Dalilin da yasa Na yanke Shawarar Zama Pro Bono Haihuwar Doula

Wadatacce

• Labari na
• Rikicin mata masu ciki a Amurka
• Me ke faruwa a nan?
• Tasirin tasirin doula a cikin ɗakin isar da sako
• Nazarin 2013 daga Journal of Perinatal Education
  
• Hali don ci gaba da tallafawa mata yayin haihuwa - 2017 Binciken Cochrane
  
• Makoma mai kyau ga doula da uwaye
• Nemi mai araha ko pro bono doula
  

Lafiya da lafiya suna taɓa kowannenmu daban. Wannan labarin mutum daya ne.

Groggy and half-bacci, Na juya zuwa inda nake tsaye don duba waya ta. Ba da daɗewa ba ya yi kara kamar cricket mai kara - sautin ringi na musamman na keɓance kawai ga abokan cinikinmu.

Rubutun Joanna ya karanta: “Ruwa kawai ya tsinke. Samun ƙananan raguwa. ”

Da karfe 2:37 na safe

Bayan na yi mata nasiha don hutawa, shayarwa, fitsari, da maimaitawa, sai na koma barci - duk da cewa koyaushe yana da wuya in tashi idan na san haihuwa ta kusa.

Menene ma'anar samun ruwan ku?

Lokacin da mahaifiyar da ba da daɗewa ba zata zama ruwan uwa, yana nufin jakarta amniotic ta fashe. (A lokacin daukar ciki, wannan jakar ta zagaye da kuma kwantar da jaririn, wanda ke cike da ruwan ciki.) Galibi, jakar fashewar ruwan wata alama ce cewa aiki ya kusa ko yana farawa.

Bayan 'yan sa'o'i kadan da ƙarfe 5:48 na safe, Joanna ta kira ta gaya mani cewa ciwan nata yana ƙaruwa kuma yana faruwa a lokaci-lokaci. Na lura tana fama da matsala wajen amsa tambayoyina kuma tana nishi yayin kwankwaso - duk alamun nakuda mai aiki.

Na shirya jakata na doula, cike da komai daga mai mai mahimmanci zuwa jakar amai, sannan na nufi gidanta.

A cikin awanni biyu masu zuwa, ni da Joanna muna yin fasahohin kwadago da muke yi a cikin watan da ya gabata: zurfin numfashi, annashuwa, yanayin jiki, gani, motsa jiki, maganganun baki, matsin ruwa daga shawa, da ƙari.

Da misalin karfe 9:00 na safe, lokacin da Joanna ta ambaci tana jin matsin na dubura da sha'awar turawa, sai mu tafi asibiti. Bayan an hau kan Uber mara kyau, an gaishe mu a asibiti ta hanyar masu jinya biyu da suka rako mu zuwa dakin haihuwa da haihuwa.

Muna maraba da jaririn Nathaniel da ƙarfe 10:17 na safe - fam 7, ogin 4 na cikakken tsarkakakke.

Shin kowace uwa ba ta cancanci samun haihuwar lafiya, tabbatacciya ba, kuma ta sami ikon haihuwa? Kyakkyawan sakamako bai kamata a iyakance ga waɗanda kawai za su iya biya ba.

Labari na

A watan Fabrairun 2018, Na kammala horon haihuwar doula na awa 35 a Albarkatun Kasa a San Francisco. Tun lokacin da na kammala karatu, na kasance mai aiki da azanci, jiki, da kuma bayanai da kuma abokai ga mata masu ƙarancin ƙarfi kafin, lokacin, da kuma bayan aiki.

Duk da yake doulas ba sa ba da shawara na asibiti, zan iya ilimantar da abokan cinikina game da ayyukan likita, matakai da alamun aiki, matakan jin daɗi, kyakkyawan matsayi na aiki da turawa, asibiti da mahalli na haihuwa, da ƙari.

Joanna, alal misali, ba ta da abokin tarayya - mahaifin ya fita daga hoto. Ba ta da iyali a yankin, ko dai. Na yi aiki a matsayin ɗayan abokanta na farko da albarkatu a duk lokacin da take cikin ciki.

