Application of the Conceptual Model of Holistic Midwifery Services to Pregnant Women in Independent Practicing Midwives in Purwakarta Regency

Holistic midwifery services are an approach that views pregnant women as complete beings, consisting of physical, mental, social and spiritual aspects. The aim of this research is to determine the application of the conceptual model of holistic midwifery services to pregnant women in independent practice midwives in Purwakarta Regency. This research uses a qualitative approach with a case study method. The research subjects were 5 independent practicing midwives in Purwakarta Regency. Data was collected through in-depth interviews and observations. Data analysis was carried out descriptively qualitatively. The research results show that the implementation of the conceptual model of holistic midwifery services for pregnant women in independent practice midwives in Purwakarta Regency is quite good. Midwives are able to carry out holistic assessments of pregnant women, covering physical, mental, social and spiritual aspects. Midwives are also able to provide holistic midwifery care, including physical, mental, social and spiritual care.


Introduction
Pregnancy is a very important period for a woman.
During this period, women experience physical, mental, social, and spiritual changes.These changes can affect the health and well-being of pregnant women.The most common physical change that occurs in pregnant women is weight gain.On average, pregnant women will gain around 10-12 kilograms of weight during pregnancy.This weight gain is caused by the growth of the fetus, placenta, amniotic fluid, and breast tissue.The mental changes that occur in pregnant women are also very diverse.Some pregnant women may feel happy and excited, while others may feel anxious, sad, or angry.These mental changes can be caused by various factors, such as pregnancy hormones, body changes, and stress.Social changes that occur in pregnant women can also affect their health and well-being.Some pregnant women may feel the need to adjust their relationships with family and friends.Pregnant women may also feel the need to prepare themselves for parenthood.Spiritual changes can also occur in pregnant women.Some pregnant women may feel closer to God, while others may feel further away.These spiritual changes can be

A B S T R A C T
Holistic midwifery services are an approach that views pregnant women as complete beings, consisting of physical, mental, social and spiritual aspects.The aim of this research is to determine the application of the conceptual model of holistic midwifery services to pregnant women in independent practice midwives in Purwakarta Regency.This research uses a qualitative approach with a case study method.The research subjects were 5 independent practicing midwives in Purwakarta Regency.Data was collected through in-depth interviews and observations.Data analysis was carried out descriptively qualitatively.The research results show that the implementation of the conceptual model of holistic midwifery services for pregnant women in independent practice midwives in Purwakarta Regency is quite good.Midwives are able to carry out holistic assessments of pregnant women, covering physical, mental, social and spiritual aspects.Midwives are also able to provide holistic midwifery care, including physical, mental, social and spiritual care.managed properly can increase the risk of pregnancy complications, such as preeclampsia, premature birth, and difficult labor.Therefore, it is important for pregnant women to understand the changes that occur in themselves.[3] Holistic midwifery services are an approach that views pregnant women as complete beings, consisting of physical, mental, social and spiritual aspects.This approach aims to provide comprehensive and holistic midwifery care, so as to improve the health and wellbeing of pregnant women.Holistic midwifery care on the physical aspect includes routine pregnancy checks, such as checking vital signs, breast examinations, abdominal examinations, and laboratory examinations.Midwives also provide immunizations and nutritional counseling.Holistic midwifery care on mental aspects includes counseling to deal with stress, anxiety and depression.Midwives also facilitate pregnant women to join support groups.
Holistic midwifery care on social aspects includes providing information about the rights and obligations of pregnant women, as well as resources that can be utilized.Midwives also help pregnant women to solve the social problems they face.Holistic midwifery care on the spiritual aspect includes facilitating pregnant women to practice religion according to their beliefs.
Midwives also provide moral and spiritual support to pregnant women. 4,5This study aims to apply the conceptual model of holistic midwifery services to pregnant women at Independent Practicing Midwives in Purwakarta Regency.

