Ukuzalwa Kwasekhaya Emva kukaKesarean (HBAC): Into ekufuneka uyazi

Umxholo

• Luthini uphando?
• Izibonelelo zeHBAC
• Umngcipheko we-HBAC
• Ibali lomfazi omnye
• Ngaba ungumgqatswa we-HBAC?
• Ukuthatha

Unokuqhelana negama elithi VBAC, okanye ukuzalwa kwesisu emva kokuyeka. I-HBAC imele ukuzalwa kwasekhaya emva koqhaqho. Ngokuqinisekileyo i-VBAC eyenziwa njengokuzalwa ekhaya.

Ii-VBACs kunye nee-HBACs zinokuhlelwa ngakumbi ngenani lokuhanjiswa okokugqibela. Umzekelo, i-HBA1C ibhekisa ekuzalweni kwekhaya emva kokuyeka okokugqibela, ngelixa i-HBA2C ibhekisa ekuzalweni kwekhaya emva kokuyeka okokugqibela.

Kukho iingxoxo ezithandekayo zombini ngokuchasene ne-HBACs.

Kubalulekile ukuba uqaphele ukuba izikhokelo ezibekwe yi-American College of Obstetricians kunye neGynecologists zincoma ukuba ii-VBAC zenzeke ngaphakathi ezibhedlele. Makhe sijonge ezinye iingenelo, ububi, kunye nezinye iimeko zokucinga njengoko uceba ukuzalwa kwakho.

Luthini uphando?

Abaphandi eUnited States baxele ii-HBACs ezili-1 ngo-2008, zisanda zisuka kuma-664 ngo-2003 zaya kuma-656 ngo-1990. Ngo-2013, elo nani lenyuka laya kutsho kwi-1,338. Ngelixa kunjalo kunqabile, inani le-HBACs liyabonakala linyuka unyaka nonyaka, abathi abaphandi batyale izithintelo kwii-VBACs kwisibhedlele.

Kuthekani ngamazinga empumelelo? Olunye uphononongo luvavanye i-1,052 yabasetyhini abazama i-HBAC. Ireyithi ye-VBAC ephumeleleyo yayiyiipesenti ezingama-87 ngenqanaba lokudluliselwa kwesibhedlele ngepesenti ye-18. Ukuthelekisa, uphononongo luvavanye abantu basetyhini abangama-12,092 abazama ukuhambisa ekhaya ngaphandle koqhaqho lwangaphambili. Inqanaba labo lokudluliselwa kwesibhedlele lalingama-7 eepesenti kuphela. Esona sizathu siqhelekileyo sokudluliselwa kukusilela kwinkqubela phambili.

Olunye ulwabelo lophando lokuba amaqondo empumelelo ngokubanzi aphakathi kwama-60 kunye nama-80 eepesenti, kwelona liphezulu livela kubantu esele benobuncinane bokuhambisa ubufazi.

Izibonelelo zeHBAC

Ukuhambisa umntwana wakho ngobufazi endaweni yokudlula kwindawo ekhethiweyo kuthetha ukuba awuzukuhlinzwa okanye ufumane iingxaki zotyando. Oku kunokuthetha ukubuyiswa okufutshane ukusuka ekuzalweni kunye nokubuyela ngokukhawuleza kwimisebenzi yakho yemihla ngemihla.

Ukuhambisa ngokwesini kunokukunceda ukuba uphephe umngcipheko wokuhambisa izinto ezininzi-izinto ezinokubakho, umzekelo-ekukhulelweni okuzayo, ukuba ukhetha ukuba nabantwana abaninzi.

