critical Appraisal Checklist. Results: The review results showed that factors consistently predicting VBAC success included: maternal age (<35 years), a history of previous vaginal delivery (particularly a history of VBAC), cervical dilation upon hospital admission (≥4 cm), Body Mass Index (BMI <30 kg/m²), pregnancy interval (≥18–24 months), fetal weight (<3,500 grams), a non-recurrent indication for the previous cesarean section, and spontaneous onset of labor. Conclusion: Understanding these factors is crucial for healthcare providers in safely screening candidates for a Trial of Labor After Cesarean (TOLAC) and providing evidence-based counseling.

Evaluating the Nexus among Early Breastfeeding Initiation, Exclusive Breastfeeding Practices, and Neonatal Weight Gain

2026-07-21T11:25:35+07:00

Background: Early Initiation of Breastfeeding (EIB) involves placing a newborn in skin-to-skin contact with the mother immediately after birth to initiate breastfeeding within the first hour of life. This clinical procedure serves as a foundational pillar for neonatal survival, successful exclusive breastfeeding, and metabolic adaptation. Globally and nationally, ensuring steady early anthropometric growth remains a priority to eliminate neonatal vulnerability. Objectives: This study aimed to analyze the operational relationship between the implementation of Early Initiation of Breastfeeding and newborn weight gain trajectory in a clinical care setting. Methods: This research employed an analytical descriptive approach using a cross-sectional study design conducted at Sundari Hospital, Medan. The sample size consisted of 35 mother-infant pairs recruited using a total sampling technique. Data collection targeted EIB adherence profiles and post-birth weekly anthropometric shifts, which were evaluated through Chi-Square statistical validation and multivariate logistic adaptation models. Results: The univariate analysis showed that EIB was successfully established in 80.0% of deliveries, and 71.4% of neonates reached the optimal weight gain index ( ≥500 grams/week). The cross-tabulation matrix revealed that 85.7% of infants who underwent immediate EIB achieved optimal weight gain trajectories, compared to only 14.3% in the non-EIB cohort. The statistical evaluation confirmed a significant clinical relationship between EIB execution and optimal neonatal weight gain (p = 0.001, OR = 4.85). Conclusions: Immediate implementation of EIB after delivery significantly speeds up newborn weight recovery and minimizes postpartum weight loss. Healthcare institutions must enforce strict baby-friendly hospital initiatives to ensure EIB protocols are maintained across all delivery settings.

MIDWIFERY CARE MANAGEMENT FOR 20-YEAR-OLD MRS. P, G1P0A0 GRAVIDA, 40 WEEKS IN PARTU, 1ST STAGE, ACTIVE PHASE WITH PREMATURE RUPTURE OF MEMBRANES AT THE TUTUN SEHATI PRATAMA CLINIC IN 2025

2026-07-20T20:52:03+07:00

Premature rupture of membranes (PROM) in the Medan region varies between 6% and 19% of all pregnancies. Meanwhile, the national rate according to the Ministry of Health and Riskesdas ranges from 5.6% to 14.6%. The expected incidence of PROM in Indonesia is targeted to be significantly reduced to below 5% in order to prevent complications. This case report aims to describe the management of midwifery care for a pregnant woman with premature rupture of membranes and to support the achievement of the Sustainable Development Goals (SDGs) 2030, particularly Goal 3: Good Health and Well-being. The method used was a descriptive case report through a systematic midwifery care approach including assessment, diagnosis, planning, implementation, and evaluation. The case involved Mrs. P, a 20-year-old primigravida (G1P0A0) at 40 weeks of gestation with a single live intrauterine fetus in cephalic presentation and diagnosed with premature rupture of membranes during the active phase of the first stage of labor. The assessment results showed clear amniotic fluid discharge,cervical dilation of 1 cm, fetal heart rate of 156 beats/minute, and stable maternal vital signs. The management provided included monitoring maternal and fetal conditions, preventing infection,emotional support, collaborating with healthcare providers, and administering antibiotics. The mother delivered a baby girl spontaneously with a birth weight of 3100 grams and an Apgar score of 8. The implementation of comprehensive and continuous midwifery care successfully maintained maternal and newborn health and reduced the risk of complications. Early detection and appropriate management of PROM contribute to improving maternal and neonatal outcomes and support the achievement of SDGs 2030 targets in maternal and child health.

MANAGEMENT OF MIDWIFERY CARE FOR A PREGNANT WOMAN WITH OBLIQUE LIE AND MODERATE ANEMIA AT SALBIYANA PRIMARY CLINIC IN 2026

2026-07-18T13:16:27+07:00

Background: Oblique lie is an abnormal fetal position in which the fetal longitudinal axis forms an angle with the maternal longitudinal axis. This condition may increase the risk of labor complications, especially when accompanied by maternal anemia. Moderate anemia during pregnancy can contribute to adverse maternal and neonatal outcomes. Early detection and appropriate management through antenatal care are essential to reduce complications.Objectives: To describe the management of midwifery care in a pregnant woman with oblique lie and moderate anemia at Salbiyana Primary Clinic in 2026. Methods: This study used a descriptive case study approach. Data were collected through interviews, physical examinations, obstetric examinations, and review of supporting medical records. Midwifery management was carried out according to the Varney midwifery management process. Results: Mrs. S, 23 years old, G1P0A0, with an estimated date of delivery on June 27, 2026, attended antenatal care. Ultrasound examination revealed oblique lie and hemoglobin level of 9 g/dL. Physical examination showed blood pressure 120/80 mmHg, temperature 36.5°C, body weight 48 kg, and fetal heart rate 150 beats per minute. Midwifery care included explaining examination findings, routine antenatal follow-up, iron supplementation, nutritional counseling, education regarding danger signs of pregnancy, and reinforcement of the obstetrician's recommendation for cesarean delivery. Conclusions: Comprehensive antenatal care and collaborative management between midwives and obstetricians are important in preventing maternal and fetal complications associated with oblique lie and moderate anemia.

