A Qualitative Exploratory Study of the Continuity of Midwifery Care for the Adolescent Pregnancy in Indonesia

Dewi Susanti1,, Hardisman Dasman2,, Yusrawati Yusrawati3,, Mudjiran Mudjiran4,, Rahmi A. Yuda5

Abstract


Background: Adolescent pregnancy poses serious biopsychosocial challenges and increases maternal and infant health risks. Continuity of Midwifery Care (CMC) is essential to ensure optimal outcomes, yet its implementation for adolescent pregnancies remains suboptimal. This study aims to explore gaps in CMC for adolescent pregnancies and provide recommendations for improvement.

Materials and Methods: This qualitative study was conducted in Padang, West Sumatera Indonesia, from January to June 2022. Using purposive sampling, participants included adolescent pregnant women (n = 4), Private Midwifery Practices (n = 4), maternal and child health (MCH) program holders (n = 3), a maternal care coordinator midwife (n = 1), and a public health division head (n = 1). Data were collected through in‑depth, semistructured interviews and analyzed thematically using an inductive approach with triangulation to ensure rigor.

Results: Three key themes emerged: (1) Management continuity; care primarily focused on physical health, with limited assessment of psychological well‑being. Diagnosis and care planning neglected adolescent‑specific needs. Emotional support was minimal during implementation and follow‑up. (2) Informational Continuity; Health information was general, lacking relevance to adolescent risks. Verbal explanations and the Maternal and Child Health Handbook were commonly used, with limited digital tools. Retention barriers included judgment, low confidence, and lack of adolescent‑friendly materials. (3) Relational Continuity; Midwifery care lacked psychological support and was disrupted by staff rotation, reducing consistency. Family and partner support were often limited, affecting adherence and safety.

Conclusions: To improve CMC for adolescent pregnancy in Indonesia, it is essential to integrated psychological support, develop adolescent‑specific guidelines, provide personalized health education and strengthen midwife‑client continuity.

 


Keywords


Maternal health services, midwifery, pregnancy in adolescent

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References


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