Izibonelelo ezibonwayo zokuhambisa ekhaya zihlala zizezakho ngokwendalo. Banokubandakanya:

• ukhetho kunye nokuxhotyiswa
• imvakalelo yokulawula
• iindleko eziphantsi
• ingqalelo yenkolo okanye yezenkcubeko
• Unxibelelwano kunye nentuthuzelo kwindawo yokubeleka

Kwaye ngelixa usenokuva unxibelelwano olubi kunye nokuzalwa okucwangcisiweyo ekhaya, ucebisa ukuba akukho lonyuka lokufa kweentsana xa kuthelekiswa nokuzalwa kwesibhedlele. Oomama banokuthi benze okungcono ekhaya, banike ingxelo ngongenelelo oluncinci kunye neengxaki, kunye nokwoneliseka okuphezulu ngamava okuzalwa.

Umngcipheko we-HBAC

Ewe kunjalo, kukho umngcipheko ngokuhanjiswa kwelungu lobufazi emva kokuyeka okokugqibela. Kwaye ezi ngozi zinokwandiswa ukuba ukhetha ukuhambisa umntwana wakho ekhaya.

Olunye uphononongo luveze ukuba abo bazama i-HBAC babeka emngciphekweni wokulahleka kwegazi, usulelo lwasemva kokubeleka, ukugqabhuka kwesibeleko, kunye nokwamkelwa kwento yokhathalelo lweentsana olunomdla xa kuthelekiswa nokuzalelwa ekhaya ngaphandle koqhaqho lwangaphambili.

Umngcipheko omkhulu kukuqhekeka kwesibeleko, esichaphazela iipesenti ezi-1 zabantu abazama i-VBAC nakweyiphi na imeko. Ngelixa kunqabile, ukuqhekeka kwesibeleko kuthetha ukuba iinyembezi zesibeleko zivulekile ngexesha lomsebenzi, efuna icandelo le-cesarean likaxakeka.

Koomama be-VBAC, olu qhekeko luhlala luhamba ecaleni komgca obomvu esibelekweni kutyando lwangaphambili. Ukopha ngamandla, ukonzakala kunye nokufa kosana, kunye ne-hysterectomy enokwenzeka zonke iingxaki ezinokufuna ukhathalelo olungxamisekileyo olufumaneka kuphela esibhedlele.

Ibali lomfazi omnye

UChantal Shelstad wazala umntwana wakhe wesithathu ekhaya emva kokuba umntwana wakhe wokuqala ehambise i-breech kwaye waziswa nge-cesarean section. Uyabelana, “Emva kokuba izicwangciso zam zokuzalwa kwendalo nomntwana wam wokuqala zajika zaya kubeleka, ukubuyela kwimeko yesiqhelo, kunye nokudakumba nasemva kokubeleka kunye noxinzelelo, ndandisazi ukuba ndifuna amava owahlukileyo okuzalwa kwaye ndafunga ukuba andinakuze ndiphinde ndenze oko esibhedlele, ukuba Ndingayiphepha. ”

"Ngokukhawuleza phambili iminyaka emithathu enesiqingatha, kwaye bendibeleka (i-VBAC) kumntwana wethu wesibini kwiziko elinobubele bendalo eSouth Korea, lijikelezwe ngabazalisikazi, abongikazi, kunye ne-OB entle endixhasayo nokuba yeyiphi na intetho wosana lwam. Besizakukhetha ukuzalelwa ekhaya ukuba besikuloo ndawo, kodwa indawo yokuzalwa yayingamava amnandi. ”

Xa kufikwa kumntwana wakhe wesithathu, uShelstad wakhetha ukubelekela ekhaya. "Umntwana wethu wesithathu nowokugqibela wazalelwa kwigumbi lam lokulala, ebhafini yokuzalwa, phantse iminyaka emibini emva kwesibini," ucacisa uShelstad.