Methods
This research uses a qualitative approach with a case study method.A qualitative approach is used to understand complex and in-depth phenomena.The

Results and Discussion
Based on the results of research that has been carried out, midwives are able to carry out holistic assessments of pregnant women, including physical, mental, social, and spiritual aspects.Midwives ask about the physical, mental, social, and spiritual condition of pregnant women at every antenatal visit.
Midwives have also been able to integrate the results of holistic assessments in providing midwifery care. The influenced by various factors, such as pregnancy experiences, religious beliefs, and culture.The physical, mental, social, and spiritual changes that occur in pregnant women can affect their health and well-being.These changes can cause stress, anxiety, and depression.Stress and anxiety that are not Application of the Conceptual Model of Holistic Midwifery Services to The author has reviewed and approved the final version of the manuscript.https://doi.org/10.37275/amcr.v5i1.474 This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
case study method is used to study a phenomenon in depth in a particular context.The research subjects were 5 independent practicing midwives in Purwakarta Regency.Subject selection was carried out by purposive sampling, namely by selecting subjects who matched the research criteria.The criteria for research subjects are: Independent practicing midwife in Purwakarta Regency and has provided midwifery services to pregnant women for at least 5 years.Data was collected through in-depth interviews and observations.In-depth interviews are conducted to extract in-depth information from the research subjects.Observations are carried out to observe the behavior and interactions of research subjects in the context of everyday life.Data analysis was carried out descriptively qualitatively.Data analysis was carried out using the following steps: Transcription of interview and observation results; Data reduction, namely the process of selecting, focusing, simplifying and abstracting data that is relevant to the research objectives; Data presentation, namely the process of organizing data that has been reduced into narrative text form; Drawing conclusions, namely the process of drawing conclusions based on the results of data analysis.
following are several examples of the implementation of holistic assessments by midwives on pregnant women: Physical aspects: The midwife measures the pregnant woman's weight, height, blood pressure, pulse, and respiratory rate.The midwife asks about physical changes experienced by the pregnant woman, such as nausea and vomiting.constipation, and back pain.Mental aspect: The midwife asks about the pregnant woman's feelings, thoughts, and emotions.The midwife asks about mental changes experienced by the pregnant woman, such as stress, anxiety, and depression.Social aspect: The midwife asks about the pregnant woman's relationship with her family and community.The midwife asks about the resources the pregnant woman has, such as social and economic support.Spiritual aspect: The midwife asks about the beliefs and values held by the pregnant woman.The midwife asks about the spiritual practices carried out by the pregnant woman.However, there are still several things that midwives need to improve in carrying out improve their communication skills in order to establish good relationships with pregnant women.Midwives need to listen actively and empathically to pregnant women.Knowledge and understanding: Midwives need to increase their knowledge and understanding of physical, mental, social, and spiritual aspects.Midwives need to understand the relationship between these aspects.Support: Midwives need to get support from the institutions where they work and professional organizations.Midwives need to get the opportunity to take part in training and personal development.By improving their skills, knowledge, and understanding, midwives can carry out more comprehensive and indepth holistic assessments.This will help midwives to provide more appropriate midwifery care that suits the needs of pregnant women. 6-9Based on the results of research that has been conducted, midwives are able to provide holistic midwifery care, including physical, mental, social, and spiritual care.Midwives provide comprehensive and thorough care according to the needs of pregnant women.The following are several examples of the implementation of holistic midwifery care by midwives for pregnant women: Physical aspects: Midwives carry out routine pregnancy checks, such as checking vital signs, breast examinations, abdominal examinations, and laboratory examinations.Midwives provide immunizations and nutritional counseling.Mental aspect: Midwives provide counseling to deal with stress, anxiety, and depression; midwives facilitate pregnant women to join support groups.Social aspect: Midwives provide information about the rights and obligations of pregnant women, as well as resources that can be utilized.Midwives help pregnant women to solve the social problems they face.Spiritual aspect: Midwives facilitate pregnant women to carry out worship according to their beliefs.Midwives provide moral and spiritual support to pregnant women.However, there are still several things that midwives need to improve in providing holistic midwifery care, namely: Communication skills: Midwives need to improve their communication skills in order to establish good relationships with pregnant women.Midwives need to listen actively and empathically to pregnant women.Knowledge and understanding: Midwives need to increase their knowledge and understanding of holistic midwifery care.Midwives need to understand the relationship between physical, mental, social, and spiritual aspects.Support: Midwives need to get support from the institutions where they work and professional organizations.Midwives need to get the opportunity to take part in training and personal development.By improving their skills, knowledge, and understanding, midwives can provide more comprehensive and in-depth holistic midwifery care.This will help midwives to improve the health and well-being of pregnant women.The following are several concrete examples of the implementation of holistic midwifery care by midwives for pregnant women: Physical aspect: A midwife carries out routine pregnancy checks on a pregnant woman.The midwife found that the pregnant woman had high blood pressure.The midwife then advised the pregnant woman to consult a doctor.Mental aspect: A midwife provides counseling to a pregnant woman who is anxious about giving birth.Midwives help pregnant women understand the birth process and how to deal with it.Social aspect: A midwife helps a pregnant