Perinatal Loss in Low-Income African American Parents
Open accessAbstract
Objective To examine the experience of low-income, African American parents surrounding perinatal loss and to describe how other life stressors influenced the parents' responses and caring needs.Design Descriptive, using a phenomenologic approach.Setting All data were collected in person. Interviews were held in parents' homes or, at the request of three parents, in an office in the university between 5 and 21 weeks after the loss.Participants A total of 23 parents (17 mothers and 6 of their partners) were interviewed after a perinatal loss (16 weeks gestation or later) or a neonatal death (first 28 days of life). Follow-up interviews were held with 21 of these parents.Results Four themes were revealed: (a) recognizing problems and responding to the loss, (b) dealing with stressful life events, (c) creating and cherishing memories of the baby, and (d) living with the loss.Conclusions The results of this study reveal experiences not previously reported and provide initial insight on the loss experience in this group of parents. Health care professionals should be aware of the presence of additional stressful events that parents may be experiencing and intervene appropriately to provide culturally competent care in a sensitive manner.
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Clear, easily understandable and structured information given sensitively at appropriate times helps parents through their experience (FES 45%).
“Clear, easily understandable and structured information given sensitively at appropriate times, helps parents through their experience, FES 45 % [21, 31, 32, 34, 36, 37, 39–42, 44–51]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
The Recommendations for Practice and Research (page not available) call for clear, explicit information about autopsy and burial policies, alongside empathy and communication. The Deciding on burial section says parents found accurate information about their options helpful. The paper does not establish that information should be structured or delivered at particular times; the FES 45% appears to be the citing authors’ synthesis, not a result attributed to this study. (LLM, conf=0.86)
Experimental — accuracy not yet measuredFathers may have different needs to mothers; they want to be involved in decision making and often focus on practical tasks (FES 18%).
“Fathers may have different needs to mothers; they want to be involved in decision making and often focus on practical tasks, FES 18 % [30, 33, 34, 36, 37, 40, 47]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
In “Living With the Loss,” the paper reports that fathers, more than mothers, found it helpful to keep busy. Its Discussion also describes differences in how fathers and mothers responded to the loss. The paper discusses parents making burial decisions, but does not establish that fathers particularly wanted to be involved in decision-making or that their activity focused on practical tasks; it does not report the FES 18% figure. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLong delays and inconclusive results can cause distress to parents (FES 5%).
“Long delays and inconclusive results can cause distress to parents, FES 5 % [36, 37]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
In “Making sense of the loss” (page not provided), the paper reports that some parents were very frustrated by delays in receiving autopsy results after a perinatal loss. It does not report distress from inconclusive results or support the “FES 5%” figure. (LLM, conf=0.86)
Experimental — accuracy not yet measuredParents feel unprepared for the postnatal period and are unaware of their entitlements and the services available.
“Parents feel unprepared for the postnatal period and are unaware of their entitlements and the services available.”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
In “Recognizing Problems and Responding to the Loss” (page not provided), the paper says these parents were often unprepared for their baby’s death, a narrower finding than being unprepared for the postnatal period generally. “Recommendations for Practice and Research” calls for clearer information about hospital policies and discusses support-group referrals, but does not establish that parents were unaware of their entitlements or available services. (LLM, conf=0.78)
Experimental — accuracy not yet measuredParents want improved training so that staff can provide tailored discussions and written information to help them make informed decisions about post-mortem and funeral arrangements (FES 20%).
“Parents want improved training so that staff can provide tailored discussions and written information to help them make informed decisions about post-mortem and funeral arrangements, FES 20 % [25, 35–37, 40, 52, 53, 56]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
In “Deciding on burial” (page unavailable), parents found accurate information from health professionals helpful when choosing burial arrangements. “Recommendations for Practice and Research” (page unavailable) calls for clear information for mothers and fathers about autopsy and burial policies. The paper does not establish that parents wanted improved staff training, tailored discussions or written information, and it does not support the “FES 20%” figure. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Parents would appreciate a healthcare system ready to provide emotional support following birth and discharge from hospital (FES 50%).
