Amidst limited access, Midwife Yane Amalo never ceases to educate pregnant women through posyandu activities in her village, Bena. In addition to the midwife, there are also community health cadres who disseminate information regarding pregnancy danger signs and miscarriage signs. <\/p>\n
\u201cWe have frequently informed that if danger signs such as spotting or bleeding from the birth canal occur, the patient must be immediately brought to the Community Health Center,\u201d said Midwife Yane. <\/p>\n
She also frequently conducts home visits to patients who have been discharged from the hospital. <\/p>\n
Miscarriage Rates in TTS Are Quite High<\/strong> <\/p>\n Obstetrician and Gynecologist Edward Manurung, often called Dr. Edo, stated that miscarriage is among the top 10 largest health cases at Soe Regional General Hospital. On average, two or three cases are handled each week. <\/p>\n \u201cMost miscarriage cases handled here are typically incomplete abortions, meaning some tissue has already exited the uterus, whether the event occurred at home or at a community health center, and then the patient is referred to the hospital in a bleeding condition,\u201d he said. <\/p>\n [\/et_pb_text][et_pb_image src=”https:\/\/ipasindonesiad.wpenginepowered.com\/wp-content\/uploads\/2025\/04\/20250318_083743-scaled-1.jpg” title_text=”20250318_083743″ align=”center” _builder_version=”4.27.4″ _module_preset=”default” width=”45%” global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n She added that miscarriage patients are typically managed using sharp curettage. This method is indeed more familiar to obstetricians and gynecologists. <\/p>\n “I am confident that almost all obstetricians in that area still predominantly use sharp curettage, because during our education, we were not introduced to MVA (Manual Vacuum Aspiration), so that’s generally the case,” she asserted.<\/p>\n Since 2012, the World Health Organization (WHO) has no longer recommended the use of sharp curettage for managing miscarriages. Alternatives include vacuum aspiration or medication. These methods can reduce severe complications for patients. <\/p>\n Dr. Edo did not deny that he has also started using MVA. “All this time, we considered MVA to be less clean, not very good, complicated, or troublesome to perform. However, after performing it ourselves, I found it to be more effective, cleaner, and caused less pain for patients,” he stated. <\/p>\n Nevertheless, he encountered several challenges when using this safer and more comfortable method for patients. “The rubber component becomes stiff after some use, making it feel harder when pulled; that’s the only issue, otherwise there are no problems,” he affirmed. <\/p>\n [\/et_pb_text][et_pb_image src=”https:\/\/ipasindonesiad.wpenginepowered.com\/wp-content\/uploads\/2025\/04\/20250318_084122-scaled-1.jpg” title_text=”20250318_084122″ align=”center” _builder_version=”4.27.4″ _module_preset=”default” width=”52%” module_alignment=”right” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″][\/et_pb_image][et_pb_text _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n He added that many hospital managements have not yet switched to using MVA. This is due to each hospital’s individual priorities. <\/p>\n Dr. Edo is one of the participants in the Comprehensive Post-Miscarriage Care Training in NTT to Support the Initial Implementation of Services at Primary Healthcare Facilities. This training was conducted in Kupang City in August 2024. <\/p>\n This training is part of the TAKENUSA project (Joint Commitment for Women’s Health in Nusa Tenggara). The project aims to expand access to contraception and post-miscarriage care in South Central Timor Regency (TTS), East Flores, and Kupang Regency. <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" Challenging