Umthombo: Intando Yeningi Evulekile
"Bengicisha umlilo njengoba uqubuka," kuhleka udokotela wezifo zabesifazane uJesanna Cooper, ekhuluma ngomsebenzi wakhe ezinyangeni ezedlule phakathi nobhubhane eBirmingham, idolobha lase-Alabama elinabantu abaningi.
Indawo eyaziwa kakhulu yokulwela amalungelo abantu ngeminyaka yawo-1960, iBirmingham isanda kubona imibhikisho eminingi yeBlack Lives Matter. Cishe u-30% wezakhamuzi zakhona siphila ngobumpofu futhi abangaphezu kuka-70% baseMelika baseMelika, nabo ababhekene namazinga aphezulu ngokulinganayo okufa komama nezinsana.
Ebhekene nokuntuleka kwezinto zokuzivikela (i-PPE) kanye neziqondiso ezihlala zishintsha nezincomo, u-Cooper uthi ube nesikhathi esinzima kakhulu ezama ukuqinisekisa ukuphepha kweziguli zakhe - namalungelo.
Uthola isikhathi sokukhuluma nami ngocingo ngoMsombuluko ntambama. Usocingweni, kodwa kuwusuku oluthule ngemva kwamasonto ambalwa. Njengomuntu wesifazane futhi olwela amalungelo abesifazane, u-Cooper uthi ufuna ukubeletha kube yinto enika amandla kuwo wonke umuntu ongena esibhedlela asebenza kuso - inhloso i-coronavirus eyenze kwaba nzima nakakhulu ukuyifinyelela.
Njengoba amacala e-COVID-19 esakazeka kulo lonke elase-United States, izibhedlela eziningi zaqala ukwethula imithethonqubo yokunciphisa izinga lokutheleleka. Abesifazane ababeletha babe nomthelela ngokushesha, futhi kabi.
The I-World Health Organization (WHO) weluleke ngokusobala amazwe ukuthi, phakathi nalolu bhubhane, abesifazane basenalo ilungelo “lokunakekelwa kwekhwalithi ephezulu ngaphambi, ngesikhathi nangemuva kokubeletha” - okuhlanganisa ukuxhumana okucacile nenhlonipho, kanye nomngane abamthandayo ngesikhathi sokubeletha. Kodwa kubonakala sengathi lesi siqondiso sasikhona igcwele ezindaweni eziningi e-US nasemhlabeni jikelele.
E-Birmingham, u-Cooper uthi ulwe kusukela ngosuku lokuqala ukuze avimbele lokhu futhi ahloniphe amalungelo abesifazane phakathi nale nkinga. “Impi yethu yokuqala kwakuwukuchaza ukuthi sasibalulekile,” uyangitshela, kanye nokuqinisekisa ukuthi abasebenzi basewodini lababelethayo abashaywa indiva ekusatshalalisweni kwe-PPE eyindlala.
Inselele elandelayo yeza lapho izikhulu zezwe lase-Alabama zincoma ukuthi izibhedlela zibeke imingcele yezinombolo zezivakashi. Izibhedlela eziningi zenze lokhu, ukuphoqa abesifazane ababeletha ukuthi bakhethe phakathi kokuba nomlingani wabo, isihlobo noma i-doula nabo. Isibhedlela sikaCooper samlandela, kodwa wazilwela.
“Bengicisha umlilo njengoba uvuka.”
UDoulas, uthi, ababona ochwepheshe bezokunakekelwa kwempilo abanelayisensi, kodwa "bayingxenye ebalulekile yethimba lokunakekelwa", abahlinzeka ngokusekela nokududuza futhi basebenze njengabameli babesifazane ngesikhathi sokubeletha. Izifundo sebekuqinisekisile ukuthi umsebenzi wabo ungaholela ekuhlinzweni okumbalwa, izinkinga kanye nokubeletha isikhathi eside.