“Ukukhulelwa kwam - besisazi ukuba sifuna ukuzalwa ekhaya. Senze udliwanondlebe nabazalisikazi abambalwa abavela kule ndawo kwaye safumana enye esasicofa nayo kwaye siyasixhasa ukuba umntwana wethu ubethwa ngumoya. Amava onke ngaphambi kokubeleka ayekhululekile kwaye aqinisekisa. Ukubonana kwethu bekuya kuthatha iyure ubude, apho sinokuthi sincokole, sixoxe ngamacebo, kwaye sidlale ngeendlela ezahlukeneyo zokuzalwa. ”

"Xa kufika ixesha lokusebenza, ndandithanda ukuba andinakushiya ikhaya lam. Ngapha koko, ukusebenza kwam kwakukhawuleza kakhulu - malunga neeyure ezimbini zomsebenzi osebenzayo - kwaye umbelekisi wam wayekhona kuphela imizuzu engama-20 ngaphambi kokuba unyana wam azalwe. Ukusuka ebhafini yokuzala ndakwazi ukuya ebhedini yam ndiphumle ndibambe usana lwam, ngelixa usapho lwalundinika ukutya kwaye lukhathalela abanye abantwana. Endaweni yokuphuma esibhedlele kwiintsuku kamva, ndahlala ngaphakathi endlwini yam ndiphumle kwaye ndiphila. Kwakumangalisa ngokwenene. ”

Ngaba ungumgqatswa we-HBAC?

Ibali likaShelstad libonisa ezinye zeekhrayitheriya ezenza ukuba umntu abe ngumgqatswa ofanelekileyo we-HBAC.

Umzekelo, unokulungela ukuba:

• ukhe wahambisa enye okanye nangaphezulu ngaphambili kwilungu lobufazi
• incision yakho isinqamlezayo esezantsi okanye iphantsi nkqo
• khange ubenakho nangaphezulu kokudluliselwa ngaphambi kwexesha okungaphaya kwesibini
• Sele ziinyanga ezili-18 okanye nangaphezulu emva kokuya kwakho okokugqibela ngoqhaqho
• akukho micimbi inokuchaphazela ukuhanjiswa kwelungu lobufazi, njengemicimbi ye-placental, intetho, okanye ukuphindaphinda okuphezulu
• awuzange ngaphambili uve ukuqhekeka kwesibeleko

Okwangoku, uninzi lolwazi olufumanayo lucebisa ukuba i-VBAC kufuneka izanywe kuphela kumaziko akwazi ukujongana nokuhanjiswa ngokukhawuleza. Oku kuthetha ukuba ukuhanjiswa kwekhaya akukhuthazwa ngokubanzi kwizinga elibanzi. Qiniseka ukuba uxoxa ngesicwangciso sokudluliselwa kwesibhedlele kunye nomboneleli wakho, onokukunceda ukukhokela isigqibo sakho kwimeko nganye.

Gcina ukhumbula ukuba nokuba ungumgqatswa ogqibeleleyo we-HBAC, ukutshintshela esibhedlele kunokuba yimfuneko ukuba umsebenzi wakho awuqhubeki, ukuba usana lwakho lusebunzimeni, okanye ukuba wopha.

Ukuthatha

Ndiyazi ukuba ii-HBACs zinokoyikisa, kodwa kum, uloyiko lwam yayikukuya esibhedlele, utshilo uShelstad. “Ndandinolawulo ngakumbi nentuthuzelo ekhaya. Ndithembele kwinkqubo yokuzalwa kunye nobungcali kumbelekisi wam kunye neqela lokuzalwa, kwaye ndiyazi ukuba xa kuvela imeko yongxamiseko, sinezicwangciso zesibhedlele ezimbalwa esinokuzifumana. ”

Ekugqibeleni, isigqibo malunga nokuba uza kuzalela njani umntwana wakho kuwe kunye nomboneleli wakho wezempilo. Kuyanceda ukubuza imibuzo kwaye uzise inkxalabo kwangethuba kukhathalelo lwakho ngaphambi kokubeleka ukuze ube nolwazi oluphambili olufumanekayo kuwe lokunceda wenze isigqibo sakho.

Njengoko umhla wakho omiselweyo usondela, kubalulekile ukuba uhlale ubhetyebhetye nesicwangciso sakho sokuzalwa xa kuziwa kwiimeko ezinokuchaphazela impilo yakho okanye yosana lwakho.