Midwifery Managers Research Articles

Co-creating the intervention ‘MAMAACT’ for improved care for pregnant migrant women in Denmark

Abstract Background The MAMAACT intervention was developed as a response to documentation of ethnic and social inequities in stillbirth in Denmark, despite free and universal access to antenatal care. The MAMAACT intervention aimed to reduce stillbirth in migrant families by improving communication about pregnancy complication during antenatal care. Methods The intervention consisted of a training program for midwives and health education materials. It was implemented at a structural level (training of midwives) and, through strengthened needs-based communication during antenatal care, the aim was to improve the health literacy of the women. 19 of the 20 Danish maternity wards participated in the study in 2018-19 and a comprehensive evaluation was conducted. The intervention was co-created with midwifery managers, midwives, and migrant women. Results The management and selected clinical midwives participated in the design of the midwifery training and the health education material as well as the intervention’s implementation and recruitment strategies for the evaluation. As representatives of the target group, a partnership with the non-profit organization Bydelsmødre was initiated. Bydelsmødre trains migrant mothers living in socially deprived areas to help vulnerable migrant women. Evening sessions were conducted with a specific group of women in their community, where the intervention components, the recruitment to the evaluation, and the interpretation of evaluation findings were discussed. A significant contribution was a video explaining the migrant experiences of becoming a mother in Denmark used in the midwifery training. MAMAACT researchers were invited to present the evaluation at the annual assembly for Bydelsmødre organization in 2019. Conclusions The partnership with Bydelsmødre provided a strong voice for migrant women, enhancing engagement with the intervention, recruitment for the trial, and its real-world relevance.

MIDWIFERY SERVICE MANAGERS’ READINESS FOR PREVENTION OF OBSTETRIC VIOLENCE IN NIGERIA: A COMMUNITY READINESS MODEL

Obstetric violence is a public health problem that needs to be prevented at all levels to improve maternal and newborn health outcomes. The midwifery service managers, as custodians of patient care in maternity centres are in a prime position to develop and implement effective obstetric violence prevention interventions. This study explored the midwifery service managers’ level of readiness for the prevention of Obstetric Violence in three maternity centres at three separate hospitals in Oyo State, Nigeria. Data was collected from six midwifery service managers as midwifery community leaders, using the adapted Community Readiness Model as a data collection tool. The Community Readiness Model scoring guide was used to score the six dimensions of community readiness. In addition, a thematic analysis was used to analyze the qualitative data from their views on each of the six dimensions of the Community Readiness Model. The findings revealed an overall level of readiness for the prevention of obstetric violence among midwifery service managers was at level five which is the preparatory level. This means that the community has a modest readiness for Obstetric violence prevention, and it would be easier to develop sustainable prevention interventions for obstetric violence. Understanding the midwifery service managers’ level of readiness for the prevention of obstetric violence is important for governments and other stakeholders intending to develop obstetric violence prevention interventions that are contextually appropriate and acceptable to communities.

THE PRACTICALITY, EFFICIENCY, POSITIVE IMPACT AND EFFECTIVENESS OF THE "MIDWIFERY MANAGER" MANAGEMENT INFORMATION SYSTEM IN IMPROVING THE QUALITY OF MIDWIFERY SERVICES AT THE MIDWIFERY'S INDEPENDENT PRACTICE PLACE BANDUNG

Introduction. Health transformation in the digital era has brought fundamental changes in health services, including midwifery. About 80% of Midwife Independent Practices in Bandung City still use manual records. The management information system for Midwife Independent Practices, named "Midwifery Manager", is one of the innovations in the health sector. This study aims to analyze the increase in practicality, efficiency, positive impact, and effectiveness of the "Midwifery Manager" Management Information System in improving the quality of midwifery services at the place of practice of independent midwives. Method. The research was quantitative, with a pre-experimental design in the form of a pre-test and post-test design. The target population in this study were all midwives who had independent practice places in the Bandung City Region, which were 300 TPMB. The sampling technique in this study used proportionate random sampling, which amounted to 40 respondents. The data analysis techniques used are normality test, Wilcoxon test, and chi-square test. Result & Analysis. The results showed an increase in practicality, efficiency, positive impact, and effectiveness of the quality of midwifery services after the use of "Midwifery Manager", respectively with a value of p 0.000; p 0.000; p 0.00; and p 0.001 (<0.05) in the independent practice of midwives. Discussion. Using the Management Information System "Midwifery Manager" increases the practicality, efficiency, positive impact, and effectiveness of midwifery service quality, and effectiveness of midwifery service quality in the independent practice of midwives in the Bandung City area.

