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Kabanata 3: Paunuri
1. Ano ang Pagpapaanak? Ang panganganak o pagluluwal ay ang wakas ng panahon ng pagdadalantao ng isang babae. Ang isang babaeng tao ay maaaring magluluwal ng isang sanggol or mahigit sa isang sanggol. Sa Amerika, ang pinakamaraming nailuwal na buhay na sanggol sa isang pagbubuntis ay walo sa paraan ng paghiwang sesaryano noong 2009. May tatalong yugto ang pagluluwal sa bata: ang pag-ikli at pagluwang ng sipit-sipitan, pagbaba at paglabas ng sanggol, at ang pagsilang sa inunan. Ang pagsisilang ay may dalawang pamamaraan, tradisyonal o moderno. 3. Ano-ano ang mga paraan ng tradisyunal na pagpapaanak? Ang tradisyonal na pamamaraan ay ang natural na panganganak sa bahay sa tulong ng hilot.Ang panganganak sa bahay ay isang magandang karanasan. Dito nakapaligid ang mga tao na mahalaga at kilala ng isang ina sa sarili niyang bahay. Ang ina mismo ang nagdedesisyon tungkol sa kanyang panganganak sa tulong ng isang hilot. Walang gamot na binibigay. Ngunit, ito lamang ay maaaring gawin kung ang pagbubuntis ng ina ay walang komplikasyon. Dapat din malaman ng hilot ang plano ng isang ina upang kung magkaroon ng problema siya ay madadala kaagad sa malapit na ospital. Ayon kay Barett (2008) isa pang paraan ang pamamaraan ng pagsilang depende sa posisyon ay ang natural na panganganak sa kama ng ospital, natural na panganganak sa isang silya, natural na panganganak sa mainit ng tubig. Ang natural na panganganak sa kama ay ang karaniwang paraan na ginagawa sa mga ospital sa tulong ng mga doktor or kumadrona. Walang gamot na binibigay sa ina at siya lamang ay tinutulungan sa paglabas ng sanggol. Ang sanggol ay naitatabi kaagad sa ina at siya ay maagang nakakapagpasuso. Sa pangalawang paraan ng panganganak, ang ina ay nakaupo sa isang silya o “bean Bag” sa natural na panganganak sa isang silya. Ito ay isang paraan na ginagwa sa ibang mga lugar upang maayos at madaling mailabas ang sanggol. Ang natural na panganganak sa mainit na tubig ay hindi karaniwang paraan ng panganganak ngunit ngayon marami ng inang gusto itong gamitin. Ang ospital ay mayroong “birthing tub”. Kapag nagsimula ang hilab ng tiyan ng isang ina, siya ay papasok sa “tub” na may maiinit na tubig (90-100 degrees). Kapag malapit ng manganak ang isang ina pwede siyang manganak sa ilalim ng tubig o sa ibabaw ng tubig. Ang panganganak sa tubig ay nakapagbabawas ng nerbiyos ng isang ina, paglambot ng mga kalamnan at malaki ang magagalawan niya. Ang bata ay lumalangoy sa loob ng sinapupunan ng isang ina ng siyam na buwan at siya ay hindi maninibago sa paglabas niya sa tubig. Paglabas ng sanggol sa ina siya ay kaagad iaahon sa tubig upang huminga. Ngunit itong paraang ito ay hindi maaari kung ang sanggol ay suhi, kambal o higit sa isa ang pagbubuntis o may ibang komplikasyon ang pagbubuntis ng isang ina. 4. Ano-ano ang mga paraan ng modernong pagpapaanak? Ayon sa Birthing Options: 5 Ways to Give Birth. (2010) may iba’t ibang pamamaraan ng pagsisilang sa modernong panahon. Una ang pagsilang, sa tulong ng mga gamit tulad ng mga “forceps” at “vaccum”. Maaari rin manganak sa tulong ng anestisya (epidural or lokal). Ang ina ay binibigyan ng gamot upang mabawasan ang sakit sa panganganak. Sa epidural anestisya ang isang ina ay gising at siya ay makakatulong sa panganganak. Ang lokal na anestisya ay binigay upang hindi maramdaman ng ina ang paggupit sa daanan ng bata sa natural na panganganak. Ang ina ay gising at siya ay tumutulong sa pagluwal ng sanggol. Ang paghiwang sesaryano ay isang paraan ng panganganak na hihiwa ang doktor sa tiyan at matres ng isang ina upang mailabas ang isang sanggol. Matagal gumaling ang isang ina sa ganitong paraan. Ito lamang ay dapat gawin kung ang ina ay nasa panganib sa panganganak ng natual , may mga komplilasyon sa ina at sanggol. Ang “hypno birth” ay gumagamit ng hypnotisimo upang makayanan ng isang ina ang sakit sa panganganak na walang gamot. Ayon sa mga experto, ang panganganak ay isang normal na proseso at ang ating katawan ay walang problema kung kaya’t ang sakit na nararamdaman ng isang ina ay isang sikolohikal na epekto ng paghilab ng katawan. Ang ina ay tinuturaan ng “self-hypnosis” at kontroladong paghinga. Ang proseso sa pagsasaayos ng pag-iisip ng ina ay makakatulong sa pagbawas sa sakit at hindi paggamit ng mga gamot.