ANALYSIS OF FACTORS INFLUENCING EARLY CERVICAL CANCER DETECTION USING VIA TESTING

2026-07-20T21:21:03+07:00

Cervical cancer remains one of the leading causes of death among women and can be prevented through early detection. Visual Inspection with Acetic Acid (VIA) is an effective, simple, and affordable screening method for the early detection of cervical cancer. However, the participation rate of women of reproductive age in VIA screening remains low. One of the factors influencing participation is women's perception of the VIA examination.

This study aims to determine the perceptions of women of reproductive age toward early detection of cervical cancer using the VIA method and to analyze the factors influencing their participation in VIA screening at Batahan Community Health Center (UPTD Puskesmas Batahan), Mandailing Natal Regency, in 2025. This research employs a quantitative approach with a descriptive correlational design. The population consists of women of reproductive age within the working area of Batahan Community Health Center. A total of 36 respondents were selected using a random sampling technique. Data were collected through a structured questionnaire covering knowledge, attitudes, socio-cultural factors, and previous experiences related to VIA screening. Data analysis was conducted using univariate and bivariate statistical methods.

The study is expected to provide an overview of women's perceptions regarding VIA screening and the relationship between perception and participation in cervical cancer early detection programs. The findings are expected to serve as a basis for healthcare providers and health institutions in developing more effective health promotion strategies to increase VIA screening coverage and reduce the incidence of cervical cancer.

MIDWIFERY CARE MANAGEMENT MRS. S, G1P0A0, WITH INCOMPLETE ABORTION AT SAM PRATAMA CLINIC

2026-07-20T18:48:35+07:00

Background: Maternal mortality remains a critical global health challenge, heavily driven by first-trimester complications like incomplete abortions. In Indonesia, this condition stands as a major cause of severe obstetric hemorrhage and maternal death. When products of conception are partially retained, it prevents uterine vessels from closing properly and acts as a medium for bacterial growth, rapidly subjecting patients to acute anemia, life-threatening hypovolemic shock, and sepsis. This severe clinical issue directly hinders the achievement of the United Nations' Sustainable Development Goals (SDGs), particularly Goal 3 which aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. Furthermore, addressing this emergency aligns with the Indonesian government's Asta Cita vision, which prioritizes reinforcing human resource development and elevating public healthcare quality to protect women's reproductive health. Therefore, immediate and structured midwifery stabilization is urgently required to mitigate these lethal risks.Objective: This study aims to analyze and execute comprehensive Midwifery Care Management for Mrs. S, a 20-year-old primigravida (G1P0A0) experiencing an incomplete abortion at Klinik Pratama SAM in 2025.Methods: This research utilized a descriptive case study method. The clinical management and approach were systematically structured using Helen Varney’s seven-step midwifery management framework, supplemented by SOAP documentation to evaluate and implement patient care.Results: The case study showed that the patient presented with active bleeding, lower abdominal pain, a dilated cervix, and tissue protrusion. Emergency management successfully stabilized the patient’s hemodynamic state through fluid resuscitation, medical therapies, and timely collaboration for uterine evacuation. Post-treatment evaluation confirmed that the bleeding was controlled, vital signs normalized, and severe complications were prevented.Conclusion: Implementing a structured case study approach using Helen Varney's seven-step management is highly effective in ensuring rapid stabilization and preventing fatal complications, thereby advancing national healthcare goals and the SDGs.

MIDWIFERY CARE MANAGEMENT FOR MRS. S A 22 YEARS OLD WOMAN WITH SECOND-DEGREE PERINEAL RUPTURE DURING LABOR AT VINA PRIMARY CLINIC, 2026

2026-07-18T15:40:13+07:00

Background Second-degree perineal rupture is a common childbirth injury that affects the vaginal mucosa, perineal skin, and perineal muscles without involving the anal sphincter. Inadequate management may result in pain, discomfort, delayed healing, infection, restricted mobility, and reduced maternal quality of life during the postpartum period. Therefore, comprehensive postpartum care is essential to support recovery and prevent complications. Objective To describe the implementation of comprehensive midwifery care for Mrs. S, a 22-year-old woman who experienced a second-degree perineal rupture during labor at Vina Pratama Clinic in 2026. Methods This study used a descriptive case study design applying Varney’s Seven-Step Midwifery Management Approach with SOAP documentation. Data were collected through interviews, physical examinations, direct observation, postpartum follow-up visits, and medical record reviews. Midwifery care included assessment, diagnosis, planning, implementation, and evaluation based on the client’s condition and needs. Results Mrs. S experienced a second-degree perineal rupture following spontaneous vaginal delivery. Interventions provided included perineal suturing, monitoring of vital signs, assessment of uterine involution and postpartum bleeding, pain management, education on perineal hygiene, nutritional counseling, breastfeeding support, and early mobilization. Follow-up findings indicated satisfactory wound healing, decreased pain, stable vital signs, absence of infection and postpartum hemorrhage, and successful breastfeeding. The mother was also able to perform self-care independently. Conclusion Comprehensive midwifery care based on Varney’s management approach effectively promoted wound healing, prevented postpartum complications, enhanced maternal comfort, and supported optimal recovery after second-degree perineal rupture.

