Chaka chilichonse ku United States, achinyamata pafupifupi 750,000 amatenga pakati, ndipo ambiri mwa amayiwa sali okonzedwa. Kuti njira yolerera ikhale yothandiza, achinyamata amafuna zosankha zomwe angagwiritse ntchito mosavuta. Achinyamata amatha kupitiriza kugwiritsa ntchito njira zothandizira njira zowalera , monga IUD njira yolerera kapena Nexplanon . Achinyamata amene ali ndi kugonana ndikugwiritsa ntchito njira zoberekera amaonetsa ntchito yosagwirizana.
Izi zachititsa American College of Obstetricians ndi Gynecologists (ACOG) kuganizira ngati ndizopindulitsa kupereka malamulo oletsa kubadwa kwa HIV kapena Nexplanon kwa achinyamata.
N'zomvetsa chisoni kuti kafukufuku wa achinyamata a ku United States akusonyeza kuti achinyamata amadziwa zambiri zokhudza ma IUD. Kafukufuku wina wa atsikana 72 a zaka zapakati pa 14 ndi 18 anawonetsa kuti ngakhale 74 peresenti anali kugwiritsa ntchito njira yolerera, 19 peresenti yokha anali atamvapo za IUDs. Ataphunzitsidwa pa kulamulira kwa birth, achinyamata ambiri adanena kuti adakonda kuti ntchito ya IUD :
- Sitinavulaze pambuyo pake kubereka
- Amafuna kugwiritsa ntchito tsiku ndi tsiku
- Sizinali zofunikira pachithunzi chilichonse
- Anali wanzeru
Achinyamata amafunika kuphunzitsidwa pazomwe zimapangidwira njira zowonetsera njira zowonongolera nthawi yaitali monga momwe IUD akulamulira, komanso Nexplanon.
Zimene Madokotala Akulongosola
ACOG yangobwereza machitidwe ake okhudzana ndi njira zothandizira njira zothandizira achinyamata.
Malingana ndi ACOG, Nexplanon ndi IUD kugwiritsa ntchito njira zowonetsera kubereka zingathandize achinyamata. Ngakhale kuti izi zimayendera ndondomeko, njira yeniyeni yowonjezera ma IUDs ndi Nexplanon ali achinyamata si. Achinyamata ambiri apatsidwa kale njira zothandizira kulera, choncho njira zowonjezera zakhala zikugwirizanitsa ndi zomwe achipatala akhala akuchita kwa zaka zambiri.
IUD Kudzisamalirako Kugwiritsa Ntchito Achinyamata
ParaGard , Skyla , Kyleena , ndi Mirena - ma CD awa amagawidwa pansi pa Gawo 2 la US Medical Eligibility Criteria kwa Kugwiritsa Ntchito Kulera. Izi zikutanthauza kuti ubwino wogwiritsira ntchito njira za kulerazi umaposa zoopsa. Kugwiritsira ntchito mankhwalawa kwalandira chigawo chachiwiri chifukwa chodera nkhaŵa chifukwa cha chiopsezo cha kuthamangitsidwa (pamene chifuwachi chimachokera pachiberekero), chomwe chingayambitse nulliparity ( osabereka ), komanso matenda opatsirana pogonana kuchokera ku khalidwe lachiwerewere lachiwerewere lomwe liri laling'ono. Kugwiritsiridwa ntchito kwa Nexplanon achinyamata kumalandira mndandanda wa Gawo 1 - izi zikutanthauza kuti palibe choletsa kugwiritsa ntchito njira yoletsa kubereka.
Zimene Kafukufuku Amanena
Tsoka ilo, pali mabuku ochepa pa Nexplanon kapena IUD ogwiritsira ntchito kulera ana mwachinyamata, kotero kufufuza kwina kumafunika kuti zikhale bwino, zotsatira zowonjezereka. Zomwe zikunenedwa, maphunziro ena alipo, ndipo zotsatira zawo zimalonjeza.
