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999.. လူေျခာက္ ( Stillbirth ) ဆိုတာ ( 24.8.10 )

 





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              လူေျခာက္ဆိုတာကေတာ့ဘံုဘ၀တမ်ိဳးမွ သတၱ၀ါမဟုတ္ပါ၊ ခႏၶာငါးပါးရွိသည့္ လူ႔ဘ၀၌ပင္ ဇလာဗုဇ ပဋိသေႏၶေနၾကသူမ်ား ျဖစ္ပါသည္။ ဗုဒၶစာေပအရဆိုေသာ္ ပထမံ ကလလံ ေသာတိ၊ ကလလာ ေဟာတိ အဗၺဳဒံ၊ စေသာ သံယုတ္ပါဠိေတာ္လာအတိုင္း

* အမိ၀မ္းတြင္း ကလကေရၾကည္ တစ္သတၱာဟ (ခုနစ္ရက္တပတ္)။
* အျမွဳပ္ တစ္သတၱာဟ။
* သားတစ္ တစ္သတၱာဟ။
* အခဲ တစ္သတၱာဟ။
* ဦးေခါင္း ေျခလက္ ခက္မငါးျဖာ တစ္သတၱာဟ ျဖစ္၍
* ၄င္းငါးသတၱာဟ (ခုနစ္ရက္ ငါးလီ) အလြန္ သတၱာဟ အနည္းငယ္မွ် ရင့္မာခဲ့ျပီး အမိ၀မ္းတြင္ ကြယ္လြန္ခဲ့ပါသည္။

                    ၄င္း၏အသက္၀ိညာဥ္သည္ ပဋိသေႏၶအစ ကလကေရၾကည္ တည္စကပင္ ျဖစ္ခဲ့ေသာ္လည္း ေဖာ္ျပပါ ငါးသတၱာဟအလြန္ ၁၀၊ ၁၂- သတၱာဟ အတြင္း ေသဆံုး၍ သေႏၶ ၂-လေက်ာ္ ၃-လနီးပါးအရြယ္ လူသားေလာင္း ရုပ္ၾကြင္းသာ အမိ၀မ္းတြင္က်န္ခဲ့ျပီး ကံအားေလ်ာ္စြာ ေပတဘ၀ (ဂႏၶဗၺ ေ၀မာနိကၿပိတၱာ) မ်ိဳးတြင္ ျဖစ္ေလသည္။ (ေရွးဘ၀ ေကာင္မႈအက်ိဳးေၾကာင္႔ သုဂတိဘံုကို ပဋိသေႏၶေတာ႔ ေနခြင္႔ရသည္။ ရွင္သန္ခံစားခြင္႔မရဘဲ ေသသြားရရွာသည္။)

                  အသက္၀ိညာဥ္မဲ့ေသာ သေႏၶသားမွာ ပ်က္က်ရမည္ျဖစ္ေသာ္လည္း တစံုတခုေသာ အေၾကာင္း  ( ဥပမာ-ေတေဇာဓာတ္ လြန္ကဲမႈ)  ေၾကာင့္ ပ်က္က်မသြားဘဲ တျဖည္းျဖည္း ေျခာက္သြားရပါသည္။ ၄င္း ေျခာက္သြားသည္ႏွင့္ ၂-၃ လအရြယ္ ႀကီးေနေသာ အမိ၀မ္းသည္လည္း ျပန္လည္ပိန္ၾကံဳ၍ သြားကာ ေန႔ေစ့ခ်ိန္ (၄၂-သတၱာဟခန္႔ )တြင္ ဖြားျမင္သည္။ ထိုအခါ မရင့္မာမီ အမိ၀မ္းတြင္းမွာပင္ ေသဆံုးေျခာက္ကပ္သြားရ၍ မႀကီးျပင္းႏိုင္ဘဲ ခက္မငါးျဖာ မ်က္စိ နား ႏွာေခါင္း အရာပါရံုမွ် ရွိသည့္ လူသားေလာင္း အေျခာက္ကေလး ( ၄-လက္မအရြယ္ ) မွ်သာ ေမြးဖြားလာခဲ့ရသည္။