ANALYSIS OF RISK FACTORS FOR LABOR WITH PREMATURE RUPTURE OF MEMBRANES (PROM) AT KOTA PINANG REGENCY SOUTH LABUHAN REGENCY NORTH SUMATRA PROVINCE IN 2025

2026-07-21T20:36:57+07:00

Background Premature Rupture of Membranes (PROM) is a pregnancy complication that can increase maternal and infant morbidity and mortality. PROM occurs when the amniotic sac ruptures before labor begins. This condition can potentially lead to infection, premature labor, and even maternal and infant death if not managed appropriately. Several factors suspected of being associated with PROM include antenatal care (ANC) visits, maternal employment status, and fetal malpresentation.Objective This study aimed to analyze risk factors associated with the incidence of PROM at Kota Pinang Regional General Hospital, South Labuhanbatu Regency in 2025. Methods This study used an analytical design with an observational approach. The study was conducted at Kota Pinang Regional General Hospital, South Labuhanbatu Regency in 2025. The variables studied included antenatal care visits, maternal employment status, and fetal malpresentation. Data were obtained from patient medical records and analyzed to determine the association between risk factors and the incidence of PROM. Results The study showed that substandard antenatal care visits, maternal employment status with heavy physical activity, and fetal malpresentation were factors associated with an increased risk of PROM. Mothers who do not attend regular antenatal care have a higher risk of delayed detection of pregnancy complications. Work requiring excessive physical activity can increase fatigue, triggering uterine contractions and weakening the amniotic sac. Furthermore, fetal malpresentation causes increased pressure on the amniotic sac, potentially accelerating the development of PROM. Conclusion ANC visits, maternal employment status, and fetal malpresentation are contributing factors to the incidence of PROM. Preventive measures can be implemented through improving the quality of antenatal care services, education regarding work activities during pregnancy, and early detection of fetal presentation abnormalities.

LITERATURE REVIEW ANALYSIS OF FACTORS THAT CAUSE ABORTION IN PREGNANT WOMEN

2026-07-18T17:52:48+07:00

Abortion remains one of the major maternal health issues that can increase maternal morbidity and mortality. Its occurrence is influenced by various factors related to the mother, the fetus, or the environment. This study analyzed the causes of abortion in pregnant women based on published research findings. A literature review was conducted by examining scientific articles retrieved from electronic databases according to predefined inclusion and exclusion criteria. The data were analyzed descriptively to identify factors associated with abortion. The results identified key contributing factors: maternal age (≤20 years or ≥35 years), parity, prior history of abortion, anemia, comorbid conditions, infections, poor nutritional status, and inadequate prenatal care (ANC). Fetal chromosomal abnormalities also represent a significant cause of abortion. The occurrence of miscarriage is influenced by various maternal and fetal factors, with maternal age, history of miscarriage, and maternal health status being the most dominant determinants. Early identification of risk factors and improvement in the quality of prenatal care are essential to reduce the incidence of miscarriage

MIDWIFERY CARE FOR WOMEN IN LABOR WITH SECOND-DEGREE PERINEAL TEARS AT THE SARFINA PRATAMA CLINIC

2026-07-19T21:02:28+07:00

Normal delivery is the physiological process of delivering the fetus, placenta, and amniotic membranes from the uterus at term gestation, namely 37–42 weeks, which occurs spontaneously through the birth canal without complications (WHO, 2025). However, complications of childbirth are still common, one of which is perineal tears that can cause postpartum pain and reduce the mother's quality of life. The high global maternal mortality rate, which is still at 197 per 100,000 live births in 2023, emphasizes the importance of improving the quality of obstetric services, including in managing complications of childbirth (Statistical Compendium, 2025). Second-degree perineal tears are the most common type that occurs in normal deliveries, especially in primiparas. Their occurrence is influenced by factors such as parity, birth weight of the baby, pushing techniques, and the skills of the birth attendant. Appropriate treatment is needed to prevent further complications, such as infection and impaired wound healing. This report aims to describe the management of midwifery care for mothers giving birth with second-degree perineal tears at the Sarfina Primary Clinic, North Sumatra Province in 2026.method: used is a case study with a midwifery management approach that includes assessment, diagnosis formulation, planning, implementation, and evaluation of care. Results: show that comprehensive and standardized midwifery care starting from identifying risk factors, correct delivery assistance techniques, to suturing and caring for perineal wounds can accelerate healing and prevent complications. Conclusion: Appropriate and continuous midwifery care management is very important in the management of second-degree perineal tears to improve maternal health and safety in the postpartum period..

