<![CDATA[Hypertension during pregnancy remains a major contributor to maternal and perinatal morbidity, particularly among women with obesity. Low adherence to antihypertensive therapy may worsen blood pressure control and increase the risk of complications such as preeclampsia, fetal growth restriction, and preterm birth. This study aimed to describe the implementation of comprehensive midwifery care to improve adherence to antihypertensive therapy in a pregnant woman with obesity and hypertension. A case report design was used involving a 26-year-old primigravida at 31–32 weeks of gestation with obesity (BMI 35.38 kg/m²), hypertension (blood pressure 150/80 mmHg), low knowledge regarding hypertension (HK-LS score 54.54%), and low medication adherence (MMAS-8 score 2.5). Data were collected through interviews, physical examinations, observation, medical record reviews, and continuous monitoring during antenatal visits at Puskesmas Plaosan, Magetan. Midwifery interventions included health education regarding hypertension in pregnancy, counseling on the importance of antihypertensive therapy, medication reminder strategies using observation sheets and alarms, family involvement, dietary counseling, physical activity recommendations, and regular blood pressure monitoring. Following the intervention, the client demonstrated improved adherence to therapy, increased understanding of hypertension management, and more consistent medication use. Blood pressure gradually decreased from 150/80 mmHg to 120/80 mmHg, and no signs of severe maternal or fetal complications were identified during the observation period. Comprehensive midwifery care contributed to improved adherence to antihypertensive therapy and supported better maternal health outcomes in an obese pregnant woman with hypertension.]]>