U-Cooper wenza isiqiniseko sokuthi isibhedlela sakhe asikukhawuleli ukuba khona kwama-doulas futhi sibaphatha njengengxenye yethimba lokunakekelwa kwezempilo, kunokuba babaphathe njengezivakashi.
Enye impi yayiphikisana nezeluleko zokuqala ezivela e-US Centers for Disease Control (CDC) - ukwephula Isiqondiso se-WHO - ukuhlukanisa abesifazane abane-COVID esolwayo noma eqinisekisiwe ezinganeni zabo ezisanda kuzalwa. UCooper uthi izibhedlela eziningi zilandele lesi seluleko (esabuyekezwa ngoMeyi, ukuze sincome ukuhlukana okunjalo kuphela ngecala ngalinye).
Uthi: “Kwakungenangqondo kimi. Ikakhulukazi ngalesi sikhathi esibucayi, uyangitshela, ukuncelisa ibele kufanele kube yinto ehamba phambili, ukuqinisa ukuzivikela kwamasosha omzimba ezinsana. Uthi: “Kubonakala kuwukungakhathali ngempela ngezinyathelo “zokuphazamisa ukuncelisa ibele ngalezo zinsuku ezimbalwa zokuqala bese kuthunyelwa umntwana ekhaya nomama ongakuhlomele kangako ukuncelisa.”
Isiqondiso se-WHO sichaza ukuthi kuphephile ukuthi omama bancelise ibele: abukho ubufakazi bokuthi i-COVID-19 ingasakazwa ngokuncelisa ibele futhi igciwane elisebenzayo alikatholakali obisini lwebele.
“Umuntu ozalayo uyinhloko yomkhumbi. Ukapteni weqembu.”
Ebhekene nalezi zinselelo ze-COVID-19, indlela ka-Cooper kube ukulwa nemikhawulo ephansi ngokucindezela amalungelo abesifazane kanye nezinqumo zabo ezinolwazi ukuthi zibe maphakathi nezinqubomgomo zesibhedlela sakhe.
“Umuntu ozalayo uyinhloko yomkhumbi. Ukapteni weqembu. Ngakho-ke obekufanele sikwenze wukuba nengxoxo eqotho mayelana nesikwaziyo nge-COVID nesingakwazi ngayo,” kuchaza yena.
Esibhedlela sakhe, ngisho noma owesifazane ene-COVID-19, angakhetha ukungahlukaniswa nosana lwakhe. "Odokotela bethu bezingane bahlanganisa i-synopsis enhle yokuthi yiziphi izinketho, kufaka phakathi imihlahlandlela yokuthi unganciphisa kanjani ingozi," uyachaza, futhi lolu lwazi lwabelwana nowesifazane obese enquma.
Ngokuziqhenya, le ndlela yokwenza, isho ukuthi omama abasanda kubeletha “bangakwazi ukuqhubeka bencelisa futhi bathole ukusondelana okungokomzwelo okutholayo nokusondelana okuhambisana nokuncelisa. Ngicabanga ukuthi lokho kubalulekile ezinganeni, futhi ngicabanga ukuthi lokho kubalulekile komama.”
Inhlangano 'yamalungelo okubeletha'
Ngaphansi Umthetho wase-US, wonke umuntu unelungelo lokuthola imvume enolwazi ngezinqubo zokwelapha. Lokhu kusho ukuthi banelungelo lokuthola ulwazi abaludingayo ukuze benze izinqumo ngempilo yabo, okuhlanganisa ukwenqaba imithi ethile. Kepha abagqugquzeli bamalungelo kanye nabacwaningi baxwayisa ngokuthi nangaphambi kwalolu bhubhane, le migomo yayikhona ukubukela phansi noma ukunganakwa ngesikhathi sokubeletha.
U-Cooper uyingxenye yenethiwekhi encane kodwa ebumbene yabasekeli 'bamalungelo okubeletha' abazama ukuguqula lokhu. UCristen Pascucci, umsunguli weqembu I-Birth Monopoly, ithi i-COVID-19 ikhulise izinselelo zabo kuphela, ngemikhawulo emisha athi yethulwa “ngaphandle kokubheka ubufakazi, amalungelo, noma ukuhlukumezeka esikubeka kubantu”.
