Adolescent pregnancy, particularly unwanted pregnancy outside of marriage, is categorized as a high-risk condition requiring intensive monitoring. Continuity of Care (CoC) in midwifery is a comprehensive and holistic approach that encompasses antenatal, intrapartum, postpartum, newborn care, and family planning services. This model emphasizes an ongoing professional relationship between the midwife and the client, aiming to improve service quality, facilitate early detection of complications, and provide continuous emotional support and education.

This case study report describes the implementation of Continuity of Care for Mrs. A, a 19-year-old adolescent with a high-risk pregnancy, using the midwifery management approach. Data collection methods included interviews, observations, physical examinations, documentation, and interventions documented through the SOAP format.

Throughout two antenatal visits, Mrs. A’s condition remained stable despite her high-risk status. False contractions were managed through health education, adequate rest, hydration, and relaxation techniques. Labor was monitored closely and proceeded physiologically; however, shoulder dystocia occurred due to disproportion between the estimated fetal weight and the actual birth weight. The complication was successfully managed using the McRoberts maneuver. On July 19, 2024, at 07:40 AM, a male infant was delivered spontaneously, weighing 4000 grams, measuring 50 cm in length, and presenting with severe asphyxia (Apgar score at 1 minute: 2). Immediate resuscitation was performed, followed by early initiation of breastfeeding (EIBF), administration of vitamin K1, hepatitis B immunization, and intensive monitoring. The newborn received one hour of uninterrupted skin-to-skin contact, which, along with early breastfeeding, supported recovery.

During the postpartum period, breastfeeding difficulties were addressed through oxytocin massage and continued breastfeeding education. Perineal wounds healed without complications, and the infant’s growth was appropriate for age. Continuous education was provided regarding umbilical cord care, neonatal danger signs, and exclusive breastfeeding. Routine follow-up visits supported optimal growth and development, ensured exclusive breastfeeding, and promoted timely immunization. On the fourth visit, Mrs. A chose implant contraception during a family planning outreach program. She reported no complaints and was counseled on possible side effects, which do not interfere with breast milk production.

The findings of this case study indicate that the application of Continuity of Care is effective in the comprehensive management of high-risk pregnancies, facilitating early detection of complications, timely interventions, and continuous health education, ultimately contributing to optimal maternal and neonatal outcomes.