Midwifery assessment and interventions protocol for adolescent pregnancy: a Delphi method approach

Background: Adolescence pregnancy poses risks for both mothers and infants, often due to insufficient prenatal care resulting from societal stigmatization and lack of awareness. Around 16 million adolescents aged 15-19 years in the world give birth each year; in Indonesia, the first pregnant women aged <20 years are 45.10%, while in West Sumatra, it is 33.7%. To address this issue, integrated programs and midwifery care have been implemented. However, providing such care to adolescent mothers comes with its own set of challenges.Purpose: This study aims to conduct a midwifery assessment and intervention protocol for adolescent pregnancy.Method: Qualitative approach The Delphi method involved two rounds of evaluation, with twenty-one participants who were independent practice midwives, six midwives involved in the mother and child health program, and nine midwifery lecturers from accredited educational institutions A (excellent). Participants had at least five years of clinical experience and were selected using purposive non-probability sampling. Participants evaluated statements related to midwifery care during the Delphi process. The validity of these statements was determined by participants providing a minimum score of 3, and the Content Validity Ratio (CVR) was calculated. Statements with a CVR greater than 0.8 were considered valid.Results: Based on expert consensus, important assessments for adolescent pregnant women include addressing issues of gender equality and domestic violence, reproductive and sexual health, risks associated with smoking and substance abuse, maintaining a healthy pregnancy, and adequately preparing for labor and parenthood.Conclusion: Midwifery management and midwifery information were deemed valid dimensions of midwifery care; relational care had one invalid item.

ASUHAN KEBIDANAN CONTINUITY OF CARE PADA KASUS FISIOLOGIS DI KLINIK DAN RB EVA

The high MMR (Maternal Mortality Rate) is still a crucial matter that must be resolved by the Indonesian government. Based on data from the Ministry of Health in 2022, the number of MMR reached 4,005 and in 2023 it will increase to 4,129, making Indonesia rank second in ASEAN in terms of maternal mortality. So Continuity of Care Midwifery Care is needed which aims to provide continuous care from pregnancy to preconception so that it is able to detect any health problems experienced by clients. Care is carried out at the Eva Clinic and Maternity Home in the period November 2023 to March 2024. A series of continuous midwifery care is carried out for Mrs. I during pregnancy, childbirth, newborns, postpartum, and the decision to use contraception. After carrying out midwifery management care with a comprehensive approach and SOAP documentation, it can be seen that Mrs. I in a physiological condition at each phase of care carried out. Keywords : Continuity of Care, Midwifery Care.

Asuhan Kebidanan Komprehensif Pada Ny. M Umur 44 Tahun G4P2A1 Faktor Resiko Umur Ibu Lebih Dari 35 Tahun Dan Pre-Eklamsia Di Wilayah Kerja Puskesmas Paguyangan Tahun 2023

The Program Registration at the Ministry of Health in 2020 shows a figure of 5,125 deaths. AKI is caused by bleeding, pre-eclampsia/eclampsia, infection, late arrival of the mother to a health facility and mothers with positive PCR/Antigen. The aim of this research is to be able to implement comprehensive midwifery care for Mrs. M, 44 years oldhe maternal mortality rate in Indonesia compiled from the Family Health. This research method used quantitative descriptive with a case study approach. The case study carried out was in the form of Comprehensive Midwifery Care which examined women during pregnancy, childbirth, newborns, postpartum and family planning with Varney's seven-step midwifery management and SOAP. Comprehensive Midwifery Care for Mrs. M, namely during pregnancy, pre-eclampsia was discovered. Delivery by Sectio Caesarea and the baby was born normally. During the postnatal period, no problems were found in the baby. During the postpartum period, no problems were found. Mother uses MOW birth control. Based on the care, it is concluded that the care has been implemented according to Midwifery Service standards.

