Zomwe Ndidasankha Kukhala Pro Bono Kubadwa Doula

Zamkati

• Nkhani yanga
• Vuto la amayi ku United States
• Chikuchitika nchiani apa?
• Zomwe ma doulas adachita mchipinda choberekera
• Kafukufuku wa 2013 kuchokera ku Journal of Perinatal Education
  
• Mlandu wothandizira mosalekeza azimayi pobereka - kuwunika kwa 2017 Cochrane
  
• Tsogolo labwino kwa doulas ndi amayi
• Pezani zotsika mtengo kapena pro bono doula
  

Thanzi ndi thanzi zimakhudza aliyense wa ife mosiyanasiyana. Iyi ndi nkhani ya munthu m'modzi.

Groggy ndi tulo tofa nato, ndimatembenukira kokagona usiku kuti ndikaone foni yanga. Inali itangopanga phokoso longa kulira kwa kricket - toni yapadera yomwe ndimangosungira makasitomala anga a doula okha.

Nkhani ya Joanna inati: “Madzi anangowonongeka. Kutsika pang'ono. ”

Ndi 2:37 a.m.

Pambuyo pomulangiza kuti apumule, azimwetsa madzi, atseke, ndikubwereza, ndimabwerera kukagona - ngakhale zimakhala zovuta kutero ndikadziwa kuti kubadwa kwayandikira.

Kodi kumatanthauza chiyani kupuma kwanu kwamadzi?

Madzi a mayi yemwe akuyembekezereka poswa, amatanthauza kuti thumba lake la amniotic laphulika. (Pakati pa pakati, khanda limazunguliridwa ndikutsekedwa ndi thumba ili, lomwe limadzazidwa ndi madzi amniotic.) Nthawi zambiri, chikwama chothira madzi ndichizindikiro chakuti kubereka kwayandikira kapena kukuyamba.

Maola angapo pambuyo pake nthawi ya 5:48 m'mawa, Joanna amandiimbira foni kuti andiuze kuti mabala ake akukula ndikumachitika pafupipafupi. Ndazindikira kuti akuvutika kuyankha mafunso anga ndipo akung'ung'udza panthawi yamavuto - zizindikilo zonse zakugwira ntchito.

Ndimanyamula chikwama changa cha doula, chodzaza ndi chilichonse kuyambira mafuta ofunikira mpaka masanzi matumba, ndikupita kunyumba kwake.

Pa maora awiri otsatira, ine ndi Joanna timagwiritsa ntchito maluso omwe takhala tikugwira mwezi watha: kupuma mwakuya, kupumula, mawonekedwe anyama, kuwonera, kutikita minofu, kutulutsa mawu, kuthamanga kwa madzi kuchokera kusamba, ndi zina zambiri.

Cha m'ma 9:00 a.m., pamene Joanna akunena kuti akumva kukakamizidwa kwa ma rectal ndikulakalaka kukankha, timapita kuchipatala. Pambuyo paulendo wodabwitsa wa Uber, timalandiridwa kuchipatala ndi anamwino awiri omwe amatiperekeza kuchipinda choberekera ndi kuberekera.

Timalandila mwana Nathaniel nthawi ya 10:17 am - 7 mapaundi, ma ola 4 angwiro.

Kodi mayi aliyense sayenera kukhala ndi kubadwa kotetezeka, koyenera, komanso kupatsidwa mphamvu? Zotsatira zabwino siziyenera kukhala kwa iwo okha omwe angathe kulipira.

Nkhani yanga

Mu February 2018, ndinamaliza maphunziro a ola 35 ogwira ntchito zachilengedwe ku Natural Resources ku San Francisco. Chiyambireni kumaliza maphunziro anga, ndakhala ndikugwira ntchito yothandizira anthu kutengeka, kuthupi, komanso kuphunzitsa komanso kucheza ndi azimayi omwe amalandila ndalama zochepa ntchito isanakwane, nthawi yayitali komanso itatha.

Ngakhale doulas samapereka upangiri wazachipatala, ndimatha kuphunzitsa makasitomala anga momwe angathandizire azachipatala, magawo ndi zizindikiritso za ntchito, njira zotonthoza, malo abwino antchito ndi kukankha, zipatala ndi malo obadwira kunyumba, ndi zina zambiri.

Mwachitsanzo, Joanna alibe mnzake - bamboyo sali pachithunzichi. Alibe banja m'derali, mwina. Ndidatumikira monga m'modzi mwaomwe anali naye pachibwenzi nthawi zonse ali ndi pakati.

