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Coping strategies and pain relief in labour

Laqabsiga iyo xanuun joojiyaha ee foosha

Close up of heavily pregnant woman leaning forwards with her birth partner standing behind her and touching her waist Markii shaqaaluhu sii socdaan, waxaa jira xulashooyin badan oo la heli karo si ay kaaga caawiyaan maaraynta dareenka ka hortagga maadaama ay sii xoogaysanayaan oo aad u xoog badan yihiin.
Nuqul ka mid ah foosha hore Is-hypnosis/Farsamooyinka nasashada ee qoto dheer Daaweynta dhameystiran TENS (kicinta dareemayaasha korantada transcutaneous) Gaaska iyo hawada (Entonox) Biyaha amniotic Opioids (pethidine/diamorphine/meptid) Epidural
Pain relief in labour Pain relief information in English and other languages
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Positions for labour and birth

Dhaq-dhaqaaqyada foosha iyo dhalmada

Heavily pregnant woman stands bent forward at right angles with her elbows resting on the back of a sofa Inta lagu jiro foosha, way fiicantahay in la sii wado sida ugu firfircoon ee suuragalka ah, iyo in la isku dayo jagooyin kala duwan. Markaad tan sameyso waxaad ku dhiiri gelin doontaa cunuggaaga marinka dhalmada meesha ugu wanaagsan ee dhalmada, iyadoo sidoo kale aad caawineyso raaxadaada iyo awooda aad ku qabsan karto. Joogitaanka firfircoon iyo toosan ayaa sidoo kale la ogyahay inuu gaabinaayo dhererka foosha. Waad isku dayi kartaa:
  • socodka
  • adoo taageero ka helaya lammaanahaaga dhalashada
  • jaranjarada kor iyo hoos
  • ruxitaanka
  • adoo adeegsanaya kubada dhalmada
  • fadhida meel toosan ama isjiidjiid
  • dhammaan boosaska afarta (gacmahaaga iyo jilbahaaga) ama jilbaha
  • u jiifto dhinacaaga, oo ay ku taageerayaan barkimooyin (markaad rabto inaad nasato).
Inta lagu jiro dhalmada, umulisadaada waxay kaa taageeri doontaa inaad tijaabiso jagooyin kala duwan. Waa muhiim inaad dhageysato jirkaaga, iskuna day wax kasta oo adiga kugu habboon. Jagooyinka aad qaadan karto waxay kuxirnaan karaan inaad dooratay inaad biyo ku dhasho, ama haddii aad leedahay epidural.
Positions for birth
Birthing positions for labour Upright birth – Episode 57, The Obs Pod
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Monitoring your baby