“Parents would appreciate a healthcare system ready to provide emotional support following birth and discharge from hospital, FES 50 % [21, 29, 31–38, 42, 43, 45–47, 50, 59, 63–65]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
In “Feeling intense emotions after the death,” parents describe appreciating nurses’ emotional care, and “Recommendations for Practice and Research” calls for a supportive environment during perinatal loss. The paper does not establish that parents wanted healthcare-system emotional support after hospital discharge; its discussion of later support concerns family, friends, and support groups. The cited passages also do not report a 50% figure. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMen in six qualitative studies who held or spent time with their baby following a stillbirth generally also reported high levels of grief.
“Similarly, men in six qualitative studies who held or spent time with their baby following a stillbirth generally also reported high levels of grief [58, 62, 66, 77, 81, 85].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [77]
In “Creating and Cherishing Memories of Their Baby” (page unavailable), the study reports that most fathers held their baby with encouragement; “Feeling intense emotions after the death” says fathers described hurt and loss of control. But “Participants” includes both stillbirths and neonatal deaths, and the copy does not report grief levels specifically for fathers who held or spent time with a stillborn baby. The six-study count belongs to the citing sentence, not to this individual source. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMen who reported religious or spiritual beliefs found this to be a source of comfort in coping with their grief (eight qualitative studies).
“In eight qualitative studies, men who reported religious or spiritual beliefs also found this to be a source of comfort in coping with their grief.”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [77]
In “Living With the Loss” (page unavailable), the paper says many bereaved parents relied on spirituality to deal with their loss. The study included fathers, but its discussion of spiritual comfort gives examples from mothers and does not establish the finding specifically for men. The paper also does not substantiate the citing sentence’s count of eight qualitative studies. (LLM, conf=0.82)
Experimental — accuracy not yet measuredDealing with stressful life events, including economic hardship and other unrelated family deaths, compounds grief for both parents.
“However, “dealing with stressful life events”, including economic hardship and other unrelated family deaths, were found to compound grief for both parents [77].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [77]
The “Dealing With Stressful Life Events” section says parents faced economic hardship and deaths of close family members around the time of the loss. The section on economic hardship also says the baby's death triggered painful memories of other deaths. The paper does not establish that these events compounded grief for both mothers and fathers, particularly in the case of economic hardship. (LLM, conf=0.82)
Experimental — accuracy not yet measuredBehaviours and actions of staff can have a memorable impact on parents (FES 53%).
“Behaviours and actions of staff can have a memorable impact on parents, FES 53 % [21, 29–48]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
Parents have a range of emotions and reactions because stillbirth is a life changing event (FES 18%).
“Parents have a range of emotions and reactions because stillbirth is a life changing event, FES 18 % [33, 36, 37, 46–48]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
Seventeen included studies grouped together different types of loss as part of the investigation of grief (e.g., miscarriage and stillbirth, stillbirth and neonatal death, or all three types together).
“Finally, 17 studies also grouped together different types of loss as part of the investigation of grief (e.g., miscarriage and stillbirth, stillbirth and neonatal death, or all three types together) [24, 46, 57–61, 73, 77, 80, 83, 84, 86, 88–90, 93].”
From Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model (2020) · cites this paper as [77]
Parents in this survey placed an emphasis on making memories as part of the hospital experience and expressed regret at not making memories or wished they would have made more memories.
“Clearly, the parents in this survey, as with parents in other studies [e.g., (10, 15, 19, 26, 27)], placed an emphasis on making memories as part of the hospital experience and have expressed regret at not making memories or wished they would have made more memories (28, 29).”
From Parent hospital experiences following stillbirth (2026) · cites this paper as [26]
Parents who decide not to see and hold their baby often later regret this decision.