Udokotela wase-Birmingham usenezindaba ezikhulayo zabezindaba zendawo ngomsebenzi wakhe - kanye nomkhankaso wakhe wamanje wokuguqula ingxenye yomtholampilo wakhe we-ob-gyn, ngaphesheya komgwaqo esibhedlela, ibe 'iyunithi yokubeletha ewusizo'. Lokhu kuzobhekelela abesifazane abakhulelwe abasengcupheni encane ukuba banikeze ukusekelwa ngunesi-mbelethisi.
Kodwa kungokokuqala exoxa indaba yakhe kubabukeli bomhlaba wonke. Inikeza ifasitela enkingeni ethathe isikhathi eside eyandulela ubhubhane: ukuhlukunyezwa okusabalele kwamalungelo abantu besifazane ngesikhathi sokubeletha. Indaba yakhe iphinde isitshele ukuthi, ikakhulukazi ngaphandle kwe-radar, odokotela abangabesifazane kanye nabameleli bamalungelo badala kanjani ushintsho emiphakathini yabo, naphezu kwezinkinga.
Akubanga lula. “Ngiye ngazabalaza phakathi neminyaka eminingi ngezinkulumo ezingezinhle nokuhlehla mayelana nendlela engiqhuba ngayo,” kusho uCooper, “nangenxa yobulili bami nokwehluleka kwami ukujwayelana nomphakathi wezokwelapha wase-Alabama.” Kodwa uthole indawo yakhe nozakwabo bamanje “abahluke kakhulu nabanomqondo ozimele”, abamnika “ukusekelwa okungaphezu kwalokho engike ngaba nakho”.
Abangane benkolo
Udokotela olwela amalungelo abantu besifazane uphinde wathola abangani phakathi komphakathi wezenkolo wase-Alabama, “okuthakazelisayo, ngoba silandela izindlela ezihlukene eziya esiphethweni esifanayo uma kuziwa ekuzalweni. Asivumelani kwezombusazwe, kodwa sobabili sifuna izindawo zokubelethela eziphephile kwabesifazane ngokungenelela okungenasidingo okumbalwa.”
UCooper uthi: “Abesifazane abakhetha umkhuba wami bahlanganisa izinhlobonhlobo zemibono yezombangazwe kanye neyenkolo. Baphinde beza nezinhlelo ezahlukene zokubeletha, futhi lokho kulungile kuye. Ukukhetha kanye nemvume kuphakathi nendawo yokusebenza kwakhe.
Kungakhathaliseki ukuthi abesifazane bakhetha ukubeletha ngokwelashwa, noma ukubeletha kwe-c-section, noma ukuzalwa ekhaya, u-Cooper uthi iphuzu elibalulekile ukuthi baqonde zonke izinketho zabo, okuhlanganisa izingozi nezindlela zokuzinciphisa.
“Umsebenzi wami wukusebenzisa amakhono ami ukusiza ukufeza uhlelo olubekwe ngumuntu obelethayo kanye nokunikeza ulwazi oluzomsiza abe nomphumela awufisayo,” usho kanje. Ukulandela le ndlela, uyanezela, kusho ukuthi “uma izinto zingahambi njengoba bekuhleliwe, abantu basazizwa bekhululekile ngakho, ngoba bebeyingxenye yenqubo, esikhundleni sokuba umkhumbi ongenzi lutho.”
Psychology kanye c-izigaba
Ukuqeqeshwa kukaCooper ngokubelethisa, uthi, “kwakuwuhlelo olunokwelashwa kakhulu futhi angizange ngithole ulwazi oluningi ngokuzalwa ngaphandle kwemithi, ukungenelela okuncane”. Kuthe lapho esezibelethile lapho aqala khona ukungabaza ayekufundile. Lapho esebuyele ekhaya nosana lwakhe, waqala ukuba nezinkinga zokuncelisa ayengakwazi ukuzichaza ekuqeqeshweni kwakhe.