La socodka cunuggaaga

Heavily pregnant woman lies on her side while a fetal monitor is attached to her abdomen Inta lagu jiro foosha, umulisadaada waxay dhagaysan doontaa garaaca wadnahaaga si ay u hubiso wanaaggiisa, iyo inay hubiso inuu si wanaagsan ula dhaqmayo foosha. Waxaa jira seddex qaab oo kala duwan oo umulisadaada ay tan ku hubin karto, ayadoo adeegsansaneysa midkood:
  • Mashiin gacanta lagu haysto
  • Tethoscope Pinard; ama
  • Kormeerka uurjiifka elektiroonigga ah ee joogtada ah.
Haddii aad uur caadi ah oo caafimaad qaba lahayd, oo fooshaadu si dabiici ah ay u bilaabatay 37 toddobaad kadib, sida caadiga ah waxaa lagu siin doonaa kormeer iyada oo la adeegsanayo mashiin gacanta lagu hayo oo soo saaraya codka garaaca wadnahaaga. Kani waa mashiin la mid ah umulisadaada/dhaqtarkaaga uu dhageysan jiray garaaca wadnaha ee cunuggaaga inta uurka la leeyahay. Umulisadaada waxay dhagaysan doontaa garaaca wadnaha ee ilmahaaga si isdaba joog ah oo joogto ah inta lagu jiro foosha. Umulisadaada waxaa laga yaabaa inay u soo bandhigto dhageysiga garaaca wadnahaaga ee Pinard stethoscope. Sida stethoscopeyadii hore ma awoodi doontid inaad maqasho garaaca wadnaha laakiin umulisada ayaa si cad u maqli doonta. La socodka uurjiifka elektiroonigga ah ee joogtada ah (oo mararka qaar loo yaqaan CTG) waa mashiin loo isticmaalo in lagu duubo garaaca wadnahaaga iyo dhawaanshaha uurkaaga si joogto ah foosha oo dhan. Waxaa lagu talin karaa inaad haysato kormeerka noocan ah haddii aad wax dhibaato ah kala kulanto inta aad uurka leedahay ama foosha iyo haddii aad u isticmaaleyso epidural xanuun baabiiye ahaan. Umulisadaada ama dhakhaatiirtu waxay si joogto ah u eegi doonaan duubitaankan shaqaalaha oo dhan. Waxaad u baahan doontaa inaad xirato laba suumanka calooshaada si aad u ilaaliso mashiinada meesha. Unugyada qaarkood mashiin wireless ah ayaa laga heli karaa (tan waxaa loo yaqaanaa telemetry), taas oo macnaheedu yahay inaad awood u yeelan karto inaad si xor ah ugu dhaqaaqdo. Vway fiicantahay in laga wada hadlo faa’iidooyinka hababka kala duwan ee korjoogteynta kahor inta aan foosha la galin. Qaabka ay ku taliyaan umulisada ama dhaqtarka waxay kuxirnaan doontaa caafimaadka adiga iyo cunuggaaga bilowga foosha. La socosho dheeri ah ayaa lagula talin karaa haddii umulisadaada ama dhakhaatiirtaadu ay ka walaacsan yihiin garaaca wadnahaaga inta lagu jiro shaqada, tani waxay noqon kartaa:
  • Electrode maqaarka maqaarka (FSE) oo si toos ah ugu xidhan madaxa ilmahaaga
  • Muunad dhiig uurjiif ah (FBS). Tijaabadani waxay ku lug leedahay qaadashada muunad aad u yar oo dhiig ah madaxa ilmahaaga si aad u hubiso sida ay ula dhaqmayaan.
What happens during labour Monitoring your baby in labour
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My team for birth and labour

Kooxdayda foosha iyo dhalmada

Midwife touches the control of a monitoring machine

Umulisooyinka

Umulisooyinku waa daryeelayaashaada ugu weyn ee foosha, haddii aad dooratid inaad cunuggaaga guriga ku haysato, xarun dhalasho oo umulisooyin ama qeybta shaqada ee dhalmada. Haweenka ku jira foosha la aasaasay waxay caadiyan ka heli doonaan daryeel hal-hal ah oo shaqaale ah umulisada la magacaabay. Umulisadaada ayaa ku taageeri doonta inta lagu jiro foosha, iyadoo hubineysa in adiga iyo ilmahaagu aad wanaagsan tihiin.

Dhakhaatiirta qalliinka

Dhakhtarkan ayaa ku lug yeelan doona daryeelkaaga haddii wax dhibaatooyin ah ama baahiyo badan oo adag ay soo baxaan inta lagu jiro foosha ama dhalashada. Haddii kicinta foosha lagugula taliyo adiga, ama haddii foosha iyo/ama dhalashadaadu ay gaabiso waxay u badan tahay inaad arki doonto qof uurjiif ah. Haddii ay jiraan walaac caafimaadkaaga,  caafimaadka cunuggaaga ama haddii dhalashada caawinta ama dhalashada caesarean lagugula taliyo sidoo kale waa lagu arki doonaa oo lagu xanaanayn doonaa ilmo-galeen ah oo ka shaqeyn doona wada-shaqeynta umulisadaada.