“Parents who decide not to see and hold their baby often later regret this decision.”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [36]
The “Creating and Cherishing Memories of Their Baby” section says nearly all parents saw their babies and describes the time they spent together as cherished. It does not report whether parents who decided not to see or hold their baby later regretted that decision; searches for regret after declining contact found no such passage. Page numbers were not available in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measured
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BackgroundCurrie, E. R., Christian, B. J., Hinds, P. S., Perna, S. J., Robinson, C. B., Day, S. W., Bakitas, M. A., & Meneses, K. (2018) · Death Studies · doi:10.1080/07481187.2018.1474285 · Cited by 48 · see citing works
“Similar to the literature (Glaser, Bucher, Moergeli, Fauchere, & Buechi, 2007; Kavanaugh & Hershberger, 2005; Raingruber & Milstein, 2007; Rosenbaum et al., 2011), study participants often encountered spiritual suffering as they tried to understand the life and death of their infant.”
BackgroundResultLewkowitz, A. K., Rosenbloom, J. I., Keller, M., López, J. D., Macones, G. A., Olsen, M. A., & Cahill, A. G. (2019) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.06.027 · Cited by 46 · see citing works
Experiences of African American Parents Following Perinatal or Pediatric Death: A Literature Review
Boyden, J. Y., Kavanaugh, K., Issel, L. M., Eldeirawi, K., & Meert, K. L. (2014) · Death Studies · doi:10.1080/07481187.2013.766656 · Cited by 43 · see citing works
“Several publications (Kavanaugh & Hershberger, 2005; Kavanaugh & Robertson, 1999; Patterson, 2000; Van & Meleis, 2003, 2010) shared data sets; however, each publication reported unique results and implications.”
BackgroundResultInfluentialBlood, C., & Cacciatore, J. (2014) · BMC Psychology · doi:10.1186/2050-7283-2-15 · Cited by 44 · see citing works
“Multicultural research is also rare, though the perinatal death rate for African Americans is double the combined mean of other ethnic groups (Kavanaugh and Hershberger 2005; MacDorman et al. 2012).”
Andalibi, N., Lacombe‐Duncan, A., Roosevelt, L. K., Wojciechowski, K., & Giniel, C. (2022) · ACM Transactions on Computer-Human Interaction · doi:10.1145/3474362 · Cited by 45 · see citing works
Stressors, Resources, and Stress Responses in Pregnant African American Women
Giurgescu, C., Kavanaugh, K. L., Norr, K. F., Dancy, B. L., Twigg, N. M., McFarlin, B. L., Engeland, C. G., Koenig, M. D., & White‐Traut, R. C. (2013) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0b013e31828363c3 · Cited by 43 · see citing works
Self-citationYoungblut, J. M., & Brooten, D. A. (2012) · Nursing Outlook · doi:10.1016/j.outlook.2012.08.007 · Cited by 43 · see citing works
Davidson, D. E. (2011) · Sociological Research Online · doi:10.5153/sro.2293 · Cited by 40 · see citing works
LGBTQ Persons' Pregnancy Loss Disclosures to Known Ties on Social Media
Pyle, C., Roosevelt, L. K., Lacombe‐Duncan, A., & Andalibi, N. (2021) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3411764.3445331 · Cited by 40 · see citing works
“After a pregnancy loss, people can experience myriad challenges, including increased depressive and anxiety symptoms and intense emotions, such as shock, devastation, self-blame, and anger [58, 63, 76, 77].”
BackgroundKavanaugh, K. L., Moro, T., Savage, T. A., Reyes, M., & Wydra, M. (2009) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0b013e3181a2cacc · Cited by 38 · see citing works
Self-citationEvents after Stillbirth in Relation to Maternal Depressive Symptoms: A Brief Report
Surkan, P. J., Rådestad, I., Cnattingius, S., Steineck, G., & Dickman, P. W. (2008) · Birth · doi:10.1111/j.1523-536x.2008.00229.x · Cited by 37 · see citing works
Suttle, M. L., Hall, M. W., Pollack, M. M., Berg, R. A., McQuillen, P. S., Mourani, P. M., Sapru, A., Carcillo, J. A., Startup, E., Holubkov, R., et al. (2021) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091211015913 · Cited by 36 · see citing works
“36,37 Anxiety is a natural reaction to bereavement.”
BackgroundParent Grief 1–13 Months After Death in Neonatal and Pediatric Intensive Care Units
Youngblut, J. M., Brooten, D. A., Glaze, J., Promise, T., & Yoo, C. (2016) · Journal of Loss and Trauma · doi:10.1080/15325024.2016.1187049 · Cited by 33 · see citing works
“African Americans use social support, maintaining a relationship with the deceased, spirituality and religion, and remaining strong to cope with loss of a child (Boyden et al., 2014; Kavanaugh & Hershberger, 2005).”