Pomulimbikitsa kuti azipita kumayi ake asanabadwe komanso kucheza naye zakufunika kwa zakudya zopatsa thanzi komanso zakudya zapakati pa mimba, ndidamuthandizanso kukhala ndi pakati wathanzi, wopanda chiopsezo.

United States ili ndi chiwerewere chachikulu kwambiri cha amayi akumwalira m'maiko otukuka. Ndi, poyerekeza ndi 9.2 ku United Kingdom.

Ndidakhala wofunitsitsa kutenga nawo gawo nditafufuza mozama za zovuta za chisamaliro cha amayi ndi zotsatira ku United States. Kodi mayi aliyense sayenera kukhala ndi kubadwa kotetezeka, koyenera, komanso kupatsidwa mphamvu?

Zotsatira zabwino siziyenera kungoperekedwa kwa iwo okha omwe angathe kulipira.

Ichi ndichifukwa chake ndimatumikira anthu omwe amapeza ndalama zochepa ku San Francisco ngati doula wodzifunira - ntchito yomwe ndikukhulupirira kuti ndiyofunika kwambiri pakukweza miyoyo ya amayi ndi ana mdziko lathu. Ndi chifukwa chake ma doulas ena amapereka kusinthasintha kapena kutsetsereka zikafika pakubweza.

Vuto la amayi ku United States

Malinga ndi kafukufuku wochokera ku UNICEF, kufa kwa amayi apadziko lonse kudatsika pafupifupi theka kuyambira 1990 mpaka 2015.

Koma United States - amodzi mwa mayiko olemera kwambiri, komanso otsogola kwambiri padziko lapansi - akusunthira mbali ina poyerekeza ndi dziko lonse lapansi. Ndi dziko lokhalo lochita izi.

Tili ndi chiwerewere chachikulu kwambiri cha amayi akumwalira m'maiko otukuka. Ndi, poyerekeza ndi 9.2 ku United Kingdom.

Kupezeka kwa doula kumabweretsa zotsatira zabwino zakubadwa ndikuchepetsa zovuta kwa amayi ndi mwana - sitimangokhala "okoma kukhala nawo"

Pakufufuza kwakanthawi, ProPublica ndi NPR adazindikira amayi opitilira 450 oyembekezera komanso amayi atsopano omwe amwalira kuyambira 2011 pazinthu zomwe zidachitika panthawi yapakati komanso yobereka. Izi zikuphatikiza, koma sizingokhala pa:

• matenda a mtima
• kukha magazi
• kuundana kwamagazi
• matenda
• kutchfuneralhome

Chikuchitika nchiani apa?

Kupatula apo, iyi si Middle Ages - sizoyenera kuti chinthu chachilengedwe komanso chofala ngati kubala mwana chikhale chotetezeka kwathunthu kupatsidwa chithandizo chamankhwala chamakono? M'masiku ano, ndichifukwa chiyani amayi akupatsidwa chifukwa choopera moyo wawo?

Akatswiri akuganiza kuti zovuta zakupwetekazi zimachitika - ndipo zikuchitika pamlingo wokulirapo - chifukwa cha zinthu zingapo zomwe zingakhudze wina ndi mnzake:

• azimayi ambiri amabereka pambuyo pake m'moyo
• kuwonjezeka kwa kubereka kosalekeza (magawo a C)
• dongosolo lovuta, losafikirika laumoyo
• kukwera kwamatenda azaumoyo monga matenda ashuga komanso kunenepa kwambiri

Kafukufuku wambiri watithandiza kudziwa kufunika kwa kuthandizabe mosalekeza, nanga bwanji thandizo lochokera kwa doula makamaka, motsutsana ndi mnzanu, wachibale, mzamba, kapena dokotala?

Amayi ambiri apakati - mosatengera mtundu wawo, maphunziro awo, kapena ndalama zawo - amakhala ndi izi. Koma kufa kwa amayi akuchuluka kwambiri kwa azimayi omwe amapeza ndalama zochepa, azimayi akuda, komanso omwe amakhala kumidzi. Makanda akuda ku America tsopano amafa kuwirikiza kawiri kufa kwa ana azungu (makanda akuda, poyerekeza ndi 4.9 pa ana 1,000 azungu).

Malinga ndi zomwe anthu amafa kuchokera ku US Centers for Disease Control and Prevention, kuchuluka kwa kufa kwa amayi m'mabwalo akuluakulu apakati panali 18.2 pa 100,000 akubadwa amoyo mu 2015 - koma kumadera akumidzi kwambiri, anali 29.4.

