Disparities in infant mortality rates exist between white and non-Hispanic black females despite improved access to prenatal care. In 2004 the preterm related infant mortality rate for non-Hispanic black women was 3.5 times higher than for white women. Adolescent females are among those with the highest rates of perinatal loss. Perinatal loss includes miscarriages, stillbirths, and neonatal deaths within the first 28 days of life. Pregnancy loss in adolescents has been linked to an increase in depressive symptoms as well as significant emotional, physical, social and cognitive grief responses. There is evidence that low socio-economic status and developmental factors are markers that increase the risk for complicated grieving. There are few published studies that describe the perinatal bereavement experience in black women, thus, very little is known about the experience of perinatal loss and the subsequent bereavement support needs in non-Hispanic black adolescents. This paucity of research has created a gap in knowledge for nurses who desire to offer culturally sensitive, evidence-based support to help young black women cope with bereavement following the loss of an infant. The overarching goal of this study is to build an understanding of the experience of perinatal bereavement in non-Hispanic black adolescent females.
The specific aims are: 1) to generate a disclosive theory that describes the experience of perinatal bereavement in non-Hispanic black female adolescents;2) to identify critical transitions in the perinatal bereavement process that may signal a need for culturally sensitive bereavement support services. This study is aligned with the NINR's strategic objectives to improve the quality of life, to eliminate health disparities, and to improve care at the end of life across all age spans. A qualitative research design using grounded theory methods is proposed. Unmarried, non-Hispanic black females, aged 16-18 years who have experienced a perinatal loss by stillbirth or neonatal death (first 28 days of life) will be interviewed at three points in time over a period of three months. Constant comparative data analysis will be used. Relevance to public health: There is a high rate of infant mortality in non-Hispanic black females;hence there is an urgent need to study the phenomenon of perinatal bereavement in black adolescents. This study is important because it will inform nurses about the perinatal loss and bereavement experience of non-Hispanic black adolescent females. Understanding critical transitions in the bereavement process may provide nurses the opportunity to offer culturally sensitive perinatal bereavement support. This study will be foundational to direct future studies to build and test bereavement support interventions.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
Project #
Application #
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Boyington, Josephine
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Pennsylvania State University
Other Health Professions
Schools of Nursing
University Park
United States
Zip Code
Fenstermacher, Kimberly H (2014) Enduring to gain new perspective: a grounded theory study of the experience of perinatal bereavement in Black adolescents. Res Nurs Health 37:135-43
Fenstermacher, Kimberly; Hupcey, Judith E (2013) Perinatal bereavement: a principle-based concept analysis. J Adv Nurs 69:2389-400