Interconception Care for Couples After Perinatal Loss
Moore, T., Parrish, H., & Black, B. (2011) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0b013e3182071a08 · Cited by 32 · see citing works
“grief, with most research having been focused on white middle-class women and men.(20) Van and Meleis(21) examined African American women’s coping strategies after”
BackgroundPsychometric Evaluation of the Spanish and English Versions of the Spiritual Coping Strategies Scale
Hawthorne, D. M., Youngblut, J. M., & Brooten, D. A. (2011) · Journal of Nursing Measurement · doi:10.1891/1061-3749.19.1.46 · Cited by 26 · see citing works
Supporting Parents After Stillbirth or Newborn Death: There is much that nurses can do
Kavanaugh, K., & Moro, T. (2006) · AJN, American Journal of Nursing · doi:10.1097/00000446-200609000-00037 · Cited by 25 · see citing works
Self-citationGold, K. J., Normandin, M. M., & Boggs, M. E. (2016) · Archives of Women s Mental Health · doi:10.1007/s00737-016-0657-x · Cited by 25 · see citing works
Peer Supporters' Experiences of a Bereavement Follow-up Intervention for Grieving Parents
Aho, A. L., Åstedt-Kurki, P. M., & Kaunonen, M. (2014) · OMEGA - Journal of Death and Dying · doi:10.2190/om.68.4.d · Cited by 26 · see citing works
“The change leads to rebuilding new purposes and meanings (Barrera, O’Connor, Mammone, Agostino, Spencer, Nicholas, et al., 2009; Bellali & Papadatou, 2006; Davies, 2004; Dyregrov & Dyregrov, 2008; Kavanaugh & Hershberger, 2005).”
BackgroundParents’ hope in perinatal and neonatal palliative care: a scoping review
Silveira, A. O., Wernet, M., Franco, L. F., Dias, P. L. M., & Charepe, Z. B. (2023) · BMC Palliative Care · doi:10.1186/s12904-023-01324-z · Cited by 22 · see citing works
“(S27) [20] crucial and linked to parent-professional interactions [25–29, 13–36, 21–24].”
BackgroundInfluentialHawthorne, D. M., Youngblut, J. M., & Brooten, D. A. (2017) · Journal of the American Association of Nurse Practitioners · doi:10.1002/2327-6924.12498 · Cited by 20 · see citing works
“The few studies of bereaved AfricanAmerican women after pregnancy loss have identified similar patterns of grieving to Caucasian women (Kavanaugh & Hershberger, 2005; Van & Meleis, 2003).”
Fathers’ Experiences of Perinatal Loss: A Sample Meta-Synthesis Study
Aydın, R., & Kabukçuoğlu, K. (2020) · Journal of Family Issues · doi:10.1177/0192513x20966002 · Cited by 20 · see citing works
“…of the fathers stated that the loss was God’s will, that there were reasons for it, and that they coped with thanks to their beliefs with the following words (Armstrong, 2001; Hamama-Raz et al., 2010; Kavanaugh & Hershberger, 2005; McCreight, 2004; Wagner et al., 2018): He [God] had reasons for it.”
BackgroundInfluentialZhang, L., Huang, R., Lei, J., Liu, Y., & Liu, D. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05604-7 · Cited by 24 · see citing works
Carlson, R., Lammert, C., & O’Leary, J. M. (2012) · Illness Crisis & Loss · doi:10.2190/il.20.3.e · Cited by 20 · see citing works
“For instance, in one study of low-income African-American bereaved parents who experienced a perinatal loss, none of the participants attended a support group (Kavanaugh & Hershberger, 2005).”
