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'There was no other way things could have been.' Greenlandic women's experiences of referral and transfer during pregnancy.
Nordic Council of Ministers, Nordic School of Public Health NHV.
Nordic Council of Ministers, Nordic School of Public Health NHV.
Nordic Council of Ministers, Nordic School of Public Health NHV.
2010 (English)In: Anthropology & Medicine, ISSN 1364-8470, E-ISSN 1469-2910, Vol. 17, no 3, 301-13 p.Article in journal (Refereed) Published
Abstract [en]

The World Health Organization (WHO) has stated that referral practices along with midwifery care are a means of heightening the quality of perinatal care and lessening perinatal mortality and morbidity. In 2002, in response to high perinatal mortality and morbidity, a referral system was instituted nationally in Greenland, transferring all at-risk pregnancies to its national referral hospital. Little or no current research has focused on evaluation of the perinatal referral system or on the thoughts, beliefs, opinions and challenges faced by women and Greenlandic families themselves. The aim of this paper is to document how women referred to Nuuk because of at-risk pregnancies narratively constructed self-understanding and defined meaning during their period of separation from family and community; and how they dealt with the challenges they were presented with. Interviews were conducted with women upon their arrival at the national referral hospital and during fieldwork over a one-year period. Narrative framework was used for analysis. Coping theory and narrative theories were the theoretical base for structuring the narratives. Through their narratives, women presented their identities as mothers, community members and caretakers. Acceptance of referral was described as a means of protecting their unborn child and was where women found an inner source of strength to deal with their own anger, joy, anxiety and loneliness. The ability to accept referral was directly connected to their family and community and the support they found therein.

Place, publisher, year, edition, pages
2010. Vol. 17, no 3, 301-13 p.
Keyword [en]
Greenland, the Arctic, qualitative, pregnancy, indigenous people, childbirth
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3780DOI: 10.1080/13648470.2010.526696PubMedID: 21153964OAI: oai:DiVA.org:norden-3780DiVA: diva2:787227
Available from: 2015-02-09 Created: 2015-02-09 Last updated: 2015-02-09Bibliographically approved
In thesis
1. Faces of Childbirth: The Culture of Birth and the Health of the Greenlandic Perinatal Family
Open this publication in new window or tab >>Faces of Childbirth: The Culture of Birth and the Health of the Greenlandic Perinatal Family
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

INTRODUCTION. This dissertation concerns childbirth and its position within the Greenlandic society. It takes a world relational view to health promotion during, focusing on the perinatal family and the importance of the mothers, the child, their families and the local community as equal pieces of a whole.

AIM. The aim of the dissertation is to present new concepts and knowledge concerning the health of the perinatal family in Greenland. It looks holistically at the place of birth with focus on the issue of support of the perinatal family. It seeks to present the perinatal family and its position within the Greenlandic society. It links the changes in health policy with the concepts of family, attitude and community structure. It draws on statistical, historical, anthropological and cultural data within the context of the Greenlandic perinatal family.

METHOD AND MATERIAL. The dissertation is comprised of four studies and uses multidisciplinary methods. Over an eight-year period from 2003 to 2011, narrative interviews and focus groups were collected at four sites in Greenland: Nuuk, Ilulissat, Sisimiut and Tasiilaq. Data included seven focus groups with 35 participants, supplemented with 18 individual interviews of mothers, fathers and Culture Bearers, as well as two literature studies. The mode of conducting focus groups and interviews was based on the principles in the Helsinki Declaration.

RESULTS. The perinatal family’s concepts of safety are often connected directly to access to family and community. Family is perceived as security, and lack of family support and network as insecurity. The concept of family and community is culturally specific and connected to the immediate family, extended family and kin. There is a cultural room for birth in Greenland, where the health of the perinatal family lies in their ability to strengthen the bonds within family, kinship and community networks. The mothers of the study perceived themselves as the bearers of their children; the fathers considered themselves to be the artisans and caregivers for their family; the community, including the extended family, deemed an important support network for the families.

CONCLUSION. It is important to understand the link that exists between traditional and cultural properties and the health of the child within the family. These are elements of the eco cultural pathways that are already integrated within the family interactions and could be a way to strengthen family interaction and health. Families and community support these traditions and in healthy eco cultural exchanges it enhances the child’s role as a health–promoting agent within the family. Greenlandic public health, health promotion programs and the national perinatal guidelines have a physical health focus, but do not address the mental, social and spiritual dimensions of perinatal health. This fragmented way of perceiving and implementing health does not support the relational worldview that is an integral part of the culture of Greenland, and thus many families struggle to exercise choice within the system

Abstract [da]

INDLEDNING. Afhandlingen omhandler fødselen og dets betydning i det grønlandske samfund, idet der anlægges et holistisk sundhedsfremmende syn på den perinatale periode og der fokuseres på vigtigheden af kvinder, børn, deres familier og lokalsamfundet som ligeværdige dele af helheden.

