Continuity of midwifery care for a pregnant woman with chronic energy deficiency: A case study
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Abstract
Background: Chronic Energy Deficiency (CED) remains an important nutritional problem among pregnant women and is associated with adverse maternal and neonatal outcomes. However, limited case-based evidence has described the implementation of continuity of midwifery care specifically for pregnant women with CED across the maternal and neonatal continuum. Objective: To implement continuity of midwifery care for a pregnant woman with CED from pregnancy through childbirth, postpartum, neonatal, and family planning care. Methods: A descriptive case study was conducted at an independent midwifery practice in Medan, Indonesia. The participant was a 22-year-old primigravida with a Mid-Upper Arm Circumference (MUAC) of 22 cm, indicating CED. Care was provided using Varney’s Midwifery Management Model and documented using the Subjective, Objective, Assessment, and Plan (SOAP) format. Data were collected through interviews, physical and obstetric examinations, supporting examinations, and documentation review. Results: Continuity of care included nutritional counseling, MUAC monitoring, iron supplementation, antenatal monitoring, intrapartum care, postpartum follow-up, neonatal care, and family planning services. Pregnancy progressed to 38 weeks and 2 days and ended in spontaneous vaginal delivery. At admission, cervical dilatation was 7 cm and fetal heart rate was 140 beats/minute. The first stage of labor lasted approximately 14 hours without complications. Four postpartum follow-up visits showed normal maternal recovery and successful exclusive breastfeeding. The newborn demonstrated normal adaptation without identified complications. Conclusion: Continuity of midwifery care facilitated early identification and management of CED and supported favorable maternal and neonatal outcomes in this case. Practically, integrating nutritional screening, individualized counseling, and continuous maternal-neonatal monitoring may strengthen care for pregnant women with CED in primary midwifery settings.
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Badan Pusat Statistik Sumatera Utara. (2020). Profil kesehatan Sumatera Utara tahun 2020. adan Pusat Statistik Sumatera Utara.
Bekele, G. G., Namara, G. T., Moti, B. E., Gonfa, D. N., Roga, E. Y., Fekene, D. B., Bulto, G. A., Tura, M. R., Kabale, W. D., Bacha, A. J., Bune, A. G., Mamo, S. T., & Alemu, S. S. (2026). The effect of maternal anemia during pregnancy on low birth weight in Ethiopia; a systematic review and meta-analysis. BMC Pregnancy and Childbirth, 26(1). https://doi.org/10.1186/s12884-025-08510-2
Cleland, J., Conde-Agudelo, A., Peterson, H., Ross, J., & Tsui, A. (2021). Contraception and health. The Lancet, 8(3), 149–156.
Dewi, R., Hadriyati, A., & Situngkir, E. N. (2025). Analisis Interaksi Obat Antidiabetik terhadap Clinical Outcome Pasien DM Tipe 2 di RS X Jambi. Jurnal Akademika Baiturrahim Jambi, 14(1), 80–92. https://doi.org/https://doi.org/10.36565/jab.v14i1.898
Estiningtyas, Q., Adnani, S., Nurfitriyani, E., Merida, Y., Khuzaiyah, S., & Okinarum, G. Y. (2025). Ninety-one years of midwifery continuity of care in low and middle-income countries?: a scoping review.
Ginting, S. S. T. (2022). Hubungan tingkat kecemasan ibu hamil dengan kesiapan menghadapi persalinan di UPTD Puskesmas Prapat Janji Kabupaten Asahan. Jurnal Kesehatan Masyarakat, 1(2), 198–206.