BackgroundGranek, L., & Peleg-Sagy, T. (2015) · Death Studies · doi:10.1080/07481187.2015.1047059 · Cited by 19 · see citing works
Perinatal Loss: Its Immediate and Long‐Term Impact on Parenting
Keren, M. (2010) · Wiley eBooks · doi:10.1002/9780470660683.ch15 · Cited by 19 · see citing works
Tong, M., Li, P., Wang, M., Sun, Y., Han, Y., Liu, H., Li, J., Li, J., Wu, F., Guan, T., et al. (2022) · International Journal of Epidemiology · doi:10.1093/ije/dyac103 · Cited by 16 · see citing works
Côté‐Arsenault, D., Denney‐Koelsch, E. M., McCoy, T. P., & Kavanaugh, K. L. (2019) · Applied Nursing Research · doi:10.1016/j.apnr.2019.151200 · Cited by 16 · see citing works
Self-citation“Your heart keeps bleeding”: lived experiences of parents with a perinatal death in Northern Uganda
Arach, A. A. O., Kiguli, J., Nankabirwa, V., Nakasujja, N., Mukunya, D., Musaba, M. W., Napyo, A. K., Tumwine, J. K., Ndeezi, G., & Rujumba, J. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04788-8 · Cited by 21 · see citing works
Evans, N. M., Hsu, Y.-L., Kabasele, C. M., Kirkland, C., Pantuso, D., & Hicks, S. (2022) · Journal of Black Psychology · doi:10.1177/00957984221127833 · Cited by 16 · see citing works
“African American women were more likely to experience acute and chronic stress compared to White women due to race-related stressors (Hogue & Bremner, 2005; Kavanaugh & Hershberger, 2005).”
BackgroundInfluentialOnline Support Groups for Perinatal Loss: A Pilot Feasibility Study for Women of Color
Gold, K. J., Boggs, M. E., Plegue, M. A., & Andalibi, N. (2022) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2021.0304 · Cited by 14 · see citing works
“46 Although our pilot study was not powered for mental health outcomes, pre–post scores improved nonsignificantly on all four measures, suggesting the value of larger randomized controlled trials.”
Tong, M., Wang, M., Li, P., Gong, J., Zhu, T., & Xue, T. (2023) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2023.166088 · Cited by 17 · see citing works
Conducting End-of-Life Research
Kavanaugh, K. L., & Campbell, M. (2014) · Nursing Science Quarterly · doi:10.1177/0894318413509711 · Cited by 14 · see citing works
“For example, for a study with bereaved low-income African American parents (Kavanaugh & Hershberger, 2005), KLK used a prescreening procedure where the referring clinician took additional steps to verify income status before making the referral.”
BackgroundSelf-citationArach, A. A. O., Nakasujja, N., Rujumba, J., Mukunya, D., Odongkara, B. M., Musaba, M. W., Napyo, A. K., Tumwine, J. K., Nankabirwa, V., Ndeezi, G., et al. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05550-4 · Cited by 13 · see citing works
“Varying rituals and symbols with similar meanings have been noted in both developed and developing countries alike, with positive impact on coping [11, 14, 16, 49, 50].”
Perinatal Loss and Spirituality
Wright, P. M. (2017) · Illness Crisis & Loss · doi:10.1177/1054137317698660 · Cited by 13 · see citing works
“Perinatally bereaved women have cited their faith as a source of strength in their deep sorrow and have explained, in qualitative studies, that their faith got them through the worst part of the grief (Kavanaugh & Hershberger, 2005; Wright, 2016).”
BackgroundInfluentialSuporte aos pais que vivenciam a perda do filho neonato: revisao de literatura
Rodrigues, L., Shimo, A. K. K., Carmona, E. V., Lopes, M. H. B. D. M., & Campos, C. J. G. (2018) · Aquichan · doi:10.5294/aqui.2018.18.1.8 · Cited by 13 · see citing works
Development of an Informational Web Site for Recruiting Research Participants
Hershberger, P. E., Kavanaugh, K. L., Hamilton, R., Klock, S. C., Merry, L. A., Olshansky, E. F., & Pierce, P. F. (2011) · CIN Computers Informatics Nursing · doi:10.1097/ncn.0b013e318224b52f · Cited by 12 · see citing works
Self-citationPrice, S., & Cohen-Filipic, K. (2013) · Social Work in Public Health · doi:10.1080/19371918.2011.592087 · Cited by 12 · see citing works
“These findings echo qualitative studies with low-income families experiencing perinatal loss (i.e., Kavanaugh & Hershberger, 2005).”
