Unyaka ngamnye eUnited States, abantwana abaselula abangama-750,000 bakhulelwa, kwaye ezininzi zezi khulozo azicetywanga. Ukuze ulawulo lokuzalwa lusebenze kakuhle, abatsha badinga ukhetho abanokulusebenzisa kalula. Abaselula banokuthi baqhubeke besebenzisa iindlela zendlela yokukhusela ezininzi, ezifana ne- IUD yokuzalwa okanye iNxplanon . Abo bafana abasebenzelana ngokwesondo kwaye basebenzise ukulawulwa kokuzalwa bavakalisa ukusetyenziswa okungahambelaniyo.
Oku kuye kwabangela i-American College of Obstetricians kunye ne-Gynecologists (ACOG) ukuba iqwalasele ukuba ngaba kunenzuzo ukunika ulawulo lwe-IUD okanye iNxplanon yabaselula.
Ngokudabukisayo, uphando olutsha lwase-United States lubonisa ukuba abatsha bayazi ulwazi oluncinane malunga nee-IUDs. Olunye uphando olunamantombazana angama-72 phakathi kweminyaka eyi-14 ukuya kwe-18 lubonise ukuba nangona ama-74 ekhulwini asebenzisa ukulawulwa kokuzalwa, kuphela i-19 ekhulwini ewake yakuva nge-IUDs. Emva kokufundiswa kulawulo lwe-IUD, abaninzi abaselula bathi bawuthanda ukuba i- use ye-IUD :
- Akuzange kubonakalise kakubi kamva
- Imfuneko yokusetyenziswa kwansuku zonke
- Akuzange kudingeke ngesenzo ngasinye sesini
- Wayengumntu oyingqondi
Abaselula kufuneka bafundiswe ekusebenzeni okuphezulu kweendlela zokukhusela ezinokuthi zenzeke ixesha elide ezifana nokulawulwa kwe-IUD, kwakunye ne-Nexplanon.
Ziziphi iidolophu eziCetyisayo
I-ACOG isanda kuhlaziya i-Practice Bulletin yayo yokujongana nesidingo sokwenza iindlela zokukhusela ezithatha ixesha elide ezilungiselelwe abantwana.
Ngokutsho kwe-ACOG, i-Nexplanon kunye nokusetyenziswa kwe-UUD yokusetyenziswa kokuzalwa kunokunceda intsha. Nangona ezi zikhokelo zikhokelo ezintsha, ukusetyenziswa kwangempela kokufaka ii- IUD kunye ne-Nexplanon kwintsholongwane ayikho. Intsha eninzi isele ibonelelwe ngolu hlobo lokulawulwa kokuzalwa, ngoko ke izikhokelo zendlela yokusebenza ziye zafikelela ekugqibeleni into eyenziwa yintlalo yonyango iminyaka.
IUD Ulawulo Lokuzalwa Usetyenziso Kubantwana Abaselula
I-ParaGard , i- Skyla , i- Kyleena , ne- Mirena - ezi ze-IUD zihlelwa phantsi kweSigaba 2 se-US Criteria for Eligibility Criteria yoNcedo lokuLawula . Oku kuthetha ukuba iinzuzo zokusebenzisa le ndlela yokukhusela ngokubanzi zigqithise kakhulu ingozi. Ukusetyenziswa kwe-IUD kuye kwafumanisa udidi olu-2 ngenxa yenkxalabo ethile malunga nomngcipheko wokuxoshwa (xa i-IUD ingenayo okanye ikhutshwe ngokupheleleyo kwisibeleko), engabangelwa yi- nulliparity (engazange izalwe ), kunye ne- STI ingozi ukusuka indlela yokuziphatha ngokwesondo ebonakalayo kumaqela amancinane. Ukusetyenziswa kwe-Nexplanon kwishumi elivisayo kufumene uluhlu lweCandelo 1 - oku kuthetha ukuba akukho mqobo yokusetyenziswa kolawulo lokuzalwa.
Oko kuthethwa nguPhando
Ngelishwa, kukho iincwadi ezincinci kwi-Nexplanon okanye kwi-IUD ekusebenziseni ulawulo lokuzalwa kwabantu, ngoko ke uphando oluninzi lufunekayo ukuze kube ngcono, iziphumo ezingaphezulu. Oko kuthethwa, ezinye izifundo zikhoyo, kwaye iziphumo zazo zithembisayo.