Shaqaalaha taageerada hooyada

Kuwani waxay ka shaqeyn doonaan kormeerka tooska ah ee umulisadaada si ay kuu siiyaan taageero inta lagu jiro foosha. Waxay kaloo kaa caawin karaan quudinta cunuggaaga isla marka dhalashada kadib.

Cudurka suuxdinta

Haddii aad leedahay suuxdin inta lagu jiro foosha, tan waxaa gelin doona suuxin. Haddii aad u baahatid dhalasho caesarean, waxaa sidoo kale lagu xanaanayn doonaa tiyaatarka suuxiyaha, iyadoo lala kaashanayo umulisadaada. Dhakhaatiirta cilminafsiga ayaa sodookale ku lug yeelan kara daryeelkaaga haddii aad wax dhibaato ah qabtid ama aad u baahan tahay daryeel heer sare ah xaaladaha caafimaad awgood.

Kooxda tiyaatarka

Haddii aad leedahay dhalasho caesarean qorshaysan ama xaalad degdeg ah, waxaa jiri doona shaqaale tiyaatarka jooga oo ka caawiya suuxdinta, dhakhaatiirta iyo umulisada ku xanaaneysa. Waxa kale oo laga yaabaa inaad tiyaatarka ku jirto haddii dhalashada la caawiyo lagugula taliyo, ama haddii aad wax dhibaato ah qabtid dhalashada ka dib taasoo u baahan daryeel degdeg ah.

Umulisooyinka ardayda/dhakhaatiirta

Inta lagu jiro shaqada iyo dhalashada, waxaa jiri kara umulisooyin arday ama dhakhtar la shaqeeya umulisadaada la magacaabay. Umulisooyinka ardayda ama dhakhaatiirta ayaa ku siin kara daryeel iyo taageero hoos imaad toos ah ama aan toos ahayn oo umulisada ah, iyadoo kuxiran marxaladooda tababarka. Daryeel ayaa ayaykusiin doonaan keliya oggolaanshahaaga, umulisadaada ayaa kaala hadli doonta tan.

Admin/clerical

Kooxda umulisooyinka iyo dhakhaatiirta xarumaha dhalmada iyo qeybaha foosha waxaa taageera koox soo dhaweyn ah, shaqaale wadaad iyo maamul oo aad la kulmi karto. Fadlan hubi inaad u sheegto kooxda wadaadka haddii aad wax isbeddel ah ku sameyso lambarka xiriirkaaga, cinwaankaaga ama GP si aad u hubiso in macluumaadka si sax ah loogu diiwaan geliyey dukumiintiyada muhiimka ah.
Your team for labour and birth Midwife-led care in labour
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Third stage

Marxaladda saddexaad

Close up of delivered placenta in the gloved hands of a midwife Marxaladan waa waqtiga u dhexeeya dhalashada cunuggaaga iyo saarida mandheerta. Kadib marka ilmahaagu dhasho waxa uu wali ku xirnaan doona xudunta, oo ku lifaaqan mandheerta gudaha uurka. Xadhiggu waa inuu ahaadaa mid aan isla markiiba la gooyn, haddii aysan dhibaato ka qabin neefsashada cunuggaaga, ama aad si xoog leh u dhiig baxeyso. Waxaa jira laba ikhtiyaar oo loogu talagalay gaarsiinta mandheerta. Xulashada koowaad waxaa loo yaqaanaa marxaladda saddexaad ee jirka, kan kalena waa marxaladda saddexaad ee firfircoon.