CASE STUDY COMMUNITY MIDWIFERY CARE FOR PREGNANT WOMEN WITH HYPEREMESIS GRAVIDARUM LEVEL 1 IN HALL II, BANGUN REJO VILLAGE, TANJUNG MORAWA DISTRICT, DELI REGENCY, SERDANG, 2026

2026-08-04T18:11:41+07:00

Background: Hyperemesis gravidarum is a condition of excessive nausea and vomiting during pregnancy that can cause dehydration, nutritional disorders, and reduce the quality of life of pregnant women. Appropriate treatment is needed to prevent complications in the mother and fetus. Objective: To describe the implementation of community midwifery care for Mrs. S, 36 years old with hyperemesis gravidarum level I in Hamlet II, Bangun Rejo Village, Tanjung Morawa District, Deli Serdang Regency in 2026. Method: Case study with a midwifery care management approach that includes assessment, diagnosis, planning, implementation, and evaluation. Results: The assessment showed that the client experienced nausea and vomiting 4–5 times per day, accompanied by weakness, dizziness, decreased appetite, decreased skin turgor, and sunken eyes. Interventions provided were health education, regulating small but frequent eating patterns, increasing fluid intake, consuming ginger, regulating rest patterns, and family support. Evaluation showed an improvement in the condition characterized by a decrease in the frequency of nausea and vomiting, increased appetite, improved hydration status, and the disappearance of complaints of weakness and dizziness. Conclusion: Comprehensive, family-based community midwifery care is effective in helping manage stage I hyperemesis gravidarum in pregnant women.

MANAGEMENT OF MIDWIFERY CARE FOR MRS. A WITH SEVERE ANEMIA AT HAJI GENERAL HOSPITAL MEDAN IN 2026

2026-07-20T12:09:13+07:00

Background: Anemia in pregnancy continues to be a major global maternal health concern. It is associated with various adverse outcomes, including postpartum hemorrhage, Anemia in pregnancy is linked to several negative health outcomes, including postpartum bleeding, preterm delivery, low birth weight, and an increased likelihood of maternal mortality. In Indonesia, anemia among pregnant women remains a significant public health concern that requires proper attention and effective management strategies. remains prevalent, highlighting the need for effective prevention and management strategies. Objectives: This study was conducted to determine the factors associated with the incidence of anemia among pregnant women in 2026.Methods: An observational analytical study with a cross-sectional method was conducted among pregnant women who participated in antenatal care visits. The participants were selected using a purposive sampling method. This study examined maternal age, parity, educational level, and adherence to iron tablet supplementation as independent variables, with anemia status as the dependent variable. Data processing and analysis were performed using the Chi-square test. The results indicated that educational level, parity, and compliance with iron tablet intake had a significant association with the incidence of anemia in pregnant women. pregnant women (p<0.05). Women with lower adherence to iron supplementation had a greater likelihood of experiencing anemia compared with those who regularly consumed iron tablets.

MIDWIFERY CARE MANAGEMENT FOR Mrs. A WITH FETAL DEATH AT 20 WEEKS OF PREGNANCY AT PMB RIMENDA TARIGAN

2026-08-04T17:51:37+07:00

Background: Intrauterine Fetal Death (IUFD) or Kematian Janin Dalam Kandungan (KJDK) remains one of the major contributors to perinatal mortality worldwide. This condition not only increases maternal morbidity but also causes significant psychological distress for mothers and families. Various maternal, fetal, placental, and environmental factors may contribute to fetal death during pregnancy. Therefore, appropriate and comprehensive midwifery management is essential to prevent complications and support maternal recovery. Objective: To describe the management of midwifery care in a pregnant woman diagnosed with Intrauterine Fetal Death at Klinik Rimenda Tarigan in 2026. Methods: This study employed a descriptive case study approach. Data were collected through anamnesis, direct observation, physical examination, obstetric examination, supporting examinations, documentation review, and the implementation of midwifery care management based on the management approach. The collected data were analyzed descriptively to illustrate the process of providing comprehensive midwifery care to the patient. Results: The subject of this study was Ny. A, a 30-year-old woman, G1P1A0, with a gestational age of 20 weeks diagnosed with Intrauterine Fetal Death. Assessment findings included complaints of absent fetal movement, no fetal heart sounds on examination, and confirmation of fetal death through clinical and supporting examinations. Midwifery care was provided comprehensively, including assessment, diagnosis establishment, monitoring of maternal physical condition, emotional and psychological support, counseling regarding the condition, preparation for pregnancy termination, collaboration with other health professionals, and postpartum evaluation. The implementation of care was carried out according to midwifery standards and successfully prevented maternal complications. Conclusion: Comprehensive and timely midwifery management plays an important role in preventing complications and supporting maternal physical and psychological recovery following IUFD. (Sinaga dkk., 2024)

