Most of maternal mortality is directly caused by obstetric hemorrhage and almost three-quarters of it take place in postpartum period. The risk of maternal death due to hemorrhage can be reduced with prompt and proper care that in turn relates to the blood loss measurement method used. Unfortunately, the most commonly practiced method is not yet accurate enough. This research proposes a postpartum blood loss measurement method using digital image processing. Initially, characterization is carried out to find out blood absorbance against digital image area and blood volume in the underpad. Results of this characterization then serve as the basis for blood loss measurement using digital image processing. This measurement basis is validated by measuring blood volume lost during delivery care. Results show that the area and volume of blood absorbed in the underpad has significant linear relation (R = 0.9734). Digital image processing can be used to measure postpartum blood loss with a high accuracy up to 83.7%. The use of this method is therefore an accurate and objective alternative to the other available method. Nonetheless, the use of this new method must also adhere to standard guidelines in delivery care as to ensure the utmost outcomes.

At the end stage of pregnancy, a certain amount of anxiety is considered a normal thing experienced by a woman in preparation for the upcoming birth. In some women, this feeling develops into fear of childbirth which might have negative consequences on both the mother and the baby. This case study describes the anxiety experienced by Mrs. G, a 27-years-old primigravida, which caused obstacles in the labor process. The anxiety arose because Mrs. G had no felt any signs of labor until a week after the due date. Counseling and personal approaches are carried out to deal with anxiety, as well as the use of hot herbal compress for relaxation. Meanwhile, uterine contraction was induced naturally by doing oxytocin massage and acupressure on the BL 67 point. Midwifery care provided in this case could reduce anxiety and stimulate uterine contractions to initiate the labor process. Comprehensive and continuous support and assistance from health workers is needed to obtain optimal midwifery care outcomes.

Exclusive breastfeeding is recognized as the single most effective preventive intervention to reduce child mortality in the world. Unfortunately, the success of this exclusive breastfeeding has still a lot of obstacles in daily practice. Breast pain due to nipple crack is one of the most common reasons for premature weaning of breastfeeding. This case study describes the management of midwifery care for Mrs. A, a 29-years-old primipara, who experienced nipple crack on the 19th day of postpartum. She was confused because her baby refused to be given milk formula while she had difficulty giving breastmilk because her nipple soreness. Expressed Breastmilk (EBM) was suggested to be applied topically on the nipple to heal the crack. Meanwhile correction of position and attachment as well as breast care were suggested to prevent repeated nipple trauma. The midwifery care provided in this case made Mrs. A was able to breastfeed her baby comfortably and the sores on her nipple had completely healed within 8 days. Single intervention is not enough to treat nipple crack for breastfeeding mothers. It is necessary to provide combination of continuous midwifery interventions so that the results are more effective. Interventions to prevent nipple trauma in breastfeeding mothers which include correct breastfeeding positions and techniques, breast care and EBM for topical use should be given as standard information provided by health workers in antenatal and postnatal counseling to ensure continuity of breastfeeding and the success of exclusive breastfeeding.

Postpartum haemorrhage is still the leading cause of maternal death in the world. One of the postpartum blood loss source comes from blood vessels that open at placental implantation site at the third phase of birth. This study aims to determine the relationship between placental diameter and postpartum blood loss volume. Cross sectional study was conducted on 120 mothers whose giving birth at Rizky Anugerah Clinic and 24-Hour Maternity Hospital from April to October 2020. The placental diameter was measured from the tip of left to right side in the center of placenta using measuring tape. Meanwhile, the volume of blood loss was measured immediately after delivery using gravimetric method. The result showed that placental diameter of respondents in this study was 17 – 22 cm and 19,72 cm in average. Meanwhile the volume of postpartum blood loss was 51 – 587 ml and 212,02 ml in average. Based on statistical test, it is known that the Sig.(2-tailed) was 0,007 and the pearson correlation was 0,243. So that, we can conclude there was a correlation between the placental diameter and the volume of postpartum blood loss whereas the larger placental diameter the greater postpartum blood loss volume. Examination of placenta after it delivered includes checking its completeness, weighing its weight and measuring its diameter and thickness can not be considered as meaningless routine examination. Although variables in this study shown a low correlation, placental diameter still provide information for midwives to anticipate the occurance of postpartum haemorrhage without ignoring other factors.

Perineal suturing due to spontaneous obstetric tears or episiotomy is the most common operative procedure experienced by women. More than 90% of primiparas experience trauma to the labia, vagina or perineum during vaginal delivery. Perineal wound healing duration is influenced by nutritional factors. This case study describes the wound healing process in two primiparas who had second-degree perineal tears. Both of those primiparas have the same socio-economic characteristics. One primipara was given additional nutrition intake of 140 grams egg white per day, while the other primipara was given standard care of education related to perineal wound care and nutritional needs during puerperium. Perineal wound observation was performed using REEDA scale, while daily intake data were collected using a food recall form. Primipara who consumed egg white every day had an average protein intake of 89 grams and her perineal wound recovered in 6 days. Meanwhile, primipara who only received standard care had an average protein intake of 67 grams and her perineal wound recovered in 8 days. Perineal wound healing was faster in primipara who received additional protein intake from egg white consumption. So that, education related to nutritional needs during puerperium is important to inform the mother and family.