Mosakayikira, dziko lathu lili pakati pa mliri wowopsa, wathanzi ndipo anthu ena ali pachiwopsezo chachikulu.

Koma doulas - akatswiri osagwiritsa ntchito mankhwala omwe mwina atangokhala ndi maola 35 okha, monga ine - atha kukhala gawo la yankho kuvuto lalikulu chonchi?

Zomwe ma doulas adachita mchipinda choberekera

Ngakhale azimayi 6% okha ndi omwe amasankha kugwiritsa ntchito doula panthawi yapakati komanso akunyamula ntchito mdziko lonse, kafukufukuyu ndiwodziwikiratu: Kupezeka kwa doula kumabweretsa zotsatira zabwino zakubadwa ndikuchepetsa zovuta kwa mayi ndi mwana - sitili chabe kukhala nazo. ”

Kafukufuku wa 2013 kuchokera ku Journal of Perinatal Education

• Kuchokera mwa amayi 226 oyembekezera a ku America ndi azungu (zosintha monga zaka ndi mtundu zinali zofanana mgululi), pafupifupi theka la azimayiwo adapatsidwa doula yophunzitsidwa ndipo enawo sanapatsidwe.
• Zotsatira: Amayi omwe amafanana ndi doula anali kanayi ochepera kubereka mwana wobadwa wochepa thupi komanso kawiri sangakhale ndi vuto lakubadwa lomwe limadziphatikizira iwo kapena mwana wawo.

Kafukufuku wambiri waunikira kufunikira kwa kuthandizira mosalekeza, koma kodi thandizo lochokera ku doula makamaka, motsutsana ndi mnzake, wachibale, mzamba, kapena dokotala ndiosiyana?

Chosangalatsa ndichakuti, pofufuza zomwe zafufuzidwazo, ofufuza adapeza kuti, anthu omwe amakhala ndi chithandizo chanthawi zonse pobereka amachepetsa chiopsezo cha gawo la C. Koma pomwe doulas ndi omwe amapereka chithandizo, kuchuluka uku kudumpha mwadzidzidzi kutsika.

American College of Obstetricians and Gynecologists idatulutsa chigwirizano chotsatirachi mu 2014: "Zolemba zofalitsa zikuwonetsa kuti imodzi mwazida zothandiza kwambiri pakukwaniritsa zotsatira za ntchito ndi kubereka ndi kukhalapo kosalekeza kwa othandizira, monga doula."

Mlandu wothandizira mosalekeza azimayi pobereka - kuwunika kwa 2017 Cochrane

• Unikani: Kafukufuku wa 26 wokhudzana ndi kuthandizidwa kosalekeza pantchito, yomwe ingaphatikizepo thandizo la doula. Kafukufukuyu adaphatikiza azimayi opitilira 15,000 azikhalidwe zosiyanasiyana.
• Zotsatira: "Kupitiliza kuthandizira panthawi ya kubereka kumatha kusintha zotsatira za amayi ndi makanda, kuphatikizapo kubadwa kwachangu kwachikulire, nthawi yocheperako ya ntchito, ndi kuchepa kwa kubereka, kubereka kwa amayi, kugwiritsa ntchito mankhwala aliwonse a analgesia, kugwiritsa ntchito analgesia yachigawo, mphambu ya Apgar ya mphindi zisanu, ndi malingaliro olakwika okhudzana ndi kubadwa kwa mwana. Sitinapeze umboni uliwonse wosonyeza kuti anthu akupitirizabe kuwathandiza. ”
• Phunziro la mawu obadwa mwachangu: "Analgesia" amatanthauza mankhwala opweteka ndipo "Apgar score" ndi momwe thanzi la ana limayesedwa pobadwa ndipo patangopita nthawi pang'ono - kukwera kwambiri, kumakhala bwino.

Koma nayi chinthu ichi: Malinga ndi kafukufukuyu wochokera ku American Journal of Managed Care, azimayi akuda komanso omwe amalandira ndalama zochepa kwambiri amafunidwa koma sangakhale ndi mwayi wopeza chisamaliro cha doula.

Izi mwina ndichifukwa choti sangakwanitse, amakhala mdera lokhala ndi ma doul ochepa kapena opanda, kapena sanaphunzirepo.

Doulas atha kukhala osatheka kufikako kwa iwo omwe amawafuna kwambiri.