THE RELATIONSHIP BETWEEN AMNIOTOMY, PROVIDER TYPE AND CAESAREAN SECTION IN A UNIVERSITY MEDICAL CENTRE

An active management of labour protocol that includes amniotomy has been widely promoted as a means of reducing a rising Caesarean section rate. However, evidence does not consistently demonstrate the effectiveness of amniotomy in promoting vaginal birth. This study explores the relationship of amniotomy, and the time at which amniotomy is performed, with the mode of delivery in term primiparous women admitted in active labour to a university teaching hospital. The study also explores several variations in practice between faculty-supervised resident physicians, community physicians and hospital-based nurse-midwives that the authors believe may confound the study findings. Selection criteria were designed to eliminate study bias. Records of 258 women delivering between January 2000 and December 2002, that met the selection criteria, were reviewed. Findings suggest that women receiving amniotomy are more likely to deliver via Caesarean section. Results also demonstrate that women ruptured prior to three centimeters are at higher risk of Caesarean. A comparison of records of cases attended by midwives and physicians suggests several significant differences in labour management including decreased use of amniotomy and amniotomy later in labour. These differences between medical and midwifery management may provide insights into interventions leading to promotion of vaginal delivery.

Asuhan Kebidanan Komprehensif Pada Ny. N G1P0A0 Dengan Faktor Resiko Umur <20 Tahun

Background: World Health Organization (WHO) in 2020 the maternal mortality rate (MMR) in the world is 152 deaths per 100,000 live births. In ASEAN, the highest MMR in 2020 is in Myanmar, which is 235 per 100,000 live births. The maternal mortality rate in Brebes Regency in 2020 was 62 cases. In the Bantarkawung Health Center working area in 2020 there was 1 case, in 2021 there were 5 cases. Objective: To provide comprehensive midwifery care services to Mrs. N Age 19 Years G1P0A0 with Risk Factors Age <20 Years at the Bantarkawung Health Center, Brebes Regency with a midwifery management approach according to Varney's seven steps and SOAP. Research method: This study uses descriptive qualitative research with a case study design. The Scientific Writing assignment report is written based on a case report of comprehensive midwifery care in pregnant women, childbirth, newborns, and postpartum using the type of case review study research method. Results: The results of comprehensive midwifery care are the absence of gaps between theory and practice where according to the theory pregnant women with a young age <20 years will experience several risks such as in any.N who experienced a short TFU of 28 cm. Conclusion: After conducting an assessment and collecting data on comprehensive midwifery care on Mrs. N with risk factors for age <20 years at the puskesmas from third trimester pregnancy.

PENGEMBANGAN MEDIA AUDIO VISUAL PEMBELAJARAN PENATALAKSANAAN ASUHAN KEBIDANAN PERSALINAN

This study aims to produce and develop an audio-visual learning media for helping teachers in Management Midwifery Care Delivery of Kala I, II, III and IV. By adapting Borg and Gall’s model (1983), procedures of development includes (1) analysis of the problem, (2) the collection of data, (3) mendesai products, (4) validation of design, (5) revision of design, (6) test cuba products, (7) revision of products, (8) the trial use, (9) revision of the product, and (10) product period. The results of this study as a whole is a product that is developed on both criteria, the following details (1) media Validator gives a value of 4 which means the product at a good level, (2) Validator of material with a value of 4.5 which means that both products are at good levels based on material elements, (3) The response of students about media fascination that was developed had an average score of 4.14 on testing a small group, is included in both criteria. Response field or group of students scored 4.25 grade categorized as good, (4) The trial results showed that the average pre-test students for field trials in the pre-test class IIA shows the average value of 56.7 and mean average post-test grade 76 at IIC pre-test showed 54.48. post-test showed the value of 64.83 calculated on a simple learning outcomes of students with a 10,5 difference between class IIA to IIC This figure shows that the product can provide the difference in student learning Study abroad and thoroughness. In the normal group based on these data we can conclude that audiovisual media learning midwifery care delivery based on the criteria of both the validity and effectiveness of student response and teacher audio visual media users midwifery management of labor. Kata kunci: Audio Visual Media, Learning Management Midwifery Care Delivery

