Asuhan Kebidanan Komunitas pada Ibu Hamil dengan Anemia Ringan: Laporan Kasus di Wilayah Kerja Puskesmas Batunyala, Kabupaten Lombok Tengah

Abstract

Background: Anaemia in pregnancy remains one of the most common maternal health problems worldwide and in Indonesia, where prevalence is still substantially above the target set by national health authorities, with West Nusa Tenggara Province and Central Lombok Regency reporting a persistently high burden. Detailed case-level documentation of community midwifery management for mild anaemia in pregnancy, particularly in rural primary care settings, remains limited compared with population-level prevalence studies. Objective: This case report describes the process of community midwifery care using the Subjective-Objective-Analysis-Planning (SOAP) framework for a pregnant woman with mild anaemia at Batunyala Primary Health Care Centre, Central Lombok Regency, and discusses the findings against current scientific evidence. Method: A descriptive case-study design was used. Data were collected through in-depth interviews, physical examination, obstetric palpation, vital-sign measurement, and laboratory testing of haemoglobin (Hb) at 32 weeks of gestation, with a follow-up assessment two weeks later. Results: The client, a 28-year-old woman in her second pregnancy (G2P1A0H1), presented with dizziness and easy fatigue. Physical examination showed pale conjunctiva with otherwise normal vital signs, and laboratory testing showed an Hb level of 9 g/dL. Fetal palpation at the initial visit suggested an unstable presentation with the presenting part not yet engaged. The client was diagnosed with mild anaemia in pregnancy and managed through nutrition counselling, iron and vitamin C supplementation, danger-sign education, and daily knee-chest positioning. At the follow-up visit, Hb had risen to 11.8 g/dL, and the fetal presentation had converted to cephalic with the head engaged in the pelvis. Conclusion: This case illustrates how a holistic, evidence-informed SOAP-based midwifery approach, combining iron supplementation with dietary counselling and a simple positional intervention, can be applied at the primary-care level to manage mild anaemia in pregnancy and to support an accompanying malpresentation. The findings support strengthening antenatal iron supplementation programs together with structured nutrition counselling as complementary strategies to reduce the burden of anaemia in pregnancy in high-prevalence regions such as West Nusa Tenggara.