Kungani Nginqume Ukuba Yi-Pro Bono Birth Doula

-Delile

• Indaba yami
• Inkinga yomama e-United States
• Kwenzekani lapha?
• Umthelela oshadiwe wama-doulas egumbini lokulethwa
• Ucwaningo luka-2013 oluvela kwiJenali Yemfundo Yokubeletha
  
• Icala lokuxhaswa okuqhubekayo kwabesifazane ngesikhathi sokubeletha - ukubuyekezwa kwe-2017 Cochrane
  
• Ikusasa elinethemba lama-doulas nomama
• Thola okungabizi noma pro bono doula
  

Impilo nokuphila kahle kuthinta ngamunye wethu ngokuhlukile. Le yindaba yomuntu oyedwa.

I-Groggy futhi ilele kancane, ngiphendukela ku-nightstand yami ukuze ngibheke umakhalekhukhwini wami. Ibisanda kwenza umsindo wokukhala njengekhilikithi - iringithoni ekhethekile engiyigcinele kuphela amaklayenti ami e-doula.

Umbhalo kaJoanna ufundeka kanje: “Amanzi avele aqhekeka. Ukuba nezinciphiso eziphansi. ”

Ngu-2: 37 ekuseni.

Ngemuva kokumeluleka ukuthi aphumule, anike amanzi, achame, bese ephinda, ngibuyela ekulaleni - yize kuhlale kunzima ukushiya lapho ngazi ukuthi ukuzalwa kuseduze.

Kusho ukuthini ukuphumula kwakho kwamanzi?

Lapho amanzi kamama ozokuba maduze ephuka, kusho ukuthi isikhwama sakhe se-amniotic sesigqabukile. (Ngesikhathi sokukhulelwa, ingane izungezwe futhi ivikelwe yilesi sikhwama, esigcwele uketshezi lwe-amniotic.) Imvamisa, isikhwama sokuphuka kwamanzi siwuphawu lokuthi ukubeletha kuseduze noma kuyaqala.

Ngemuva kwamahora ambalwa ngo-5: 48 ekuseni, uJoanna uyangishayela ezongitshela ukuthi izingqinamba zakhe ziyaqina futhi zenzeka ngezikhathi ezithile. Ngiyabona ukuthi unenkinga yokuphendula imibuzo yami futhi uyabubula ngesikhathi sokucindezela - zonke izimpawu zomsebenzi osebenzayo.

Ngipakisha isikhwama sami se-doula, ngigcwalise konke kusuka kumafutha abalulekile kuya ezikhwameni, bese ngiya efulethini lakhe.

Emahoreni amabili alandelayo, mina noJoanna senza amasu okusebenza ebesisebenza kuwo enyangeni edlule: ukuphefumula okujulile, ukuphumula, ukuma komzimba, ukubona ngeso lokhozi, ukubhucunga, ukukhomba ngamazwi, ingcindezi yamanzi kusuka eshaweni, nokuningi.

Cishe ngo-9: 00 a.m., lapho uJoanna ekhuluma ukuthi uzizwa ecindezelekile emaceleni kanye nesifiso sokuphusha, siya esibhedlela. Ngemuva kohambo lwe-Uber olungajwayelekile, siyabingelelwa esibhedlela ngabahlengikazi ababili abasiphelezela basiyisa egumbini labasebenzi nababelethi.

Samukela umntwana uNathaniel ngo-10: 17 a - 7 amakhilogremu, ama-ounces ama-4 okuphelela okumsulwa.

Ngabe bonke omama abakufanele yini ukuzalwa okuphephile, okuhle, nokunika amandla? Imiphumela engcono akufanele ibekelwe kuphela labo abangakhokha.