             ထိုအခါ၌ ၄င္းလူသားေလာင္းကေလးမွ ဘ၀ေျပာင္း၍ ျဖစ္ေနေသာ ဂႏၶဗၺ (သို႔မဟုတ္) ေ၀မာနိကျပိတၱာမွာ ေလခၽြန္နတ္သူငယ္ ကဲ့သို႔ အသင့္အတင့္တန္ခိုးရွိသျဖင့္ ၄င္း၏ရုပ္ၾကြင္း လူေျခာက္ကေလးကို တြယ္တာစြဲ၀င္၍ ေနလာေလသည္။ ထို႔ေၾကာင့္ ဆိုင္ရာ မိဘစသည္တို႔အား အိပ္မက္ေပးျခင္း၊ အရိပ္အေရာင္ျပျခင္း စသည္ ျပဳလုပ္ႏိုင္ေလသည္။

               အထက္ပါတို႔ကို ေထာက္၍ လူေျခာက္သည္ အသက္ရွင္ျခင္း၊ အာဟာရမွီ၀ဲျခင္း၊ က်င္လည္လႈပ္ရွားျခင္း မရွိ၊ ၄င္းအား မွီတြယ္စြဲ၀င္ေနေသာ ေ၀မာနိက ေပတ၊ ဂႏၶဗၺ၏ သေဘာသဘာ၀ အတိုင္းသာလွ်င္ ျဖစ္ေၾကာင္း မွတ္သားသင့္ပါသည္။ ( အမိ၀မ္းတြင္းတြင္ ေသဆံုးျပီး ေ၀မာနိကေပတ ဂႏၶဗၺ မျဖစ္၊ သို႔မဟုတ္ မွီတြယ္ စြဲကပ္မႈ မရွိ၍ မထူးမျခား အေသအတိုင္း ေမြး၍ စြန္႔ပစ္ရေသာ လူေျခာက္မ်ားလည္း ရွိေသးေၾကာင္း သိရပါသည္။ ၄င္းလူေျခာက္ျပႆနာကို ေဆးပညာ ရႈေထာင့္မွလည္း ေလ့လာသင့္ေသးသည္။)

What is a stillbirth?

Stillbirth is the death of a baby after the 20th week of pregnancy, but before delivery. The baby may have died in the uterus weeks or hours before labor, or during labor.

How common are stillbirths?

About one in every 150 births, or 1% of all births, is a stillbirth.

What causes stillbirths?

The three major causes of stillbirths are:

  • Problems with the placenta and/or umbilical cord. Because the fetus gets its blood, oxygen and nutrients through the placenta and umbilical cord, problems in either will interfere with fetal development.

  • Maternal medical conditions and lifestyle choices. Certain illnesses in the mother, or their treatments, sometimes cause stillbirths. Some of these conditions include chronic hypertension (high blood pressure), preeclampsia, diabetes, lupus, heart or thyroid disease and certain viral or bacterial infections. Older mothers are usually at increased risk for these conditions, as well as for stillbirths. Smoking, drinking alcohol, and using certain recreational drugs during pregnancy are also associated with higher rates of stillbirth.

  • Birth defects. In about one-fourth of stillborn babies, one or more birth defects are responsible for the death. Many are found only after a thorough examination of the baby and an autopsy.

Unfortunately, more than half of stillbirths are unexplained, which only adds to parents' grief.

What happens after a stillborn baby is delivered?

You will be able to hold your baby, and your health care providers will allow you as much time as you need to spend with your child. You may feel uncomfortable with this idea, but it will be a cherished moment at a later time.

Keep and ask for any mementos and keepsakes of your child such as the I.D. bracelet, blanket, or a lock of your child's hair, and take as many pictures as possible. As with holding your baby, this may also be uncomfortable but it may be a cherished possession at a later time and may help you during your grieving process. Most hospitals will issue the family a birth certificate, but make sure you ask so you are sure to get one, and request that it include the baby's hand and footprints.

