Ke kali nei ʻoe i kahi pēpē ʻē aʻe? Inā ua hānau ʻia kāu pēpē mua ma o ka ʻoki ʻoki cesarean ( C-section ), e noʻonoʻo paha ʻoe, "E hiki anei iaʻu ke hānau maoli i kaʻu pēpē i kēia manawa?" He nīnau nui kēia no nā makuahine he nui. ʻO ka hānau ʻana ma ka ʻōpū ma hope o ka ʻoki ʻoki cesarean ua kapa ʻia ʻo VBAC (Vaginal Birth After C-section) ma ke ʻano lapaʻau. No laila, ʻoiai hiki kēia no nā makuahine he nui, aia kekahi mau mea e pono ai mākou e kamaʻilio e pili ana ma mua o ka hoʻoholo ʻana inā kūpono ia iā ʻoe a palekana hoʻi.
ʻO ka mea nui loa, ʻo ia ka palekana o ʻoe a me kāu pēpē. ʻAʻole palekana ka VBAC no nā mea āpau.
I kekahi manawa, inā hoʻāʻo kekahi mea i loaʻa i ka pilikia nui o nā pilikia e hānau maʻamau, hiki iā ia ke hana i nā pilikia koʻikoʻi, a hiki ke hoʻoweliweli i ke ola, no ʻoe a me kāu pēpē. No laila he mea nui e kūkākūkā i nā pilikia me kāu kauka ma mua o ka hoʻoholo ʻana.
Pehea kou olakino a me ke olakino o kāu pēpē?
No ka hoʻoholo ʻana inā hiki iā ʻoe ke hoʻāʻo no ka VBAC, he mea nui e hōʻoia i ke olakino ʻoe a me kāu pēpē. Inā olakino ʻoe, hiki paha iā ʻoe ke hoʻāʻo no ka VBAC ʻoiai inā he mau māhoe kāu. Akā pono ʻoe e loaʻa ka ʻae a kāu kauka.
Eia nō naʻe, i kekahi mau hihia, e ʻōlelo paha kāu kauka he mea pilikia loa ka hoʻāʻo ʻana i kahi VBAC. Aia ma lalo iho kekahi mau mea pilikia e pale aku ai iā ʻoe mai ka hānau ʻana i kahi ʻōpū.
| Kumu Hoʻopilikia | He wehewehe maʻalahi |
|---|---|
| Momona | Inā ʻo kāu Body Mass Index (BMI) he 30 a ʻoi aku paha. |
| ʻO ka preeclampsia | Ke koko kiʻekiʻe i ka wā hāpai. |
| Makahiki | ʻO ka maʻamau, ʻoi aku ka nui o ka makuahine ma mua o 35 mau makahiki. |
| Ka manawa ma waena o nā ʻoki kino ma mua | Inā he 19 mau mahina i hala aku nei mai kāu ʻoki cesarean ma mua. |
| Ka nui o ka pēpē | Inā ʻoi aku ke kaumaha o ka pēpē i loko o ka ʻōpū ma mua o kona nui (fetus nui). |
E aʻo kākou e pili ana i nā ʻeha o ke ʻoki ʻoki C-section ma mua .
ʻO kekahi o nā mea nui loa āu e kūkākūkā ai me kāu kauka, ʻo ia ke ʻano o kou ʻōpala uterine . He mea nui loa kēia. Manaʻo ka poʻe he nui he like ka ʻōpala ma waho o kou ʻōpū a me ka ʻōpala ma loko o kou uterus. Eia nō naʻe, hiki ke ʻokoʻa nā ʻoki ʻana. ʻElua mau ala nui e hana ʻia ai nā ʻoki ʻana i loko o kou ʻōpū a me ka uterus i ka wā o ka ʻoki cesarean:
- ʻOki kū pololei: He ʻoki i hana ʻia mai luna a lalo.
- ʻOki transverse: He ʻoki i hana ʻia mai kēlā ʻaoʻao a i kēia ʻaoʻao.
| ʻAno o ka ʻoki ʻana o ka ʻōpū | Hopena ma VBAC |
|---|---|
| ʻOki kū pololei | ʻAʻole hiki iā ʻoe ke hoʻāʻo i kahi VBAC . Aia kahi pilikia kiʻekiʻe loa o ka haki ʻana o kēia ʻōpala i ka wā hānau. He mea weliweli loa kēia no ka makuahine a me ke pēpē. Pono ʻoe e hana hou i kahi ʻoki cesarean. |
| ʻOki transverse haʻahaʻa | Hiki paha iā ʻoe ke hoʻāʻo i kahi VBAC . ʻO kēia ke ʻano c-section maʻamau a palekana loa. Inā haʻahaʻa nā kumu pilikia ʻē aʻe, ʻoi aku ka nui o kāu kauka e ʻae i kahi VBAC. |
No laila hiki iā ʻoe ke ʻike i ke koʻikoʻi o ka ʻike pono ʻana i ke ʻano o ka maʻi ʻeha o kou ʻōpū.