Indaba yami

NgoFebhuwari 2018, ngiphothule ukuqeqeshwa kwe-doula yokuzalwa kwamahora angama-35 kwa-Natural Resources eSan Francisco. Kusukela ngithweswe iziqu, bengisebenza njengesisetshenziswa somzwelo, somzimba, kanye nesokwazisa futhi ngihambisana nabesifazane abahola kancane ngaphambi, ngesikhathi nangemva kokubeletha.

Ngenkathi ama-doulas enganikeli ngeseluleko somtholampilo, ngingafundisa amaklayenti ami ngokungenelela kwezokwelapha, izigaba kanye nezimpawu zomsebenzi, izindlela zokududuza, izikhundla ezifanele zabasebenzi nokuxoshwa, izindawo zokubeletha ezibhedlela nezasemakhaya, nokunye okuningi.

UJoanna, isibonelo, akanaye umlingani - ubaba akekho esithombeni. Akanawo umndeni endaweni, futhi. Ngasebenza njengomunye wabangane bakhe abayinhloko nezinsizakusebenza phakathi nokukhulelwa kwakhe.

Ngokumkhuthaza ukuthi aye emihlanganweni yakhe ngaphambi kokubeletha futhi ngixoxe naye ngokubaluleka kokudla okunomsoco nokudla ngesikhathi sokukhulelwa, ngamsiza nokuthi abe nokukhulelwa okunempilo, nokubeka engcupheni.

Izwe laseMelika linezinga elibi kakhulu lokushona komama emazweni athuthukile. Kuyi, uma kuqhathaniswa ne-9.2 e-United Kingdom.

Ngazizwa nginesifiso sokubandakanyeka ngemuva kokwenza ucwaningo olunzulu ngesimo esethusayo sokunakekelwa komama kanye nemiphumela e-United States. Ngabe bonke omama abakufanele yini ukuzalwa okuphephile, okuhle, nokunika amandla?

Imiphumela engcono akufanele ibekelwe kuphela labo abangakhokha.

Yingakho ngikhonza abantu abahola kancane eSan Francisco njengevolontiya i-doula - insiza engikholelwa kuyo ngokuqinile ukuthi iyadingeka kakhulu ukwenza ngcono izimpilo zabesifazane nezingane ezweni lethu. Kungakho futhi amanye ama-doulas enikeza ukuguquguquka noma isikali sokuhambisa uma kukhulunywa ngokukhokha.

Inkinga yomama e-United States

Ngokusho kwedatha evela ku-UNICEF, amazinga okufa komama emhlabeni ahla cishe isigamu kusuka ngo-1990 kuya ku-2015.

Kepha i-United States - elinye lamazwe acebe kakhulu, futhi athuthuke kakhulu emhlabeni - empeleni ithambekela kolunye uhlangothi uma iqhathaniswa nawo wonke umhlaba. Kuphela futhi izwe elenza njalo.

Sinezinga elibi kakhulu lokushona komama emazweni athuthukile. Kuyi, uma kuqhathaniswa ne-9.2 e-United Kingdom.

Ukuba khona kwe-doula kuholela emiphumeleni engcono yokuzalwa nokuncipha kwezinkinga zomama nengane - asiyona nje "into enhle ukuba nayo."

Ngesikhathi sophenyo lwesikhathi eside, iProPublica ne-NPR bakhombe omama abangaphezu kuka-450 abalindayo nabomama abasha abashonile kusukela ngo-2011 ngenxa yezinkinga ezavela ngesikhathi sokukhulelwa nokubeletha. Lezi zinkinga zifaka, kepha azikhawulelwanga ku:

• isifo senhliziyo
• ukopha
• amahlule egazi
• izifo
• preeclampsia

Kwenzekani lapha?

Ngemuva kwakho konke, lokhu akuyona iNkathi Ephakathi - akufanele yini into engokwemvelo nejwayelekile njengokuzalwa komntwana iphephe ngokuphelele inqubekela phambili kwezokwelapha zesimanje? Kulesi sikhathi esiphila kuso, kungani omama benikezwa isizathu sokwesabela izimpilo zabo?

