Inā ua loaʻa iā ʻoe kahi ʻoki cesarean (C-section) ma mua, e hānau maʻamau anei ʻoe i kēia manawa? E kamaʻilio kākou e pili ana i ka VBAC!

Inā ua hānau ʻia kāu pēpē mua ma o ka ʻoki ʻoki cesarean (C-section), e noʻonoʻo paha ʻoe, "E hānau maʻamau anei au i kēia manawa?" He nīnau kēia a nā makuahine he nui e manaʻolana nui nei, akā i kekahi manawa hele mai me ka makaʻu iki. No laila, i kēia lā, e kamaʻilio kākou e pili ana i kēia me ka maopopo a ma ke ʻano e hiki ai iā ʻoe ke hoʻomaopopo.

I kēlā manawa a me kēia manawa: Ua loli anei kou manaʻo no ka hānau keiki ʻana ma hope o ka ʻoki ʻana i ka ʻōpū?

E hoʻomanaʻo paha ʻoe, i ka wā o kou makuahine, ua manaʻo ka poʻe he nui inā loaʻa iā ʻoe kahi ʻoki C i hoʻokahi manawa, pono ʻoe e loaʻa i kahi ʻoki C hou no kēlā me kēia pēpē ma hope o kēlā. ʻOiai nā kauka i kēlā manawa ua kuhikuhi pinepine i kēlā. Aia nā kumu no kēlā.

Akā i kēia mau lā, ua holomua loa ka ʻepekema lapaʻau . Me ka noiʻi hou a me ka ʻike hou, ua loli nā mea he nui. I kēia manawa, ʻōlelo nā kauka ponoʻī he nui nā makuahine kūpono, ʻoiai inā ua hana mua lākou i kahi ʻoki cesarean, hiki iā lākou ke hānau ma ke ʻano vaginal (Vaginal Birth After Cesarean - VBAC) . ʻO ka ʻoiaʻiʻo, ua manaʻo ʻia kēia he koho palekana no nā makuahine he nui a me kā lākou mau pēpē.

E noʻonoʻo, hiki iā ʻoe ke hoʻi koke i ka home ma hope o ka loaʻa ʻana o kahi pēpē maʻamau. ʻAʻole nui ka ʻoluʻolu ʻole a hiki iā ʻoe ke hoʻōla wikiwiki. ʻO kēia kekahi o nā pono nui o ka VBAC.

No laila, hiki iaʻu ke hana pū (VBAC)? He aha ka mea e hoʻoholo ai i kēlā?

ʻO kēia ka nīnau koʻikoʻi loa. ʻAʻole like nā kānaka a pau. Aia kekahi mau kumu e hoʻoholo ai inā hiki iā ʻoe ke loaʻa i kahi VBAC a i ʻole. E nānā kākou i kēlā me kēia pākahi.

1. He aha ke kumu o kāu ʻoki ʻoki mua ʻana (C-section)?

I kekahi manawa, hiki ke hana ʻia ke ʻoki mua ma muli o kahi pilikia me ka pēpē, a i ʻole ma muli o kahi pilikia e like me ke koko o ka makuahine. Aia kekahi mau kumu, inā pili paha kēlā kumu i kēia hāpai ʻana, he mea weliweli paha ka loaʻa ʻana o ka VBAC. Akā aia kekahi mau kumu, inā he mea ia i hoʻopilikia wale i kēlā manawa. No ka laʻana, inā ua loaʻa iā ʻoe kahi ʻoki cesarean ma muli o kahi mea e like me ke kūlana breech, inā aia ke pēpē i ke kūlana kūpono i kēia manawa, ʻoi aku paha kou makemake e hoʻāʻo i ka VBAC. E wehewehe kāu kauka a kahu hānai paha i kēia iā ʻoe me ka kikoʻī.

2. ʻAno o ka ʻoki ʻana o ka ʻōpū - ʻO kēia ka mea nui loa!

Eia kekahi mea e makaʻala nui ai. He mea koʻikoʻi ke ʻano o ka ʻoki ʻana i loko o kou ʻōpū i ka wā o kāu ʻoki cesarean mua no ka VBAC. ʻAʻole kēia ka ʻoki ʻana i ʻike ʻia ma kou ʻili, akā, ʻo ka ʻoki ʻana i loko o kou ʻōpū.

ʻO ka mea nui, ke kamaʻilio nei mākou e pili ana i ʻelua mau ʻano ʻoki:

• ʻOki ʻana ma ke ʻano transverse:

I ka ʻōlelo maʻalahi, ʻo kēia ke ʻano maʻamau o ka ʻoki ʻana i hana ʻia, a ʻo ka mea kūpono loa no ka VBAC.Hana ʻia kēia ʻoki ma ka ʻaoʻao haʻahaʻa a lahilahi o ka ʻōpū, ma ke ʻano transverse. E noʻonoʻo e like me ka laina bikini (ʻaʻole he ʻoki ʻili, akā he ʻoki i loko o ka ʻōpū). ʻO kēia ʻoki kahi ʻaʻole i lalo o ke kaomi nui o ka ʻōpū i ka wā e hānau ai ka pēpē (i ka wā e ʻaelike ai e paʻi i ka pēpē i waho). No laila, ʻoi aku ka nui o ka manawa o ka makuahine me kēia ʻano ʻoki e loaʻa ai kahi VBAC holomua. ʻO kekahi inoa no kēia ʻoki ʻo (Low-transverse incision) .