Marxaladda saddexaad ee jir ahaaneed

Doorashadani waxay ku habboonaan kartaa haddii aad qorsheynaysid dhalasho jir ahaaneed (dabiici ah). Haddii aad u baahatid dhalasho la caawiyay, ama haddii umulisadaada ay ka walwalsan tahay inaad halis sare ugu jirto dhiigbax dhalashada kadib, tan laguma talin karo. Cilmi baarista qaar ayaa ogaatay in dhiigbaxa dhalashada kadib in waxyar la kordhin karo haddii mandheerta si dabiici ah loo saaro, si kastaba ha noqotee haddii aad ku habboon tahay oo aad caafimaad qabtid heerarka ironka wanaagsan ka hor dhalmada, Tani uma badna inay wax dhibaato ah kuu keento adiga. Kadib marka ilmahaagu dhasho, isagu/iyadu waxay ku sii dhagnaan doonaan mandheerta iyada oo loo marayo xudunta, oo bixisa oksijiin iyo dhiig iyadoo ilmahaagu sidoo kale bilaabayo inuu neefsado. 10-15 daqiiqo ka dib dhiiggan ayaa si dabiici ah u joogsan doona maadaama mandheerta ay ka soocdo uurka. Waqtigan xaadirka ah xadhkaha waa la xaqiijin karaa oo la gooyn karaa. Wax yar ka dib waxaad dareemi doontaa xoogaa uurjiif ah oo ku jira uurka iyo laga yaabee rabitaan inaad riixdo. Waxaad ka heli kartaa qaadashada jagooyinka toosan inay caawiyaan, mandheerta ayaa si fudud u soo bixi doonta. Tani caadi ahaan waa xanuun la’aan maadaama mandheerta ay jilicsan tahay.

Marxaladda saddexaad ee firfircoon

Haddii aad dooratid marxalad saddexaad oo firfircoon, ama haddii umulisadaada ay kugula taliso dhalashada cunuggaaga ka dib, umulisadaada waxay ku siin doontaa duriin daawo ah oo keenta in uurku cadaadis galo. Duritaankan ayaa caadi ahaan qaadanaya dhowr daqiiqo si uu u shaqeeyo, markanna xadhigga ilmaha ayaa la hubin doonaa oo la gooyn doonaa. Umulisadaada/dhaqtarkaaga ayaa markaa cadaadis jilicsan saari doona calooshaada hoose oo si taxaddar leh u jiidi doona xadhkaha xudunta, taasoo keenaysa mandheerta inay imaato. Hawshani waxay caadi ahaan qaadataa inta u dhaxaysa 10-20 daqiiqo.
The third stage of labour More on the third stage
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Second stage

Marxaladda labaad

Close up of a woman holding her new born baby Marxaladan foosha ayaa bilaabmaysa marka ilma mareenkaagu yahay toban sintimitir oo la, oo madaxa ilmaha ayaa u wareegaya marinka dhalashada. Tani waxay caadi ahaan la socotaa cadaadis xagga hoose ah, oo ay ku xigto rabitaan riixid kaasoo dareemi kara inay adag tahay in la xakameeyo oo la mid ah dareenka u baahan in la furo mindhicirkaaga. Haweenka qaar waxaa laga yaabaa inaysan helin rabitaan ay ku riixaan, gaar ahaan haddii ay leeyihiin epidural. Haddii ay taasi dhacdo, umulisadaada ayaa kaa caawin doonta inay ku hagto adiga oo dareemaya in caloosha ku soo dhaca oo ay ku ogeysiineyso goorta aad riixeyso. Umulisadaada waxay si joogto ah u hubin doontaa garaaca wadnaha ilmaha waxayna kaa taageeri doontaa inaad isku daydo jagooyin kala duwan. Marka madaxa ilmahaagu ku dhow yahay, umulisadaada waxay kugu dhiiri galin doontaa inaad si tartiib ah u neefsato oo aad ka fogaato riixitaanka haddii ay suurtagal tahay. Tani waxay xaqiijineysaa in madaxa ilmahaagu uu si tartiib tartiib ah u fidiyo perineum-kaaga wuxuuna gacan ka geysan karaa dilaaca. Marxaladda labaad ee fosha waxay ku dhammaanaysaa dhalashada cunuggaaga. Marxaladan foosha waxay socon kartaa ilaa afar saacadood haddii ay tahay cunuggaaga ugu horreeya, oo badanaa waa dhakhso badan tahay haddii ay tahay cunuggaaga labaad ama saddexaad.
Positions for birth
The second stage of labour More in the second stage
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First stage

