„NORMAL IS NOT JUST ONE SPECIFIC EXPERIENCE“ WOMEN´S EXPERIENCES AND VIEW OF NORMAL BIRTH: A QUALITATIVE RESEARCH

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadVerndun eðlilegra fæðinga hefur verið mikilvægt viðfangsefni innan ljósmóðurfræða síðustu áratugi. Þar er iðulega stillt upp mismunandi sýn læknisfræðinnar og ljósmóðurfræðinnar en sjónum sjaldnar beint að upplifun kvenna sjálfra og hvað fyrir þeim eðlileg fæðing er. Í þessari rannsókn var markmiðið að fá fram reynslu kvenna og sýn á eðlilega fæðingu. Aðferðafræði rannsóknarinnar er eigindleg og byggist á viðtölum við tíu konur, fjölbyrjur og frumbyrjur, sem eiga samtals nítján fæðingar að baki. Viðtölin eru greind með fyrirbærafræðilegri aðferð Vancouver-skólans. Við heildargreiningu á fyrirbærinu eðlileg fæðing er unnið úr reynslu allra kvennanna og spunninn sameiginlegur vefur. Undirstöðuþemað við úrvinnslu á sögum kvennanna er Að gera fæðingarreynsluna að sinni eðlilegu fæðingu. Í þeirri ferð er fólgin óvissa, þar sem eðlilegt er að fá hjálp og ef vel tekst til eru þar tækifæri til valdeflingar. Sjö meginþemu með undirþemum eru greind sem öll hafa áhrif innbyrðis á heildarupplifun og lýsingu á fyrirbærinu eðlileg fæðing. Þessi þemu eru eftirfarandi: að hafa stjórn, stuðningur ljósmóður, sameiginlegt verkefni, öryggi og umhverfi, reynsla af sársauka, að taka á móti eigin barni, ekki eðlileg fæðing. Í skilgreiningum fagfólks á eðlilegri fæðingu hafa jafnan andstæðurnar „inngrip“ og „ekki inngrip“ legið til grundvallar. Í hugum þeirra kvenna sem rætt var við í rannsókninni er þessi tvískipting ekki útgangspunktur eðlilegrar fæðingar. Allar konurnar líta svo á að þær eigi eðlilega fæðingu að baki – jafnvel náttúrulega fæðingu – þrátt fyrir fjölbreytt inngrip og ólíkar fæðingarsögur. Sýn þessara kvenna brýtur á vissan hátt upp hugtakið eðlileg fæðing eins og það hefur hingað til verið skilgreint innan ljósmóðurfræðinnar. Niðurstöður rannsóknarinnar styðja ljósmæður í að leggja einstaklingsbundnari skilning á mörk hins eðlilega, treysta á innsæisþekkingu og mæta konum á þeirra eigin forsendum í fæðingu. Rannsaka mætti hvernig tæknilegt, félagslegt og menningarlegt umhverfi barneignarþjónustu hefur áhrif á persónubundnar skilgreiningar á eðlilegri fæðingu.Protecting normal birth has for a number of years been an important and significant topic in midwifery. The contrasting visions of the medico-technical approach and the physio-social midwifery approach are regularly juxtaposed, but less space has been given to what women´views are and how they experience normal birth. This research explores women´s own perceptions of what normal birth is. The methodology of the research is qualitative and based on interviews with ten women, both multiparous and primiparous, who have given a total of nineteen births. Anlalysis of data was based on the Vancouver School of doing phenomenology. Through making a comprehensive analysis of the phenomenon of normal birth from the point of view of women, a collective multi- -voice construction of their normal birth was designed. The overriding theme which emerged was “Making birth your own normal birth experience.” This journey of birth is full of uncertainty, where it is normal to get help, but the experience can also be an empowering self-discovery. Seven central themes with sub themes emerged which are all inter-related. Together they make up the holistic experience of „ÞAÐ ER EKKI EITTHVAÐ EITT EÐLILEGT“ Reynsla og sýn kvenna á eðlilega fæðingu: Eigindleg rannsókn „NORMAL IS NOT JUST ONE SPECIFIC EXPERIENCE“ WOMEN´S EXPERIENCES AND VIEW OF NORMAL BIRTH: A QUALITATIVE RESEARCH LJÓSMÆÐRABLAÐIÐ - JÚLÍ 2018 39 normal birth. These themes are: to be in control, midwife´s support, a joint venture, safety and surroundings, experience of pain, to receive your child, not a normal birth. “Intervention” or “non- intervention” into the birth process, which is the critical dichotomy many birth professionals use to define normal birth, is not a central concern in the women´s experiences. All the women interviewed describe their births as normal – even natural – despite there having been varied interventions and birth stories at work. Their views critically challenge traditional definitions of normal birth. This may encourage us to consider more subjective and contextual approaches to defining normalcy. It vitalizes our reliance on our intuitive knowledge and prioritizes meeting women on their own terms in every birth experience. For future studies it would be interesting to explore techno - social and cultural aspects of maternity services on personal definitions of normal birth

