Ngomsebenzi wekhulu lama-20 kuphela owaqala ezibhedlela zokubeletha. Esihlokweni esihlokweni esithi "Ukuzalwa kwengane ngaphandle kwesibhedlela sokubeletha" uzofunda ulwazi olubalulekile futhi uqonde lapho kunethezekile kakhulu ukubeletha ingane.
Izinzuzo
Abesifazane abaningi bazizwa bevikelekile kakhulu esibhedlela sokubeletha, kodwa abanye babo besaba yimishini nezibani ezikhanyayo eziyingxenye ebalulekile yokuhlelwa kwezokwelapha. Ngakho-ke, banquma ukubeletha ekhaya. Abanye besifazane bakhetha ngale ndlela yokulethwa kwezidingo, ngoba imvelo yasemakhaya ibonakala ibonakala ingokwemvelo ngokwengeziwe ekuzalweni kwengane. Ngaphezu kwalokho, ukuzalwa ekhaya kuvumela umlingani futhi, uma befisa, amanye amalungu omndeni ukuthatha ingxenye enkulu kule nqubo. Ukubeletha ekhaya kuyaba kakhulu. Futhi, inani elikhulayo labesifazane likhetha ukulawula inkambo yokukhulelwa kwabo futhi bafune ukuqinisekisa ukuthi ukubeletha kuyisenzakalo esiseduze kunendlela yokwelashwa. Imiphumela yalezi zifundo ibonisa ukuthi ukubeletha ekhaya kuvumela umama ukuba azizwe ekhululekile futhi engaphansi kakhulu ukuze adinge i-anesthesia.
Ukulungiselela
Lapho owesifazane eqala ukubonisana nodokotela ukuqinisekisa ukuthi ukhulelwe, angakwazi ukuxoxa ngendlela ekhethiwe yokudiliva.
Ingozi
Ezimweni eziningi, ukubeletha ekhaya kuphephile njengesibhedlela sokubeletha. Noma kunjalo, uma owesifazane ene-anamnesis (isibonelo, noma yikuphi ukukhubazeka kokuzalwa kwangaphambilini) noma ngesikhathi sokuzalwa kwangempela, izinkinga (isibonelo, nge-breech presentation ye-fetus) ezingahle zidinga ukunakekelwa okwelapha okukhethekile, kuphakanyiswa odokotela ukuba basebenzise esikhungweni sezokwelapha . Ngokuvamile umbelethisi onolwazi lokubeletha ekhaya uyasiza. Ngaphezu kwalokho, usekela owesifazane lapho ekhulelwe. Ezimweni ezingavamile, ukuba khona kwababelethisi ababili kuyadingeka. Ngosuku lwesonto oluhlongozwayo lokuzalwa, umbelethisi uvakashela indlu ukuqinisekisa ukuthi konke kukulungele. Ukufinyelela okulula endlini kuyadingeka uma kwenzeka ukuthutha okuphuthumayo kowesifazane ekubelethweni esibhedlela, umoya omuhle, ukushisa okuphezulu kwemoya, ukukhanyisa nokuhlinzeka ngamanzi. Umbelethisi ngokuvamile uhlela uhlu lwezinto ezidingekayo, okufaka:
- amabhakede - angadingeka ukuqinisekisa ukuthi owesifazane osebenzayo uhlakaza ngesikhathi sokuphuma kwe-asphyxia, futhi nokuhlanzwa;
- amathawula ahlanzekile nama-diapers;
- isibani;
- i-thermometer;
- izilonda zokukhipha amagciwane kanye nekhishi;
- izikhwama ze-polyethylene yodaka;
- ezinye izinto ngokuthandayo, isibonelo isimboli sokuqopha ngomculo othulile namakhandlela, ukuze owesifazane azizwe ekhululekile ngesikhathi sokubeletha.
Umbelethisi uletha amathuluzi amaningi adingekayo kuye, ngosuku lokuzalwa, kufaka phakathi izinsimbi zokubopha futhi ukuhlukanisa intambo yomzimba, uboya obunamakhele okhanda, ukugqoka nezinye. Kungabuye ibe nedivayisi yokurekhoda izinga lokushaya kwenhliziyo le-fetus ne-tonometer yokulinganisa umfutho wegazi kumama. Ukuze i-analgesia isebenze, umbelethisi angase abe ne-bottle-air mix bottle futhi, uma kunesidingo, amanye ama-painkillers. Ezimweni eziphuthumayo, isithandwa sombelethini sinikeza konke okudingekayo ukuze kuvuselelwe ingane esanda kuzalwa: i-oksijeni, amathuluzi okuthungatha (ukugcina i-airway patency), i-catheter ye-urinary nokuluthwa ukuhlanza iphethri yokuphefumula kusuka kumasiki. Lapho kuqala ukusebenza, umama ubeletha umbelethisi. Phakathi nalesi sikhathi sokubeletha owesifazane angakwazi ukuhamba ngokuzungezile endlini bese ephumula. Umbelethisi ulinganisa ubude nobude bezinzalo zokubeletha. Esikhathini sokuqala sokusebenza, angakwazi ukuxhumana nowesifazane osebenza ngefoni futhi ngaleyo ndlela aqaphe isimo sakhe.