Ta hanyar ƙarfafa ta don halartar alƙawarinta na haihuwa kuma na yi mata magana game da mahimmancin abinci mai gina jiki da abinci a lokacin ɗaukar ciki, na kuma taimaka mata ta sami lafiya, ciki mai ƙananan haɗari.

(Asar Amirka na da mafi yawan yawan mutuwar mata masu ciki a cikin ƙasashe masu tasowa. Yana da, idan aka kwatanta da 9.2 a cikin Kingdomasar Ingila.

Na ji sha'awar in shiga ciki bayan na yi bincike mai zurfi game da mummunan yanayin kula da uwa da sakamakon da ke Amurka. Shin kowace uwa ba ta cancanci samun haihuwar aminci, tabbatacciya ba, kuma ta ba da iko?

Kyakkyawan sakamako bai kamata a iyakance ga waɗanda kawai za su iya biya ba.

Wannan shine dalilin da yasa nake bautawa masu karamin karfi na San Francisco a matsayin doula na sa kai - sabis ne da nayi imanin da gaske ana buƙatar inganta rayuwar mata da yara a ƙasarmu. Hakanan shine dalilin da yasa wasu doulas ke ba da sassauci ko sikeli idan aka zo biyan kuɗi.

Rikicin mata masu ciki a Amurka

A cewar bayanai daga UNICEF, yawan mace-macen mata masu juna biyu a duniya ya ragu da kusan rabi daga 1990 zuwa 2015.

Amma Amurka - daya daga cikin mawadata, kasashe masu ci gaba a duniya - a zahiri tana tafiya ne a akasin haka idan aka kwatanta da sauran kasashen duniya. Hakanan ita kadai ce kasar da take yin hakan.

Muna da mafi munin yawan mutuwar mata a kasashen da suka ci gaba. Yana da, idan aka kwatanta da 9.2 a cikin Kingdomasar Ingila.

Kasancewar doula yana haifar da kyakkyawan sakamako na haihuwa da rage rikitarwa ga uwa da ɗa - ba mu kawai "nice-to-have."

A yayin bincike na dogon lokaci, ProPublica da NPR sun gano sama da masu tsammani 450 da sabbin iyaye mata da suka mutu tun daga 2011 daga al'amuran da suka taso yayin ciki da haihuwa. Waɗannan batutuwan sun haɗa da, amma ba'a iyakance ga:

• cututtukan zuciya
• zubar jini
• daskarewar jini
• cututtuka
• preeclampsia

Me ke faruwa a nan?

Bayan duk wannan, wannan ba tsararru ba ce - shin bai kamata wani abu kamar na ɗabi'a da gama gari kamar haihuwa ba shi da cikakkiyar kariya da aka ba ci gaban likitancin zamani? A wannan zamani da muke ciki, me yasa ake baiwa iyaye mata abin tsoro ga rayukansu?

Masana sunyi tunanin waɗannan rikice-rikicen na faruwa - kuma suna faruwa a mafi girma - saboda abubuwa da yawa waɗanda zasu iya tasiri ga juna:

• karin mata masu haihuwa daga baya a rayuwa
• karuwa a cikin haihuwa (C-sassan)
• hadadden, tsarin kiwon lafiya mara wahala
• tashi a cikin al'amuran kiwon lafiya na yau da kullun kamar ciwon sukari da kiba

Yawancin bincike sun ba da haske kan mahimmancin ci gaba da tallafi, me game da tallafi daga doula musamman, game da abokin tarayya, memba na iyali, ungozoma, ko likita?

Yawancin mata masu ciki - komai launin fatarsu, iliminsu, ko kuɗin shiga - suna ƙarƙashin waɗannan abubuwan. Amma yawan mace-macen mata ya fi na mata masu karamin karfi, bakar fata, da wadanda ke zaune a karkara. Bakar fata jarirai a Amurka yanzu sun fi saurin mutuwa kamar jarirai farare (jariran baƙi, idan aka kwatanta da jarirai farare 4.9 cikin 1,000).

Dangane da bayanan mutuwar jama'a daga Cibiyoyin Kula da Rigakafin Cututtuka na Amurka, yawan mace-macen mata masu juna biyu a manyan yankunan manyan biranen ya kai 18,2 cikin 100,000 da aka haifa a shekara ta 2015 - amma a mafi yankunan karkara, ya kasance 29.4.

