Midwifery Care for a Woman in Labor with Prolonged First Stage Using a Gym Ball at Kanapa Napa Community Health

Abstract

Background: Prolonged first stage of labor is marked by slow cervical dilation from ineffective uterine contractions, which can cause maternal fatigue, anxiety, infection, and fetal distress. The gym ball is a non-pharmacological complementary care to support labor progress. Purpose: To provide intranatal midwifery care to Mrs. “W” with prolonged first stage at Kanapa-Napa Community Health Center using Varney's seven-step approach with SOAP documentation. Sample/Subject: A woman in labor, Mrs. “W”, 28 years old, G1P0A0, 39 weeks 3 days gestation, diagnosed with prolonged first stage of labor. Method: A descriptive case study using Varney's seven-step approach; data were collected through interviews, observation, physical examination, and documentation, then analyzed and recorded as SOAP. Results: After care—monitoring vital signs, fetal heart rate, and contractions every 30 minutes, psychological support, nutrition support, and gym ball for 30 minutes—contractions improved from 3×10 minutes/15–20 seconds to 4–5×10 minutes/35–40 seconds, cervical dilation progressed from 4 cm to full, and the baby was born spontaneously and healthy without major complications. Conclusion: Intranatal care using Varney's seven-step approach with the gym ball method helped accelerate labor progress and improve maternal comfort in a case of prolonged first stage of labor.