Ekupheleni kokukhulelwa, kuvamile ukuthi umama okhulelwe ezwe ukuzwa okusha:

• umuzwa wobunzima ku-pelvis kanye nobuhlungu (ngezinye izikhathi kuqhathaniswa nezimbotshana ezincane) ku-pubis kanye nesitho sangasese sowesifazane, isibonakaliso sokuthi ingane iqala ukwehla emgodini;
• umuzwa wokuqina ngaphansi kwesisu ngenxa yokuphumula kwamalunga e-pelvis okuthi, ngaphansi komphumela wamahomoni, aqale ukuhamba eceleni ukuze kudlule umntwana;
• ukukhathala okukhulu kanye nesicanucanu futhi ngenxa yesimo sezulu se-hormonal ekupheleni kokukhulelwa, futhi ikakhulukazi i-prostaglandin enomphumela we-laxative kancane;
• ukulahlekelwa kwepulaki yamafinyila, lelo nqwaba yamafinyila omlomo wesibeletho avala umlomo wesibeletho. Ngaphansi komphumela wokufinyela ekupheleni kokukhulelwa okuvuthwa umlomo wesibeletho, ipulaki yamafinyila ingaphuma ngendlela yokuphuma okunamathelayo, okuguquguqukayo noma okunsundu, ngezinye izikhathi kuhambisane nemivimbo emincane yegazi;
• isiphithiphithi sokuhlanza nokulungisa okungaba, ngokusho kochwepheshe abathile, ukuziphatha okuvamile kuzo zonke izilwane ezincelisayo. Siphinde sikhulume “ngemvelo yokuzalela” (1).

Zonke lezi zimpawu zibonisa ukuthi umzimba uzilungiselela ngenkuthalo ukubeletha, kodwa akuzona izimpawu zeqiniso zokuqala kokubeletha ezidinga uhambo oluya ewodini lababelethayo.

Isibeletho siyisisipha esakhiwe izinhlobo ezahlukene zemicu ezofinyela ukuze uvumele umlomo wesibeletho ukuba ushintshe futhi ingane yehlele okhalweni. Ekupheleni kokukhulelwa, kuvamile ukuzwa ukufinyela "kwangaphambi kokubeletha" okuzokhuthaza ukuvuthwa komlomo wesibeletho ngosuku lwe-D. Lokhu-ke kuba yizifinyezo ezingenabuhlungu noma ezibuhlungu kancane, ezinyamalala ngemva kokuphindaphinda oku-3 noma oku-4. ihlukaniswe imizuzu engu-5-10.

Ngokungafani nalezi zifinyezo zokulungiselela, ukufinyela kwabasebenzi akumi, kuya ngokushuba futhi kuya ngokuya kuba kude nokusondelana ndawonye. Imvamisa kanye nokujwayelekile kwalokhu kufinyela okukhombisa ukuqala komhelo. Kuye ngowesifazane kanye nokulingana, ukusikwa kwemihelo kumiswa ngokuvumelana namaphethini ahluke kakhulu, kodwa sincoma ukuthi uye ewadini yababeletha:

• ngemva kwamahora ama-2 okufinyela njalo emizuzwini emi-5 kuya kweyi-10 uma kuyingane yokuqala;
• emva kwe-1h30 yokufinyela njalo ngemizuzu eyi-10 kuma-multiparas.

Umama ozozala kumele acabangele ukubekezelela ukufinyela futhi alalele imizwa yakhe. Uma ukufinyela kungavamile kodwa kunamandla kangangokuthi kuvimbela ukukhuluma, uma kuba nzima ukubhekana nakho yedwa noma uma ubuhlungu bungokoqobo, kuhle ukuya esibhedlela sokubeletha okungenani. ukuqinisekiswa. Umama wakusasa uyohlale emukelwa kahle yiqembu lababelethisi abajwayele lolu hlobo lwesimo.

Abanye besifazane ababi nakho ngempela ukufinyela kodwa basuke benesifiso esivamile sokuphuma amathumbu noma ukuchama. Kanti abanye bazozwa ukufinyela phezulu kwesisu, ngaphansi kwezimbambo, kuyilapho abanye omama bezwa kungezansi. Uma ungabaza, kuhle ukuya ewodini lababelethayo.

Okokugcina, phawula ukuthi ukuthola umsebenzi wamanga, okusho ukuthi ukufinyela okungenamthelela emlonyeni wesibeletho, omama besikhathi esizayo bayelulekwa ukuba bageze kanye ne-antispasmodic. Uma ukufinyela kuqhubeka, cishe kuwukufinyela “kwangempela”.

Kuso sonke isikhathi sokukhulelwa, umntwana uguqukela emgodini we-amniotic, iphakethe elenziwe ngolwelwesi olubili (i-amnion ne-chorion) futhi eligcwele uketshezi lwe-amniotic. Lapho umlomo wesibeletho ususuliwe futhi ipulaki yamafinyila ikhishwa, umntwana ube esevikelwa yilolu lwelwesi noma “isikhwama samanzi” (isigxobo esingezansi sesaka le-amniotic). Imvamisa, ulwelwesi luyaqhuma ngokuzenzekelayo ngesikhathi sokubeletha esivuleke ngokugcwele, kodwa ngezinye izikhathi lokhu kuqhuma kwenzeka ngesikhathi sokubeletha noma ngisho nangaphambili. “Ukulahlekelwa kwamanzi” okudumile noma, ngolimi lokubelethisa, “ukuphuka ngaphambi kwesikhathi ngaphambi kwesikhathi sokubeletha” okuthinta u-8% wokukhulelwa (2). Uketshezi lwe-amniotic - uketshezi olusobala, olunganuki futhi olufudumele - luzobe selugeleza esithweni sangasese emifudlaneni emincane uma kuwumfantu wesikhwama noma ngokungagwegwesi uma kwenzeka ukuqhuma. Uma kunokungabaza okuncane, ikakhulukazi lapho kuphuma uketshezi oluncane okungase kwenziwe ngephutha njengokuphuma kwesitho sangasese sowesifazane, kuhle ukuthi uye ewodini yababeletha lapho kuzohlolwa khona ukuze kuqinisekiswe ukuthi uketshezi lwe-amniotic ngempela.

Ukulahleka kwamanzi kungenzeka ngaphambi kokuqala kokusikwa nokufinyela kodwa kudinga ukuthi uye egunjini lababeletha ngoba uma isikhwama sesidabuke, ingane ayibe isavikelekile ezifweni. Kukhona futhi ingozi yokuqhuma kwentambo: idonselwa phansi kanye nezingozi zokucindezelwa ngesikhathi sokubeletha. Ngemuva kokuphuka ngaphambi kwesikhathi ngesikhathi ngaphambi kokusikwa, ingxenye yomama bakusasa ibeletha emahoreni ama-5 kanye nama-95% kungakapheli amahora angama-28 (3). Uma ukuteta kungaqali ngemva kwamahora ayisi-6 noma ayi-12, kuyokwenziwa ngenxa yengozi yokutheleleka (4).