Ba lallai ba ne a faɗi, ƙasarmu tana cikin mummunan bala'i, mummunar cutar lafiya kuma wasu mutane sun fi fuskantar haɗari.

Amma ta yaya doulas - kwararru marasa aikin likita tare da watakila kawai awanni 35 ko makamancin haka na horo, kamar ni - su zama wani bangare na warware irin wannan babbar matsalar?

Tasirin tasirin doula a cikin ɗakin isar da sako

Duk da cewa kashi 6 ne kawai na mata suka zabi amfani da doula yayin daukar ciki da kuma nakuda a duk fadin kasar, binciken ya bayyana karara: Kasancewar doula tana haifar da kyakkyawan sakamako na haihuwa da kuma rage rikitarwa ga uwa da da yaro - ba mu da "kyau -da-samun. ”

Nazarin 2013 daga Journal of Perinatal Education

• Daga cikin mata 226 masu jiran tsammani 'yan asalin Afirka da iyayen fari (masu canzawa kamar shekaru da launin fata sun yi kama da juna a cikin rukunin), kusan rabin matan an ba su horo doula kuma sauran ba haka ba.
• Sakamako: Uwayen sun dace da doula sun sau hudu ƙasa da ƙarancin haihuwar jariri a ƙananan ƙarancin haihuwa da sau biyu da ƙarancin fuskantar matsalar haihuwar da ta shafi kansu ko jaririnsu.

Yawancin bincike sun ba da haske game da mahimmancin ci gaba da tallafi, amma tallafi daga doula musamman, game da abokin tarayya, memba na iyali, ungozoma, ko likita daban?

Abin sha'awa, yayin nazarin bayanan, masu bincike sun gano cewa gabaɗaya, mutanen da ke da ci gaba da tallafi yayin haihuwa suna fuskantar raguwar haɗarin ɓangaren C. Amma idan doulas sune suke bada tallafi, wannan kaso ba zato ba tsammani ya tashi zuwa ragu.

Kwalejin koyon ilimin mata da cututtukan mata ta Amurka ta fitar da wannan bayani na yarjejeniya a shekarar 2014: "Bayanan da aka buga sun nuna cewa daya daga cikin ingantattun kayan aiki don inganta sakamakon aiki da kuma isar da sako shi ne ci gaba da kasancewar masu ba da tallafi, kamar su doula."

Hali don ci gaba da tallafawa mata yayin haihuwa - 2017 Binciken Cochrane

• Dubawa: Nazarin 26 akan tasirin tallafi na ci gaba yayin aiki, wanda zai iya haɗawa da taimakon doula. Karatun ya hada da mata sama da 15,000 daga bangarori da dama.
• Sakamako: “Ci gaba da tallafi a lokacin nakuda na iya inganta sakamako ga mata da jarirai, gami da ƙaruwar haihuwar farji ba da jimawa ba, mafi ƙarancin lokacin aiki, da rage haihuwar haihuwa, haihuwa ta farji, amfani da duk wata cuta, amfani da maganin cutar yankin, ƙaramin minti na Apgar, da kuma mummunan ra'ayi game da gogewar haihuwa. Ba mu sami wata hujja ba game da illolin ci gaba da aikin kwadago. ”
• Darasi mai saurin haihuwa game da haihuwa: "Analgesia" yana nufin maganin ciwo kuma "Apgar score" shine yadda ake auna lafiyar jarirai a lokacin haihuwa kuma jim kaɗan bayan haka - mafi girman maki, mafi kyau.

Amma ga abin da ke: A cewar wannan binciken daga Jaridar Amurka ta Kulawa da Kulawa, baƙar fata da ƙananan mata masu ƙarancin kuɗi za su fi so su so amma mafi ƙarancin damar samun damar kula da doula.

Wannan mai yiwuwa ne saboda ba za su iya biyansa ba, suna rayuwa a cikin yankin ƙasa da withan kaɗan ko babu doula, ko kuma kawai ba su taɓa koyo ba game da shi.

Doulas na iya zama babbar hanya ga waɗanda suke buƙatar su sosai.

Yana da mahimmanci a ambaci cewa yawancin doulas farare ne, masu ilimi, matan aure, dangane da sakamakon wannan binciken na 2005 da aka buga a cikin Batutuwan Kiwan Lafiya na Mata. (Ni ma na faɗa cikin wannan rukunin.)