Marxaladda koowaad

Heavily pregnant woman stands holding the end of a hospital bed with her birth partner standing behind her holding her waist Foosha firfircoon ayaa badanaa la sheegaa inay bilaabato marka foosha ay xoog badan tahay, xoog joogto ah oo waarta ugu yaraan 60 ilbiriqsi, oo ilmahaaguna uu furan yahay ugu yaraan afar sentimitir. Inta lagu gudajiro marxaladda koowaad ee foosha ka hortagyadaadu waxay sii wadi doontaa inay si joogto ah u timaado, oo ay si tartiib tartiib ah u xoog yeelato. Marxaladan foosha waxay socon kartaa ku dhawaad 6-12 saacadood haddii ay tahay cunuggaaga ugu horreeya, oo inta badan waa dhakhso haddii ay tahay cunuggaaga labaad ama saddexaad. Markaad timaadid qaybta hooyadaada (ama umulisadaada ayaa gurigaaga u imaanaysa) marxaladda koowaad ee foosha umulisadaada waxay bixin doontaa qiimeyn joogto ah oo ku saabsan horumarkaaga iyo wanaaggaaga, iyo samaqabka cunuggaaga, oo ay ku jiraan:
  • Aragtidaada (cadaadiska dhiigga, garaaca wadnaha iyo heerkulka)
  • Calool xanuun
  • Dhageysiga garaaca wadnahaaga
  • Baaritaanka xubinka taranka si loo qiimeeyo horumarka foosha iyo booska cunuggaaga.
Umulisadaada waxay kugu taageeri doontaa jagooyin kala duwan iyo istiraatiijiyado la xiriira, oo ay kujirto xanuun baabiiye haddii loo baahdo. Haddii umulisada ay ka walaacsan tahay adiga ama cunuggaaga waqti kasta, waxay weydiin doonaan umuliso sare ama uurjiif fikrad labaad. Tani waxay mararka qaarkood macnaheedu noqon kartaa u wareejinta qaybta foosha haddii aad guriga joogtid ama qaybta hoggaaminta dhexe. Dhamaadka marxaladda koowaad waxaad la kulmi kartaa wax loo yaqaan ‘kala-guurka’ taas oo haweenka qaar ka dhigi karta inay dareemaan cabsi ama xakamayn. Tani waa wax caadi ah oo waxaa ku xiga rabitaan ah in la riixo maadaama ilmagaleenka uu gaaro toban sintimitir oo la kala diray, oo ilmuhu u guuro marinka dhalashada. Umulisadaada ayaa si dhow kuu taageeri doonta inta lagu gudajiro marxaladan.
The first stages of labour More on the first stage
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Early labour/latent phase

Wejiga hore ee foosha/wajiga

Heavily pregnant woman lies on her side in bed Fooshaa hore (oo mararka qaar loo yaqaan wejiga qarsoon ee foosha) waxay socon kartaa laga bilaabo dhowr saacadood ilaa maalmo. Waqtigan xaadirka ah waxaad lahaan kartaa waqtiyo ka hortag ah oo joogto ah, oo ay ku xigto waqtiyo ka hortag aan caadi ahayn oo xitaa joogsan kara dhowr saacadood. Inta lagu jiro foosha hore ee ilmahaagu wuxuu ka tagi doonaa inuu noqdo mid qaro weyn, xiran oo adag ama jilicsan, dhuuban ama fidsan. Isbeddelkani wuxuu awood u siinayaa ilmo-galeenka inuu bilaabo furitaanka.
What is the latent phase