MIDWIFERY CARE MANAGEMENT FOR NEWBORN BABY MRS. F WITH ASPHYXIA AT SALBIYANA PRIMARY CLINIC

2026-07-21T17:00:22+07:00

Background: Neonatal asphyxia is a critical condition in newborns caused by the failure to initiate and maintain spontaneous breathing immediately after birth. This condition leads to hypoxia, hypercapnia, and metabolic acidosis. Globally, neonatal asphyxia remains one of the leading causes of neonatal mortality and requires interventions.Objective: This study aimed to implement and evaluate comprehensive midwifery care management for Baby Mrs. F with moderate neonatal asphyxia at Salbiyana Primary Clinic, Deli Serdang Regency.Methods: This study employed a descriptive case study design using Varney’s seven-step midwifery management approach. The stages included basic data collection, data interpretation, identification of potential diagnoses, anticipation of immediate actions, planning, implementation of interventions, and clinical evaluation. Data were collected through direct observation, physical examination, and review of medical records.Results: At birth, the infant presented with signs of moderate asphyxia characterized by central cyanosis, weak muscle tone, slow respiration (30 breaths/minute), and an initial APGAR score of 6 due to a triple nuchal cord complication. Immediate resuscitation procedures were performed according to standard protocols, including positioning the head in slight extension, clearing the airway, drying the infant under an infant warmer, providing tactile stimulation, and ensuring positive pressure ventilation. Following intervention, the infant’s nificantly, with stable respiration (40–60 breaths/minute), heart rate above 100 beats/minute, pink skin coloration, stronger reflexes, and an APGAR score increasing to 7–8 at the fifth minute without secondary complications.Conclusion: The implementation of midwifery management based on Varney’s seven-step approach proved highly effective in managing moderate neonatal asphyxia. Early detection, prompt standardized resuscitation.

AN AI-BASED MATERNAL HEALTH RISK PREDICTION MODEL USING MULTILAYER PERCEPTRON AND COMPREHENSIVE DATA PREPROCESSING

2026-07-19T10:11:41+07:00

Background: Maternal health risk detection is essential for reducing pregnancy-related complications and improving maternal and fetal outcomes. However, conventional risk assessment remains challenging due to data quality issues and limitations in accurately identifying high-risk pregnancies. Artificial Intelligence (AI) offers promising solutions for improving maternal health risk prediction. Objectives: This study aims to develop and evaluate an AI-based maternal health risk prediction model using the Multilayer Perceptron (MLP) classifier and to assess the contribution of comprehensive data preprocessing techniques in improving prediction performance. Methods: The study utilized the Maternal Health and High-Risk Pregnancy Dataset containing maternal clinical and physiological indicators. Data preprocessing included missing value imputation, duplicate removal, outlier treatment using the capping method, feature scaling with Robust Scaler, and class balancing through Random Oversampling (ROS). The MLP classifier was trained using a supervised learning approach and evaluated using Accuracy, Precision, Recall, F1-score, Specificity, and Classification Error. Results: The proposed model achieved an accuracy of 97.60%, precision of 97.07%, recall of 98.20%, F1-score of 97.62%, specificity of 96.99%, and a classification error of 2.40%, demonstrating excellent predictive performance. Conclusions: The integration of comprehensive preprocessing techniques with the MLP classifier significantly improves maternal health risk prediction. The proposed model shows strong potential to support early risk detection, clinical decision-making, and preventive maternal healthcare through accurate and reliable AI-based prediction.

THE EFFECTIVENESS OF SOCIAL MEDIA BASED REPRODUCTIVE HEALTH EDUCATION ON ADOLESCENTS KNOWLEDGE LEVEL

2026-07-19T22:28:36+07:00

Background: A lack of understanding regarding reproductive health remains a primary trigger for high clinical risks among adolescents in developing countries. In the modern era, digital media offers an alternative space to disseminate education massively. However, its effectiveness is hindered by the prevalence of vulgar content, the digital divide, and rigid conventional school curricula that focus solely on biological and medical threats. Objective: This study aims to examine and synthesize scientific literature regarding the effectiveness of structured and participatory digital interventions, as well as to formulate strategies for integrating technology into the formal school system. Methods: This study employed a literature review design with a narrative synthesis approach. Article searches were conducted electronically across Google Scholar, PubMed, ScienceDirect, and Sinta databases using specific keywords from recent publication years. Ten articles meeting the inclusion criteria were extracted and analyzed comprehensively. Results: The synthesis indicates that structured digital interventions, such as web-based programs, peer discussion spaces, and educational games, effectively improve knowledge and guide safe reproductive health behaviors among adolescents in the long term. Economically, interactive web-based programs are proven to be cost-effective and potentially cost-saving. However, the benefits of this technology remain unequal due to demographic biases favoring urban and wealthier adolescents. Conclusion: Digital media holds immense potential to modernize adolescent reproductive health education. To address access disparities and prevent exposure to negative content, valid and participatory digital educational tools must be integrated directly into formal school curricula. This integrated approach is crucial to guarantee safe, engaging, and equitable reproductive health education for all adolescents.

BOOM BHOI: FUNCTIONAL FOOD INNOVATION BASED ON SESAME (Sesamum Indicum L.) THROUGH THE TRANSFORMATION OF BHOI (Traditional Acehnese Cake) AS AN EFFORTS TO PREVENT STUNTING IN NORTH ACEH DISTRICT

