Juniarsih Juniarsih
Praktik Kebidanan Independen (PMB) Bd. Juniarsih, S.Keb., Medan Amplas, Indonesia

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Continuity of midwifery care for a pregnant woman with chronic energy deficiency: A case study Melisda Nainggolan; Rumondang Sitorus; Ribur Sinaga; Lisa Putri Damanik; Juniarsih Juniarsih
Journal of Midwifery and Nursing Vol. 8 No. 3 (2026): September: Health Science
Publisher : Institute Of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/jmn.v8i3.7386

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.