Ukulethwa Okujwayelekile Nezinsimbi

Umsebenzi Wokulethwa EHyderabad

Inqubo yokubeletha ingane ibizwa ngokuthi ukubeletha noma ukubeletha. Ukubeletha ngesitho sangasese sowesifazane noma ukuhlinzwa ngokuhlinzwa izindlela ezimbili zokubeletha umntwana. Izinhlangano eziningi zezempilo ezinkulu zincoma ukuthi usana olusanda kuzalwa lubekwe esifubeni sikamama ngokushesha ngangokunokwenzeka ngemva kokuzalwa, kungakhathaliseki ukuthi lubelethwe ngesitho sangasese sowesifazane noma ngesigaba C. Ngakho-ke ukuthintana kwesikhumba nesikhumba kuyatholakala kubo bobabili umama nengane.  

Ezibhedlela ze-CARE, siyaqaphela ukuthi wonke umuntu wesifazane unezidingo ezithile zokunakekelwa kwezempilo. Ithimba lethu lihlanganisa ochwepheshe bezempilo abanekhono eliphezulu abanokuqeqeshwa okubanzi nolwazi ekunakekelweni kwezempilo kwabesifazane. Ngokungeziwe ekunakekelweni kahle kwabesifazane kanye nokubelethisa, siphinde sinikeze ukuhlinzwa kwezifo zabesifazane okungangeneleli ukuze kwanelise iziguli zethu.

Izibhedlela ze-CARE zihlinzeka ngezinsiza eziningi ezihambisana nezidingo zowesifazane ngamunye, okuhlanganisa ukuxilongwa nokwelashwa. Singakusiza ekuzuzeni umphumela ongcono kakhulu kanye nezinga lempilo ngokulalelisisa, ukuqonda izinkinga zakho, nokuthola isixazululo esifanele ngemva kokuxilongwa okuphelele. Siyaqiniseka ukuthi sizokwanelisa zonke izidingo zakho futhi sikunikeze isisombululo esiphelele nesiphephile ngethimba lethu elinolwazi, amakhono asezingeni eliphezulu elabhorethri, nengqalasizinda yesimanjemanje. Sizoncoma izinketho zokwelapha ngemva kokuhlolwa ngokucophelela, futhi singabonisana nochwepheshe beminye imikhakha ehlanganisa i-urogynaecology, i-oncology yezifo zabesifazane, kanye ne-endocrinology yokuzala, uma kunesidingo, ukuze uqinisekise ukuthi uthola ukwelashwa okungcono kakhulu kwe-multidisciplinary.

Ukulethwa Okujwayelekile

Igama elithi “ukubeletha okuvamile” libhekisela kumama obeletha ingane yakhe ngokwemvelo ngaphandle kokungenelela kochwepheshe bezokwelapha.

Izigaba zokulethwa okuvamile

1. Isigaba sokuqala

Ukungasebenzi kanye nokuqedwa komlomo wesibeletho

Esigabeni sokuqala sokubeletha okuvamile, ukufinyela kuyanwebeka, kuthambe, futhi kunwebe umlomo wesibeletho ukuze kube lula ngomntwana ukuba abelethe. Ukubeletha kowesifazane kokuqala kungathatha amahora angu-13, futhi ukubeletha okulandelayo kungathatha amahora angu-7-8.

Isigaba sokuqala sihlukaniswe izingxenye ezintathu:

• Umsebenzi wangaphambi kwesikhathi: Njengoba ukufinyela kwenzeka njalo emizuzwini emi-3 kuya kwemi-5, umama uyakubona. Ngesikhathi sokukhulelwa, umlomo wesibeletho ungavuleka ufike kumasentimitha ama-4. Omama bangabelethela ekhaya ngesikhathi sokubeletha kusenesikhathi. Nokho, kufanele bazise udokotela.
• Umsebenzi osebenzayo: Lapho ukufinyela kuba namandla futhi kaningi, umama ungena esigabeni sokusebenza. Cishe njalo ngemizuzu engu-3-4, ahlala cishe umzuzu ngamunye. Umlomo wesibeletho ukhula ngamasentimitha angu-7. Owesifazane kumele ayiswe esibhedlela ukuze abelethe. Phakathi nalesi sigaba, amanzi owesifazane ayaphuka. Ukufinyela bese kuyashuba.
• Isigaba soshintsho: Cishe ngamasentimitha ayi-10, umlomo wesibeletho usuvuleke ngokugcwele futhi uyisigaba esibuhlungu kakhulu. Kukhona ukufinyela okubuhlungu, okuqinile njalo ngemizuzu engu-2-3, futhi ngayinye ithatha imizuzwana engama-60-90.

2. Isiteji

Ukuphusha nokuzalwa kwengane

Ngemva kokuvuleka okuphelele komlomo wesibeletho, lesi sigaba siqala. Ingane iphushwa emseleni wokuzalwa kuqala ngokufinyela okukhulu. Ngaso sonke isikhathi ukufinyela, umama kulindeleke ukuthi aphushe, futhi ngenxa yalokho angase akhathale kakhulu. Ngesikhathi umntwana ephusha indlela yakhe yokuphuma, angase futhi ezwe ubuhlungu obukhulu lapho evuleka khona isitho sangasese sowesifazane. Uma udokotela enquma ukwenza i-episiotomy kulesi sigaba, anganweba ukuvuleka komsele wesitho sangasese sowesifazane ukuze umntwana abelethwe kalula. Ukuze umntwana azalwe ekugcineni, umama kufanele aqhubeke nokuphusha.