2026-07-20T16:09:31+07:00

Background: Stunting remains a major public health problem in Indonesia, including North Aceh Regency, affecting children's physical growth, cognitive development, and future productivity. Efforts to reduce stunting require sustainable nutritional interventions that utilize locally available resources. Sesame (Sesamum indicum L.) is rich in protein, calcium, iron, zinc, healthy fats, and antioxidants, making it a promising ingredient for functional food development. Therefore, BOOM BHOI was developed by incorporating sesame into bhoi, a traditional Acehnese cake, to enhance its nutritional value while preserving local culinary heritage. Objective: To develop BOOM BHOI as a sesame-based functional food innovation that can serve as a nutritious snack alternative and support stunting prevention efforts in North Aceh Regency. Methods: This innovation was developed through problem identification related to stunting, product formulation by incorporating sesame into traditional bhoi recipes, product processing, and evaluation of nutritional characteristics and consumer acceptability. The approach integrated local resource utilization, food innovation, and the preservation of Acehnese traditional cuisine. Results: BOOM BHOI was successfully developed as a functional food product with improved nutritional value compared to conventional bhoi. The addition of sesame increased the content of protein, essential minerals, and antioxidants without significantly altering the taste, texture, and sensory characteristics preferred by consumers. The product has potential as a healthy snack for children, pregnant women, and breastfeeding mothers, while also creating opportunities for community-based entrepreneurship and local economic development. Conclusion: BOOM BHOI represents an innovative functional food based on local wisdom that has the potential to contribute to stunting prevention through the provision of nutrient-rich food. By utilizing locally available ingredients and a culturally accepted traditional product, BOOM BHOI not only supports nutritional improvement but also promotes the preservation of Acehnese culinary heritage and community economic empowerment in North Aceh Regency.

MIDWIFERY CARE MANAGEMENT REPORT FOR MS. S WITH COLIC ABDOMEN DYSPEPSIA DI RUANGAN FITRAH RSU HAJI MEDAN

2026-08-04T14:45:48+07:00

MIDWIFERY CARE MANAGEMENT REPORT FOR MS. S WITH COLIC ABDOMEN DYSPEPSIA DI RUANGAN FITRAH RSU HAJI MEDAN

1Tasya Lamtiur Simanjuntak, 2Febriana Sari, 3Febihendawati Zamili,Dewi , 4Dewi Tanfuza, , 5Roza

Juliana

1,2,3,4,5Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan

Email: 2419201065@mitrahusadamedan.ac.id, 2419201069@mitrahusadamedan.ac.id, febrianasari@,2419201166 @mitrahusadamedan.ac.id,2419201419@mitrahusada,ac,id

ABSTRACT

Background: Colic abdomen et dyspepsia is a common gastrointestinal problem among adolescents and young adults. The condition is characterized by epigastric pain, nausea, vomiting, abdominal discomfort, and reduced appetite, which may interfere with daily activities and quality of life. Irregular eating patterns, unhealthy dietary habits, stress, and lifestyle factors contribute significantly to the occurrence of this disorder. Comprehensive and timely management is required to relieve symptoms, prevent complications, and improve patient recovery. Objective: To describe the implementation of midwifery care management for a 19-year-old adolescent with colic abdomen et dyspepsia in the Fitrah Ward of Haji General Hospital Medan. Methods: This study used a descriptive case study design applying Varney’s Seven-Step Midwifery Management Process. Data were collected through interviews, physical examination, observation, medical records review, and documentation. The care process included assessment, diagnosis, planning, implementation, and evaluation of midwifery interventions. Results: (Pinem et al. 2021)The patient complained of epigastric pain, nausea, vomiting, dizziness, and decreased appetite. Physical examination showed stable vital signs, including blood pressure of 104/77 mmHg, pulse rate of 77 beats/minute, respiratory rate of 20 breaths/minute, body temperature of 37.2°C, and oxygen saturation of 99%. Midwifery interventions included monitoring vital signs, assessing pain intensity, collaborating with physicians in medication administration, providing nutritional counseling, and educating the patient regarding healthy lifestyle modifications. Evaluation results indicated a reduction in pain intensity, improvement in appetite, resolution of nausea, and stabilization of the patient’s overall condition. Conclusion: Comprehensive midwifery care management through systematic assessment, continuous monitoring, collaborative treatment, and health education was effective in improving the patient’s condition and supporting recovery. Early detection and appropriate management are essential to prevent complications and reduce symptom recurrence.(Batubara, Surbakti, and Sinurat 2022)

COMPREHENSIVE MIDWIFERY CARE FOR MRS.N 19 YEARS OLD, WITH NUCHAL CORD

2026-07-21T08:58:33+07:00

Background: Nuchal cord is a condition in which the umbilical cord wraps around the fetal neck or other body parts. Although most cases do not cause complications, a tight nuchal cord may interfere with fetal oxygenation and increase the risk of fetal distress during labor. Proper midwifery management is essential to prevent adverse maternal and neonatal outcomes. Objectives: This case study aimed to describe the implementation of midwifery care using Varney’s Seven-Step Management Approach in a primigravida mother with a nuchal cord at Klinik Pratama Nirmala in 2026. Methods:This study used a descriptive case study design. Data were collected through anamnesis, physical examination, observation, labor monitoring, and documentation using Varney’s Seven-Step Midwifery Management and SOAP format. The subject was Mrs. N, a 19-year-old primigravida at term pregnancy diagnosed with a nuchal cord during labor. Results:The assessment revealed that the mother was in active labor with stable maternal and fetal conditions. During the second stage of labor, a single tight nuchal cord was identified around the baby’s neck. Immediate management was performed by clamping and cutting the umbilical cord according to standard procedures. The baby was delivered spontaneously, cried strongly at birth, and showed no signs of asphyxia. The placenta was delivered completely, postpartum bleeding was within normal limits, and both mother and newborn remained in good condition during the postpartum period.Conclusions: The application of Varney’s Seven-Step Midwifery Management in this case was effective in identifying and managing a nuchal cord, resulting in a safe delivery and favorable maternal and neonatal outcomes.