• ʻOki kū pololei:

Ma kēia, hana ʻia ke ʻoki ʻana mai luna o ka ʻōpū a i lalo, ma ka lōʻihi. Ma muli o ka hele ʻana o kēia ʻoki ma waena o nā ʻiʻo o ka ʻōpū, aia kahi pilikia nui o ka haehae ʻana o ka ʻōpū (ka haki ʻana o ka ʻōpū) ma o ke ʻoki ʻana i ka wā e ʻūlū ikaika ai ka ʻōpū i ka wā hānau. Hiki i kēia ke lilo i kūlana weliweli loa no ka makuahine a me ke pēpē. No laila, ʻaʻole aʻo pinepine nā kauka i kahi VBAC inā he ʻoki kū pololei (ʻoi aku ka ʻoki maʻamau i hana ʻia ma ka ʻaoʻao o luna o ka ʻōpū).

He mea nui: ʻOiai inā he pae kou ʻoki ʻili, i kekahi manawa hiki ke kū pololei ka ʻoki i loko o kou ʻōpū. No laila, he mea nui e nānā hou i kāu mau memo ʻokiʻoki mai kāu ʻoki cesarean mua e ʻike pono ai i ke ʻano o ka ʻoki. E kamaʻilio me kāu kauka e pili ana i kēia.

3. ʻEhia mau ʻoki cesarean āu i hana ai ma mua?

ʻOiai ua noʻonoʻo pinepine ʻia ka VBAC ma hope o hoʻokahi ʻoki cesarean, inā ua loaʻa iā ʻoe ʻelua a ʻoi aku paha mau ʻoki cesarean, hiki i ka loaʻa ʻana o ka VBAC ke lilo i mea pilikia iki. Hiki ke kiʻekiʻe aʻe ka pilikia o ka haki ʻana o ka ʻōpū ma muli o ka hoʻonui ʻia o nā ʻiʻo ʻeha i loko o ka ʻōpū. Eia nō naʻe, i kekahi mau hihia kūikawā, ʻoiai ka poʻe i loaʻa i ʻelua mau ʻoki cesarean ma mua e ʻae ʻia e hoʻāʻo i ka VBAC, me ka mālama nui, ma kahi hale kūpono. Aia wale nō kēia i kou mōʻaukala olakino, ke ʻano o ka ʻoki ʻana o ka ʻōpū, a me ka hoʻoholo a ke kauka e mālama iā ʻoe.

4. Kou kūlana hāpai o kēia manawa a me nā hopohopo olakino ʻē aʻe

Inā loaʻa iā ʻoe nā maʻi e like me ka maʻi diabetes mellitus, ke koko kiʻekiʻe, ka pilikia ulu ʻana me kāu pēpē, a i ʻole kahi pēpē i ʻike ʻia he nui loa (macrosomia) i kēia wā hāpai, e noʻonoʻo paha kāu kauka e pili ana i ka hele ʻana no kahi VBAC. Eia kekahi, inā loaʻa iā ʻoe kekahi mau pilikia me ke ʻano o kou uterus (e.g. fibroids), hiki nō hoʻi kēlā ke hoʻopilikia i ka hoʻoholo e loaʻa kahi VBAC.

ʻAʻole anei he pilikia i loko o (VBAC)?

ʻOiai he koho palekana ka VBAC no ka hapa nui o nā makuahine, ʻaʻole ia he mea me ka ʻole o nā pilikia . ʻO ka pilikia nui ka haki ʻana o ka ʻōpū . ʻO kēia ka wā e haehae ai ka paia o ka ʻōpū ma kahi o ka ʻoki cesarean ma mua. He hanana kakaikahi loa kēia (ʻaʻole i hiki i ka 1% e like me nā helu helu Sri Lanka, ʻoi aku hoʻi no ka poʻe i loaʻa kahi ʻoki ʻia), akā inā hana ia, hiki ke lilo i mea pilikia e hoʻoweliweli i ke ola no ka makuahine a me ka pēpē. ʻO ia ke kumu inā ʻoe e hoʻāʻo nei no ka VBAC,Wahi a lākou, pono e hana ʻia ma kahi haukapila i loaʻa nā pono āpau e hana ai i ka ʻoki caesarean ulia pōpilikia.

Ma ka ʻaoʻao ʻē aʻe, inā ʻoe e hoʻāʻo i kahi VBAC a ʻaʻole ia e holo pono, pono paha ʻoe e hana i kahi ʻoki cesarean ulia pōpilikia. ʻOi aku ka nui o kēia ʻoki ulia pōpilikia i hoʻolālā ʻole ʻia e hoʻoulu i nā pilikia liʻiliʻi ma mua o kahi ʻoki cesarean i hoʻonohonoho ʻia.