3. Isigaba Sesithathu

I-Placenta Iphushwa Ngaphandle

Yonke i-placenta ikhishwa ngomsele wesitho sangasese sowesifazane phakathi nalesi sigaba sokugcina sokubeletha okuvamile esibizwa ngokuthi 'ukubeletha'. I-placenta ijwayele ukubeletha phakathi kwemizuzu eyi-10 kuya kwemizuzu engu-30 yokuzalwa kwengane. Ukubhucungwa kwesisu esingaphansi kungase kusize ekubelethweni.

Izinzuzo Zokulethwa Okujwayelekile

Ukubelethisa ngesitho sangasese sowesifazane kunezinzuzo ezilandelayo:

• Yehlisa ubungozi bokutheleleka kubo bobabili umama nengane.
• Ukululama kuyashesha kumama futhi uhlala esibhedlela isikhathi esifushane (amahora angama-24-48 kunezinsuku ezi-3 ukuya evikini ngemva kokuhlinzwa).
• Amasosha omzimba wengane aqiniswa amagciwane emvelo namagciwane atholakala esithweni sangasese, asuka kumama aye enganeni, ayenze ilungele ukuphila iphuma esibelethweni.
• Ukufinyela kokubeletha kusiza ukulungisa amaphaphu engane ukuze akwazi ukuphefumula, ngakho mancane amathuba okuthi umntwana abe nezinkinga zokuphefumula
• Ngesikhathi sokubeletha, inani lamahomoni omama wemvelo akhululwa. Lawa ma-hormone avuselela ukuncelisa.

Ukulethwa kwezinsimbi

Ama-Forceps noma inkomishi yokumunca i-ventuse isetshenziswa ngesikhathi sokubeletha okusizwayo futhi okwaziwa ngokuthi ukulethwa kwensimbi.

I-ventouse noma i-forceps isetshenziswa kuphela uma kunesidingo enhlalakahleni yakho nengane yakho. Abesifazane ababelethe umntwana ngokwemvelo mancane amathuba okuthi bathole usizo lokubeletha.

Kwenzekani ngesikhathi sokubeletha noma ukulethwa kwe-venous?

Kufanele ukhulume nodokotela wakho wokubelethisa ngezizathu zokukhetha ukubeletha okusizwayo, kanye namathuluzi nezinqubo okufanele zisetshenziswe. Ngaphambi kwenqubo, kuzodingeka unikeze imvume yakho.

Uma i-epidural ingekho, ngokuvamile uzothola umuthi obulala izinzwa wendawo ukuze uvale isitho sakho sangasese sowesifazane kanye nesikhumba phakathi kwesitho sakho sangasese sowesifazane kanye nedidi (i-perineum).

Udokotela wokubelethisa angase akuyise egunjini lokuhlinza uma kuphakama isidingo sokuhlinzwa. Ukusikwa okuncane (i-episiotomy) kungenzeka kudingeke ukuze kwandiswe ukuvuleka kwesitho sangasese sowesifazane. Uma kukhona ukuklebhuka noma ukusika, kuzosetshenziswa imithungo ukuyilungisa. Kungase kwenzeke ukuletha umntwana esiswini sakho futhi uvumele umlingani wakho okuzala ukuthi asike intambo, kuye ngezimo.

• Inkomishi yokumunca: Inkomishi yokumunca ixhunywa ekhanda lomntwana ngombhobho. Umshini wokumunca unamathiselwe enkomishini ethambile noma eqinile yepulasitiki/yensimbi ngeshubhu. Inkomishi ingena ngokuvikelekile ekhanda lomntanakho. Udokotela wokubelethisa uyadonsa ngesineke ukuze akusize ekubelethweni kwengane yakho ngesikhathi sokufinyela. Ukulethwa kwe-Forceps kungase kufaneleke kakhulu uma ubeletha emasontweni angaphansi kwama-36 ukhulelwe futhi udinga ukubeletha okusizwayo. Kuleli qophelo ekukhulelweni kwakho, mancane amathuba okuthi ulimaze ikhanda lengane yakho ngezindlawu njengoba lithambile.
• Ukuphoqelela: Ifana nezinkezo noma izindlawu ezinkulu kodwa yenziwe ngensimbi ebushelelezi. Igobile ukuze ingene ekhanda lomntwana. Ikhanda lomntwana wakho limiswe ngokucophelela eduze kwezindlawu, ezixhunywe ezibanjeni. Ngenkathi uphusha futhi uyafinyela, udokotela wokubelethisa ukhipha ingane yakho ngesineke. Ama-forceps ahlukene ayatholakala. Eminingi yale mishini iklanyelwe ngokukhethekile ukuvumela ingane ukuba izalwe isendaweni efanele, njengokuthi ingane yakho ilele ibheke phezulu (i-occiput-posterior position) noma ngohlangothi olulodwa (i-occipital-lateral position).