SIANTURI

2026-07-22T08:31:32+07:00

Background: Amidst SDG Target 3.1, postpartum hemorrhage (PPH) causes 30% of 287,000 global maternal deaths annually with retained placenta contributing 15%–20%, while in Indonesia it triggers 16%–17% of hemorrhages within the national MMR of 144 per 100,000 live births, including 12–18 cases yearly in Medan City. Therefore, this study evaluates comprehensive midwifery care management in handling a retained placenta emergency for Mrs. J at a primary healthcare facility. Objectives: To identify clinical problems, assess immediate intervention needs, and implement emergency midwifery care for a patient with retained placenta. Methods: This observational case study monitored Mrs. J (32 years old, G5P4A0, 41 weeks gestation) at Klinik Pratama Tutun Sehati using subjective data, physical examinations, and a partograph. Results: After spontaneously delivering a 3800-gram male infant, the placenta was undelivered after 30 minutes despite two oxytocin injections at 18:40 and 19:10 WIB. The mother's condition worsened with a blood pressure of 90/60 mmHg, pulse of 103 bpm, respiration of 28 rpm, temperature of 37.8°C, and ±400 cc of blood loss. Due to severe exhaustion making manual extraction impossible, the midwife administered 1000 mL of Ringer's Lactate and referred her via the BAKSO KUDA PN method. Conclusions: Retained placenta management at primary facilities requires early recognition, rapid fluid resuscitation, and an efficient referral system. Immediate referral using BAKSO KUDA PN is critical when manual removal is unfeasible due to maternal fatigue, preventing hypovolemic shock.

THE CORRELATION BETWEEN THE DURATION OF USE OF 3-MONTH INJECT-ABLE CONTRACEPTION AND THE INCREASE IN BODY WEIGHT OF CONTRACT ACCEPTORS IN THE WIRATA DAYA BANGUN PERSADA III PLANTATION UNIT CLINIC WORK AREA IN 2025

2026-07-28T15:31:21+07:00

Family planning initiatives across Indonesia are predominantly driven by injectable contraceptive adoption, with body mass expansion standing as the most frequently reported adverse effect. Preliminary field evaluations at the Kebun Wirata Daya Bangun Persada III Clinic demonstrated that 80% of quarterly injection clients experienced an upward shift in body weight, typically ranging from 1 to 5 kg within the first year of initiation. This study aimed to analyze the association between the duration of 3-month injectable contraceptive use and body weight changes among family planning acceptors within the clinic's operational area in 2025. Analytical survey research design is using cross sectional approach. The population in this study was 132 of 3 months syringe acceptor. The 57 sample of 3-month acceptors was taken by purposive sampling, selecting the number of samples and populations according to the inclusion and exclusion criteria. Research instruments used questionnaires and scales. The results showed that more than half (60%) of 3 months injection users>1 year and more than half (68%) had gained weight. The results of the chi square test were p = 0.010 <α= 0.05. The researcher conclude There is a relationship between the length of use of 3-month injectable contraception and weight gain in 3-month injectable contraception acceptors in the Wirata Daya Bangun Persada III Plantation Unit Clinic Work Area. Suggestions for health workers is to provide support and improve services to 3-month injection KB acceptors.

THE RELATIONSHIP BETWEEN KNOWLEDGE AND MOTHERS' WORK REGARDING BREAST MILK STORAGE IN THE WORKING, FAKFAK DISTRICT, WEST PAPUA PROVINCE IN 2024

2026-07-21T14:57:44+07:00

Background Exclusive breastfeeding is the most appropriate source of nutrition for infants and contributes significantly to improving child health and survival. However, working mothers often experience difficulties in maintaining exclusive breastfeeding because of limited time with their infants. Expressing and storing breast milk is a practical solution that enables continued breastfeeding during maternal absence. The successful implementation of this practice depends largely on mothers’ knowledge of correct breast milk storage procedures. Objective This study aimed to examine the relationship between maternal knowledge and breast milk storage practices among working mothers. Methods A descriptive-analytic study with a cross-sectional design was conducted among 32 pregnant and breastfeeding mothers. The respondents were selected using a total sampling technique. Data were collected through a structured online questionnaire and analyzed using univariate and bivariate statistical methods. The association between maternal knowledge and breast milk storage practices was assessed using the Spearman Rank correlation test with a significance level of 0.05. Results The findings indicated that 45.1% of respondents had limited knowledge regarding breast milk storage. Meanwhile, 51.6% demonstrated appropriate breast milk storage practices. The statistical analysis showed a significant relationship between maternal knowledge and breast milk storage practices (p = 0.000). Mothers with a better understanding of breast milk management were more likely to apply proper storage procedures. Conclusion Maternal knowledge is an important factor influencing breast milk storage practices among working mothers. Enhancing knowledge through breastfeeding education, counseling, and workplace support programs may improve breast milk handling practices and contribute to the achievement of exclusive breastfeeding.