geographical conditions coupled with low public awareness exacerbate the miscarriage situation in South Central Timor Regency (TTS). Dr. Kristina Lawung stated that three miscarriage patients visited her community health center between August 2024 and February 2025. All these patients were referred to a hospital. She emphasized that referrals are not a simple matter. Sometimes, many patients are referred due to their worsening condition. “Sometimes patients arrive having been bleeding since the previous night, but are only brought to the community health center the next day,” said Dr. Kristina. This is not without reason. Road access conditions in the villages of TTS are not as smooth as Jakarta’s paved roads. “Due to difficult road access, patients often arrive with bleeding, so specialists usually request immediate referral to the regional general hospital (RSUD),” she added. The problem does not end there. Cost considerations create a dilemma for patients. \u201cBecause if, upon referral and examination, it is determined that they need to be hospitalized in the city, this often burdens families with costs,\u201d she said. Patient families often need a considerable amount of time to decide on this matter. They often end up refusing referral. Proactive Outreach and Raising Awareness about Miscarriage […]<\/p>\n","protected":false},"author":4,"featured_media":2950,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"\r\n Kondisi geografis yang menantang disertai dengan rendahnya pengetahuan masyarakat memperburuk situasi keguguran di Kabupaten Timor Tengah Selatan (TTS). Dokter Kristina Lawung mengatakan ada tiga pasien keguguran yang datang ke puskesmasnya dalam periode Agustus 2024 hingga Februari 2025. Semua pasien tersebut dirujuk ke rumah sakit.\u202f\u00a0<\/p>\r\n\r\n Perkara rujuk, ia menegaskan, bukan hal yang mudah. Terkadang banyak pasien yang dirujuk karena kondisinya yang semakin parah. \u201cTerkadang pasien datang sudah dengan perdarahan dari malam hari, tapi baru dibawa ke puskesmas keesokan harinya,\u201d ujar Dokter Kristina.\u202f\u00a0<\/p>\r\n\r\n Hal itu bukan tanpa sebab. Kondisi akses jalan di desa-desa di TTS tidaklah semulus aspal jalanan Jakarta. \u201cKarena kondisi akses jalan yang sulit, sering kali pasien datang dengan kondisi pendarahan, sehingga biasanya dokter spesialis minta segera dirujuk ke RSUD,\u201d imbuhnya.\u202f\u00a0<\/p>\r\n\r\n \u00a0<\/p>\r\n\r\n Permasalahan tidak sampai di situ. Pertimbangan biaya membuat pasien menjadi dilema. \u201cKarena jika saat dirujuk dan dari hasil pemeriksaan dinyatakan harus dirawat inap di [rumah sakit] di kota, ini yang sering membuat keluarga terbebani dengan biaya,\u201d ujarnya.\u00a0<\/p>\r\n\r\n Keluarga pasien kerap membutuhkan waktu yang tak singkat\u202f memutuskan hal tersebut. Kerap mereka akhirnya menolak untuk dirujuk.\u202f\u00a0<\/p>\r\n\r\n Jemput bola dan sosialisasi soal tanda keguguran\u202f<\/strong>\u00a0<\/p>\r\n\r\n Di tengah terbatasnya akses, Bidan Yane Amalo tak pernah berhenti untuk memberikan edukasi kepada perempuan yang tengah hamil lewat kegiatan posyandu di desanya, Bena.\u00a0 Selain bidan, ada juga kader-kader yang mensosialisasikan terkait dengan tanda bahaya kehamilan dan tanda-tanda keguguran.\u202f\u00a0<\/p>\r\n\r\n \u201cKami sudah sering menginformasikan jika terjadi tanda bahaya seperti flek atau keluar darah dari jalan lahir harus segera dibawa ke Puskesmas,\u201d ujar Bidan Yane.\u202f\u00a0<\/p>\r\n\r\n Ia juga kerap melakukan kunjungan ke rumah pasien yang telah selesai dirawat di rumah sakit.\u202f\u00a0<\/p>\r\n\r\n Angka keguguran di TTS cukup tinggi\u202f<\/strong>\u00a0<\/p>\r\n\r\n Dokter Spesialis Kandungan dan Kebidanan Edward Manurung atau yang kerap disapa Dokter Edo mengatakan, keguguran masuk dalam 10 daftar kasus kesehatan terbesar di RSUD Soe. Secara rata-rata setiap minggu ada dua atau tiga kasus yang ditangani.