PENERAPAN AROMATERAPI SEREH TERHADAP KECEMASAN MENGHADAPI PERSALINAN PADA NY D DI PUSKESMAS TANJUNG BALAI KARIMUN

Anxiety about childbirth is felt by all pregnant women before delivery. Essential oils in labor can improve coping strategies in birthing mothers. The main role of essential oils during labor and delivery is to help relieve pain, stress and anxiety. The aim is to provide midwifery care for mothers in a comprehensive and sustainable manner, with management of midwifery care in accordance with midwifery service standards. Midwifery care that is applied is the application of citronella aromatherapy to anxiety in facing childbirth. The practice report preparation method is descriptive research with the case study method conducted at the Tanjung Balai Karimun Health Center in February 2023. The subject used in this case study with midwifery care management was Mrs. D. Results and Conclusions Evaluation of the care provided related to the application of lemongrass aromatherapy to the anxiety of facing childbirth there is a reduction in the anxiety that the mother feels

ASUHAN KEBIDANAN PADA IBU BERSALIN NY P DENGAN PEMBERIAN KELAPA UNTUK MENINGKATKAN TENAGA PERSALINAN DI PUSKESMAS TANJUNG BALAI KARIMUN

Childbirth is influenced by three main elements, namely energy (his power of straining), the condition of the birth canal, and the size of the fetus. Foods and drinks that are scientifically proven to be used to facilitate labor are dates, young coconut water, honey and soy milk. Objective To provide comprehensive and continuous midwifery care for mothers giving birth, with management of midwifery care in accordance with midwifery service standards. The midwifery care that is applied is Midwifery Care for Mrs. P. Giving Birth Coconuts to Increase Labor Force. The practice report preparation method is descriptive research using the case study method. The research was conducted at the Tanjung Balai Karimun Health Center in March 2023. The subject used in this case study with midwifery care management was Mrs. P. Results and Conclusions Evaluation of the care provided related to the implementation Midwifery Care for Maternity Mrs. P By Giving Coconuts to Increase Labor Force, there is an Increase in Labor Force for Mothers

STUDI KASUS: ASUHAN KEBIDANAN PASKA PERSALINAN DENGAN RETENSIO URINE

Postpartum urinary retention is defined as the absence of spontaneous urination or the inability to urinate spontaneously starting 6 hours after vaginal delivery, and the inability to urinate spontaneously 6 hours after catheter removal during delivery with the following actions:caesarean section. This complaint can be caused by hormonal changes, changes in the contractile response of the bladder, innervation trauma that occurs in the bladder, and several other risk factors, namely perineal laceration or episiotomy, delivery with the help of tools, duration of the first stage of labor.>12 hours, duration of second stage of labor>1 hour in multiparas, and birth weight of the baby>3800 grams. The aim of this research is to provide midwifery care to mothers after giving birth who complain of not being able to urinate since 3 days after giving birth. Care is carried out by paying attention to midwifery management steps according to Helen Varney. The research was carried out from 27 March to 09 April 2023 at Gunung Jati Hospital, Cirebon City, using a case study research method and the research subject was Mrs W P1 A0 aged 23 years. Primary and secondary data collection. Primary data was obtained through interviews, observation and physical examination, while secondary data was obtained through documentation and literature studies. The analysis used is descriptive and exploratory through studying data from research subjects. The results of the care were discussed by taking into account similar previous research and a review of relevant literature so that it could be concluded that there was no gap between theory and the care given to Mrs W

PENATALAKSANAAN ASUHAN PADA IBU POSTPARTUM BLUES DI KLINIK MANDA MEDAN

Postpartum blues Approximately 70-80% of post-partum mothers experience mood or feeling disorders, in general this condition is still considered normal, is felt from 2-3 days after giving birth and normally disappears after 2 weeks postpartum. This study provides comprehensive midwifery care for pregnant women, maternity, postpartum, BBL, neonates and family planning using a midwifery management approach to Ny. “D” with the case of the ASI Dam. Care in this study with observation and evaluation. The subject of this care is Mrs. “D” with POSTPARTUM BLUES at Manda Clinic. This research activity is about the handling of POSTPARTUM BLUES in postpartum mothers. The study conducted observations and evaluations of mothers on a regular basis. Observations and evaluations were carried out not only assessing but knowing and assessing the conditions and support for mothers. Husbands and parents are also needed to support mothers. This research was conducted at the Manda Clinic.Factors that cause the appearance of signs and symptoms of the postpartum blues. The results showed that age and parity were not always the triggering factors for postpartum blues symptoms, the causes of postpartum blues were worrying about the baby, maternal fatigue factor, comments from people around about the mother, husband's support and presence, adaptation to the baby's presence.

