Ngenxa yokuthi bamele u-2% kuphela wokuzalwa, ukukhulelwa kwentsha akukhulunywa ngakho kakhulu. Nokho kuyiqiniso ukuthi unyaka ngamunye uthinta amakhulu amantombazanyana abe omama abasebasha. Buyekeza ngezingozi zezinkinga zalokhu kukhulelwa okuthile.

Ayikho incazelo esemthethweni “yokukhulelwa kusencane”. Ngokuvamile, sibeka ikhesa eminyakeni yobudala, okusho ukuthi iminyaka engu-18. Ngezinye izikhathi ku-20.

Izinkinga zokukhulelwa nokubeletha ziyimbangela yesibili yokufa kwamantombazane aneminyaka engu-15 kuya kwengu-19 emhlabeni jikelele, kusho i-WHO (1). Emhlabeni wonke amantombazane angu-194 ashona nsuku zonke ngenxa yokukhulelwa esemncane (2), kodwa okunokwehluka okuqinile kwezifunda kuye ngokuthi izwe lithuthuka kangakanani. Lesi simo sanda kakhulu emazweni asathuthuka, lapho intombazane eyodwa kwama-1 ikhulelwa ingakahlanganisi iminyaka engu-3. Ukungabi bikho kolwazi nemfundo yocansi, ukushada ngenkani, ukunukubezwa ngokocansi, ukungakwazi ukuthola izindlela zokuvimbela inzalo, ukuvinjelwa kokukhishwa kwezisu kuchaza lezi zibalo eziphezulu.

E-France, ngokusobala isimo asifani ngenxa yokufinyelela ekuvimbeleni inzalo kanye nesimo senhlalo namasiko. Ngakho, ngokwezibalo ze-INSEE (3), ukuzala kwabesifazane abaneminyaka engu-15 kuya kwengama-24 kuyaqhubeka nokwehla ngezinga lokuzala kwezingane ezingu-2,7 kwabesifazane abayi-100 ngo-2016 (uma kuqhathaniswa neminyaka engu-11,5 kwabaneminyaka engu-25-29 kanye nezingane ezingu-12,9 phakathi Abaneminyaka engama-30-34). Ngo-2015:

• I-0,1% yezingane zokuqala yayinomama oneminyaka engu-15;
• 0,2% umama oneminyaka engu-16;
• 0,5% umama oneminyaka engu-17;
• 0,9% weminyaka engu-18;
• 1,7% weminyaka engu-19;
• 2,5% yeminyaka engama-20 (4).

Ukukhulelwa kwentsha kubhekwa njengokukhulelwa okusengcupheni hhayi ngenxa yezimbangela ezijulile ngenxa yobusha bomzimba, kodwa ngenxa yesimo senhlalo-mnotho lapho la mantombazane athuthuka khona kanye nokuziphatha okuyingozi kakhulu kuleli qembu lobudala. Ngaphezu kwalokho, ngenxa yokuthi abakunaki ukukhulelwa kwabo (ngokuqaphela noma cha), bakuthole sekwephuzile noma bafisa ukukufihla, ukuqapha ukukhulelwa ngokuvamile akwanele noma kuphuze kakhulu. Ngakho-ke laba omama abasebancane bakusasa abazuzi kukho konke ukuhlolwa kokwelulekwa nokuhlolwa okuhlinzekwe mayelana nokuqapha ukukhulelwa.

Embikweni wayo wokukhulelwa nokubeletha ebusheni, i-French National College of Gynecologists and Obstetricians (5) ikhombisa nokho ukuthi ukwanda kwezinga lezinkinga zohlobo lwe-pre-eclampsia akubonwanga (2,7%) noma ukopha kokubeletha (5,4%) kuleli qembu lobudala.

Ukuntuleka kokunakekelwa ngaphambi kokubeletha, ukuziphatha okuyingozi kanye nesimo sengqondo nenhlalo yomphakathi yalabo mama abasebasha bakusasa kubeka umntwana engozini ethile. Izinkinga ezimbili ezinkulu yisisindo sokuzalwa esiphansi kanye nokungakabi yisikhathi. Ucwaningo olwenziwa phakathi kuka-1996 no-2003 esibhedlela i-Jean Verdier (93), olwalandela ukukhulelwa kwamantombazane angama-328 aneminyaka engu-12 kuya ku-18, lubonise izinga lokungakabi yisikhathi lika-8,8%. "Lezi zinkinga ezimbili eziyinhloko zixhumene ngokuqondile nokulandelela sekwephuzile kanye" nokuziphatha "kwe-exfoliation" yesimo sokukhulelwa okuhlotshaniswa nokungabikho kwanoma yisiphi isixwayiso esingokomzimba noma sokudla, ngokuqhubekayo, noma ngisho nokwanda kokuziphatha okuluthayo. », Ikhombisa i-CNGOF (6).

Ingozi ye-IUGR (ukuncipha kokukhula kwe-intrauterine) nayo iphezulu ekukhulelweni kusenesikhathi, nokusabalala okungama-13%, okungaphezulu kwenani labantu elijwayelekile (7). Ngokocwaningo lwaseMelika (8), izingane zomama abangaphansi kweminyaka engama-20 nazo zinengozi isiyonke yokonakala ngokuphindwe izikhathi ezingu-11 kunaleyo ebonwa abesifazane abasengozini encane kakhulu, phakathi kweminyaka engama-25 nengu-30. Nakulokhu futhi, ukuchayeka kombungu ezintweni ezinobuthi (utshwala, izidakamizwa, ugwayi) kuyimbangela enkulu.

Ukubeletha kona, ngakolunye uhlangothi, kuthathwa njengokuphephile ngombandela wokuthi ukukhulelwa kwaziwe ukuze kwenziwe umsebenzi othile wokukhulisa ingane ngaphambi kokufika kwengane, kukhombisa i-CNGOF (9).