Case Report: Comprehensive Midwifery Care for Pregnant Women with Mild Anemia and Chronic Energy Deficiency Supported by Date Extract

Abstract

Mild anemia and chronic energy deficiency (CED) are maternal nutritional problems that may coexist during pregnancy and can increase the risk of adverse maternal and fetal outcomes. This case report describes comprehensive midwifery care for a pregnant woman with mild anemia and CED in the working area of Plaosan Public Health Center, Magetan, Indonesia. A descriptive case report was conducted from 9 to 24 March 2026. The participant was Mrs. A, 23 years old, G1P00000, at 21–22 weeks of gestation at the initial assessment. Data were collected through anamnesis, observation, physical and obstetric examinations, laboratory assessment, and review of the maternal health record. Care was documented using the SOAP framework and implemented through four visits over two weeks. The main outcomes monitored were symptoms, hemoglobin (Hb), body weight, mid-upper arm circumference (MUAC), vital signs, fundal height, and fetal heart rate. At the first visit, the participant reported dizziness, fatigue, and blurred vision. Hb was 10.7 g/dL and MUAC was 21.5 cm, supporting the assessment of mild anemia and CED. Management included education on correct and regular iron-tablet intake, nutritional counseling, encouragement of iron-rich foods and balanced energy-protein intake, supportive date extract, ANC adherence, rest and activity management, danger-sign education, and P4K counseling. After four visits, the complaints resolved, Hb increased to 11.1 g/dL, body weight increased from 44.05 kg to 46.20 kg, and MUAC increased from 21.5 cm to 22 cm. Maternal vital signs remained stable and fetal heart rate remained within the normal range. Comprehensive and continuous midwifery care integrating iron supplementation, nutritional improvement, supportive date extract, education, and serial monitoring was associated with improvement in maternal symptoms, Hb, body weight, and MUAC in this case. Because MUAC remained below 23.5 cm, continued nutritional monitoring and follow-up are still required.