BackgroundLehner, C., Harry, A., Pelecanos, A. M., Wilson, L., Pink, K., & Sekar, R. (2018) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/ajo.12799 · Cited by 10 · see citing works
Recurrent Perinatal Loss: A Case Study
Kavanaugh, K. L., & Robertson, P. A. (1999) · OMEGA - Journal of Death and Dying · doi:10.2190/x65f-enlv-valg-f7ag · Cited by 10 · see citing works
Self-citationEmpty Arms: Supporting bereaved mothers during the immediate postnatal period
McGuinness, D., Coughlan, B., & Power, S. (2014) · British Journal of Midwifery · doi:10.12968/bjom.2014.22.4.246 · Cited by 9 · see citing works
Structural Violence and Stress Experiences of Young Pregnant Black People
Koenig, M. D., Crooks, N. K., Burton, T. C. J., Li, Y., Hemphill, N. O., Erbe, K., Rutherford, J. N., Liese, K. L., Pearson, P., Stewart, K., et al. (2023) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-023-01661-y · Cited by 9 · see citing works
“Individuals attribute poor pregnancy outcomes to stress from everyday hassles, feeling unsupported, untimely deaths of family members and friends, and economic hardship [26], which often lead to depression and anxiety [27].”
Experiences and needs of family members of perinatal infant deaths: a meta-synthesis
Cui, N., Wu, S., Wang, X.-Y., & Sheng, L. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1580039 · Cited by 6 · see citing works
“For many parents, discovering the cause becomes one of their most urgent concerns following the loss (26, 29).”
InfluentialThe Meaning of Food and Multicultural Implications for Perinatal Palliative Care
Chichester, M., & Wool, C. (2015) · Nursing for Women s Health · doi:10.1111/1751-486x.12204 · Cited by 8 · see citing works
“Th ere is a long-standing history of mistrust in the health care system among African Americans (CampinhaBacote, 2013; Dula & Williams, 2005), who tend to have poorer access to health care and receive poorer quality care (Chichester, 2005; Kavanaugh & Hershberger, 2005).”
BackgroundMcGrath, J. M., Butt, M. L., & Samra, H. A. (2011) · Newborn and Infant Nursing Reviews · doi:10.1053/j.nainr.2011.09.011 · Cited by 8 · see citing works
Sterpu, I., Bolk, J., Oberg, S., Varli, I. H., & Itzel, E. W. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-03402-z · Cited by 8 · see citing works
Fenstermacher, K. H. (2014) · Research in Nursing & Health · doi:10.1002/nur.21583 · Cited by 8 · see citing works
“Other qualitative researchers have noted the connection to spirituality among African American women after perinatal loss, including searching for a reason in order to find meaning (Kavanaugh & Hershberger, 2005) and feeling that God does everything for a reason (Van & Meleis, 2003).”
BackgroundMethodResultInfluentialStiffler, D., Cullen, D. L., Stephenson, E., Luna, G., & Hartman, T. D. (2015) · Clinical Nursing Research · doi:10.1177/1054773815619580 · Cited by 7 · see citing works
“However, African American parents rarely chose to attend support groups, so other methods of support were necessary (Kavanaugh & Hershberger, 2005).”
Neonatal and infant death: what bereaved parents can teach us
Carter, B. S. (2007) · Journal of Perinatology · doi:10.1038/sj.jp.7211777 · Cited by 7 · see citing works
Hospital Practices for Parents Following Perinatal Loss
Kalanlar, B. (2018) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222818803809 · Cited by 6 · see citing works
“Studies conducted on this issue identified that the rate of women who held their deceased babies varied from 25% to 88% (Kavanaugh & Hershberger, 2005).”
BackgroundNormalizing the Changes Experienced During Each Trimester of Pregnancy
Bonillas, C., & Feehan, R. (2008) · The Journal of Perinatal Education · doi:10.1624/105812408x266287 · Cited by 6 · see citing works
“Kavanaugh and Hershberger (2005) found that expectant parents misread symptoms of pregnancy complications, which may have contributed to a pregnancy loss or neonatal death.”