He mea nui nō hoʻi ka haukapila āu e koho ai!
He mea kēia e pono ai ʻoe e noiʻi ma mua. E nīnau i kāu kauka inā ʻae ka haukapila āu e hoʻolālā nei e loaʻa ai kāu pēpē iā VBAC a inā loaʻa iā lākou nā pono e pono ai. ʻAʻole ʻae nā haukapila āpau i kēia.
ʻO ke kumu, ʻoiai he haʻahaʻa ka pilikia o ka haki ʻana o ka ʻōpala kahiko i ka wā e hoʻāʻo ai i kahi VBAC, inā hana ia, he pilikia ia. Pono ka haukapila e mākaukau e hana me ia pilikia. ʻO ke ʻano kēia, pono e mākaukau nā mea āpau e pono ai no ka ʻoki cesarean pilikia, e like me nā lumi hana, nā anesthesiologists, a me nā hale waihona koko, i kēlā me kēia manawa. ʻAʻole paha i loaʻa i kekahi mau haukapila nā pono e hana me ia pilikia. No laila, he mea nui loa ke koho ʻana i ka haukapila.
ʻO ke ʻano o ka pilikia haʻahaʻa, ʻaʻohe pilikia?
ʻAʻole. He liʻiliʻi loa ka pilikia o ka haki ʻana o ka ʻōpū no kekahi makuahine olakino me kahi ʻeha transverse haʻahaʻa e hoʻāʻo nei i ka VBAC. ʻAʻole hiki i nā kauka ke ʻōlelo me ka maopopo 100% inā e hiki mai ana kēia iā ʻoe a i ʻole.
ʻOiai ʻo ka haki ʻana o ka ʻōpū e hana ʻia ma lalo o 1% o nā wahine e hoʻāʻo nei iā VBAC, hiki iā lākou ke lilo i mea weliweli loa inā hana lākou, no laila ʻaʻole makemake kekahi mau makuahine e lawe i kēlā pilikia liʻiliʻi.
No laila, ʻoi aku ka maikaʻi o ka noʻonoʻo pono ʻana i kāu mau koho, e kamaʻilio me kāu kauka , a hoʻoholo ma hope o ka hoʻomaopopo ʻana i nā pono a me nā pōʻino.
He aha nā pōmaikaʻi o kahi VBAC holomua?
ʻAe, i kēia manawa ua kamaʻilio mākou e pili ana i nā hemahema, e nānā kākou i nā pono o kahi VBAC holomua. Inā hiki iā ʻoe ke uku i kahi VBAC a makemake ʻoe i kahi hānau vaginal, nui nā kumu maikaʻi e hoʻāʻo ai. A kiʻekiʻe nā manawa kūpono o ka holomua. Ma kahi o 70% o nā makuahine e hoʻāʻo nei i kahi VBAC e hānau pono i kā lākou pēpē ma ka vaginal. No ke koena, pono nā pilikia i ka wā hānau i kahi ʻoki cesarean hou.
Inā loaʻa iā ʻoe kahi VBAC holomua, e loaʻa iā ʻoe kēia mau pono:
- ʻAʻole pono ʻoe e hana i kahi ʻoki kino nui.
- Kakaikahi ka kahe ʻana o ke koko .
- Hiki iā ʻoe ke ho'ōla koke ma mua o ka pau ʻana o ke ʻoki kino.
- Haʻahaʻa ka pilikia o ka maʻi.
- He haʻahaʻa ka manawa kūpono e hōʻino ai i kou ʻōpū mimi a i ʻole nā ʻōpū.
- Inā ʻoe e kali ana i kahi keiki ʻē aʻe i ka wā e hiki mai ana, e hōʻemi ʻia nā pilikia hiki ke loaʻa i ka wā hānau keiki.
Leka Lawe-Home
- ʻOiai hiki i nā poʻe he nui ke hānau ʻana ma hope o ka ʻoki cesarean (VBAC), ʻaʻole kūpono ia no nā kānaka a pau.
- ʻO ka mea nui loa i ka hoʻoholo ʻana inā hiki iā ʻoe ke loaʻa kahi VBAC ʻo ia ke ʻano o ka ʻōpala ma ka ʻōpū mai ke ʻoki kino ma mua (inā he kū pololei a moe paha).
- Ma mua o ka ho'āʻo ʻana i ka VBAC, e hoʻomaopopo pono e kūkākūkā pono a hoʻomaopopo i nā pono, nā pōʻino, a me nā pilikia āpau me kāu kauka.
- E hōʻoia i loaʻa i ka haukapila āu i koho ai no kou hānau ʻana nā pono āpau e pono ai (ETU, nā lumi hana) e hana ai i kahi ʻoki cesarean ulia pōpilikia.
- ʻO ka mea hope loa, ʻo ka mea nui loa ke koho ʻana i ke ʻano palekana loa nou a me kāu pēpē. E kōkua kāu kauka iā ʻoe e hana i kēlā hoʻoholo.
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