Isigaba esisebenzayo sokubeletha
Lapho kuqala isigaba esisebenzayo sokubeletha (uma umlomo wesibeletho ungama-4 cm noma ngaphezulu uvulekile), umbelethisi uhlala njalo eduze komfazi ekubelethweni. Ukuzalwa ekhaya kuqhutshwa ngendlela efanayo nesibhedlela sokubeletha, ngaphandle kokuthi umama unethuba lokulawula inqubo yokudiliva ngaphezulu. Owesifazane oqamba amanga akufanele alale embhedeni ngaso sonke isikhathi noma abe egumbini elifanayo. Angakwazi ukuhamba, ukugeza noma ukuya ngaphandle engadini. Isikhundla esiqondile somzimba singasheshe siphumelele, njengoba nalezi zithonya zifaka isandla ekunciphiseni ikhanda le-fetus, kunciphisa umlomo wesibeletho nokuvula kwayo ngokushesha. Uma kukhona ukuhlukunyezwa kwenzeka ngesikhathi sokuzalwa ekhaya, umbelethisi ngokushesha uxhumana nabasebenzi besibhedlela sokubeletha. Ngokusekelwe ezimpawu eziqhubekayo, udokotela osebenzayo angancoma esibhedlela ukuze ngenze usizo lwezokwelapha oludingekile. Ababelethisi banesipiliyoni esanele ekutholeni izinga lokusebenza kwabasebenzi.
Ukuqaphela
Isilinganiso senhliziyo, ukushisa komzimba, izinga lokushaya kwenhliziyo nokucindezeleka kwegazi, kanye nokukala kwenhliziyo kwe-fetus kuhlolwe ngokucophelela. Ngaphezu kwalokho, amandla, ubude kanye nemvamisa yezinqamulelo ze-uterine zirekhodwa. Ukuhlolwa okujwayelekile kwezinga lokuxilonga komlomo wesibeletho kanye nokuthuthukiswa komntwana ngokusebenzisa amathanga wokuzalwa kwenziwa. Ukuqapha okuqhubekayo kusenza sikhombise ngokuhamba kwesikhathi ukungajwayelekile komsebenzi futhi sikholele owesifazane ekubelethweni kuze kuthuthukiswe izinkinga eziyingozi.
Izinkinga
Ukwakhiwa kwezibhedlela ngesikhathi sokubeletha noma ngokushesha emva kwazo kuyadingeka ekuthuthukiseni izinkinga ezilandelayo:
- ukubola kwe-amniotic fluid ne-meconium (eluhlaza noma emnyama) - kungabonisa isimo esibi se-fetus. Ukungena kwe-meconium emgodini wokuphefumula wengane kungabangela ukuphazamiseka okukhulu kokuphefumula;
- ukucindezeleka kwe-fetus - nokusebenza isikhathi eside kungase kube nokukhubazeka okuhambisane nokuphazamiseka kwengqondo yenhliziyo ebusweni;
- ukuphuma kwegazi - ukuphuma okuncane kancane ngesikhathi sokubeletha kuvamile, kodwa kungabonisa ukuphazamiseka kweplantshi ngaphambi kwesikhathi;
- ukukhathala komama - kukhula ngokubeletha okunzima noma okude isikhathi eside. Kulokhu, umbelethisi angahlinzeka ngezinga elithile le-anesthesia (i-gas-air ingxube), kodwa kungase kudingeke ukuba kutholakale esibhedlela ukuze kutholakale i-epestural anesthesia (ukuvinjelwa kwamagciwane omgogodla);
- ukujula kakhulu kwe-postpartum -mymrrhage - ingabonwa nge-contraction eyanele ye-uterine emva kokukhululwa kokuzalwa komzimba;
- ukuhamba kwesikhathi kokubeletha - kungase kube nesidingo sokuhlukaniswa ngamabhokisi we-placenta ngaphansi kwe-anesthesia;
- ukwephulwa kokuphefumula emntwaneni - naphezu kokutholakala kwesithandwa sokubeletha umntwana osanda kuzalwa, ezimweni ezinjalo, kufanele ushayele i-ambulensi ngokushesha.
Ekwazisa izimpawu zokuqala zomsebenzi, owesifazane uthintana nombelethisi. Ngesikhathi sokubeletha, kuzovumela amalungu omndeni ukuthi abelane ngalesi senzakalo esithandanayo nomunye nomunye. Ngenkathi yokuzalwa, izikhathi ezintathu ziyaziwa:
- ukujula komlomo wesibeletho;
- ukuxoshwa kwe-fetus;
- ukuxoshwa kwe-placenta.
Ngokuqala kokusebenza (uma izibeletho ze-uterine ziba njalo noma amniotic fluid iyahamba), umbelethisi ufika kumfazi osebenzayo, uhlole, ulinganisa ukucindezeleka kwegazi futhi anqume isiteji senqubo yokuzalwa.
