Doğum Ortamının Düzenlenmesi ve Doğumun Fizyolojisini Desteklemede Ebe Önderliğinde Bakım

Öz

Doğum eylemi, kadınların çevresel ve psikososyal etmenler de dahil pek çok faktörlerden kolayca etkilenebildiği oldukça hassas fizyolojik bir süreçtir. Doğum ortamları, doğum fizyolojisini destekleyebilir ya da engelleyebilir. Doğumun gerçekleştiği yerler ev, doğum merkezi ve hastanelerdir. Sakinleştirici ve stresi azaltan bir doğum ortamı, fizyolojik doğumu destekler. Hareket kısıtlaması olan ve mahremiyete önem vermeyen ortam ise kadının kendini ve bebeğini güvende hissetmemesine neden olmaktadır. Bu durumda kadının yaşadığı stres ve anksiyete düzeyi artar. Kadının stres düzeyi arttığında kortizol ve adrenalin artmakta, oksitosin ve beta-endorfin seviyesi azalmaktadır. Bu hormonal döngü doğum eyleminin ilerleyişini durdurmakta ve medikalize doğum ya da sezaryen oranını arttırmaktadır. Ebeler tarafından verilen eğitim ve danışmanlık ile kadınlar, nasıl bir ortamda doğum gerçekleştireceğine kendileri karar verebilmelidir. Ebeler, kadınların kendilerini güvende ve huzurlu hissedebileceği, aynı zamanda doğal doğumu destekleyen doğum ortamlarının oluşturulmasında gerekli destek ve düzenlemeleri yapabilecek yetkinliktedirler. Ebeler, düşük riskli gebeler için doğum fizyolojisini destekleyen uygulamaları doğum ortamlarında kullanılabilir. Bu derlemede, doğum ortamları ve doğumun fizyolojisini desteklemede ebe önderliğinde bakımın önemini belirtmek amacıyla güncel bilgiler ışığında hazırlanmıştır.

Anahtar Kelimeler

• Doğum
• Doğum Ortamı
• Doğum Fizyolojisi
• Ebelik Bakımı

Midwife-Led Care in Arranging the Birth Environment and Supporting the Physiology of Birth

Öz

Labor is a highly sensitive physiological process during which women can easily be affected by many factors, including environmental and psychosocial factors. The physiology of labor can be supported or hindered by birth environments. Places where birth takes place include homes, birth centers, and hospitals. A calming and stress-reducing birth environment supports physiological birth. An environment restricting movements and ignoring privacy causes the woman to feel insecure about herself and her baby. In such situation, there is an increase in the woman’s level of stress and anxiety. When a woman's level of stress increases, there is an increase in cortisol and adrenaline levels and a decrease in oxytocin and beta-endorphin levels. This hormonal cycle ceases the progression of labor and increases rates of medicalized birth or cesarean section. The training and counseling provided to women by midwives should be able to help them decide what kind of environment they want to give birth in. Midwives are competent to provide the necessary support and arrangements to create birth environments where women can feel safe and peaceful and also support natural childbirth. Midwives can use practices that support the physiology of labor in birth environments for women with low-risk pregnancies. This review was prepared in light of current knowledge to indicate the importance of birth environments and midwife-led care in supporting the physiology of birth.

Anahtar Kelimeler

• Birth
• Birth Environment
• Physiology of Birth
• Midwifery Care

Kaynakça

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