Ndikofunikanso kunena kuti ma doulas ambiri ndi azungu, ophunzira bwino, akazi okwatiwa, kutengera zotsatira za kafukufukuyu wa 2005 wofalitsidwa mu Women's Health Issues. (Inenso ndagwera m'gululi.)

Ndizotheka kuti makasitomala a doulas awa amafanana ndi mtundu wawo komanso chikhalidwe chawo - kuwonetsa kuti pangakhale cholepheretsa chikhalidwe ndi zachuma ku doula thandizo. Izi zitha kutsimikiziranso malingaliro akuti doulas ndiwosangalatsa kwambiri omwe ndi azimayi olemera okha omwe angakwanitse.

Doulas atha kukhala osatheka kufikako kwa iwo omwe amawafuna kwambiri. Koma bwanji ngati kugwiritsidwa ntchito kwa doulas - makamaka kwa anthu osowa - kungalepheretse zovuta zina zomwe zikuchititsa kuti azimayi aku America azimwalira modabwitsa modabwitsa?

Tsogolo labwino kwa doulas ndi amayi

Ili ndiye funso lenileni lomwe boma la New York likuyembekeza kuyankha kudzera mu pulogalamu yoyendetsa ndege yomwe yalengezedwa posachedwa, yomwe idzawonjezera kufalitsa kwa Medicaid ku doulas.

Ku New York City, azimayi akuda ali pachiwopsezo chofa kwambiri kawiri kawiri pazifukwa zokhudzana ndi pakati kuposa azungu. Koma chifukwa chofufuza bwino za doulas, opanga malamulo akuyembekeza kuti chiwerengerochi chikuphulika nsagwada, kuphatikiza kukulitsa kwamaphunziro a amayi asanabadwe komanso kuwunikiridwa bwino kwa zipatala, zikhala bwino.

Ponena za pulogalamuyi, yomwe idzayambike chilimwechi, Bwanamkubwa Andrew Cuomo akuti, "Imfa za amayi siziyenera kukhala mantha aliyense ku New York ayenera kukumana nawo m'zaka za zana la 21. Tikuchita zinthu zankhanza kuti tithetse zopinga zomwe zimalepheretsa amayi kulandira chithandizo chamankhwala asanabadwe komanso chidziwitso chomwe angafune. ”

Pakadali pano, onse a Minnesota ndi Oregon ndi mayiko ena okha omwe amalola kubwezeredwa kwa Medicaid kwa doulas.

Zipatala zambiri, monga San Francisco General Hospital ku Bay Area, zakhazikitsa mapulogalamu odzipereka a doula kuti athane ndi vutoli.

Wodwala aliyense amatha kufanana ndi pro bono doula yemwe amapezeka kuti azitsogolera amayi asanabadwe, panthawi yobadwa, komanso pambuyo pake. Odzipereka a doulas amathanso kugwira ntchito yosinthana ndi kuchipatala kwa maola 12 ndikupatsidwa ntchito kwa mayi wogwira ntchito yemwe akufuna thandizo, mwina ngati samalankhula bwino Chingerezi kapena atafika kuchipatala yekha wopanda mnzake, wachibale, kapena mnzake wothandizira.

Kuphatikiza apo, San Prenatal Prenatal Program ya San Francisco ndi yopanda phindu yomwe imapereka doula ndi chithandizo chamankhwala kwa anthu opanda mzindawo.

Pamene ndikupitiliza kuphunzira ndikutumikira monga doula, ndikuyembekeza kuyika chidwi changa pa anthu omwe ali pachiwopsezo chodzipereka pantchitozi ndikutenga makasitomala a pro bono ngati Joanna.

Nthawi iliyonse ndikamva phokoso lodziwika bwino la crickets likulira pafoni yanga m'mawa, ndimadzikumbutsa kuti ngakhale ndili doula m'modzi yekha, ndikuchita gawo langa laling'ono kukonza miyoyo ya azimayi, mwinanso kuthandiza kupulumutsa enanso.

Pezani zotsika mtengo kapena pro bono doula

• Wopambana Doula
• Wodzipereka ku Chicago Doulas
• Chipata cha Doula Gulu
• Dongosolo Lakubereka Panyumba
• Zachilengedwe
• Kubadwa
• Ntchito ya Bay Area Doula
• Mwala Wa Pangodya Doula

English Taylor ndi mlembi wa zaumoyo waumoyo wa azimayi ku San Francisco komanso doula wobadwa. Ntchito yake idawonetsedwa mu The Atlantic, Refinery29, NYLON, LOLA, ndi THINX. Tsatirani Chingerezi ndi ntchito yake pa Medium kapena on Instagram.