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The highest mortality cases during pregnancy until the postpartum period are caused by several factors such as hypertension, infection, bleeding, anemia and KEK. Data obtained from pregnant women at the Bumiayu Community Health Center in 2023 were 30 cases, in 2024 there was an increase of 183 cases and in 2025 from January to February there were 30 KEK cases (Bumiayu Community Health Center profile, 2025). The purpose of the study was to provide comprehensive midwifery care to pregnant women, childbirth, newborns, postpartum and family planning (KB) using the Varney and SOAP management approaches. The method used in this study is a qualitative descriptive method with a comprehensive case study approach. The results of the study of comprehensive midwifery care to Mrs. S found problems in pregnancy with KEK have been given management according to the mother's needs. In labor, newborns, postpartum to KB Mrs. S there were no complications. Conclusion Comprehensive midwifery care to Mrs. S with KEK has been carried out in accordance with Standard Operating Procedures with the condition of the mother and baby being good.  

Teenage pregnancy remains a reproductive health issue in Indonesia, including in Batam City. According to data from the Batam City Health Office in 2024, there were 18 cases of teenage pregnancy (0.06%) with the Lubuk Baja Health Center being one of the highest areas. Pregnant teenagers are at high risk of complications such as anemia, malnutrition, and low birth weight (LBW), which contribute to high rates of maternal and infant morbidity. This study used a descriptive method with a case study approach on Ny. S, an 18-year-old teenager with a pregnancy in the Lubuk Baja Health Center area of Batam City in 2025. Data collection was conducted through interviews, observations, physical examinations, and SOAP documentation following the 7-step Varney obstetric management. The findings revealed that Ny. S experienced mild complaints such as nausea, reduced appetite, and anxiety about her pregnancy. After three visits, the mother's complaints decreased, appetite improved, anxiety decreased, and nutritional status was within normal limits. Comprehensive midwifery care with a biopsychosocial approach was proven effective in improving both the physical and mental health of pregnant teenagers and preventing pregnancy complications.

Interpregnancy interval is a modifiable risk factor that may influence pregnancy complications, which remain a significant issue for maternal health despite most women being of ideal reproductive age. This study aimed to analyze the relationship between interpregnancy interval and pregnancy complications at Marisa Health Center. An analytical observational quantitative design with a cross-sectional approach was used. The study population consisted of pregnant women who received antenatal care at the Marisa Community Health Center during the study period. A total of 20 respondents were selected using total sampling according to inclusion criteria. Data were collected through medical record reviews and observation sheets covering maternal characteristics, gestational age, and pregnancy complications. Data analysis was conducted using univariate and bivariate analysis, with Spearman's Rho correlation test. Results showed that most respondents had a pregnancy interval of 1–2 years, and the most common pregnancy complication was anemia. Spearman's Rho test revealed a p-value of 0.542 and a correlation coefficient of r = −0.145, indicating no statistically significant relationship between pregnancy interval and complications. The study concluded that interpregnancy interval was not a dominant factor related to pregnancy complications in the respondents. Preventing pregnancy complications requires a comprehensive approach, including improving antenatal care quality, early detection of risk factors, and continuous pregnancy planning counseling.

Abortion remains a complex reproductive health issue due to the interplay of multiple interrelated determinants. This study aimed to map the factors influencing the incidence of abortion based on recent scientific evidence. A literature review design was applied by analyzing ten selected articles published within the last five years and retrieved from major scientific databases. The selection process was conducted systematically through title, abstract, and full-text screening based on predefined inclusion criteria. The extracted data included study characteristics, type of abortion, examined determinants, and key conclusions. The synthesized findings indicate that abortion incidence is shaped by a combination of biological, social, and healthcare system related factors. Clinical determinants such as maternal age, endocrine disorders, uterine anatomical abnormalities, obstetric history, anemia, and hypertension play a substantial role in spontaneous and recurrent miscarriage. In contrast, structural factors including income level, contraceptive access, and legal regulations predominantly influence induced abortion. The discussion highlights that abortion should not be viewed as an isolated clinical event, but rather as the cumulative outcome of risks operating across multiple levels of influence. In conclusion, abortion represents a multifactorial phenomenon that requires comprehensive prevention strategies extending beyond medical interventions alone. These strategies should also address healthcare accessibility and broader social conditions. This review contributes to a deeper understanding of the complexity of abortion determinants and provides an evidence-based reference for developing more effective preventive approaches in the future.