Vietnam national competency standards for midwifery: A Delphi study

Background After nearly a decade, Vietnam’s basic midwifery competency standards need to be updated to effectively implement midwives, enhance the quality of midwifery human resources to meet the requirements of integration of countries in the region and around the world. This study aims to develop the competency standards for midwifery in Vietnam by using a Delphi process. Methods The draft midwifery competency standard was initially developed based on a literature review. Midwives and professionals working with midwives completed a two-round Delphi survey to evaluate the relevance of standards of competence on a four-point Likert scale. The criteria with consensus of under 80% were revised and included in the second round. 75 participants were in the first round and 72 participants were in the second round. Phase 3 was led by the Ministry of Health to finalize the consensus on the midwifery competency standards in Vietnam. Results The research results indicated that midwifery competency was mostly rated as quite relevant or higher (over 80%). Some standards were removed, and some were included in the second round of the Delphi process. The final competency standards were issued with 4 areas (midwifery professional practice; care management; midwifery management; professional development), 11 standards and 44 criteria; along with the general skills of midwifery. Conclusions The study developed a midwifery competency standard in Vietnam. These competency standards are consistent with the perceptions of the International Confederation of Midwives and the domestic midwifery context. The higher education institutions, employers, policy makers and midwives themselves benefit from this developed midwifery competency standards. Future research needs to be conducted to validate midwifery competency standards in clinical settings for further responses.

Asuhan Kebidanan Komprehensif Pada Ny. I Umur 32 Tahun Dengan Grande Multipara Dan Kurang Energi Kronik Di Puskesmas Bumiayu Tahun 2023

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.

ASUHAN KEBIDANAN PEMBERIAN SARI KURMA UNTUK MENINGKATKAN KADAR HEMOGLOBIN IBU HAMIL DENGAN ANEMIA DI PUSKESMAS TANJUNG BALAI KARIMUN

According to WHO, the global prevalence of anemia in pregnant women worldwide is 41.8%. The main cause of anemia in pregnancy is iron deficiency, followed by folate deficiency. One way to overcome anemia in pregnancy is by consuming iron foodstuffs, including dates. The purpose of this study was to provide integrated midwifery care for pregnant women with mild anemia by giving date juice to increase hemoglobin levels. Midwifery care uses a midwifery management approach. This type of research uses case study qualitative data. Midwifery care was carried out at the Tanjung Balai Health Center with subjects pregnant women at 32 weeks of gestation with mild anemia. The research instrument uses a case study format and observation sheets. Data collection techniques use primary data through anamnesis, physical examination, interviews and observation. Evaluation of the care provided related to giving date palm juice 3 times a day can help increase HB levels. For health workers, it is hoped that they can improve the quality of midwifery services through a management approach to midwifery care for the prevention of mild anemia with date juice.

Comprehensive Midwifery Care In Ny "R" With Normal Pregnancy At The Health Center Caile Ujung Bulu District Bulukumba District May-July Priod Year 2023

Pregnancy is a normal process, but this situation can turn abnormal if it is not monitored. Complications that can occur are one of the causes of irregular ANC visits. So comprehensive midwifery care is needed, where this care is expected to minimize complications that can occur during pregnancy and it is hoped that the mother can go through all the processes normally. The aim is to provide comprehensive care for Mrs "I" aged 20 years. The method used is a case study with a Varney midwifery management approach with data collection techniques including observation, interviews, physical examination and documentation studies. The results of comprehensive midwifery care for Mrs "I" with a normal pregnancy were known from the results of observations which indicated that there were no problems since midwifery care was carried out starting at 35 weeks 4 days of gestation. The conclusion of comprehensive midwifery care for Mrs "I" was carried out according to midwifery care standards with normal results without any complications.

