Isilinganiso Esithusayo Sokukhishwa Kwezisu

KUFA abantwana abangakazalwa abasukela ezigidini ezingu-50 kuya kwezingu-60 unyaka ngamunye ngenxa yokukhishwa kwezisu. Ingabe ungakwazi ukuqonda lelonani? Kungafana nokuqothula wonke umphakathi waseziQhingini zaseHawaii masonto onke!

Kunzima ukuthola amanani aqondile ngoba ohulumeni abaningi abayigcini ngokucophelela imibhalo yokukhishwa kwezisu. Futhi lapho ukukhishwa kwezisu kungavunyelwe khona ngokomthetho, ochwepheshe bangamane baqagele kuphela. Kodwa ukulinganisela kokukhishwa kwezisu emhlabeni wonke kubonakala kumi ngalendlela:

E-United States, ukukhishwa kwezisu kuyinqubo yokuhlinza yesibili evame kakhulu, elandela ukuhlinzwa kwamathansela. Unyaka ngamunye, kukhishwa izisu ezingaphezu kwezigidi ezingu-1,5. Iningi labesifazane alishadile—abane kwabahlanu. Abesifazane abangashadile banqamula ukukhulelwa kwabo ngokuphindwe kabili kunezikhathi abazale ngazo, kuyilapho ngokwesilinganiso, abesifazane abashadile bazala ngokuphindwe kayishumi kunezikhathi ababekhiphe ngazo isisu.

EMelika ePhakathi neseNingizimu—egcwele amaKatolika—imithetho yokukhishwa kwezisu iqine ukwedlula yonke emhlabeni. Nakuba kunjalo, ukukhishwa kwezisu okungekho emthethweni kuyanda, kubangela izinkinga ezingokwempilo ezingathi sína kwabesifazane. Ngokwesibonelo, abesifazane baseBrazil, bakhipha izisu ezicishe zibe yizigidi ezine ngonyaka odlule. Abangaphezu kuka-400 000 babo kwadingeka ukuba bafune ukwelashwa kukadokotela ngenxa yezinkinga ezabangelwa yikho. ELatin America cishe ingxenye eyodwa kwezine yakho konke ukukhulelwa iyanqanyulwa.

Ngaphesheya kwe-Atlantic ezwekazini lase-Afrika, imithetho iqinile futhi. Ukulimala nokufa kuvamile, ikakhulukazi phakathi kwabesifazane abampofu abafuna usizo lodokotela abangekho emthethweni.

Kuyo yonke iMpumalanga Ephakathi, amazwe amaningi anemithetho eshicilelwe eqinile, kodwa ukukhipha izisu kusafunwa futhi kutholwa kakhulu yilabo besifazane abakwaziyo ukukhokha izimali ezinkulu.

Ingxenye enkulu yaseNtshonalanga Yurophu iyakuvumela ukukhishwa kwezisu okuthile, iScandinavia ingevelele kakhulu kulokhu. I-National Health Service yaseBrithani iye yagcina umbhalo olotshiwe wokukhishwa kwezisu kusukela lenqubo yamiswa ngokomthetho ngo-1967. Yaphawula ukuphindeka kabili kwalelinani lokukhishwa kwezisu kanye nokwanda kokuzalwa kwamavezandlebe, izifo ezithathelwana ngobulili, ubufebe, kanye nenkindlane yezifo zokuphazamiseka kokuzala.

Okwamanje iMpumalanga Yurophu isesimweni senguquko enkulu, kungokufanayo futhi nangemithetho yokukhishwa kwezisu lapho. Ezweni okwakuyiSoviet Union, ukukhishwa kwezisu kulinganiselwa ezigidini ezingu-11 ngonyaka, okuphakathi kwamanani aphakeme kakhulu emhlabeni jikelele. Njengoba izinto zokuvimbela inzalo zintuleka nezimo ezingokomnotho zimpofu, owesifazane ovamile kulesosifundazwe angase akhiphe isisu izikhathi eziyisithupha kuya kweziyisishiyagalolunye esikhathini sokuphila kwakhe.