MÅL. Målet med afhandlingen er, at præsentere nye begreber og viden om sundheden om den perinatale familie i Grønland. Der ses holistisk på fødested og dens indflydelse på familiestøtte i den perinatale periode. Afhandlingen tilstræber at præsentere den perinatale familie og dens placering i det grønlandske samfund. Den forbinder ændringerne i sundhedspolitikken med begreberne familie, holdninger og samfundsstruktur. Den bygger på statistisk, historisk, medicinsk-antropologisk og kulturel data inden for rammerne af den perinatale sundhed i Grønland.

METODER OG MATERIALER. Afhandlingen indeholder fire studier som benytter sig af tværfaglige metoder. Der er i en otteårig periode fra 2003 til 2011 gennemført fokusgrupper og individuelle interviews, ligesom der er gennemført to litteraturstudier i samme periode. Det empiriske data er indsamlet fire steder i Grønland: Nuuk, Ilulissat, Sisimiut og Tasiilaq. Syv fokusgrupper med i alt 35 deltagere, er suppleret med 18 individuelle interview med kvinder, fædre og Kulturbærer. De anvendte metoder til gennemførsel af afhandlingens interviews og fokusgrupper er i overensstemmelse med Helsinki-Erklæringen

RESULTATER. For de perinatale familier er begrebet sikkerhed ofte knyttet direkte til familie og samfund. Familien opfattes som sikkerhed, og manglende mulighed for familie støtte og netværk opfattes omvendt som usikkerhed. Begrebet ansvar er for familien og samfundet kulturelt specifikt og er knyttet til den nærmeste familie, udvidede familie og slægtninge. Der findes et ‘kulturelt rum’ for fødsel i Grønland, hvor den perinatale families evne til at styrke båndene indenfor familien, slægtskabet og det lokale netværk er medvirkende til familiens sundhed. Lokalsamfundene, familierne og kvinderne i studierne opfatter sig selv som bærer af deres børn, fædrene opfatter sig som støtteskabende omsorgsgiverer for deres familie, og lokalsamfundet, herunder den udvidede familie, opfatter sig som et vigtigt støttenetværk for familierne.

KONKLUSION. Det er vigtigt at forstå det sammenhæng, der eksisterer mellem traditionelle og kulturelle egenskaber og barnets sundhed i familien. Disse er elementer af de øko-kulturelle stier, der allerede er integreret i familiens samspil og kan være måder hvorved familiens samspil og dens sundhed styrkes. Familierne og samfundet støtter disse traditioner og i en sund øko-kulturudveksling styrker det barnets rolle som sundhedsfremmende agent inden for familien. Grønlandsk folkesundhed, sundhedsfremmende programmer og de nationale perinatale retningslinjer har et fysisk sundhedsfokus, men der tages ikke højde for de mentale, sociale og åndelige dimensioner indenfor perinatal sundhed. Denne opsplittede måde at opfatte og gennemføre sundhed på, understøtter ikke det relationelle verdenssyn der udgør en integrerende del af kulturen i Grønland, hvofor mange familier kæmper for at udøve selvbestemmelse inden for systeme

Abstract [kl]

AALLARNIINEQ. Ilisimatuutut allaatigisap ernineq pillugu imarisaqarpoq, erninerullu kalaallit inuiaqatigiinni pingaaruteqassusia aamma sammineqarluni, erninerup nalaani ataatsimut isiginninnittaaseqarluni aammalu arnat, meeqqat, ilaqutaasa najukkamilu innuttaasut ataatsimoornermi naligiittut isigalugit.

ANGUNIAGAQ. Ilisimatuutut allaatigisami anguniagaavoq, isummat nutaat ilisaritissallugit kalaallillu ilaqutariit meeraalu erninerup nalaani peqqissutsimut ilisimasariaqartut sammineqassallutik. Ilisimatuutut allaatigisap anguniarpaa ilaqutariit ernininerup nalaani ilisaritissallugit aammalu erninerup kalaallit inuiaqatigiinni inissisimanera takutissallugu. Peqqinnissaqarnermi allannguutit eqqarsaatigalugit ilaqutariissuseq, isummersortarneq inuiaqatigiinnilu aqqissuusaaneq sammineqarput. Sumi inunngorsimaneq ataatsimut isiginnittaaseqarluni sammineqassaaq aammalu erninerup nalaanni sumi inunngorsimaneq ilaqutariinnut tunaartaanersoq. Allaaserisami paasissutissat Kalaallit Nunaanni erninerup iluani peqqinnissaqarnikkut tunngasutigut aamma statistikkikkut, oqaluttuarisaanikkut, antropologiskimik, biofysiskimik, kulturikkullu tunngavilersuutit atorneqassapput.