BackgroundYusuf, H., Stokes, J., Wattar, B. H. A., Petrie, A., Whitten, S. M., & Siassakos, D. M. (2023) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2023.2165062 · Cited by 3 · see citing works
“A systematic review found parents reported several negative emotional and psychological symptoms following stillbirth [7 – 9].”
InfluentialThe Psychology of Agency in Childbearing
Geller, P. A., Nelson, A. R., & Eichenbaum, E. (2013) · Wiley eBooks · doi:10.1002/9781394260454.ch15 · Cited by 3 · see citing works
Boakye, P. N., Prendergast, N., Obewu, O. A. T., & Mugambi, D. (2025) · Canadian Journal of Nursing Research · doi:10.1177/08445621251320570 · Cited by 2 · see citing works
“Consistent with other studies, Black women unjusti fi ably accepted responsibility for their perceived inactions for being unable to prevent the loss (Evans et al., 2023; Jones et al., 2021; Kavanaugh & Hershberger, 2005; Kelley & Trinidad, 2012).”
Keenan, G. M., Kavanaugh, K. L., Wilkie, D. J., Bonner, G. J., Ryan, C. J., Fischer, D. J., Savage, T. A., Choi, H., Burgener, S. C., Foreman, M. D., et al. (2011) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0b013e318202b255 · Cited by 2 · see citing works
“One investigator’s interdisciplinary research focuses on palliative and EOL care for infants and their families.(22-29) One investigator’s research focuses on advance care planning for African Americans with dementia,(30-32) and another’s research focuses on quality of life in persons with dementia.”
BackgroundSelf-citationFielding, A. M., Haddow, G., Wilson, S., & Fernandes, C. (2009) · JBI Library of Systematic Reviews · doi:10.11124/jbisrir-2009-505 · Cited by 2 · see citing works
Perinatal and neonatal palliative care: targeting the underserved
Boss, R. D., & Clarke‐Pounder, J. P. (2012) · Progress in Palliative Care · doi:10.1179/1743291x12y.0000000039 · Cited by 2 · see citing works
Advancing the Field of Perinatal Palliative Care: Needs and Strategies
Denney‐Koelsch, E. M., Kobler, K., Kirch, R., Leuthner, S. R., Kavanaugh, K. L., & Côté‐Arsenault, D. (2020) · Springer eBooks · doi:10.1007/978-3-030-34751-2_18 · Cited by 2 · see citing works
Self-citationAn Exploration of Black Couples’ Experience with Perinatal Loss
Simonson, C., Mann, T., & Ko, M.-J. (2024) · Journal of Couple & Relationship Therapy · doi:10.1080/15332691.2024.2430790 · Cited by 1 · see citing works
“Compared to Caucasians, African Americans are faced with more frequent acute life stressors and unfair treatment from society (i.e., racism and discrimination) diminishing the capacity to manage the loss of a child (Kavanaugh & Hershberger, 2005).”
InfluentialStressors, Resources, and Stress Responses in Pregnant African
Giurgescu, C., Kavanaugh, K. L., Norr, K. F., Dancy, B. L., Twigg, N. M., McFarlin, B. L., Engeland, C. G., Hennessy, M. D., & White‐Traut, R. C. (2013) · Cited by 1 · see citing works
Self-citationPerinatal death, collective action and legislation against obstetric violence in Argentina
Irrazábal, G., Álvarez, A. L. O., & Martínez, B. B. (2024) · Death Studies · doi:10.1080/07481187.2024.2433108 · Cited by 1 · see citing works
“…bereavement requires specific competencies that allow medical personnel to meet the emotional and cultural needs of those affected (Memmi, 2011), which should be tailored to the characteristics of each population (Kavanaugh & Hershberger, 2005; Kersting & Wagner, 2012; McCreight, 2008; Shah, 2004).”