Midwifery care during the postpartum period for Ny "A" at Bontobangun Community Health Center, Rilau Ale District, Bulukumba Regency

Postpartum is a normal process, but this situation can turn abnormal if it is not monitored. Complications that can occur are one of the causes of irregular PNC visits. So comprehensive midwifery care is needed, where this care is expected to be able to minimize complications that can occur during postpartum and it is hoped that the mother can go through all the processes normally, the aim is to provide comprehensive care to the child. NY “A” is 26 years old. The method used is a case study with a Varney midwifery management approach with data collection techniques including observation, interviews, physical examination and documentation studies. The results of comprehensive midwifery care in NY "A" with normal postpartum were known from the results of observations which indicated that there were no problems since midwifery care was carried out from the first postpartum visit to the fourth postpartum visit. Conclusion: Comprehensive midwifery care in NY "A" was carried out according to midwifery care standards with normal results without any complication
 
 Keyword : Comprehensive; Midwifery

Enhancing new graduate nurses and midwives person-centredness through clinical supervision during COVID-19; evaluation of a non-randomized intervention study.

The aim of the study was to evaluate a person-centred model of clinical supervision to enhance person-centredness. Experimental, quantitative. One hundred and three New Graduates were supported to reflect through a person-centred lens (July-December 2020). Evaluation was undertaken at 6 months using: the Manchester Clinical Supervision Scale-26 (effectiveness of supervision) and the Person-centred Practice Inventory (measures attributes of the nurse/midwife, the care environment and person-centred processes). Due to participation difficulties, scores were calculated by attendance rates using descriptive and inferential statistics. Regular attendees scored higher on the supervision's effectiveness; however, this did not reach efficacy. 'Finding time' to attend contributed to low scores. Supervision scored well on its supportive function when attended. Many New Graduates perceived a decline in their care environment. Attendance aside, New Graduates averaged an increased in their person-centred attributes and processes. Greater participation was found in those who scored higher at baseline on their person-centred attributes and processes, and this higher scoring continued at 6 months than those who attended less. New Graduates who perceive themselves as person-centred and reflective at baseline are more likely to attend a person-centred clinical supervision and score higher at 6 months than those who attended less often. New Graduates found support within supervision during challenging times. For successful implementation of Person-centred Clinical Supervision, New Graduates need support to attend, as attendance supports them to begin seeing value in the process. This intervention kept person-centred practice at the forefront of New Graduates reflection, in a time of extreme change. The research has implications for nursing and midwifery management with the imperative to deliver person-centred care and create the person-centred cultures for staff to feel supported and empowered. Transparent Evaluation of Non-randomized Designs (TREND). No patient or public contribution. New Graduates grow their person-centredness over their transitioning year; however, this can be enhanced with regular clinical supervision underpinned by person-centred theory. Clinical supervisors can provide support to New Graduates when the environment is challenged.

Asuhan Kebidanan Komprehensif Pada Ny N Umur 22 Tahun Dengan Kekurangan Energi Kronik Di Puskesmas Bumiayu Tahun 2023

Background: KEK is one of the risk factors for pregnancy causes complications and maternal death. The global maternal mortality rate due to CED is 37%, maternal deaths in Central Java Province in 2020 were 530 cases. The maternal mortality rate in Brebes district is 62 cases. At the Bumiayu Health Center, the maternal mortality rate in 2020 was 2 cases. The aim is to be able to carry out Comprehensive Midwifery Care for Mrs N aged 22 years with Chronic Energy Deficiency at the Bumiayu Community Health Center using Varney's seven-step midwifery management and SOAP Research Method: this research is a qualitative descriptive research with a case study approach. The results: of Comprehensive Midwifery Care for Mrs N were that during pregnancy KEK was found. Delivery was normal and the newborn was found to be underweight. In neonates, boils were found on the legs and the baby's body temperature was high, then appropriate management was carried out so that the problem was resolved. During the postpartum period, the stitched wound was found to be still wet, then ointment was given to solve the problem. Mother uses birth control implant. Conclusion: care has been carried out in accordance with midwifery service standards.