The role of continuity of care in high-risk pregnant women in Indonesia.

Abstract

Introduction: High-risk pregnancies require special attention in maternal and child health services, given the high potential for complications that can affect maternal and fetal health. The continuity of care (COC) approach is expected to increase family independence and prevent pregnancy complications. This study aims to analyze the effectiveness of COC in improving the family independence of high-risk pregnant women in preventing pregnancy complications.

Methods: This study used a quasi-experimental design with a pretest-posttest approach without a control group, involving 134 high-risk pregnant women, in the target area at the Wonoayu Community Health Centre, Sidoarjo, Indonesia from February to May 2024, who were selected through purposive sampling. Data were collected through structured questionnaires before and after the COC intervention, which included assessing knowledge and family roles in supporting pregnant women's health. The COC mentoring program was implemented for three months, with a focus on family education and involvement in maternal healthcare. A validated questionnaire measured family self-reliance before and after the intervention.

Results: The study showed a significant increase in family self-reliance, with a p<0.001 in all aspects measured, including fulfilment of physiological and psychological needs, preparation for labor, the postpartum period, and preparation after the baby is born. This increase suggests that the COC intervention is effective in empowering families to support high-risk pregnant women. Before the intervention, the mean score for physiological and psychological needs fulfilment was 17.45, which increased to 36.42 after the intervention (p<0.001). In addition, labor preparation also showed a significant increase from 11.40 to 24.38, as well as postpartum preparation from 13.00 to 28.79, and preparation after the baby is born from 13.25 to 28.75 (all p<0.001).

Conclusions: The consistent improvement in all measured aspects, indicated that the COC intervention not only improved families' knowledge and skills, but also contributed to their preparedness in supporting pregnant women during and after pregnancy.