Ukuhlaziywa okujonge ekujongeni kwe-IUD kwintsholongwane kufumene ukuba amazinga okuxoshwa ahlala ngokubanzi-ukusuka kumahlanu ukuya kuma-22 ekhulwini. Ezi ntlawulo zingahle zilahlekise ngenxa yokuba amaxabiso abonakala echaphazelekayo ngeminyaka yakho kwaye nokuba awuzange ukhulelwe okanye awuzange ukhulelwe.
Ngaphezulu, uphando olukhoyo lubonisa iziphumo ezingahambelaniyo. Ngokomzekelo, uphando oluthile lubonisa ukuba abasetyhini abangakaze bazalwe banamaxesha amaninzi okuxoshwa kwe-IUD, ngelixa ezinye iingcaphephe zibonisa ukuba abo banikezele ingxelo yokuzala baphakamileyo amazinga okuxoshwa. Akukho nanye kwezi zifundo ziqwalasele indlela ukudibanisa ngayo iminyaka kunye nokukhulelwa kwimbali kunokushukumisa iziphumo.
Abaselula banokuthi baqhubeke nokusetyenziswa kwe- IUD yokuzalwa kokuzalwa kunezinye iindlela. Inani labaselula abasalisebenzisa i-IUD kwiminyaka eli-1 liphezulu (ukususela kuma-48 ukuya kuma-88 ekhulwini), kwaye i-IUD yabo isebenzise ngokuthe gqithwa kwexesha.
Abaselula bayaqhubeka nokusebenzisa i-IUD kwisilinganiso esifanayo okanye nangaphezulu kunabantwana abasebenzisa iipilisi zokulawula ukuzalwa .
Ukuqhekeza kwakungavamile nakubantu abaselula abalawula ukuzalwa kwe-IUD. Olunye uphando olulinganisa nokukhulelwa kwentsha lufumene ukuba (emva kweenyanga ezingama-24 zokusetyenziswa okuqhubekayo), abatsha basebenzisa ubhedu i-IUD (ParaGard) babecelwa ukuba bangakhulelwa, ngelixa iipesenti ezintathu zabasebenzisi beepilisi zokukhulelwa kwabazali abasakhulayo bakhulelwa. Olunye uphando lubonise ukuba ukukhulelwa kwentsha kubangelwa kwipesenti ezimbini emva kweenyanga ezintandathu ze-IUD zisebenzisa kwi-11 ekhulwini kwiinyanga ezingama-48 zokuba i-IUD.
Enye inkxalabo yokugqibela eyenziwa nguphando malunga nokusetyenziswa kwe-UUD lokulawula ukuzalwa kwabafundi kwintlungu. Ucwaningo luye lwabonisa ukuba ubuhlungu okanye ubunzima bokufakwa kwe-IUD kukuba yinkxalabo ebantwini. Oku kungenzeka kuba umntwana osemva akazange abelethe ngaphambili. Kukho izenzo oogqirha abanokuzithatha ukuze bancede ukuphucula ezinye zeentlungu, kodwa ezi ndlela azizange zibonakaliswe ukuba zihlala zibonelela ukuphucula intlungu ngexesha lokufaka i-IUD. Ii-IUD ezintsha ze-Iike Skyla kunye ne-Kyleena zinama-tubes amancinci angenayo, ngoko ukufakela intlungu kunokungaphantsi kwezi zikhetho.Ukukhangela kwakhona uye wabonisa ukuba intlungu kunye nokuphuma kwegazi zizathu eziqhelekileyo kubaselula ukuba banqunywe i-ParaGard IUD. Olunye uphando lubonise indlela abaninzi abasebenzisi be-IUD abaselula bekhalaza ngemicimbi yokuphuma kwegazi kunokuba abasebenzisi beepilisi abaselula.
Uphando nge-Teenage Nexplanon Usetyenziso luye lukhulu ngakumbi
Ngo-2010, isifundo sasiqhutyelwe kuma-137 abaselula (abaneminyaka eli-12 ukuya kwe18 ubudala) ababeza kuzalwa. Wafanisa ukunyamezela, ukuqhubeka, nokuphindaphinda amazinga okukhulelwa kwabaselula abasebenzisa i-Implanon, iipilisi zokulawula ukuzalwa , i- Depo Provera , iindlela zokukhawulela (ezifana neikhondom kunye ne- spermicide ), okanye akukho nto.