Ukuvulwa komlomo wesibeletho
Ezikhathini eziningi, isikhathi sokuqala sokusebenza sithatha amahora angu-6 kuya kwangu-12 - esigabeni sokuqala, ukuba khona kombelethisi akudingekile. Enye yezinzuzo zokubeletha ekhaya ukuthi ngalesi sigaba owesifazane angahamba ngokukhululekile endlini, futhi angabe esesimweni sezempilo. Lokhu kuvumela ukuba azizwe ekhululekile futhi ephazanyiswa ebuhlungu.
Ukwamukelwa kokubeletha
Lapho umlomo wesibeletho usuvulekile ngokugcwele, umbelethisi uhlale ehambisana nowesifazane ekubelethweni, ukuqapha isimo sakhe nokunikeza ukusekelwa kwengqondo. Ukubamba iqhaza kwakhe kunciphisa ukuvumela umama nomlingani wakhe, kanye namanye amalungu omndeni, ukuba babelane ngokuzwa okukhulu kusukela ekuzalweni okuhlangene. Umbelethisi uqaphela ukuvama kanye namandla emikhawulweni ye-uterine, kanye nezinga lokuvulwa komlomo wesibeletho. Ubuye ahlole ukucindezeleka kwegazi. Eqinisekisiwe ngendlela evamile yokusebenza, umbelethisi ngokuvamile ushiya futhi uxhumana njalo nowesifazane ekubelethweni, eqondisa inqubo ngocingo. Ubaba wengane engakazalwa usondelene nowesifazane obelethayo, emsekela ekuqaleni kokubeletha. Njengoba umsebenzi uqhubeka, izinkinga ziba njalo futhi zivame kakhulu. Owesifazane uzwa ukukhululeka okukhulu lapho ulwelwesi lwama-amniotic oluzungezile le-fetus luphumula ngaphandle kwe-amniotic fluid. Igumbi ekamelweni lapho owesifazane okhulelwe elele khona limbozwe nge-plastic. Amniotic fluid engaqondakali iyisibonakaliso sesimo esijabulisayo se-fetus.
Ukunwetshwa komlomo wesibeletho
Umbelethisi unelisekile ngempumelelo yowesifazane ekubelethweni. Amahora ambalwa emva kokuqala kwezimpi, futhi umlomo wesibeletho cishe uvuliwe ngokuphelele. Kulesi sigaba, iziqholo ze-uterine ziba zivame kakhulu futhi zinamandla kakhulu. Umlingani usiza owesifazane ekubelethweni ukuba aqhube, ngenkathi umbelethisi echaza izingane ukuthi kwenzekani ngempela kumama. Ngenhlanhla, abazali babalungiselela izenzakalo ezizayo. Njengoba owesifazane obeletha ephikisana, izindlela zokhokho bakhe zikhula futhi kusukela kubo ikhanda le-fetus liboniswa. Wonke umndeni ubukele amahlombe wengane avele ngemuva komzamo wesibili. Ubaba usekela ikhanda, futhi emva komunye umzamo, umntwana uzalwa. Ngemuva kokuhlolwa kokuqala, unina unikezwa ingane. Umbelethisi ubonisa uyise ukuthi angayinqamula kanjani intambo. Ngemva kwemizuzu embalwa i-placenta izalwa. Umbelethisi uyamhlola ngokucophelela.
Umama nengane bazizwa behle. Umbelethisi uhlola ingane, ilawule ukuvama kokuphefumula kwakhe kanye ne-pulse. Uhlola ngokucophelela intambo ye-umbilical, ngoba noma iyiphi i-anomaly, njengokuntuleka komthambo, ingaba uphawu lwe-pathology yesimiso senhliziyo. Khona-ke i-placenta ihlolwe: kubalulekile ukuqinisekisa ukuthi kuphelile ngokuphelele emgodini wesibindi. Njengoba eqiniseke ngobuqotho be-placenta, umbelethisi uyaqaphela ngokucophelela. Uma umama nengane bezwa kahle, umbelethisi ushiya ekamelweni ukuze avumele umndeni ukukhulumisana nomntwana, bese uqala ukuhlanza. Ngesikhathi umama ephumula, umbelethisi usiza uyise ukuba ageze umntwana osanda kuzalwa. Khona-ke ushiya indlu bese ebuya ngamahora ambalwa ukuze aphinde ahlole umama nengane, futhi aphendule imibuzo yabazali. Umbelethisi uvakashela umndeni ezinsukwini zokuqala emva kokuzalwa futhi uyaqhubeka nokuqapha isimo somama wakhe ngenyanga. Esikhathini se-postpartum, kunconywa ukunciphisa ukuvakashelwa kwabangane nezihlobo ukunikeza isikhathi somama nengane ukuphumula nokuphinde bathole amandla. Manje siyazi ukuthi ukuzalwa kwengane ngaphandle kwesibhedlela sokubeletha kungenziwa ngokuphepha.