Kuyo yonke iMpumalanga Yurophu ukuthambekela ngokuvamile kungasenkululekweni yabesifazane. Isibonelo esiphawulekayo iRomania, lapho umbuso wangaphambili wenqabela khona ngentshiseko ukukhishwa kwezisu futhi wavimbela ukusetshenziswa kwezinto zokuvimbela inzalo ukuze ukhuthaze ukwanda kwabantu. Abesifazane baphoqelelwa ukuba okungenani bazale inani elinqunyiwe labantwana abane, futhi ngo-1988, amakhaya ezintandane aseRomania ayenobhuzane lwentsha elahliwe. Ngakho, selokhu uhulumeni wenguquko wango-1989 alahla lemithetho evimbelayo yokukhishwa kwezisu, abantwana abathathu kwabane babulawa ngokukhishwa kwezisu, okuyisilinganiso esiphakeme kakhulu saseYurophu.

I-Asia inenani elikhulu ukwedlula wonke lokukhishwa kwezisu. I-People’s Republic of China, nenkambiso yayo yokuba nengane eyodwa kuphela nokukhishwa kwezisu okuphoqelelwe, inenani eliphakeme kunawo wonke lokukhishwa kwezisu, ibika izigidi ezingu-14 ngonyaka. EJapane abesifazane bahlobisa imifanekiso emincane eyenziwe ngamatshe ngamabhibhi nangamathoyizi bekhumbula abantwana babo ababulawe ngokukhishwa kwesisu. Umphakathi ukhathazeke kakhulu ngamaphilisi okuvimbela inzalo, futhi ukukhishwa kwezisu kuyindlela eyinhloko yokuhlela umndeni.

Kulo lonke elase-Asia, futhi ikakhulukazi eNdiya, ubuchwepheshe bezokwelapha buye babangela isimo esibucayi kubashisekeli bamalungelo abesifazane. Ubuchwepheshe obunjenge-amniocentesis ne-ultrasound bungasetshenziswa ukuze kutholwe ubulili bomntwana ezikhathini zokuqala zokukhulelwa. Sekuyisikhathi eside isiko laseMpumalanga lazisa amadodana ngaphezu kwamadodakazi. Ngakho lapho zombili lezinqubo zokuthola ubulili nokukhishwa kwezisu zitholakala kalula khona, imibungu yesifazane ibulawa ngokukhishwa kwezisu ngamanani amakhulu, okwenza isilinganiso sokuzalwa kwabesilisa nabesifazane singalingani. Eqinisweni, umzabalazo wabesifazane manje usesimweni esiyindida, sokufuna ilungelo lowesifazane lokubulala ngokukhipha isisu umbungu wakhe wesifazane.

Lokho Umama Akuzwayo

Njengezinye izinqubo zezokwelapha, ukukhipha isisu kuhambisana nesilinganiso esithile sezingozi nobuhlungu. Phakathi nesikhathi sokukhulelwa umlomo wesizalo noma i-cervix, uvaleka ngcí ukuze ugcine umntwana elondekile. Ukunwetshwa nokufakwa kwezinto ezithile kungaba buhlungu futhi kulimaze izicubu. Ukukhishwa kwesisu ngokusetshenziswa kwezinto ezimunca umbungu kungase kuthathe imizuzu engu-30 noma ngaphezulu, isikhathi lapho abanye besifazane bengase bezwe ubuhlungu obulinganiselwe kuya kobukhulu kakhulu kanye nenkwantshu. Lapho kukhishwa isisu ngokusetshenziswa koketshezi i-saline, kuvuswa imihelo yangaphambi kwesikhathi, ngezinye izikhathi ngosizo lwe-prostaglandin, ebangela imihelo. Lokufinyela kwemisipha kungase kuthathe amahora amaningi noma ngisho izinsuku futhi kungase kube buhlungu futhi kuqede amandla ngokomzwelo.