Background : The Maternal Mortality Rate (MMR) worldwide reaches 183,000 per 100,000 live births (WHO, 2024). In Indonesia, there were 4,305 reported cases (Ministry of Health RI, 2024), while Central Java Province recorded 315 cases (Central Java Health Office, 2024). In Brebes Regency, there were 54 maternal deaths in 2024 (Brebes Health Office, 2024), and in the Bumiayu Public Health Center area, 2 maternal deaths were recorded (Bumiayu PHC Data, 2024). Objective : To analyze, implement, and provide comprehensive midwifery care for Mrs. A, 25 years old, with anemia in the Bumiayu Public Health Center area in 2025, using the Varney midwifery management approach and the SOAP method. Research Methods : This study used a qualitative descriptive design in the form of a case study. Results : Midwifery care during pregnancy for Mrs.A with anemia was carried out bassed on the mother’s needs. During labor, newborn care, postpartum period, and family planning services, no complications were found. Conclusion: The comprehensive midwifery care provided to Mrs. A with anemia was carried out in accordance with the Standard Operating Procedures (SOP), with both the mother and baby in good condition.

Background: Maternal mortality according to WHO (2024) is 287,000, in Indonesia (2024) 183/100,000 live births, in Central Java (2024) 3,149 live births, in Brebes (2024) there were 54 cases of maternal mortality. At Bantarkawung Community Health Center (2024), there were no maternal deaths. One of the causes of maternal mortality is postpartum hemorrhage. Postpartum hemorrhage can be caused by anemia in mothers during pregnancy. Objective: It is hoped that the researcher can provide comprehensive midwifery care for Mrs. L in accordance with midwifery service standards, covering pregnancy, childbirth, newborns, neonates, postpartum, and family planning, using the midwifery management approach according to Varney and SOAP. Research method: The method used is qualitative descriptive with a comprehensive case study approach. Findings: During the researcher's assistance with anemia cases, the researcher did not find issues that required further in-depth investigation, but there were some occurrences resulting from anemia, one of which was the mother experiencing retained placenta. From the assistance process conducted by the researcher, the midwifery findings have been applied comprehensively, from pregnancy stages to family planning, in accordance with midwifery service standards.  

Anemia during pregnancy is a significant maternal health issue with serious impacts on maternal and perinatal outcomes, including complications such as severe preeclampsia, postpartum hemorrhage, and low birth weight (LBW), all of which contribute to increased morbidity and mortality rates. This literature review aims to analyze the clinical impacts of pregnancy anemia, related complications, and effective management strategies based on the latest scientific evidence (2020-2024). The study examines the relationship between anemia and preeclampsia, LBW, and postpartum hemorrhage, as well as the importance of nutritional fulfillment in prevention and management. Five research articles from indexed journals were collected from the Scopus database, with inclusion criteria of studies with clear designs, focusing on pregnancy anemia, and published in Indonesian or English. The analysis results show that pregnancy anemia is a predisposing factor for preeclampsia through mechanisms such as placental hypoxia and oxidative stress. Anemia is also closely related to an increased incidence of LBW and postpartum hemorrhage, particularly due to lower hemoglobin reserves and uterine contractility issues. Adequate nutritional fulfillment is influenced by socioeconomic barriers, supplementation side effects, and lack of family support. Anemia management requires a comprehensive approach, including routine screening, prophylactic supplementation, nutritional education, and effective referral systems for complex cases. Prevention through early detection and timely intervention is crucial in reducing maternal and perinatal morbidity.

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) can be a measure of a country's welfare in determining the optimal degree of health. The maternal mortality rate in the world is 303 thousand people (WHO 2023). MMR in Indonesia was 4,129 people in 2023. Meanwhile, the Infant Mortality Rate (IMR) in the world is 29,945 people (WHO, 2023). In Indonesia, there were 16.85 infant mortality rates in 2023. SEZ is a nutritional deficiency in pregnant women that lasts for several months or years. SEZ conditions can indirectly cause MMR and IMR. SEZ in pregnant women can cause complications such as IUGR, Abortion, LBW, Circulation, Anemia, Bleeding, and Childbirth complications. Research Objective: Providing Comprehensive Midwifery Care in accordance with midwifery care standards starting from pregnancy, childbirth, postpartum, newborn, and family planning in Mrs. A 22 years old with Chronic Energy Deficiency (SEZ) and Chepalo Pelvic Disproportion (CPD) with a midwifery management approach according to Varney and SOAP. Research Methods: Descriptive Qualitative with Case Study approach Results: Comprehensive Midwifery Care on Mrs. A aged 22 years with SEZ can be overcome by an increase in LILA, there is a CPD so that SC delivery is performed and appropriate case management is carried out so that labor, newborn, postpartum period, and family planning goes well. Conclusion: The results of the comprehensive care given to Mrs. A 22 years old with Chronic Energy Deficiency (SEZ) can be resolved marked by an increase in LILA, SC delivery on indications of CPD, normal LBW, normal postpartum, and mini pill birth control.