2. Ano-ano ang panganib na dulot ng maling proseso ng pagpapaanak?
Ayon sa DOH, ang panganganak ay isang delikadong proseso dahil marami itong mga komplikasyon sa ina at sa sanggol. Ang kasabihan ay ang isang paa ng ina ay nakalubog sa kanyang libingan tuwing siya ay manganganak. Sa Pilipinas noong 2009, mayroong 8,043 na sanggol ang namatay sa panganganak at 1,599 na ina ang namatay sa pangnganak. Ayon kay Bastia, Keirse, Lancaster, (1998) ang komplikasyon sa panganganak ay maaari dahil sa ina, sa sanggol, ito ay maaaring panandalian or pangmatagalan. Ang mga komplikasyon sa ina ay ang pagsira ng daanan ng sanggol. Sa pagsira ng daanan ng sanggol maaaaring masira ang mga laman at ugat sa tabi ng daana n ng panganganak na magdudulot ng paghirap sa pagihi o pagdumi matapos manganak. Ang impeksyon ay maaari ring magdulot ng komplikasyon sa isang ina na nanganak. Ang matinding pagdurogo ay ang unang dahilan kung bakit maraming ina ang namamatay sa pangangank. Ang mga komplikasyon sa isang sanggol ng pangangank ay maaring inpeksyon sa tagal ng panganganak o kung kulang sa buwan ang sanggol. Ayon kay Weber (1996) ang pagiging malaki ang isang sanggol ay maaring magdulot ng pagkasira ng ugat ng bata. Ang isang sanggol ay maaari din mamatay kung kulang sa buwan at kung nagkulang ng oxygen ang sanggol habang siya ay pinapaanak.

Kabanata 4: Sanggunian
12 Ways to Give Birth. 2012. Binasa noong March 10, 2014 mula sa http://www.babyzone.com/pregnancy/labor-and-delivery/ways-to-give-birth_95292#gallery/medicated-birth
Advantages and disadvantages of birthing at home, birth center, and hospital. Binasa noong March 11, 2014 mula sa http://www.houstonnaturalbirth.com/adv_homebirth.shtml.
Birthing Options: 5 Ways to Give Birth. 2010. Binasa noong March 11, 2014 mula sa http://www.sofeminine.co.uk/childbirth/birthing-options-d15171c225302.html
Barrett, Lisa. 2008. Homebirth vs hospital: statistics to die for. Binasa noong March 10, 2014 mula sa http://www.homebirth.net.au/2008/06/homebirth-vs-hospital-statistics-to-die.htm
Philippine Beliefs on Pregnancy. 2011. Binasa noong March 11, 2014 mula sa http://philippines-events-culture.knoji.com/philippine-beliefs-on-pregnancy/
Weber, S.E. (1996). “Cultural aspects of pain in childbearing women”.. Binasa noong March 14,2014 mula sa Journal of Obstetrics, Gynecologic, & Neonatal Nursing 25 (1): 67-72, doi:10.1111/j.1552-6909.1996 tb02515 PMID 8627405
Bastian, H. Keirse, M.; Lancaster, P. (1998).”Perinatal death associated with planned home birth in Australia:population based study”. Binasa noong March 14,2014 mula sa Department of Health – Republic of the Philippine www.doh.gov.ph/

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