The Lived Experience of the African American Pregnancy That Ends in Preterm Birth Clarise Hairston Ottley

Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Fall 2009 The Lived Experience of the African American Pregnancy that Ends in Preterm Birth Clarise Hairston Ottley Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Ottley, C. (2009). The Lived Experience of the African American Pregnancy that Ends in Preterm Birth (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/1001 This Immediate Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. THE LIVED EXPERIENCE OF THE AFRICAN AMERICAN PREGNANCY THAT ENDS IN PRETERM BIRTH A Dissertation Submitted to the School of Nursing Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Clarise Hairston Ottley December 2009 Copyright by Clarise Hairston Ottley 2009 THE LIVED EXPERIENCE OF THE AFRICAN AMERICAN PREGNANCY THAT ENDS IN PRETERM BIRTH By Clarise Hairston Ottley Approved November 20, 2009 Mary Ann Thurkettle, PhD, RN Carolyn Nickerson, EdD, RN, CNE Assistant Professor of Nursing Associate Professor of Nursing (Committee Chair) (Committee Member) Cynthia Persily, PhD, RN, FAAN Eileen Zungolo, EdD, RN, CNE, FAAN Professor of Nursing Professor of Nursing (Committee Member) Dean, School of Nursing iii ABSTRACT THE LIVED EXPERIENCE OF THE AFRICAN AMERICAN PREGNANCY THAT ENDS IN PRETERM BIRTH By Clarise Hairston Ottley December 2009 Dissertation supervised by Dr. Mary Ann Thurkettle The research study was undertaken to help fill the gap in understanding the disparity between the current preterm birth rates of African American women and White women. A phenomenological methodology was used with a sample of seven African American women who had experienced preterm birth. The findings provide insight into experience of a pregnancy that ends in preterm birth. An in-depth understanding of the contextual factors associated with preterm birth in African American women was provided through a description of experiences as voiced by the participants themselves. Their stories provided rich, detailed data and insight into their lived experiences, revealing new insights and perspectives on the phenomenon of the African American pregnancy ending in preterm birth. Two Themes emerged:"Strong Black Woman Ideal" and "Feeling Trapped." iv Awareness regarding the need to “peel back” layers of generational factors which influence stress on and the types of stressors specific to African American women were noted. While it is safe to say that stressors, stress, and stress responses are experienced by all pregnant women, it may be that African American women are unique in their cumulative experiences of and response to stress. Reflection on and review of extant knowledge in the literature on the extracted themes revealed some concepts that may be related to the extracted themes "Strong Black Woman Image" and "Feeling Trapped." Permeating both themes was the experience of stress these women felt in having to live up to self- and other-imposed expectations of strength resulting from the image of a strong Black woman and feeling trapped by the expectations of the image, along with other responsibilities and obligations. The end result is feelings of being trapped by the expectations of that image and a pregnancy that is affected by the cumulative effects of the two. Knowledge gained from this study will contribute to future knowledge development regarding factors that may be associated with preterm birth among African American women. v DEDICATION I dedicate this research to the hundreds of thousands of women who have lost their babies as a result of prematurity, and to the thousands who may lose their babies in the future. May God comfort you where you hurt, and may He instill the wisdom and knowledge in those who desire to find ways to reduce the pain associated with premature births. I also dedicate this research to other African American women who are nurses, those who aspire to become nurses, and those who did not believe they could ever become a nurse. You are a gift to this great nation! You can become leaders and giants by tapping into your rich heritage, ordained steps, and destiny prepared in advance for you by God. I pray for your strength, perseverance, and faith to trust Him to use you to make a difference! To my grandchildren, who are yet to be born, please know that you are precious, you are royal, you are chosen kings and queens, and you are loved! May you follow my footsteps, no matter your chosen profession, and go wherever God leads you. Serve Him and others with the gifts He has place within you. vi ACKNOWLEDGEMENTS I first express my gratitude and acknowledgement to God, my Father, for loving me so much that He would give me the strength, wisdom, knowledge, perseverance, and faith to accomplish this task. To Him I give all glory and honor for my success! He is truly a keeper of His promises (Jeremiah 29:11-13). To Jesus Christ, the lover of my soul! My Jehovah Jireh, Jehovah Rapha, Jehovah Shalom, Jehovah Rohi, and Jehovah Shammah, thank you for giving your life in exchange for mine, and for choosing me to be your favorite! To the Spirit of God, who has kept me, comforted me, encouraged me, and empowered me to “step out on waters, when they said it could not be done.” Thank you for your power which gave me the strength to speak to this mountain! To my husband Al, my mentor, my confidant, my supporter, and my friend! Thank you for your obedience to God 30 years ago! Thank you for your innumerable sacrifices! Thank you for the life lessons in stepping out in faith. Thank you for the verbal visual that stayed before me, whenever I felt “choked” by the enormity of the task:”How do you eat an elephant? One bit at a time!” Your love and encouragement helped me stay the course. Now that you have reached your summit, you can sit down from your labor and rest! To my four sons, Jason, Jonathan, Jordan and Joel, a mother’s most cherished treasure and gift! Thank you for your love and forgiveness for those days when I was not able to be there for you! I still hear your voices echoing in my head: “Are you almost done???” vii To mama (Vinnie Nellie Bell Moyer [Hairston] Pinnix), mom (Vera Anita [Ottley] Smith) daddy (Tommy Clarence Hairston), and “Stuff” (Carl Clayden Pinnix), thank you for your never ending, never ceasing, countless acts of unconditional love and support. To my family, the Hairstons, the Moyers, and the Pinnix, you represent generations of faith walkers. Thank you for lighting the way for me! To Marlene Gray, thank you for believing in me, seeing my worth, and giving me a chance eighteen years ago, as a new nurse on the Maternity Unit. The seed you deposited into my life will continue to grow and positively impact the lives of people we may never know. To Kathleen Gaberson, my friend, thank you for your example of courage, strength, and perseverance. Thank you for believing in me and showing me the way. Thank you for laboring with me as I stepped out in tumultuous waters of indecision and apprehension. It was your example, nurture and faith in me that rekindled my passion to pursue this degree. To all my sisters in Christ, especially the women who are a part of WWWGOD & WCW, thank you for your prayers, words of encouragement, and countless shoulders to cry on. Thank you for your confidence in me and your sacrificial love. Thank you for allowing me the opportunity to teach, serve and be served by you! Because of you, I have grown personally, professionally, and spiritually! To my church family (Covenant), thank you for your endless prayer, and for keeping a vigil for me when I was too exhausted to pray! viii To Dr. James Brown and staff, thank you for your assistance and the opportunity to serve the OB community! Our partnership will assist in providing ongoing research that will help reduce and/or eliminate preterm birth for all women in general, but especially for African American women who currently have the highest preterm birth rate of all races. To my colleagues at Shepherd University and my co-workers at City Hospital, thank you for stepping in and covering for me during times of family crisis and sheer exhaustion. To each of the participants of this research study, please know that I will be forever grateful for your story! As a result of your unselfish sacrifices, the preterm birth rate for African American women will decrease! Last, but certainly in no ways least, I thank you Dr. Mary Ann Thurkettle (dissertation chair), Dr. Carolyn Nickerson and Dr. Cynthia Persily (committee members) for your sacrificial guidance and support. Your expertise in your respective areas is evident throughout this manuscript, and will reach further than the words on the following pages could ever go! ix TABLE OF CONTENTS Page Abstract.............................................................................................................................. iv Dedication.......................................................................................................................... vi Acknowledgements........................................................................................................... vii Chapter 1: Introduction........................................................................................................1

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