Perinatal Loss and Bereavement in Non-Hispanic Black Adolescents
Open Access
- Author:
- Fenstermacher, Kimberly H
- Graduate Program:
- Nursing
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- August 18, 2011
- Committee Members:
- Judith E Hupcey, Dissertation Advisor/Co-Advisor
Judith E Hupcey, Committee Chair/Co-Chair
Kim Kopenhaver Doheny, Committee Member
Mary Beth Clark, Committee Member
Carol S Weisman, Committee Member - Keywords:
- grounded theory
qualitative research
perinatal bereavement
perinatal loss - Abstract:
- Abstract Background: Perinatal loss is one of the most stressful events a person can experience in life. The experience of perinatal loss is different from other types of loss through death because it represents the loss of future hopes, dreams, and parenthood. The period that follows perinatal loss is referred to as perinatal bereavement. Despite an overall decline in infant and fetal mortality, non-Hispanic Black adolescents continue to experience rates of perinatal loss that are higher than any other racial or ethnic group. Adolescents are at higher risk for complicated grieving after perinatal loss due to the sudden nature of the loss and the potential negative stigma associated with the pregnancy. Numerous research studies have focused on the experience of perinatal loss and bereavement, however, most research has concentrated on the experience of middle-class, adult White women. Consequently, there is limited scientific literature available to describe the experience of perinatal loss and bereavement in African American adolescents. Purpose: The overarching goal of this study was to build an understanding of the experience of perinatal bereavement in non-Hispanic Black (African American) adolescent females after perinatal loss. There were two specific aims: To generate a disclosive theory of perinatal bereavement in non-Hispanic Black adolescent females and to identify critical transitions in the perinatal bereavement process that may signal a need for well-targeted, culturally sensitive bereavement support services. Methods: This study used qualitative methods of grounded theory to explore the experience of perinatal bereavement in eight non-Hispanic Black adolescents (ages 18-21) who had experienced recent perinatal loss. IRB approval was obtained from six urban hospitals with a high-risk perinatal population. Potential participants were approached by the perinatal bereavement coordinator at each hospital using a script for recruitment. Upon obtaining verbal consent, participants were followed with interviews at three points in time over 12 weeks following their loss. Data were analyzed using constant comparative methods. Results: The outcome of this research is a grounded theory, “Enduring to gain new perspective” which discloses the main theoretical concepts of the experience, grounded in the data from the thick, rich descriptions of the participants. Analysis of the data revealed the following theoretical categories: Life before pregnancy; Reacting to the pregnancy (sub-categories: accepting and attaching); Living through the loss event (sub-categories: emotional response and physical response); Seeking and receiving support; Maintaining relationship; Searching for meaning; and Gaining new perspective. The core conceptual theme was “Enduring the loss”. Conclusions: The theoretical concepts of the theory correspond in many ways to what other perinatal bereavement researchers have found, yet the manifestations of the experience within the non-Hispanic Black adolescents in this study were different, mostly attributed to age and culture. This study offers new knowledge and suggestions for interventions that add to the perinatal bereavement science. Perinatal bereavement is an interpretive process that is lived out in relation to the meaning that the adolescents ascribe to their pregnancy. Young African American women in late adolescence attribute meaning to the experience of perinatal loss and bereavement in interaction with partners, family and friends, taking cues from their cultural norms and inherent value systems. Over time, as they endured the loss, these adolescents gained new perspective on how they have changed from the experience and how the experience will shape their future.