Experiences of Fetal or Infant Loss Among Tanzanian Women in HIV Care
Kisigo, G., Manavalan, P., Cichowitz, C., Knettel, B. A., Mmbaga, B. T., & Watt, M. H. (2019) · Journal of Loss and Trauma · doi:10.1080/15325024.2019.1600850 · Cited by 1 · see citing works
Henner, N., Wojnar, D., & Denney‐Koelsch, E. M. (2020) · Springer eBooks · doi:10.1007/978-3-030-34751-2_16 · Cited by 1 · see citing works
Orthodox Jewish Mothers’ Lived Experiences of Perinatal Loss: An Interpretive Phenomenological Study
Greenwald, N. (2019) · TSpace (University of Toronto) · Cited by 1 · see citing works
Parent hospital experiences following stillbirth
Kremkow, J. M. D., & Lamberson, J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1706931
The Meaning of Miscarriage: Measurement, Reproductive Factors, and Trajectories in Couple Dyads
Huffman, C. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/k364-dy48
Volsch, J. (2015) · The Scholars Repository - LLU (Loma Linda University)
Surviving the death of a baby : end of life and the enormity of grief
Barnard, M. (2019) · University of Salford Institutional Repository (University of Salford)
Loss of a Baby in Cultural Context
Silman, M. (2014)
Simcock, I. C., & Lewis, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-69694-7_10
Suicide Bereavement Among Black-Americans: Evidence From the General Social Survey
Feigelman, W. T., Cerel, J., McIntosh, J. L., Gutin, N. J., & Edwards, A. C. (2025) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228251370910
Mbae, D., Gitonga, L. K., & Gichuru, B. (2025) · Journal of Gynecology and Obstetrics · doi:10.11648/j.jgo.20251305.11
Additional file 1 of Parents’ hope in perinatal and neonatal palliative care: a scoping review
Silveira, A. O., Wernet, M., Franco, L. F., Dias, P. L. M., & Charepe, Z. B. (2024) · Figshare · doi:10.6084/m9.figshare.26655379
Boakye, P. N., Prendergast, N., Desta, F., Obewu, O. A. T., & Mugambi, D. (2026) · Canadian Journal of Nursing Research · doi:10.1177/08445621251409460
“Consistent with existing literature (Kavanaugh & Hershberger, 2005; Mota et al., 2023; O ’ Leary & Thorwick, 2006; Simonson et al., 2024), Black Canadian men ’ s responses to the loss were characterized by feelings of sadness, anger, disappointment, and hopelessness.”
Verdi, E., Thampuran, A., & Marino, L. V. (2026) · Birth · doi:10.1111/birt.70092
Preterm birth and the perception of risk among African Americans
Norman, G. (2012) · Human Biology
- Authors
- Kavanaugh, K., & Hershberger, P.
- Affiliations
- University of Illinois Chicago (US)
- University of Michigan (US)
- Corresponding author
- Kavanaugh, Karen
- Venue
- Journal of Obstetric, Gynecologic & Neonatal Nursing
- Publisher
- Elsevier BV
- Published
- 2005-09
- Volume
- 34
- Issue
- 5
- Pages
- 595-605
- ISSN
- 0090-0311 (ISSN-L)
- 0884-2175
- PMC
- PMC1388191
- OpenAlex
- W2007253841
- Cited by
- 98
- References
- 45
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 2 · 2020: 5 · 2019: 8 · 2018: 5 · 2017: 2 · 2016: 5 · 2015: 6 · 2014: 6 · 2013: 7 · 2012: 5
- FWCI
- 4.24
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Obstetric, Gynecologic & Neonatal Nursing (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institute of Nursing Research (1R15NR4224-1A1, R15NR004224)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- perinatal loss, neonatal death, African American parents, low-income parents, grief, life events, coping with loss, culturally competent care, maternal experience
- MeSH terms
- Abortion, Spontaneous, Adaptation, Psychological, Adult, Attitude to Death, Attitude to Health, Black or African American, Female, Follow-Up Studies, Grief, Health Services Needs and Demand, Humans, Life Change Events, Male, Parents, Poverty, Pregnancy, Pregnancy Outcome, Quality of Health Care, Surveys and Questionnaires, Social Support, Nursing Methodology Research, Nurse's Role, Qualitative Research
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