Living with grief after pregnancy loss: Perspectives of African American women

African American women experience pregnancy loss at rates at least twice those of women from other ethnic/racial backgrounds. However, there is limited data about their lived experiences with the loss and the effects of these experiences on their health. In this study I examined the African American experience with grief and its impact on health. I also examined the strategies that these women used to cope with their grief. Using a descriptive, cross-sectional, historic design with convenience, snowball, and purposive sampling techniques, African American women were recruited from community-based sites in California with small subsample from Texas. Seventy-four participants responded to four questionnaires: the Perinatal Grief Scale, Women's Role Integration Protocol, Medical Outcomes Study 6-Item Health Survey, and a personal profile. Of the 74 participants, 20 women were recruited to participate in a semistructured interview. Multivariate regression models were examined for grief and health. Selected grounded theory methods were used to identify themes for their coping strategies. The findings indicated that: (a) the variance in grief intensity was explained by the level of role integration (sr2 = .05, p = .04) and attendance at religious services (sr2 .06, p = .02) and not by time since loss or gestation at loss; (b) the variance in general health could not be predicted by time since loss, gestation at loss, level of role integration, grief intensity or attendance at religious services; (c) the variance in emotional health was explained by gestation at loss (sr2 = .08, p = .01); (d) the participants used prayer, talking to others, internal reflection, and avoiding discussion of the loss as coping strategies; and (e) the participants had a high level of grief as long as three years postloss, as compared to the Euro-American sample used in the PGS development studies. Women who experience pregnancy lose may need support and preventive health interventions much longer than the one-year suggested in the current literature. We are challenged to figure out ways to harness the influences of familial relationships and religious practice for women living with grief after pregnancy loss.