Ngaphambi kwalokhu, “Bengingacabangi ukuthi kuncane kangakanani ukuqeqeshwa enganginakho ekusekeleni abesifazane abancelisa ibele nokuthi indlela esibeletha ngayo ithinta ukuncelisa. Ngemva kwalokho, uCooper waqala ukutadisha lezi zindaba, kanye nokubelethisa, athi kwavula amehlo akhe “kungakanani okushodayo emzimbeni wolwazi thina njengodokotela esinakho uma kuziwa ekubelethweni kwengane.”
Nakuba odokotela bokubelethisa beqeqeshelwe ukubheka izifo nezifo, uyachaza, ababelethisi baphinde bagxile ekulungiseleleni abesifazane ngokwengqondo ukubeletha, okuhlanganisa “ukuba sendaweni ezolile nokusondela ekuzalweni ngaphandle kokwesaba”.
"I-US iyindawo eyingozi kakhulu yokubeletha emazweni athuthukile."
U-Cooper wanquma ukufaka ababelethisi kubasebenzi bakhe esibhedlela - elwa nokuphatha iminyaka emithathu ukwenza lokhu kwenzeke. Uthi uma selufikile, imiphumela yaba ngokushesha. "Sibe nama-doulas amaningi angenayo, abesifazane abaningi ngokwengeziwe bebeletha ngokwezinhlelo zabo nangendlela ethuthukisiwe, futhi amanani ethu e-c-section aqala ukwehla."
Inani le-c-section elenziwe libalulekile ngoba, njengoba uCooper exwayisa, “i-US ingelinye lamazwe athuthukile anezinga lokufa komama elikhuphukayo, futhi ingxenye yalokho kungenxa yokukhuphuka kwethu kwenani le-c-section.”
I-WHO incoma ukuthi i-c-section yenziwe kuphela lapho kudingeka ngokokwelashwa, futhi ithi izinga elikahle le-c-sections liphakathi kuka-10% no-15%. Lezi zibalo aphezulu kakhulu e-US, futhi ikakhulukazi e-Alabama, lapho ngo-2018 cishe u-35% wokuzalwa kwenzeka ngale ndlela.
Ezinyangeni eziyisithupha nje kuphela, izinga le-c-section lomama abaqalayo esibhedlela sikaCooper lisuke ku-25% laya ku-11%, kanti izinga labo bonke abazalwa lisuka ku-33% laya ku-20%. Ukwehlisa la mazinga bekungeyona inhloso yakhe, nokho, futhi ukuchaza njengomphumela wemvelo wendlela yakhe, esekela ukuthathwa kwezinqumo kwabesifazane.
Isibhedlela sakhe sihlinzeka ngezigaba ezikhethiwe, futhi sinikeza nabesifazane ithuba lokulinda futhi banqume ukuthi bafuna ini eduze nosuku lwabo olunqunyiwe. Ucabanga ukuthi lokhu kube nomthelela omkhulu, njengoba iziguli ezingacindezelekile ngokushesha zivame ukucela ukulinda, "futhi uma ulindile, uthola ukubeletha okuningi kakhulu kwesitho sangasese sowesifazane".
I-WHO iphinde ixwayise ngokuthi okuhlobene ne-C-section "izingozi ziphezulu kwabesifazane abanokufinyelela okulinganiselwe ekunakekelweni okuphelele kokubelethisa." Ngisho nangaphambi kwe-COVID-19, abesifazane abaningi e-US babhekane nalezi zingozi eziphakeme.
Uphenyo lwango-2018 uthe i-US "iyindawo eyingozi kakhulu yokubeletha emazweni athuthukile", abesifazane abangu-50,000 ngonyaka balimala kanzima ngesikhathi noma ngemva kokubeletha, kanye nokufa kwe-700.
