OPTIMALISASI PERAN BIDAN DALAM PENANGANAN KEGAWATDARURATAN OBSTETRI DI DAERAH TERPENCIL DAN RAWAN BENCANA

Abstract

Obstetric emergencies such as postpartum haemorrhage, hypertensive disorders of pregnancy, and maternal sepsis remain major contributors to preventable maternal deaths. In remote and disaster-prone contexts, disrupted transport, limited supplies, and communication gaps amplify delays in recognition, stabilization, and referral. This community service article describes an intervention to optimize midwives’ roles through competency-based training, in-situ simulation, and strengthening of referral communication at a primary care facility (Puskesmas Klampis Ngasem, Surabaya) as a replicable model for limited-access settings. The program included (1) rapid needs assessment of emergency preparedness, (2) development of pocket guidelines aligned with recent international recommendations, (3) a two-day workshop and skills stations for initial management of haemorrhage, eclampsia, and sepsis, (4) simulation drills with debriefing and role allocation, and (5) linkage to the integrated emergency response system (SPGDT/PSC 119). Evaluation used pre–post knowledge tests and skills checklists. The program achieved the expected targets: knowledge increased by at least 20% and at least 80% of participants passed key skills stations. Simulation-based training improved teamwork, closed-loop communication, and confidence in early stabilization and timely referral. Integrating periodic drills, standardized communication (SBAR), and teleconsultation pathways is recommended to sustain readiness for obstetric emergencies during routine service and when disasters disrupt access.