Zai yuwu cewa waɗannan abokan cinikin doulas ɗin sun dace da nasu bayanin launin fata da al'adu - yana nuna akwai yuwuwar shamaki da tattalin arziki don tallafawa doula. Hakanan wannan na iya haifar da irin tunanin da ake da shi na cewa doulas kayan marmari ne na yau da kullun da kawai farar mata masu kuɗi za su iya ɗauka.

Doulas na iya zama babbar hanya ga waɗanda suke buƙatar su sosai. Amma yaya idan yawan amfani da doulas - musamman ga waɗannan mutanen da ba su da tabbas - na iya hana wasu matsalolin da ke bayan yawan mutuwar mata masu juna biyu na Amurka?

Makoma mai kyau ga doula da uwaye

Wannan ita ce ainihin tambayar da jihar New York ke fatan amsawa ta cikin shirin matashin jirgi da ta sanar kwanan nan, wanda zai faɗaɗa aikin Medicaid zuwa doulas.

A cikin Birnin New York, mata baƙi suna da saurin mutuwa sau 12 daga abubuwan da ke da alaƙa da juna biyu fiye da fararen mata. Amma saboda kyakkyawan fata na bincike kan doulas, 'yan majalisar suna fatan wannan kididdigar-fadada jawaban, hade da fadada shirye-shiryen ilimin haihuwa da sake duba ayyukan asibiti mafi kyau, zasu inganta.

Game da shirin, wanda za a fara a wannan bazarar, Gwamna Andrew Cuomo ya ce, “Yawan mace-macen mata bai kamata ya zama tsoron wani a New York ya kamata ya fuskanta a karni na 21 ba. Muna daukar tsauraran matakai don karya shingen da ke hana mata samun kulawar haihuwa da kuma bayanan da suke bukata. "

A yanzu, duk Minnesota da Oregon sune kawai wasu jihohin da ke ba da izinin Medicaid sake dawowa don doulas.

Asibitoci da yawa, kamar Babban Asibitin San Francisco a cikin Yankin Bay, sun kirkiro shirye-shiryen sa kai na doula don magance matsalar.

Kowane mai haƙuri zai iya dacewa da pro bono doula wanda ke can don ya jagoranci mahaifar ciki, lokacin haihuwa, da kuma bayan haka. Doulas na sa kai na iya yin aiki na awanni 12 na canjin asibiti kuma a sanya ta ga mahaifiya mai wahala da ke buƙatar tallafi, wataƙila idan ba ta jin Turanci sosai ko kuma ta isa asibitin ita kaɗai ba tare da wani abokin tarayya, dangi, ko kuma aboki don tallafi ba.

Allyari ga haka, Shirin Haihuwar Marasa Gida na San Francisco kyauta ce mai zaman kanta wacce ke ba da doula da kula da haihuwa ga mutanen garin marasa gida.

Yayin da na ci gaba da koyo da kuma zama mai doula, ina fatan in mayar da hankali ga waɗannan ƙalubalen ta hanyar ba da kansu ga waɗannan shirye-shiryen da kuma karɓar kwastomomi kamar Joanna.

A duk lokacin da na ji wannan sanannen sautin na cakulan da ke jiyowa daga waya ta cikin wayewar gari, ina tuna wa kaina cewa duk da cewa ni dola ɗaya ce, ina yin ƙaramin ɓangare na don inganta rayuwar mata, kuma wataƙila ma ina taimakawa don adana wasu, suma.

Nemi mai araha ko pro bono doula

• Doula mai tsattsauran ra'ayi
• Birnin Chicago Doulas Volunteer
• Wayungiyar ouofar Doula
• Shirin Haihuwar marassa gida
• Albarkatun Kasa
• Hanyoyin haihuwa
• Bay Area Doula Project
• Horon Dutse na Doula

Turanci Taylor marubuciya ce a San Francisco wacce take rubuce-rubuce game da kiwon lafiya da lafiyar jiki da haihuwa. An nuna aikinta a cikin The Atlantic, Refinery29, NYLON, LOLA, da THINX. Bi Ingilishi da aikinta a Matsakaici ko a kan Instagram