Girard, A. W., & Olude, O. (2012). Nutrition education and counselling provided during pregnancy: Effects on maternal, neonatal and child health outcomes. Paediatric and Perinatal Epidemiology, 26(SUPPL. 1), 191–204. https://doi.org/10.1111/j.1365-3016.2012.01278.x
Halisah, H., Nur, A., Taslim, N. A., Chalid, S. M., Juliaty, A., Mappaware, N. A., Ahmad, M., Hamid, F., Alasiry, E., Aminuddin, A., Thalib, K. U., Hermanses, S. S., Fasiha, F., Achmad, I. H., & Mustardianto, M. (2022). The Effect of Family Approach Model Education and Zinc Supplementation on Pregnant Women with Chronic Energy Lack from Poor Family. Open Access Macedonian Journal of Medical Sciences, 10(E), 708–713. https://doi.org/10.3889/oamjms.2022.9192
Indarti, J., Wonodihardjo, H. S., Sianipar, K. A., & Antoniman, M. A. (2023). Maternal and Neonatal Outcome in Pregnant Women with Chronic Energy Deficiency in Cipto Mangunkusumo General Hospital, Indonesia. Open Access Macedonian Journal of Medical Sciences, 11(B), 474–479. https://doi.org/10.3889/oamjms.2023.8509
Kementerian Kesehatan Republik Indonesia. (2021). Profil kesehatan Indonesia 2021. Kementerian Kesehatan Republik Indonesia.
Khusniyati, E., & Purwati, H. (2024). Analisis Faktor yang Mempengaruhi Kelancaran Produksi ASI pada Ibu Menyusui. Jurnal Ilmu Kesehatan, 13(1), 15–24.
Kuntari, T., & Utami, U. (2024). Chronic energy deficiency in young pregnant women in rural Indonesia?: an analysis of basic health survey 2018. 19(4), 433–440.
Munthe, J. (2022). Buku ajar asuhan kebidanan berkesinambungan (Continuity of Care). Sinar Grafika.
Nadimin, & Asikin, H. (2025). Impact of nutrition mentoring by dietetic students on knowledge, dietary intake, and nutritional status in pregnant women with chronic energy deficiency in South Sulawesi. Healthcare in Low-Resource Settings, 13(1). https://doi.org/10.4081/hls.2024.12958
Pasaribu, R. (2018). Asuhan kebidanan berkelanjutan pada ibu hamil. Jurnal Kebidanan., 12(1), 34.
Republik Indonesia. (2024). Undang-Undang Dasar Negara Republik Indonesia Tahun 1945. Sekretariat Negara Republik Indonesia. Sekretariat Negara Republik Indonesia.
Sandall J, Soltani H, Gates S, Shennan A, D. D. (2024). Midwife-led continuity models versus other models of care for childbearing women, Sandall et al (2015). Practising Midwife, 19(3), 34–35. https://doi.org/10.1002/14651858.CD004667.pub5.www.cochranelibrary.com
Simbolon, M., Sembiring, M., Ginting, S. S., & Feronika, E. (2025). Pengaruh senam yoga terhadap kesiapan ibu hamil Kecamatan Panyabungan Utara Kabupaten Mandailing Natal Tahun 2024. Jurnal Kebidanan Indonesia, 2(2), 346–352.
Sinaga, R., Azizah, N., Sirait, A. I., & Zahra, I. A. (2025). Pemberdayaan ibu hamil dalam pencegahan kekurangan energi kronik (KEK) melalui edukasi kesehatan di BPM Deby Cintya Yun. Jurnal Pengabdian Masyarakat, 5(1), 766–773.
Srininta, Simarmata, M., Ginting, S. S. T., Sembiring, I., & Putri, S. M. (2023). Pelayanan kebidanan berkelanjutan. Jurnal Kebidanan, 12(2), 118.
Tambun, M., Agussamad, I., Rezeki, S., & Sembiring, D. A. (2025). Pemberdayaan masyarakat dan keluarga berbasis inovasi e-leaflet untuk mendukung peran serta suami menggunakan alat kontrasepsi. Jurnal Pengabdian Masyarakat, 4(4), 1335–1340.
Tambun, M., Tinggi, S., Kesehatan, I., Husada, M., Timur, A., & Regency, E. A. (2025). Pengaruh faktor dukungan keluarga dengan keaktifan penggunaan kontrasepsi. Jurnal Kesehatan Masyarakat, 2(1), 38–44.
Triyawati, L., & Yuliani, E. (2023). Knowledge , education , and information affect chronic energy deficiency among pregnant mothers in the area of Public Health Center Balen , Bojonegoro , Indonesia. 31(1).
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