Ochwepheshe bacabanga ukuthi lezi zinkinga ezibulalayo zenzeka - futhi zenzeka ngezinga eliphakeme - ngenxa yezici ezahlukahlukene ezingaba nomthelela komunye nomunye:

• abesifazane abaningi ababeletha kamuva empilweni
• ukwanda kokudiliva ngokuhlinzwa (izigaba ze-C)
• uhlelo oluyinkimbinkimbi, olungenakufinyeleleka lwezempilo
• ukukhuphuka kwezinkinga zezempilo ezingamahlalakhona njengesifo sikashukela nokukhuluphala

Ucwaningo oluningi lukhanyisile ngokubaluleka kokusekelwa okuqhubekayo, kuthiwani ngokuxhaswa okuvela ku-doula ikakhulukazi, kuqhathaniswa nomlingani, ilungu lomndeni, umbelethisi noma udokotela?

Abesifazane abaningi abakhulelwe - noma ngabe baluphi uhlanga, imfundo, noma iholo - bangaphansi kwalezi zinto ezibangela lokho. Kepha amazinga okushona komama aphakeme kakhulu kwabesifazane abahola kancane, abesifazane abamnyama, nalabo abahlala ezindaweni zasemakhaya. Izinsana ezimnyama eMelika manje zisengozini ephindwe kabili yokufa kunezingane ezimhlophe (izingane ezimnyama, uma kuqhathaniswa nezingu-4.9 ezinganeni ezimhlophe eziyinkulungwane).

Ngokuya ngemininingwane yokufa komphakathi evela e-U.S. Centers for Disease Control and Prevention, isilinganiso sokushona komama ezindaweni ezinkulu ezisenkabeni yedolobha sasingu-18.2 kwabangu-100,000 ababelethwe bukhoma ngo-2015 - kodwa ezindaweni ezisemaphandleni kakhulu, kwakungu-29.4.

Akudingeki ukuthi kushiwo, izwe lethu liphakathi kwesifo esesabekayo, esiwumqedazwe sezempilo futhi abantu abathile basengozini enkulu.

Kepha kungenzeka kanjani ukuthi ama-doulas - ochwepheshe abangaqeqeshwanga ngemitholampilo anamahora angama-35 noma ngaphezulu wokuqeqeshwa, njengami - abe yingxenye yesixazululo senkinga enkulu kangaka?

Umthelela oshadiwe wama-doulas egumbini lokulethwa

Ngaphandle kokuthi amaphesenti ayisi-6 kuphela abesifazane akhetha ukusebenzisa i-doula ngesikhathi sokukhulelwa nasemsebenzini ezweni lonke, ucwaningo lucacile: Ubukhona be-doula buholela emiphumeleni engcono yokuzalwa nokuncipha kwezinkinga zomama nengane - asiyona nje into "enhle -ba nakho. ”

Ucwaningo luka-2013 oluvela kwiJenali Yemfundo Yokubeletha

• Kuma-226 omama abalindelwe base-Afrika baseMelika nabamhlophe (okufana nobudala nohlanga kwakufana ngaphakathi eqenjini), cishe uhhafu wabesifazane babelwa i-doula eqeqeshiwe kanti abanye babengekho.
• Imiphumela: Omama abafaniswe ne-doula babe kane mancane amathuba okuthi ingane izalwe isisindo esincane sokuzalwa futhi amahlandla amabili mancane amathuba okuthi babhekane nenkinga yokuzalwa ebandakanya bona noma ingane yabo.

Ucwaningo oluningi lukhanyisile ngokubaluleka kokusekelwa okuqhubekayo, kepha ingabe ukwesekwa okuvela ku-doula ngqo, kuqhathaniswa nomlingani, ilungu lomndeni, umbelethisi, noma udokotela kuhlukile?