Kufufuza mozama ndikuyang'ana pa ntchito ya IUD m'masewera anapeza kuti kuthamangitsidwa kwachulukirapo kwakukulu - kuyambira asanu mpaka 22 peresenti. Mitengo iyi ikhoza kusokoneza pang'ono chifukwa mitengoyo ikuwoneka kuti ikukhudzidwa ndi msinkhu wanu komanso ngati simunakhalepo ndi mimba kapena ayi.
Ndiponso, kufufuza komwe kulipo kumasonyeza zotsatira zosagwirizana. Mwachitsanzo, kafukufuku wina amasonyeza kuti akazi omwe sanabereke ali ndi zochitika zambiri za kuchotsedwa kwa IUD, pamene kafukufuku wina akusonyeza kuti omwe apereka chilolezo cha kubala apamwamba kwambiri. Palibe mwa maphunziro awa omwe adalingalira momwe kuyanjana kwa zaka ndi mimba yakale mwina zakhudza zotsatira.
Achinyamata amakhalanso ndi mwayi wopitiliza kugwiritsa ntchito njira zothandizira kulera ana kusiyana ndi njira zina. Chiwerengero cha achinyamata omwe akugwiritsabe ntchito IUD pa chaka chimodzi chiri chapamwamba (kuyambira 48 peresenti mpaka 88 peresenti), ndipo ntchito yawo ya IUD imagwiritsira ntchito kuchepa pang'ono.
Achinyamata akupitiriza kugwiritsa ntchito mankhwalawa pogwiritsira ntchito mlingo womwewo kapena ngakhale motalikira kuposa achinyamata omwe amagwiritsa ntchito mapiritsi oletsa kubereka .
Mimba inalinso yachilendo pakati pa ogwiritsira ntchito njira zothandizira ana omwe ali ndi HIV. Kafukufuku wina woyerekeza mimba ya mimba yocheperapo yachinyamata imapezeka kuti (patapita miyezi 24 yogwiritsiridwa ntchito), achinyamata omwe amagwiritsa ntchito mkuwa wamtunduwu (ParaGard) adanena kuti alibe mimba, pamene ana atatu pa 100 aliwonse omwe amagwiritsa ntchito mapiritsi akubereka amakhala ndi pakati. Kafukufuku wina anapeza kuti chiwopsezo cha mimba ya atsikana chidayamba kuchoka pa awiri peresenti pambuyo pa miyezi isanu ndi umodzi ya ntchito ya IUD mpaka 11 peresenti pa miyezi 48 yokhala pa IUD.
Chomaliza chodetsa nkhaŵa kuti kafukufuku wasonyeza za kugwiritsira ntchito njira zothandizira ana kuti azitha kulera ana akuvutika. Kafukufuku wasonyeza kuti kuika kwachisoni kapena kovuta kuyimika kwadongosolo ndilo vuto lalikulu kwa achinyamata. Izi zikhoza kukhala chifukwa mnyamatayo sanaberekepo kale. Pali zochitika zimene madokotala angatenge kuti athandize zowawa zina, koma njira izi sizinatsimikizidwe kuti zimapereka chithandizo cha kupweteka panthawi yolemba. Zida Zatsopano Zomwe Iike Skyla ndi Kyleena ali nazo zing'onozing'ono zowonjezera ma tubes, kotero kupweteka kwambiri sikungakhale kochepa ndizimene mungasankhe.Zowonjezera zasonyeza kuti kupweteka ndi kukhetsa magazi ndi zifukwa zambiri zomwe achinyamata amachotsera ParaGard IUD yawo. Kafukufuku wina adawonetsa momwe ogwiritsira ntchito IUD achinyamata ambiri amadandaula ndi mavuto otha magazi kusiyana ndi ogwiritsa ntchito mapiritsi achinyamata.
Kafukufuku pa Matenda a Achinyamata Osagwiritsa Ntchito Ndi Ochepa Kwambiri
Mu 2010, phunziro linachitidwa pa 137 achinyamata (zaka 12-18) amene adangobereka kumene. Iwo ankafanizira kuleza mtima, kupitiriza, ndi kubwereza chiwerengero cha mimba mwa achinyamata omwe amagwiritsa ntchito Implanon, mapiritsi ophatikizira odwala, Depo Provera , njira zothetsera (monga makondomu ndi spermicide ), kapena palibe.
