Management of Midwifery Care for Ms. S, Age 27, G3P2A0, with a Post-Term Pregnancy Complicated by Primary Postpartum Hemorrhage at the Salbiyana Primary Care Clinic in 2026

Abstract

Background & Objective: Postdate pregnancy is a pregnancy that lasts more than 42 weeks or 294 days and increases the risk of complications for both the mother and the fetus. Primary postpartum hemorrhage remains one of the leading causes of maternal mortality in Indonesia. This study aims to implement midwifery care in a case of postdate pregnancy complicated by primary postpartum hemorrhage using the 7-step Varney midwifery management approach.

Method: This research used a descriptive method with a case study approach on Mrs. S, 27 years old, G3P2A0, who experienced postdate pregnancy and primary postpartum hemorrhage at Salbiyana Primary Clinic in 2026. Data collection was conducted through anamnesis, physical examination, observation, and documentation of midwifery care.

Result: The patient presented with complaints of abdominal pain accompanied by mucus mixed with blood at 42+ weeks of gestation with cloudy amniotic fluid. Labor induction was performed using oxytocin drip and delivery proceeded spontaneously. The baby was born in good condition with a birth weight of 2900 grams and length of 48 cm. During the fourth stage of labor, primary postpartum hemorrhage occurred due to the cervix failing to close adequately. Immediate management was provided including oxytocin drip and misoprostol, followed by referral to the hospital.

Conclusion: Comprehensive midwifery care with close monitoring and early detection of complications is essential in postdate pregnancy cases. Prompt management of primary postpartum hemorrhage and appropriate referral decisions can prevent more severe complications and save maternal lives.