Benthic community structure on offshore northern shrimp (Pandalus borealis) grounds north of Iceland

The main fisheries of northern shrimp in Icelandic waters are located west and north of Iceland. These locations are studied in an annual survey to estimate stock size and distribution of northern shrimp. In July 2015, an additional survey was conducted to study the benthic community structure and function to describe the habitat where the northern shrimp fisheries take place. Underwater images were taken from 26 stations, grab samples were collected at 11 stations and in addition, by-catch was collected from the annual Icelandic shrimp survey in August 2015. The sampling sites, despite being distributed throughout a relatively large area north of Iceland, were rather uniform in relation to sediment type and fauna composition. The stations were similar in grain size and dominated by soft sediment of sand and silt/mud and soft sediment fauna. The infauna was mainly burrowing infauna with affinity to soft sediment and surface deposit feeding. The epifauna were free-living crawlers with affinity for predation feeding habit. No relationship with environment was observed for either the epifauna or the infauna. Species diversity and community composition did not vary with depth, probably because of the narrow depth range of the sites. This study provides the first data on benthic in- and epifauna in northern shrimp fishery locations north of Iceland, which can later be used to estimate possible changes and/or the effect of shrimp fishing within this area

Vulnerable Marine Ecosystems (VMEs) : Applying management tools to measure human impacts on Arctic and sub-Arctic Vulnerable Marine Ecosystems

In NovasArc I spatial distribution of VMEs within the sub-arctic waters were predicted. NovasArc II updated the predictions with new observations to produce spatially estimates of the predictive uncertainty and the outputs of the earlier models were updated and validated. We discuss how the model output could be used in the development of criteria and indicators relevant to management of benthic habitats including the Good Environmental Status descriptors 1 and 6 in the MSFD, and the OSPAR common indicator “Physical damage of predominant and special habitats”. Also we explore the relevance of our results against the Performance Indicator Scores used in the certification requirements for Marine Stewardship Council. The results were discussed with stakeholders to exchange experiences and views regarding best practices for sustainable fisheries in light of management goals

Vulnerable marine ecosystems (VMEs) : Coral and sponge VMEs in Arctic and sub-Arctic waters – Distribution and threats

This report presents results from the NovasArc project that has collated data on the distribution of vulnerable marine ecosystems (VMEs) in Arctic and sub-Arctic waters. Eleven VMEs were identified, based on management goals for coral and sponge communities. Many of the vulnerable marine ecosystems (VMEs) in the study area has a wide distribution. Soft and hard bottom sponge aggregations, hard bottom gorgonians, sublittoral sea pen communities, and cauliflower corals are predicted to cover > 20% of the study area shallower than 1000 meters. Of the anthropogenic activities in the study area bottom trawling represents the main threat to the VMEs. The compilation of trawling activity in the study area shows that fisheries mainly occurs shallower than 1000 meters and that 50 to 60% of the seafloor is not targeted. However, 30% of the seafloor has experienced intermediate to very high fishing effort. In general, the VMEs shows a larger overlap with fishing when the risk analysis is based on areas with an optimal habitat suitability. Using this conservative threshold to model the distribution of VMEs the results indicate that most VMEs have experienced an intermediate to high level of fishing in less than 40% of their distribution area in the whole study area