Kuyathakazelisa ukuthi lapho behlaziya idatha, abacwaningi bathole ukuthi sekukonke, abantu abanokuxhaswa okuqhubekayo ngesikhathi sokubeletha bathola ukwehla engcupheni yesigaba se-C. Kepha uma ama-doulas yiwona ahlinzeka ukwesekwa, leli phesenti ngokuzumayo ligxumela ekwehleni.

I-American College of Obstetricians and Gynecologists yakhipha lesi sitatimende sokuvumelana ngo-2014: “Idatha eshicilelwe ikhombisa ukuthi elinye lamathuluzi asebenza kakhulu ukuthuthukisa imiphumela yezabasebenzi kanye nokulethwa kwaba khona okuqhubekayo kwabasebenzi abasizayo, njenge-doula.”

Icala lokuxhaswa okuqhubekayo kwabesifazane ngesikhathi sokubeletha - ukubuyekezwa kwe-2017 Cochrane

• Buyekeza: Izifundo ezingama-26 ngokusebenza kokusekelwa okuqhubekayo ngesikhathi sokubeletha, okungafaka phakathi usizo lwe-doula. Lezi zifundo zibandakanya abesifazane abangaphezu kwe-15,000 abavela ezizindeni nasezimeni ezahlukahlukene.
• Imiphumela: “Ukwesekwa okuqhubekayo ngesikhathi sokubeletha kungathuthukisa imiphumela yabesifazane nezinsana, kufaka phakathi ukwanda kokuzalwa kwesitho sowesifazane sangasese, isikhathi esifushane sokubeletha, nokwehla kokubeletha ngesikhathi sokubeletha, ukuzalwa kwesitho sangasese sowesifazane, ukusetshenziswa kwanoma iyiphi i-analgesia, ukusetshenziswa kwe-analgesia yesifunda, amaphuzu aphansi we-Apgar yemizuzu emihlanu, nemizwa engemihle mayelana nokuhlangenwe nakho kokubeletha. Asibutholanga ubufakazi bokulimala kokwesekwa okuqhubekayo kwabasebenzi. ”
• Isifundo segama lokuzalwa esisheshayo: "I-Analgesia" ibhekisa emithini yezinhlungu futhi "amaphuzu e-Apgar" yindlela impilo yezingane ehlolwa ngayo lapho izalwa futhi kungekudala ngemuva kwalokho - amaphuzu aphezulu, aba ngcono.

Kodwa nansi into: Ngokwalolu cwaningo oluvela kwi-American Journal of Managed Care, abesifazane abamnyama nabahola kancane yibo abangahle bafune kodwa mancane amathuba okuthola ukunakekelwa kwe-doula.

Lokhu kungenxa yokuthi abakwazi ukuyikhokhela, bahlala endaweni enezindawo ezimbalwa noma bengenawo ama-doulas, noma bamane nje abakaze bafunde ngakho.

I-Doulas ingahle ingafinyeleleki kulabo ababadinga kakhulu.

Kubalulekile futhi ukusho ukuthi iningi lama-doulas abamhlophe, abafunde kahle, abesifazane abashadile, ngokususelwa kwimiphumela yalolu cwaningo lwango-2005 olushicilelwe kwi-Women’s Health Issues. (Nami ngiwela kulesi sigaba.)

Kungenzeka ukuthi lawa maklayenti e-doulas afane nephrofayili yawo yobuhlanga namasiko - ekhombisa ukuthi kukhona okungaba yisithiyo senhlalo nomnotho ekusekelweni kwe-doula. Lokhu kungasekela nenkolelo yokuthi ama-doulas ayindawo yokunethezeka enganikezwa ngabesifazane abamhlophe abacebile kuphela.

I-Doulas ingahle ingafinyeleleki kulabo ababadinga kakhulu.Kepha kuthiwani uma ukusetshenziswa kabanzi kwe-doulas - ikakhulukazi kulaba bantu abangasetshenziswanga - kungavimbela ezinye zezinkinga ezisemuva kwesilinganiso sokufa komama okuphezulu ngokumangazayo kwe-U.S.