Pa miyezi 24, achinyamata 35 pa 100 aliwonse adakhalanso ndi pakati. Ogwiritsa ntchito achinyamata a Nexplanon anayamba kukhala ndi pakati patapita nthawi kusiyana ndi magulu ena oletsa kubereka (pokhala ndi kachilombo koyamba pa miyezi 23.8, poyerekeza ndi miyezi 18.1 ya mapiritsi / gulu la depo ndi miyezi 17.6 chifukwa choletsa / palibe gulu). Ogwiritsira ntchito Implanon amatha kupitiriza kugwiritsa ntchito Implanon pa miyezi 24 kusiyana ndi ogwiritsa ntchito mapiritsi / achinyamata.
Mwa achinyamata omwe anali ndi Nexplanon atachotsedwa miyezi isanu ndi iwiri isanafike, 40 peresenti adanena kuti kutuluka mwadzidzidzi kunali chifukwa chawo chokhalira. Izi zanenedwa, ochita kafukufukuwo adatsimikiza kuti achinyamata omwe amasankha kugwiritsa ntchito Nexplanon sakhala ochepa kwambiri kuti atenge mimba ndipo amapezeka kuti amamatira njira yoletsa kubereka imeneyi kuposa omwe adasankha njira zina zothandizira.
Kusanthula Kwambiri
Ngakhale kuti mabuku a Nexplanon ndi a IUD akuletsa achinyamata akusowa, maphunziro omwe akupezeka amasonyeza kuti ma IUD monga Mirena, Skyla, Kyleena, ndi ParaGard, komanso Nexplanon, ndizo zothandiza achinyamata masiku ano. Kulimbikitsa kugwiritsira ntchito njira zothandizira kubereka kwa nthawi yaitali kungathandize kuchepetsa chiwerengero cha mimba yosakonzekera. Chiwerengero chachikulu cha achinyamata omwe amamatira ku ntchito yawo ya Nexplanon ndi IUD akulonjeza, ndipo achinyamata amakhala ovomerezeka ndi njira zowononga.
Malangizo omwe amachitidwa ndi ACOG amasonyeza kuti IUDs ndi Nexplanon ziyenera kuperekedwa kwa achinyamata ngati njira zothetsera kubereka. Mapindu ndi ubwino wa ParaGard, Mirena, Skyla, ndi / kapena Kyleena ali achinyamata nthawi zambiri amathetsa mavuto omwe angakhalepo, ndipo palibe choletsa kugwiritsa ntchito Nexplanon achinyamata. Chifukwa cha izi, zikuwoneka kuti izi ndizowonjezereka komanso zowonjezereka zowononga zokhudzana ndi kubereka zomwe ziyenera kuperekedwa kwa achinyamata omwe akufuna njira za kulera pazipatala za kulera kapena maofesi a dera.
Zotsatira:
Kalasi ya Amerika Yotsutsa Amayi ndi Amuna a Gynecologists. "Muzigwiritsa Ntchito Bulletin # 121 - Kuchita Kubereka Kotheka Kwambiri Kuyambira Kale: Implants ndi Devotuterine Devices." Zovala zamaliseche & Gynecology . July 2011. 118 (1): 184-196.
A Dean, EI, & Grimes, DA "Zida Zogwiritsira Ntchito Pakati pa Achinyamata: Kusanthula Mwadongosolo." Kulera . 2009. 79: 418-423.
Lewis, LN, Doherty, DA, Hickey, M., & Skinner, SR "Implanon ngati Njira Yopangira Ana Amayi Achinyamata: Kuyerekezera Zosankha za Kulera, Kulandiridwa ndi Kubwereza Mimba." Kulera . 2010. 81 (5): 421-426.
Bungwe la World Health Organization. "Njira Zogwiritsira Ntchito Zamankhwala Zovomerezeka Zogwiritsira Ntchito Kulera." 4th ed. Geneva: WHO; 2009.