According to the World Health Organization (WHO), in 2023, around 305,000 per 100,000 live births of women will die due to prevalence due to CED related to pregnancy throughout the world, MMR in ASEAN in 2023 will be 100 per 100,000 live births with prevalence due to CED 40%, MMR in Indonesia in 2023 will be 4,129 with a prevalence due to KEK of 17.3%, MMR in Central Java will be 183 per live birth with a prevalence due to KEK of 6.7%. The MMR in Brebes is 1,083 with a prevalence due to CED of 5%, in Paguyangan women with a prevalence of CED from 2023-2024 is 119 cases. To find out about cases of pregnancy, childbirth, childbirth, postpartum and birth control Mrs. A with CED and history of TB. Qualitative descriptive research method with a case study approach. Comprehensive Care for Mrs. A was found to have problems with pregnancy with CED and a history of TB. Childbirth was carried out by induction based on KPD indications, there were no problems or abnormalities in the postpartum period, the postpartum period was still CED and had mild anemia, there were no complications during the postpartum period. Mrs. A chose the KB implant and there were no complaints after installation. It can be concluded that comprehensive midwifery care for Mrs. At 26 years of pregnancy, childbirth and postpartum there is a gap between theory and practice.

Maternal mortality remains a challenge in Indonesia, and one contributing factor is chronic malnutrition (CED), which impacts pregnancy, childbirth, the postpartum period, and the newborn. The 2022 registration report shows that of the 3,249,203 pregnant women whose MUAC was measured, 283,833 had a MUAC of less than 23.5 cm (at risk of CED), meaning 8.7% of these pregnant women were at risk of CED. In the Brebes area, the 2022 report recorded 3,475 pregnant women with CED. At the Bantarkawung Community Health Center in 2023, there were 36 cases of preeclampsia, 22 cases of transverse lie, 107 cases of CED, and anemia. Objective: Provide comprehensive midwifery care in accordance with standards of care for pregnant women, women giving birth, newborns, postpartum women, and family planning. Research method: Qualitative descriptive method, the type of research approach used in this study is a comprehensive case study approach. Results: Comprehensive care was provided to Mrs. R who suffered from chronic energy deficiency, and was successfully overcome. Delivery was carried out by caesarean section, the baby was born normally, and the postpartum period went smoothly, and the mother chose a contraceptive method, namely a three-monthly birth control injection. Conclusion: Comprehensive obstetric care has been proven effective in overcoming chronic energy deficiency, ensuring a safe delivery, a normal baby born, a normal postpartum period, and compliance with contraceptive methods.

Anemia in pregnancy is a major health problem that increases maternal and fetal morbidity and mortality, thus requiring prompt and appropriate management. This study aimed to describe nursing care for Mrs. D, a 19-year-old primigravida with anemia in the Nusa Indah Ward of RSUD dr. Soeselo, Tegal Regency. The method used was a case report with data collected through interviews, direct observation, and medical record review during hospitalization from January 13–15, 2025. Assessment results showed a hemoglobin level of 6.5 g/dL with clinical signs of pallor, cold extremities, tachycardia, and complaints of dizziness and weakness. The nursing diagnoses established were ineffective peripheral perfusion and risk for nutritional deficit. Interventions included monitoring vital signs, providing nutritional education, administering iron and folic acid supplements, and collaborating on blood transfusion. Evaluation indicated both subjective and objective improvement, and the nursing problems were resolved. In conclusion, comprehensive and collaborative nursing care contributed to the improvement of the patient’s condition with pregnancy-related anemia.

