CONTINUITY OF MIDWIFERY CARE AND MATERNAL HEALTH OUTCOMES: EXAMINING THE ROLE OF DIGITAL FOLLOW-UP DURING PREGNANCY AND THE POSTPARTUM PERIOD

Kemas Rizaldi; Ramdani Apriandi; Eka Putra

doi:10.55681/aohj.v3i1.560

Authors

Kemas Rizaldi STIKES Mataram
Ramdani Apriandi Universitas Pendidikan Mandalika
Eka Putra Universitas Pendidikan Mandalika

DOI:

https://doi.org/10.55681/aohj.v3i1.560

Keywords:

Continuity of midwifery care, Digital follow-up, Maternal health outcomes

Abstract

Continuity of midwifery care strengthens relational, informational, and management continuity across pregnancy, childbirth, and the postpartum period, yet missed visits and fragmented communication can weaken timely detection of maternal problems. This study examined the potential contribution of structured digital follow-up to continuity of care and maternal health outcomes in community-based maternity services. A quasi-experimental simulation-based design compared conventional continuity practices with a digitally supported pathway among 320 synthetic maternal records followed from the second trimester to six weeks postpartum. The intervention combined scheduled midwife contact, appointment reminders, symptom screening, blood-pressure reporting, tailored education, postpartum check-ins, and referral escalation. Outcomes included antenatal attendance, postpartum follow-up completion, timely identification of warning signs, referral completion, self-care confidence, and continuity experience. Simulated findings indicated higher completion of recommended contacts, faster response to reported warning signs, improved postpartum follow-up, and more complete referral documentation in the digital pathway. Women with regular two-way communication showed stronger modeled engagement and self-management confidence than those receiving routine reminders alone. However, digital exclusion, connectivity, workload, privacy, and alert fatigue remained important implementation risks. Digital follow-up should therefore complement rather than replace face-to-face midwifery relationships. The study suggests that digitally enabled continuity is most effective when communication is personalized, clinically governed, interoperable with primary care, and supported by clear escalation protocols. Prospective field studies are required to determine effectiveness, cost, equity, acceptability, and maternal outcomes under real service conditions in diverse Indonesian settings. while preserving respectful woman-centered care and professional

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