\u202f\u00a0<\/p>\r\n\r\n \u201cKebanyakan kasus keguguran yang ditangani di sini rata-rata abortus inkomplit yaitu sebagian jaringan sudah keluar dari rahim baik kejadiannya di rumah atau di puskesmas, kemudian baru dirujuk ke rumah sakit dalam kondisi pendarahan,\u201d ucapnya.\u202f\u00a0<\/p>\r\n\r\n Ia menambahkan, pasien keguguran biasanya ditangani dengan cara menggunakan kuretase tajam. Metode ini memang lebih dikenal oleh para spesialis kandungan dan kebidanan.\u202f\u00a0<\/p>\r\n\r\n \u201cSaya yakin hampir semua spesialis kandungan yang masih di daerah itu rata-rata masih menggunakan kuret tajam, karena memang selama pendidikan kita tidak dikenalkan dengan AVM (Aspirasi Vakum Manual), jadi rata-rata seperti itu,\u201d tegasnya.\u202f\u00a0<\/p>\r\n\r\n Sejak tahun 2012, Badan Kesehatan Dunia (WHO) sudah tidak merekomendasikan penggunaan kuretase tajam dalam menangani keguguran. Alternatifnya adalah menggunakan vakum aspirasi atau obat-obatan. Metode ini bisa mengurangi komplikasi berat pada pasien.\u202f\u00a0<\/p>\r\n\r\n Dokter Edo tak menampik dirinya juga mulai menggunakan AVM. \"Selama ini kita menganggap bahwa AVM itu kurang bersih atau AVM itu tidak terlalu bagus atau ribet atau repot mengerjakannya. Ternyata setelah kita\u202f kerjakan sendiri malah menurut saya lebih efektif, lebih bersih terus lebih tidak membuat rasa nyeri pada pasien,\u201d ujarnya.\u202f\u00a0<\/p>\r\n\r\n Meski begitu, ada sejumlah kendala yang dihadapi ketika ia menggunakan metode yang lebih aman dan nyaman bagi pasien ini. \u201cKaretnya setelah penggunaan beberapa lama itu menjadi kaku sehingga pada waktu ditarik terasa lebih keras, itu saja sih selain itu tidak ada masalah,\u201d tegasnya.\u202f\u00a0<\/p>\r\n\r\n Ia menambahkan, manajemen rumah sakit belum banyak yang beralih menggunakan AVM. Hal ini terjadi karena memang prioritas rumah sakit masing-masing.\u202f\u00a0<\/p>\r\n\r\n Dokter Edo merupakan salah satu peserta Pelatihan Asuhan Pasca Keguguran yang Komprehensif di NTT untuk Mendukung Implementasi Awal Layanan di Fasilitas Kesehatan Tingkat Pertama. Pelatihan ini dilakukan di Kota Kupang pada Agustus 2024.\u00a0<\/p>\r\n\r\n Pelatihan ini merupakan bagian dari proyek TAKENUSA (Tekad Bersama untuk Kesehatan Perempuan Nusa Tenggara). Tujuan dari proyek ini adalah untuk memperluas akses kontrasepsi dan asuhan pasca keguguran di Kabupaten TTS, Flores Timur dan Kabupaten Kupang.\u202f\u00a0<\/p>\r\n\r\n \u00a0<\/p>\r\n","_et_gb_content_width":"","footnotes":""},"categories":[167],"tags":[47,15,126,183,127,105,185,182,184,186,128],"topic":[],"class_list":["post-2946","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-aki","tag-apk","tag-avm","tag-healthcare","tag-keguguran","tag-kesehatan","tag-miscarriage","tag-mmr","tag-mva","tag-south-central-timor","tag-timor-tengah-selatan"],"_links":{"self":[{"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/posts\/2946","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/comments?post=2946"}],"version-history":[{"count":0,"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/posts\/2946\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/media\/2950"}],"wp:attachment":[{"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/media?parent=2946"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/categories?post=2946"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/tags?post=2946"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/ipasindonesia.org\/en\/wp-json\/wp\/v2\/topic?post=2946"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/ipasindonesiad.wpenginepowered.com\/wp-content\/uploads\/2025\/04\/Dipakai-831x1024.jpg\"){kind=spacer}
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