Test and examinations

The doctor will carefully examine the baby and placenta to check for abnormalities, and parents may be asked to consent to an autopsy and other studies. In most cases, a blood sample will be taken from the baby and tested for chromosomal abnormalities.

The doctor will also review medical records and the circumstances surrounding the stillbirth.

How can I find out what caused my baby to be stillborn?

Pending your consent, an internal examination (autopsy) can be performed to determine the cause of your baby's death. An autopsy is a surgical procedure performed by a skilled pathologist. Incisions are made to avoid any disfigurement. The incisions are surgically repaired in the usual way. A doctor can explain the procedure in more detail. You have the right to limit the autopsy to eliminate any incisions on your baby that are not comfortable for you (for instance, you can give instructions that no incisions are to be made on the baby's head). Be sure to write these requests on the autopsy permission form.

Some hospitals do not perform their own autopsies, so your baby may have to be transported to another hospital. Be sure you feel comfortable about where your child is being taken.

You have the right to deny an autopsy, if this is your wish.

An autopsy is legally required when:

  • A baby has died within 24 hours of a surgical operation
  • A doctor cannot certify the cause of death
  • A baby has lived (defined as "drawing breath") and died suddenly

What physical symptoms will the mother have after delivering a stillborn baby?

If you have heavy bleeding, fever, chills or pain, contact your health care provider right away. These may be signs of an infection.

After the delivery of the placenta, the milk-producing hormones will be activated. Please talk to your health care provider about your options to stop lactation.

Can a stillbirth be prevented?

Usually a stillbirth cannot be prevented and often occurs because the baby's development was not normal.

Sometimes, treatment of a mother's illness can improve the chances for a successful pregnancy.

Is a funeral necessary?

After the death of your baby, one of the first decisions you will be faced with is whether or not you need to arrange a funeral.

The type of arrangements you make may play an important role in the grieving process. It is a decision that only you and your partner can reach together. You may find that you need time to make your decisions and arrangements. It is quite common for families to take up to a week (and sometimes longer) to make arrangements. This is okay.

No matter what your choice is, you have the right to change your mind " be sure you ask whoever is carrying out your arrangements just how long you have to make any changes.

How to communicate with your other children?

You may find your surviving children are a comfort, a worry or just too hard to deal with. These are normal reactions. Take time to grieve and say goodbye to the child you lost. You will eventually feel more normal feelings for your living children, and the bond you have with them may become even stronger because of this experience.

No matter how much you may want to shelter your children from pain, they can sense the emotion around them. Honesty is the best way to help your children cope with this painful experience. Children have a different understanding of death at different developmental stages. Help them to understand as much as they are able, but don't forget that they usually interpret what they're told very literally.

Can I get pregnant after I've delivered a stillborn baby?

Yes. Most women who deliver stillborn babies have subsequent normal pregnancies and births. If the stillbirth was caused by a malformation or umbilical cord problem, the chances of recurrence in a subsequent pregnancy are minimal. If the cause was a chronic maternal illness or a genetic disorder, the risk is somewhat higher. On average, the chance that a woman's next pregnancy will result in stillbirth is about 3%, which means the majority of post-stillbirth pregnancies result in healthy births.

Taking time to heal both physically and emotionally after delivering a stillborn baby is important. Regardless of the stage of pregnancy during which your loss occurred, you are still a mother or father and the life you nurtured was real. Above all, don't blame yourself. Give yourself time to grieve and accept your loss. Counseling is available to help you cope. Pregnancy loss support groups may also be a valuable resource to you and your partner. Ask your health care provider for more information about counseling and support groups.

Discuss the timing of your next pregnancy with your health care provider to ensure that you are physically ready to begin a new pregnancy. Some health care providers recommend waiting a certain amount of time (from 6 months to 1 year) before trying to conceive again. Some studies have shown that women who wait for at least one year to conceive may have less depression and anxiety during a subsequent pregnancy.

Statistics show that about 60% of couples take up to 6 months to conceive and another 30% take up to 12 months after delivery of a stillborn baby. Don't be surprised if things don't happen quickly.


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