Kwiinyanga ezingama-24, iipesenti ezingama-35 zentsholongwane zazikhulelwe kwakhona. Abasebenzisi baseNtshonalanga yeNxplanon bakhulelwa kamva kunamanye amaqela okulawula ukuzalwa (ngokuphindaphinda kokukhulelwa kwiinyanga ezingama-23.8, xa kuthelekiswa neenyanga ezili-18.1 kwiqela lepill / depo kunye neenyanga ezili-17.6 zokukhawulela / akukho iqela elinye). Abasebenzisi be-Implanon nabo banokuthi baqhubeke nokusebenzisa i-Implanon kwiinyanga ezingama-24 kune-tablet yebill / abasebenzisi be-depo.
Kuloo mfana owayenayo iNxplanon isuswe ngaphambi kweenyanga ezingama-24 zokusetyenziswa, ama-40 ekhulwini athi ukuphuma kwegazi okungavamile kwakuyisizathu sokuyeka. Oko kuthethwa, abaphandi baphetha ukuba abatsha abagqibayo ukusebenzisa i-Nexplanon abanamathuba amaninzi okukhulelwa kwaye bafunyaniswa ukuba banamathele kule ndlela yokulawula ixesha elide kunabo abo bakhetha ezinye iindlela zokukhusela.
Uhlalutyo lokugqibela
Nangona iincwadi ze-Nexplanon kunye ne-IUD zokulawula abantwana abazinqongophala kakhulu, izifundo ezikhoyo zibonisa ukuba ii-IUD ezifana neMirena, Skyla, Kyleena, kunye ne-ParaGard, kwakunye ne-Nexplanon, zizinto ezikhethekileyo zentsholongwane namhlanje. Ukukhuthazwa kokusetyenziswa kwentombazana yeendlela zokulawula ukuzalwa kokuthatha ixesha elide kunokuncedisa ukunciphisa inani lokukhulelwa okungaphantsi kwentsha. Inombolo ephakamileyo yabaselula abanamathele kwi-Nexplanon yabo kunye ne-IUD isebenzisa ithemba, kwaye abatsha banokuthi bavumelane nale ndlela yokulawula ukuzalwa.
Izikhokelo zoqulunqo ezidalwe yi-ACOG zibonisa ukuba ii-IUD kunye ne-Nexplanon kufuneka zicetyiswe kubaselula njengendlela yokulawula ukuzalwa. Iintlobo kunye neenzuzo zeParaGard, iMirena, Skyla, kunye / okanye uKyleena kwintsholongwane ngokuqhelekileyo ukucutha ingozi, kwaye akukho mingcipheko ekusebenziseni i-Nexplanon kulutsha. Ngenxa yalokhu, kubonakala ukuba ezi zinto ziyimpumelelo kwaye zithembekileyo zokulawulwa kokuzalwa okufuneka zinikezelwe kubaselula abafuna ukukhulelwa kwezalalini kwikliniki yokucwangcisa intsapho okanye iiofisi zedolophu.
Imithombo:
Ikholeji yase-American College of Obstetricians kunye neGynecologists. "Yenza i-Bulletin # 121 - Ukukhulelwa okuKhuselekileyo okuPhatha ixesha elide: Izimpembelelo kunye namadivayisi ase-Intrauterine." I-Obstetrics & Gynecology . Julayi 2011. 118 (1): 184-196.
I-Deans, i-EI, ne-Grimes, i-DA "Izixhobo ze-Intrauterine ze-Adolescents: Uhlolo lokuHlola." Ukukhulelwa . 2009. 79: 418-423.
Lewis, LN, Doherty, DA, Hickey, M., & Skinner, SR "Implanon njengoKhetho lokuNyundela kwabaNina abaselula: Ukuthelekiswa kweeNyunyanzelo zokuKhusela, Ukwamkela nokuPhinda ukukhulelwa." Ukukhulelwa . 2010. 81 (5): 421-426.
Umbutho WezeMpilo Wehlabathi. "Iimpawu zokuLungiswa kweeMpilo zoNyango." Wesi-4. Geneva: WHO; 2009.