Anemia during pregnancy is a public health issue that remains a challenge in developing countries, including Indonesia. Iron tablets are recommended as the primary intervention to prevent anemia, but compliance among pregnant women in taking iron tablets varies and is influenced by various factors, including health worker counseling. This study aims to analyze the relationship between the intensity of cadre assistance and the level of compliance with TTD consumption among pregnant women at the Tomalou Community Health Center, Tidore Kepulauan City. The study design used an observational analytical approach with a cross-sectional method. The study sample consisted of 30 pregnant women selected using total sampling technique. The independent variable was the intensity of cadre assistance, while the dependent variable was the level of compliance with TTD consumption. Data were collected using observation sheets, consumption monitoring forms, and respondent identity questionnaires, then analyzed using Spearman's rank correlation test at a significance level of 0.05. The results showed that most respondents were compliant in consuming TTD, but there was no significant relationship between the intensity of cadre assistance and the level of compliance with TTD consumption (r = 0.036; p = 0.848). This study concluded that the frequency of assistance alone was not sufficient to influence TTD consumption compliance, thus requiring a more comprehensive, educational assistance approach that involved family support. These findings could form the basis for evaluating the cadre assistance program in preventing anemia in pregnant women.

The maternal mortality rate is an indicator of health status and is one of the health problems in the world. Brebes Regency is one of the contributors to the highest maternal mortality rate in Central Java. In 2021, the Bumiayu Regional General Hospital contributed to the Maternal Mortality Rate in Brebes Regency by 15 cases. The purpose of this research is to be able to provide comprehensive midwifery care for Mrs. The research method used is qualitative descriptive research with a case study approach. The case study carried out is in the form of comprehensive midwifery care that examines pregnancy, childbirth, newborns, postpartum and family planning with Varney's 7-step midwifery management and SOAP. The results of the pregnancy were found to be anemia and CED, delivery by caesarean section, the newborn was normal, during the neonatal period physiological jaundice was found, then appropriate management was carried out so that it could be resolved, during the postpartum period no problems were found, the mother used MOW KB. The conclusion obtained was that care had been carried out in accordance with midwifery service standards and the problem of anemia and CED had not been resolved  

Risk factors for pregnancy that cause complications and maternal death include chronic energy deficiency and anemia. The pregnancy rate for pregnant women with chronic energy deficiency at the Bumiayu Community Health Center in 2022 is 56 cases, while the incidence of anemia at the Bumiayu Community Health Center is 22 cases. Research method: the method used in this research is a qualitative descriptive method with a comprehensive case study approach. Comprehensive midwifery care for Mrs S found early pregnancy problems, namely chronic energy deficiency and anemia. The delivery was carried out normally vaginally and the baby was born normally. During the postpartum and birth control period, no complications were found. Comprehensive midwifery care for Mrs S with chronic energy deficiency and anemia was in accordance with midwifery care and no complications occurred.

This study is a Systematic Literature Review (SLR) which aims to analyze the relationship between risk factors and the incidence of birth canal laceration and its impact on postpartum hemorrhage. The review of various studies showed that postpartum hemorrhage and perineal rupture have complex and interrelated risk factors, with placental retention, uterine atony, and birth canal laceration as the main causes (p-value <0.05). Maternal characteristics such as age, parity (especially in multiparous with a prevalence of 32.9%), history of previous bleeding (OR=7.725), and pregnancy spacing less than two years (OR=6.943) contributed significantly to the risk of complications. Birth weight had a significant association with the incidence of perineal rupture, while the innovative use of warmpad proved effective with 58.8% of cases showing an intact perineum post-delivery. The study also identified anemia in pregnancy as an important risk factor, with the distribution of causes of postpartum hemorrhage including placental retention (44%), uterine atony (28%), uterine rupture (18.6%), and uterine inversion (9.4%), confirming the importance of comprehensive monitoring during pregnancy to prevent complications.

Background: The global maternal mortality rate (MMR) in 2022 is 91.46 per 100,000 live births with the cause of death being bleeding while the indirect causes of maternal mortality are during pregnancy wheere many pregnant women experience nutritional problems such as Chornic Energi Deficiency ( CHD) and Nutritional Anemia at 8.43% (WHO, 2022). The maternal mortality rate in ASEAN is 235 per 100,000 live births with the majority of causes of death being bleeding (ASEAN Secretariat, 2022). Until now, the maternal mortality rate in Indonesia alone in 2020 was 91.45/100,000 live births. In 2021, maternal mortality will increase to 305/100,000 live births. Meanwhile, in 2022, the maternal mortality rate will decrease by 230/100,000 live births. Within a period of 3 years, the causes of maternal death included Covid 19, bleeding, hypertension in pregnancy, and heart disease (Ministry of Health of the Republic of Indonesia, 2022). The maternal mortality rate in Central Java in 2020 was 84.6/100,000 live births, in 2021 it will be 199/100,000 live births. In 2022 there will be a decrease to 98.6/100,000 live births, hypertension in pregnancy and bleeding are still the cases of death in that year (Central Health Office, 2022). Brebes Regency shows that the maternal mortality rate in 2020 was 62 cases. In 2021 there were 105 cases and in 2022 there was a decrease to 50 cases with the causes of death being bleeding, hypertension, infection and heart disorders (Brebes District Health Office, 2021) Objective: Reduce maternal and infant morbidity and mortality rates in Brebes Regency, especially the Bumiayu Community Health Center area Conclusion: After providing comprehensive midwifery care to Mrs. S aged 32 years with Chronic Energy Deficiency (KEK) at BPM Mrs. The R working area of the Bumiayu Community Health Center from the third trimester of pregnancy, childbirth, newborns, postpartum and family planning is in good condition.