Izinkinga ezivela ngokushesha ngemva kokukhishwa kwesisu zihlanganisa ukopha okukhulu, umonakalo noma ukudabuka komlomo wesizalo, ukubhoboka kwesizalo, amahlule egazi, ukulahlekelwa ingqondo, imiqhabanyeko, umkhuhlane, ukugodola, nokuhlanza. Ingozi yokungenwa yilezifo inkulu kakhulu uma izingxenye zosana noma ze-placenta zisala esizalweni. Ukukhishwa kwesisu okungaphelele kuvamile, futhi kungase kudingeke ukuhlinzwa ukuze kususwe isicubu esibolayo esisalile noma ngisho nesizalo ngokwaso. Ukuhlola kukahulumeni e-United States, eBrithani, nasezweni elaliyiCzechoslovakia kubonisa ukuthi ukukhishwa kwezisu kwandisa kakhulu amathuba angesikhathi esizayo okungazali, ukukhulelwa okwenzeka emapayipini e-fallopian (tubal pregnancy), ukuphuphuma kwesisu, ukuzala ngaphambi kwesikhathi, nokukhubazeka kokuzalwa.

Owayengudokotela omkhulu wezokuhlinza wase-U.S. uC. Everett Koop waphawula ukuthi akekho owayeke wenza “ukuhlola kokusabela okungokomzwelo noma umuzwa wecala wowesifazane owayeke wakhipha isisu futhi manje osemfuna kakhulu umntwana angenakumthola.”

Ukuhlola kufanele ngabe kwahlanganisa emaqenjini ayehlolwa amaKristu amasha amsulwa angazange ahlanganyele ubulili ngenxa yokuhlonipha ukuphila nemithetho kaNkulunkulu. Lokho kuhlola kwakuyothola ukuthi lamaKristu ajabulela ubuhlobo obuhle, ukuzihlonipha okukhudlwana, kanye nokuthula kwengqondo okuhlala njalo.

Lokho Umntwana Ongakazalwa Akuzwayo

Kuzwakala kanjani kumntwana ongakazalwa ukukhoseliswa ngokulondeka ekuthokomaleni kwesizalo sikanina bese ngokungazelele ebulawa ngamandla abhubhisayo? Singacabanga nje kuphela ngalokho, ngoba inhlwa kayibanjwa ngekhanda isavela.

Izisu eziningi zikhishwa emasontweni angu-12 okuqala kokuphila. Ngalesikhathi umbungwana uzijwayeza ukuphefumula nokugwinya, futhi inhliziyo yawo iyashaya. Ungagobagoba izinzwanyana zawo, ufumbe inqindi, uphenduphenduke endaweni yawo ewuketshezi—futhi uzwe ubuhlungu.

Imibungu eminingi iyabhonculwa esizalweni futhi imuncelwe ojekeni ngeshubhu lokumunca elinechopho elicijile. Lenqubo ibizwa ngokuthi i-vacuum aspiration. Lokumunca okunamandla (aphindwe izikhathi ezingu-29 kunamandla e-vacuum cleaner yasekhaya) kudabula lomzinjana phakathi. Abanye abantwana bakhishwa ngokunwetshwa kwesizalo sikamama noma ngokusebenzisa i-curette, ummese omise okwe-loop oxebula ulwelwesi lwesizalo, usike umntwana umenze izicucwana.

Imibungu enamasonto angaphezu kwangu-16 ingase ife ngokukhishwa kwesisu ngoketshezi lwe-saline, noma ngokusebenzisa ushevu kasawoti. Inaliti ende ibhoboza isikhwama esinoketshezi, ikhiphe olunye loketshezi lwe-amnion, futhi esikhundleni salo ifake uketshezi olushubile olunosawoti. Njengoba umntwana egwinya futhi ephefumula, egcwalisa amaphaphu akhe antekenteke ngaloluketshezi olunoshevu, uyashikashikeka futhi akhahlele. Ithonya elibulalayo laloshevu lishisa ingxenye engaphezulu yesikhumba, lisishiye sivuthiwe futhi sishwabene. Ubuchobo bakhe bungase buqale ukopha kakhulu. Ukufa okubuhlungu kungase kufike ngemva kwamahora amaningana, nakuba ngokuvamile lapho imihelo iqala esikhathini esingangosuku noma ngaphezulu kamuva, umntwana osaphila kodwa ofayo uyabelethwa.