Izinga lokufa komama nezinsana liphezulu e-Alabama kunakwezinye izingxenye eziningi zezwe, kanti uCooper uthi “lokho kuhlukana kugqama nakakhulu uma ukuhlephula ngokohlanga.”
“Ngesikhathi ngiqala ukuzama ukwenza izinguquko endleleni yami yokwenza kanye nokuhlanganisa indlela yokubelethisa,” uyachaza, “ngangikwenza kakhulu ukweseka ukuncelisa kanye nokusekela amalungelo abesifazane, ngoba kwakubalulekile kimina ukuthi abesifazane bazenzele izinqumo zabo. mayelana nendlela abazala ngayo.”
“Angifuni ukunikeza engicabanga ukuthi kuyimodeli enhle yokunakekela kuphela kulabo abakwazi ukukukhokhela.”
Wonke umuntu obelethayo, u-Cooper uyagcizelela ukuthi, kufanele athole ukwelashwa okufanayo, futhi kumzwisa ubuhlungu ukuthi indlela yakhe yokwelapha ayitholakali kabanzi. Inkinga ye-COVID-19 yenze kwaba kubi kakhulu ukungalingani ekufinyeleleni kwabantu baseMelika ekunakekelweni kwezempilo, uyanezela, enikeza isibonelo sokuzalelwa emakhaya.
Ababelethisi bokubelethisa emakhaya basemthethweni kuphela ngonyaka odlule futhi ababaningi kakhulu e-Alabama. Futhi azithengeki, kusho u-Cooper, “kwabesifazane abaningi abesaba ukuza esibhedlela” ngesikhathi sodlame. Uthi zibiza u-$3,000-$5,000 ngokudiliva ngakunye futhi kufanele zikhokhelwe ngokheshi.
Njengoba izibhedlela ezizungeze i-US seziphenduke izindawo zokutheleleka nge-coronavirus, abesifazane badinga izindawo eziphephile zokubeletha, kusho udokotela, nokukhulelwa okusengozini encane okungenzeka ukuthi zidinge ukungenelela okukhethekile noma imithi inganakekelwa abahlengikazi nababelethisi ngaphandle kwesibhedlela. amawadi okubeletha.
Yingakho eqale umkhankaso wakhe wokuguqula umtholampilo wakhe, ngaphesheya komgwaqo nesibhedlela asebenza kuso, ube 'yiyunithi yokubeletha ewusizo'. Umgomo wakhe uwukwenza ukubeletha kuphephe futhi kufinyeleleke kalula - phakathi nangemuva kwe-COVID-19.
Ukuze enze lokhu, udinga ukwesekwa yiMedicaid, uhlelo lomshwalense wezempilo oluxhaswe nguhulumeni abantu baseMelika abahola kancane abangaphezu kwezigidi ezingama-70 abathembele kulo. Ngo-2018, yahlanganisa 50% wokuzalwa e-Alabama. “Kubaluleke kakhulu kimina ukuthi sithole imbuyiselo ye-Medicaid,” kusho u-Cooper, “ukuze nginganikezi engicabanga ukuthi kuyisibonelo esihle ngempela sokunakekela kulabo abakwaziyo ukuyikhokhela.”
Uma i-Medicaid imenqaba, udokotela unecebo B – eliphendukela emphakathini wakhe 'wamalungelo okubeletha' ukuze bathole usizo lwezezimali kwabesifazane abanezinsiza ezilinganiselwe. Nakuba usemncane, uthi lo mphakathi uyakhula futhi “singabuyela emuva lapho sizama ukwenza lezi zinguquko.”
Ngale kwalolu bhubhane, u-Cooper ukholelwa ukuthi “izikhungo zokuzalwa”, ngaphandle kwesibhedlela, “ziyingxenye ebalulekile yesixazululo sezinkinga esizibona e-Alabama. Kepha nge-COVID kanye nesimo esibhedlela, kwaphuthuma kakhulu. Kufanele siyeke ukulinda kulokhu. Asikwenze manje.”
I-ZNetwork ixhaswa kuphela ngokuphana kwabafundi bayo.
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