Ikusasa elinethemba lama-doulas nomama

Lona ngumbuzo ngqo izwe laseNew York lithemba ukuwuphendula ngohlelo lwayo lomshayeli olusanda kumenyezelwa, oluzothuthukisa ukumbozwa kweMedicaid iye eDoulas.

ENew York City, abesifazane abamnyama basengozini ephindwe ka-12 yokufa ngezimbangela ezihlobene nokukhulelwa kunabesifazane abamhlophe. Kepha ngenxa yocwaningo olunethemba nge-doulas, abomthetho bathemba ukuthi lesi sibalo esilahla umhlathi, kuhlangene nokwandiswa kwezinhlelo zemfundo yabakhulelwe kanye nokubuyekezwa kwemikhuba emihle kakhulu esibhedlela, kuzothuthuka.

Mayelana nohlelo, oluzokwethulwa kuleli hlobo, uMbusi u-Andrew Cuomo uthi, “Ukufa komama akufanele kube yikwesaba noma ngubani eNew York okufanele abhekane nakho ngekhulu lama-21. Sithatha isenzo esinolaka ukwephula imigoqo evimbela abesifazane ekutholeni ukunakekelwa ngaphambi kokubeletha nolwazi abaludingayo. ”

Njengamanje, zombili iMinnesota ne-Oregon yizona kuphela izifundazwe ezivumela ukubuyiselwa kwemali kweMedicaid kwama-doulas.

Izibhedlela eziningi, njengeSan Francisco General Hospital eBay Area, zenze izinhlelo zokuzithandela ze-doula ukuxazulula le nkinga.

Noma yisiphi isiguli singafaniswa nepro bono doula okhona ukuqondisa umama ngaphambi kokubeletha, ngesikhathi sokuzalwa, nangemva kwalokho. I-Volunteer doulas nayo ingasebenza amashifu esibhedlela esibhedlela futhi inikezwe umama osebenzayo odinga ukwesekwa, mhlawumbe uma engakhulumi kahle isiNgisi noma efika esibhedlela eyedwa ngaphandle kozakwethu, ilunga lomndeni, noma umngane wokuxhaswa.

Ngokwengeziwe, iSan Francisco's Homeless Prenatal Programme iyinhlangano engenzi nzuzo enikeza i-doula nokunakekelwa kokubeletha kubantu abasedolobheni abangenakhaya.

Njengoba ngiqhubeka nokufunda futhi ngisebenza njenge-doula, ngiyethemba ukugxila emizameni yami kulaba bantu abasengozini enkulu ngokuzinikela kulezi zinhlelo nangokuthatha amaklayenti e-pro bono njengoJoanna.

Ngaso sonke isikhathi lapho ngizwa lowo msindo ojwayelekile wezinyendle obhuza ngocingo lwami ekuseni ngovivi, ngizikhumbuza ukuthi yize ngingu-doula oyedwa kuphela, ngenza ingxenye yami encane ukwenza ngcono izimpilo zabesifazane, mhlawumbe futhi ngisize ukusindisa abanye, futhi.

Thola okungabizi noma pro bono doula

• I-Radical Doula
• I-Chicago Volunteer Doulas
• Isango leDoula Group
• Uhlelo Lokubeletha Olungenamakhaya
• Okumbiwayo kwendalo
• Izindlela zokuzalwa
• Iphrojekthi yaseBay Area Doula
• Ukuqeqeshwa kweCornerstone Doula

U-English Taylor ungumbhali wezempilo nenhlalakahle yabesifazane waseSan Francisco kanye nokuzalwa kwe-doula. Umsebenzi wakhe ubonisiwe kuThe Atlantic, Refinery29, NYLON, LOLA, naseTHINX. Landela isiNgisi nomsebenzi wakhe kuMedium noma ku Instagram.