Eco-Education Based Nursing Care to Improve Type 2 Diabetes Self-Management

2026-07-23T15:03:39+07:00

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from insulin resistance and impaired insulin secretion. The increasing prevalence of T2DM has become a major global health concern due to its association with high morbidity and various complications, including infections, impaired skin integrity, nephropathy, neuropathy, and vascular disorders. This condition aligns with the Sustainable Development Goals (SDGs), particularly Goal 3: Good Health and Well-Being, which aims to ensure healthy lives and promote well-being for all at all ages. In addition, the implementation of Eco-Education, through continuous health education and lifestyle awareness, is essential to encourage patients to adopt healthier behaviors and improve disease management. Methods: This case study applied the nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. Nursing care was provided to Mrs. R, a patient diagnosed with Type 2 Diabetes Mellitus and hospitalized in the VIP Ward of Latersia General Hospital Binjai in 2025. Data were collected through interviews, physical examinations, observations, and medical record reviews. Objective: To implement comprehensive medical-surgical nursing care in order to improve glycemic control, enhance skin integrity, and increase patient adherence to treatment and healthy lifestyle practices. Results: Assessment findings revealed a blood glucose level of 347 mg/dL and an HbA1c value of 13.4%, accompanied by fatigue, polyuria, polydipsia, and an infected wound on the left calf. Nursing diagnoses included unstable blood glucose levels, impaired skin integrity, and noncompliance. Interventions consisting of hyperglycemia management, wound care, health education, and insulin therapy collaboration contributed to improvements in the patient’s condition. Conclusion: Comprehensive nursing care supported by Eco-Education-based health promotion can improve the quality of life of patients with T2DM and contribute to achieving SDGs health targets.

Keywords: Type 2 Diabetes Mellitus, Nursing Care, SDGs, Eco-Education, Hyperglycemia.

THE RELATIONSHIP BETWEEN KNOWLEDGE OF NEONATAL CARE MANAGEMENT FOR ASPHYXIA AND NEONATAL EMERGENCY MANAGEMENT IN THE OPERATIONAL AREA OF PUSKESMAS PERUMNAS, LUBUKLINGGAU CITY, 2025

2026-07-23T16:07:42+07:00

Background: The role of nurses in assisting newborns, especially those experiencing severe asphyxia, is responsible for ensuring good coordination and high-quality service standards. Nurses are equipped with the knowledge and skills to ensure the care provided is accompanied by appropriate and correct attitudes (Lucky, 2020). One of the initial emergency treatments for asphyxia is cardiopulmonary resuscitation (CPR). Resuscitation is a life-saving measure for the cardiovascular system. Neonatal resuscitation typically occurs in the delivery room or in intensive neonatal care. Resuscitation is expected to reduce newborn mortality and reduce the number of complications due to long-term hypoxia. Errors in resuscitation can be caused by several factors, including facility factors and human error. Objectives: The purpose of this study was to determine the relationship between knowledge about neonatal care management and asphyxia in handling neonatal emergencies at the Perumnas Community Health Center in Lubuklinggau City. Methods: The method used was a descriptive analytical study with a cross-sectional design. Data were collected by distributing questionnaires to 35 health workers, namely midwives and nurses at the Perumnas Community Health Center in Lubuklinggau City. The sampling method used in this study was a total sampling technique. Results: The results of univariate analysis showed that some respondents, 21 people (60.0%) had good knowledge and almost all respondents, 14 people (40.0%) had sufficient knowledge. Some respondents, 18 people (51.4%) had good neonatal emergency handling and some of the respondents, 17 people (48.6%) had poor neonatal emergency handling. Bivariate analysis showed that there was a significant relationship between Knowledge About Neonatal Care Management and Asphyxia in Neonatal Emergency Handling.

Conclusions: This study concludes that there is a statistically significant relationship between healthcare professionals' level of knowledge regarding neonatal care management for asphyxia and their actual execution of neonatal emergency management within the operational area of Puskesmas Perumnas Kota Lubuklinggau in 2025.

ANALYSIS OF MATERNAL HEALTH PROGRAMS IN KWALA BEKALA, MEDAN JOHOR: THEIR IMPACT ON FUTURE GENERATIONS' HEALTH YEAR 2026

2026-07-28T17:32:35+07:00

Maternal health is a critical component of public health, as the well-being of mothers directly influences the survival and development of future generations. Pregnancy is a vulnerable period in which women require adequate healthcare services, nutritional support, and community-based interventions to ensure safe delivery and healthy outcomes for both mother and child. Globally, maternal health programs have been established to reduce maternal and infant mortality rates, yet challenges remain in ensuring equitable access and effective implementation at the local level.

In Indonesia, maternal health continues to be a priority within national health strategies, particularly in urban and semi-urban communities where disparities in healthcare access still exist. Kelurahan Kwala Bekala, located in Medan Johor, represents a community where maternal health programs play a vital role in shaping the quality of life and future health of its residents. Understanding how these programs are implemented, and analyzing their impact on the health of future generations, is essential for strengthening community-based health initiatives.

This study seeks to analyze maternal health programs in Kelurahan Kwala Bekala, Medan Johor, with a focus on their effectiveness, challenges, and long-term implications for the health of future generations. By examining local practices and outcomes, the research aims to provide insights that can contribute to policy development and improved maternal health services at the community level.