Postpartum hemorrhage is a serious complication that can occur after delivery and is a major cause of maternal morbidity and mortality. This literature review aims to analyze postpartum hemorrhage as a major risk factor for anemia in postpartum mothers. The method used was Systematic Literature Review with a literature research approach using the Google Scholar database. The analysis of eight articles showed that anemia during pregnancy had a significant association with the incidence of postpartum hemorrhage, with a risk of up to 45.7 times greater than mothers without anemia. Other contributing factors included type of delivery, where sectiocaesarea increased the risk of postpartum anemia compared to normal delivery (p=0.004). In conclusion, anemia is a significant risk factor for postpartum hemorrhage that requires early detection, nutritional status monitoring, and comprehensive antenatal care to prevent complications in postpartum women.

. According to WHO (2019) TB mortality rate (AKI) in the world namely 303,000 people. Maternal   Mortality Rate (MMR) in ASEAN (2020), namely amounting to 235/100,000 live births. Based on data from the Ministry of Health Figures Maternal mortality (MMR) in Indonesia in 2020 was 4,627 deaths. Data Health Department (2021) MMR 62 cases. Data from Kaliwadas Community Health Center (2022) MMR 0 case. The aim of this research was to reduce maternal and infant morbidity and mortality rates in Brebes district, especially the Kaliwadas Community Health Center area. This research method is qualitative research, namely a research method carried out by exploring, describing and explaining and predicting a phenomenon that occurs on the basis of it in the field. The results of this research are after carrying out comprehensive midwifery care in Mrs. S is 42 years old with risk factors: age, anemia and CED at the Community Health Center Kaliwadas from the third trimester of pregnancy, childbirth, newborns, postpartum and family planning using Varney and midwifery approaches SOAP found gaps between theory and practice.        

According to WHO (2019), the maternal mortality rate (MMR) in the world is 303,000 people. The Maternal Mortality Rate (MMR) in ASEAN (2020) is 235/100,000 live births. Based on data from the Ministry of Health, the Maternal Mortality Rate (MMR) in Indonesia in 2020 was 4,627 deaths. Health Department data (2021) MMR 62 cases. Data from Bumiayu Community Health Center (2022) AKI 2 cases. The aim of this research is to reduce maternal and infant morbidity and mortality rates in Brebes Regency, especially the Bumiayu Community Health Center area. This research method uses descriptive research with a qualitative descriptive approach. The results of this research show that in the results of Comprehensive Care there was a gap between theory and practice after comprehensive midwifery care was carried out on Mrs. E is 39 years old with risk factors for CED age and anemia in Mrs. BPM. R working area of Bumiayu Health Center from third trimester pregnancy, childbirth, newborns, postpartum and family planning using Varney midwifery and SOAP approaches.

High parity pregnancies increase the risk of complications for both the mother and fetus. In the Bumiayu Community Health Center alone in 2021-2022 there were 45 cases of mother with grande multipara. To provide Comprehensive Midwifery Care service to pregnant, maternity, newborn, postpartum and family planing sevices in a comprehensif manner though a midwifery management approach according to Varney and SOAP. Based on the bacground above, the problem formulation is how to provide comprehensive midwifery care for Mrs. I aged 32 years in the Bumiayu Community Health Center, Brebes Regency in 2022. The author uses a quality descriptive research method with a case study approach. In pregnancy cases of anemia and CED were found, partus precipitatus birth accurred. As well as giving formula milk to babies and lack of personal hygiene in neonatus and the normal postpartum periode. Grande Multipara Comprehensive Midwifery Care, Presipitatus delivery, giving formula milk to babies, and lack of personal hygiene with newborn and normal postpartum bebies.