Mai makaʻu! Ua manaʻo ʻia kēia mau pilikia e hoʻonaʻauao iā ʻoe, ʻaʻole e hoʻoweliweli iā ʻoe. Hoʻokō maikaʻi ka hapa nui o nā makuahine i ka VBAC me ka ʻole o nā pilikia. ʻO ka mea nui loa, ʻo ia ke kamaʻilio me kāu kauka e pili ana i ka kūpono no kou kūlana, he aha nā pilikia, a he aha nā pono.

Inā makemake au i kahi (VBAC), he aha kaʻu e hana ai?

Inā ʻoe e noʻonoʻo ana i kahi VBAC, e hahai i kēia mau hana:

1. E kamaʻilio me kāu kauka: ʻO kēia ka mea mua a koʻikoʻi loa. E kūkākūkā i kāu mau ʻoki cesarean ma mua (ʻoi aku ke ʻano o ka hysterectomy), kou olakino o kēia manawa, a me kāu mau hopohopo olakino kikoʻī me kāu kauka. E nīnau iā lākou e pili ana i nā pono a me nā pōʻino o kahi VBAC, a me nā pilikia kikoʻī āu e loaʻa ai. E nānā kāu kauka iā ʻoe, e nānā i kāu mau moʻolelo, a hoʻoholo inā kūpono kahi VBAC iā ʻoe.

2. E nīnau i ka haukapila āu e koho ai e hānau i kāu pēpē: ʻAʻole like nā haukapila a pau i nā pono a i ʻole nā ​​kulekele VBAC. Kākoʻo kekahi mau haukapila i ka VBAC, me nā lumi pilikia a me nā lumi hana i loaʻa 24/7. Eia nō naʻe, ʻaʻole ʻae kekahi mau haukapila, ʻoiai nā mea liʻiliʻi, i ka VBAC no ka mea he palena ko lākou mau kumuwaiwai e lawelawe i nā pilikia. No laila, he mea nui e ʻike mua i ke kulekele VBAC ma ka haukapila āu e hoʻolālā nei e hānau i kāu pēpē.

3. E mākaukau, akā e loli: ʻOiai inā ua mākaukau ʻoe no ka VBAC, i kekahi manawa ʻaʻole hele nā ​​​​mea e like me ka hoʻolālā. Inā he mau pilikia i ka wā hānau, hiki i kāu kauka ke hoʻoholo e hana i kahi ʻoki cesarean ulia pōpilikia. E hoʻomanaʻo, ʻo ka pahuhopu hope loa he makuahine olakino a me kahi pēpē olakino. No laila, e mākaukau e hahai i nā ʻōlelo a kāu kauka.

E noʻonoʻo, inā ʻaʻole ʻae ka haukapila āu i koho ai iā VBAC, akā makemake maoli ʻoe a ʻae kāu kauka, hiki paha iā ʻoe ke hoʻololi i kahi haukapila ʻē aʻe e hana ana. E kamaʻilio pū me kāu kauka e pili ana i kēia.

E hoʻomanaʻo pōkole kākou i kā kākou i kamaʻilio ai? (Leka Lawe-Home)

ʻAe, no laila, mai nā mea a mākou i kamaʻilio ai, eia nā mea nui loa e pono ai ʻoe e hoʻomanaʻo:

• ʻOiai inā ua loaʻa iā ʻoe kahi ʻoki cesarean (C-section) ma mua, hiki i nā makuahine he nui ke hānau ma ke ʻano he vaginal (VBAC) . He koho palekana kēia i kēia manawa.
• ʻO ke kumu nui i ka hoʻoholo ʻana inā hiki iā ʻoe ke loaʻa i kahi VBAC ʻo ia ke ʻano o ka ʻoki ʻana o ka ʻōpū i hana ʻia i kāu hana cesarean mua . ʻO ka ʻoki transverse paha ke koho maikaʻi loa.
• Hoʻopilikia ʻia kēia e nā mea e like me ke kumu o kāu cesarean mua, ka helu o nā ʻoki cesarean ma mua, a me kou kūlana olakino o kēia manawa.
• Aia paha kekahi mau pilikia i loko o ka VBAC, akā hiki ke hoʻemi ʻia kēia mau pilikia me ka hoʻolālā maikaʻi a me kahi hui lapaʻau akamai.
• ʻO ka mea nui loa, ʻo ia ke kamaʻilio ākea e pili ana i kēia me kāu kauka. ʻO ia ka mea nāna e aʻo iā ʻoe i ka mea maikaʻi loa no kou kūlana.
• Eia kekahi, e makaʻala i ke kulekele VBAC o ka haukapila kahi āu e hānau ai i kāu pēpē.

E hoʻomanaʻo, he kū hoʻokahi kēlā me kēia hāpai ʻana a me kēlā me kēia hānau ʻana. Ke makemake nei au iā ʻoe i ka ikaika e koho i ka mea palekana a olakino hoʻi no ʻoe a me kāu pēpē!

VBAC , Caesarean, Hānau maʻamau, Hysterectomy, Hānau keiki, Ola kino makuahine, ʻŌlelo aʻoaʻo lapaʻau