Uma umntwana esekhule kakhulu ukuba angabulawa ngalezindlela noma ezinye ezifanayo, kusala indlela eyodwa engakhethwa—i-hysterotomy, ukusikwa kwesibeletho okwenziwa ngenjongo ehlukile, okuqeda ukuphila esikhundleni sokukusindisa. Isisu sikamama sivulwa ngokuhlinzwa, futhi cishe ngokuvamile kukhishwa umntwana ophilayo. Angase akhale ngisho nokukhala. Kodwa kumelwe ayekwe aze afe. Abanye babulawa ngamabomu ngokuncishwa umoya, ukuminziswa, nangezinye izindlela.

Lokho Udokotela Akuzwayo

Emakhulwini amaningi eminyaka odokotela baye bamukela izindinganiso ezichazwe esifungweni esihlonishwayo sikaHippocrates, ngokwengxenye esithi: “Anginakunikeza muntu isidakamizwa esibulalayo, ngisho noma ngabe ngincengwa, noma ngiluleke umuntu ukuba adle isidakamizwa esibulalayo, futhi akekho owesifazane engiyomnikeza ukusikisela okubhubhisayo [kokukhipha isisu], kodwa ngizokwelapha ngonembeza okhululekile nangenhlonipho.”

Yikuphi ukulwisana nezimiso zokuziphatha okubhekene nodokotela abaqeda ukuphila okusesizalweni? UDkt. George Flesh ukuchaza ngalendlela: “Ukukhipha kwami izisu okokuqala, njengodokotela ofundayo nesakhamuzi, akuzange kungibangele ukucindezeleka okungokomzwelo. . . . Ukungeneliseki kwami kwaqala ngemva kokukhipha izisu ezingamakhulu amaningi. . . . Kungani ngashintsha? Ekuqaleni kwami njengodokotela, umbhangqwana othile oshadile weza kimi futhi wacela ukukhishwa kwesisu. Ngenxa yokuthi umlomo wesizalo salesiguli wawuqinile, ngahluleka ukuwunweba ukuze ngenze lenqubo. Ngamcela ukuba abuye esikhathini esingangesonto, lapho umlomo wesizalo wawuzobe usuthambe khona. Lombhangqwana wabuya futhi wangitshela ukuthi wawusushintshe umqondo wawo. Ngabelethisa ingane yabo ezinyangeni eziyisikhombisa kamuva.

“Eminyakeni ethile kamuva, ngadlala noJeffrey omncane edanyini lokubhukuda okwakuhlangene kulo iqembu lethenisi mina nabazali bakhe esasingamalungu alo. Wayejabule futhi emuhle. Kwangihlasimulisa ukucabanga ukuthi kwakuyisithiyo esingokobuchwepheshe kuphela esasingivimbele ekuqedeni ukuphila kukaJeffrey okwakuzovela. . . . Ngikholelwa ukuthi ukuhlukanisa phakathi umbungu owakhekile, ilunga kwelinye ilunga, ngenxa nje yesicelo sikamama, kuyisenzo sokonakala umphakathi okungafanele usivumele.”

Umhlengikazi othile owayeka ukusiza ekukhishweni kwezisu walandisa ngomsebenzi wakhe emtholampilo wokukhishwa kwezisu: “Omunye wemisebenzi yethu kwakuwukubala izingxenye zomzimba womntwana. . . . Uma intombazane ibuyela ekhaya nezingxenye zomntwana zisesesizalweni sayo, kungase kube nezinkinga ezingathi sína. Ngangizithatha lezingxenye futhi ngizihlole ngokucophelela ukuze ngiqiniseke ukuthi izingalo ezimbili, imilenze emibili, nomzimba, nekhanda kwakukhona. . . . Nginezingane ezine. . . . Kwakunempi enkulu phakathi kokuphila kwami kwasemsebenzini nokuphila kwami komuntu siqu kangangoba ngangingenakukuvumelanisa. . . . Ukukhipha isisu kuwumsebenzi onzima.”