ILISIMATUSARNERMI NAJOQQUTASSANIK KATERSUINEQ. Atuagarsornikkut misissuinerit ukiuni arfineq pingasuni ingerlanneqarput ukioq 2003-miit ukioq 2011 ilanngullugu, soorlulusooq alaatsinaanneqartunik apersuinerit inunillu ataasiakkaanik apersuinerit ingerlanneqarsimallutik. Atuagassiaqarnikkut misissuinerit marluk ingerlanneqarsimapput, ilisimatusarnikkut paasissutissanik misissuinerit Kalaallit Nunaanni piffinni sisamaasuni ingerlanneqarsimalluni: Nuuk, Ilulissat, Sisimiut Tasiilarlu. Alaatsinaanneqartunik apersuinerit arfineq marluk, taakku katillutik 33-nik peqataasullit ingerlanneqarsimapput, tassungalu ilanngullugu inunnik ataasiakkaanik 18-iusunik arnanik, ataataasunik, kulturikkullu ersuttunik apersuinerit. Ilisimatusarnikkut sakkugineqartut ilisimatuutut allaatigisami apersuinermi alaatsinaanneqartunillu apersuinerit Helsinki-Erklæring naapertorlugu ingerlanneqarput

ILISIMATUSARNIKKUT INERNERI. Nunasiaajunnaarnermi ernineq arnanut namminerminut tunngatinneqarpoq taamaasilluni ernineq pillugu paasissutissat amerlagisassaanngitsutut oqaatigisariaqarlutik. Erninermut naalakkersuinikkut anguniakkat malittarisassallu sumiiffinni ataasiakkaani qinikkanit allaffimmilu aqutsisunit saqqummiunneqartarsimapput, qaqutiguinnartumillu arnanut ernilersunut aammalu najukkami inuiaqatigiinnut isumaqatiginninniutaasarsimallutik. Ilaqutariinnut erneqqajaasunut isumannaallisaaneq isummap imarisaatut isigalugu ilaquttariinnut inuiaqatigiinnullu tunngatinneqarput. Ilaquttariit toqqaannartumik isumannaallisaasutut isigineqarput, ilaqutariinnilu qanigisanilu tapersersuisoqarsinnaanngikkangat nalornineq pilersarluni. Akisussaaneq ilaqutariinnut inuiaqatigiinnullu isummap imarisaatut isigalugu kulturikkut immikkut isigineqarpoq qaniginerpaasanullu tunngatinneqarluni, ilaquttanut qanigisanullu allanut. Kalaallit Nunaanni erninermut tunngasut "kulturikkut immikkut inissaqartinneqarput", tamatumani erninerup nalaani ilaqutariit imminut qanilleqqajaallaqqissisarlutik, ilaqutariissuseq najukkamilu inuiaqatigiit ataqatigiinnerat peqqissutsimut tapertaalluartarlutik.

ILISIMATUSARNERUP NAAMMASSILERNERANI ISUMMIUSSAQ. Kalaallit ilaqutariit unamminartunik naapitsinermi naapertuulluartumik aaqqiisinnaasimapput, tamatumani nunarsuarmioqatigiinni aningaasaqarnikkut ineriartornermi inuiaqatigiillu malinnaataasumik ineriatorfiata kingunerisaannik pisimasut anigorluarsimallugit. Najukkami inuiaqatigiit, ilaqutariit arnallu misissuinermi meeqqanik nammattutut imminut paasinnipput, ataataasullu ilaqutariinni meeqqanut tapersersuisutut inuttullu isumaginnittutut imminut paasinnipput, aammalu najukkami inuiaqatigiit ilaqutariillu tamarmiusut ilaqutariinnut pineqartunut ataqatigiiaattut pingaarutilittut imminut paasillutik.

Place, publisher, year, edition, pages
Nordic School of Public Health NHV Göteborg, Sweden, 2013. 92 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Report 2013:4
Keyword
Kalaallit ilaqutariit, ernineq, ilaqutariit erninerup nalaanni, ilaqutariit meeraarartallit ataqatigiiaanik tapersersuisoqarnera, Greenlandic family, childbirth, perinatal family, health promotion, family support networks, Grønlandsk familie, fødsel, den perinatale familie, sundhedsfremme, netværk hos småbørns familie
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3781 (URN)978-91-86739-54-6 (ISBN)
Public defence
2013-04-18, Nordic School of Public Health NHV, Göteborg, Sweden, 13:00 (Danish)
Opponent
Supervisors
Available from: 2015-02-09 Created: 2015-02-09 Last updated: 2015-02-09Bibliographically approved

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