Collaborative Development and Implementation of a Video-Based Curriculum Expansion to Improve Refugee Women’s Birth Experiences in the United States

Abstract

Many refugee and immigrant women in the United States experience cultural and language barriers when seeking pregnancy-related medical care. Such barriers may delay needed care and adversely impact birth outcomes. Embrace Refugee Birth Support (Embrace) in Clarkston, Georgia, supports pregnant refugee women by offering birth education classes in the women’s primary languages. Our academic–practice partnership designed and implemented a series of birth education videos for Embrace participants. Based on input from former participants, the partnership team created video scenarios that could be embedded into Embrace’s existing didactic curriculum. The videos addressed common challenges and learning needs identified by previous participants. All videos were filmed in the participant’s primary languages (Swahili and Kinyarwanda) and featured actual Embrace graduates who spoke the languages. Then, Embrace trainers used the video scenarios to augment teaching on birth preparedness and foster participant discussion during class sessions. After implementation, a focus group with participants in the video-expanded class reported the videos were well received, understood, and practically related to their pregnancy needs. Overall, participants reported that video scenarios were an important part of their learning and skill development, as well as a positive experience. Embrace has plans to continue creating native language educational videos for additional languages and birth-related topics. The academic partner’s attempts to measure video impact with standardized quantitative instruments at baseline were terminated. The substantive revisions in data collection strategies highlight the need for cross-cultural flexibility and the potential for unforeseen barriers when using quantitative research tools among non–English-speaking participants.

Evaluating Birth Outcomes From a Community-Based Pregnancy Support Program for Refugee Women in Georgia

“…A core value of Embrace is cultural sensitivity; through their programming, education, and birth support, Embrace seeks to integrate a refugee's home culture into her birth experience in America. Additionally, the Embrace volunteers help alleviate many barriers women face in accessing and navigating pregnancy-related services, particularly as it relates to relationships and communication with providers during the pregnancy, birth, and postpartum periods ( 40 ). As highlighted by Khan and DeYoung ( 41 ), culturally sensitive programs and strategies such as these are needed to assist refugee women with accessing maternity services that can improve outcomes.…”

Early action in the asylum support sector: a scoping review

“…Data indicate that maternal mortality rates are higher among asylum-seeking women than other population groups, and many face barriers to accessing maternity health services, or access these sporadically (Feldman, 2013;Mccarthy and Haith-Cooper, 2013;Tobin and Murphy-Lawless, 2014;Byrskog et al, 2015;Balaam et al, 2016;Fuller et al, 2021). In one study in Liverpool, UK, all asylum-seeking women identified via maternity units, asylum screening centres and mental health services were invited to participate, on the assumption that any woman seeking asylum while pregnant or with a young baby would be traumatised and need support to avert a mental health crisis (O'Shaughnessy et al, 2012).…”

“…A 'social return on investment' analysis 9 calculated a social return of £5.44 for every £1 invested, through reduced use of health services (due to improved wellbeing and better knowledge about available services), increased employment, and other variables . A project in Georgia, USA, produced videos in a range of languages on 'birth education', featuring interviews with women who had already participated in the organisation's face-to-face education programme; these videos were well received, understood, and practically related to asylum seekers' pregnancy needs (Fuller et al, 2021).…”

A scoping review of maternal health among resettled refugee women in the United States

“…Cultural practices to keep postpartum women warm were noted in studies on Indochinese refugee women and Haitian refugee women (25,50). After birth, the Vietnamese, Mien, and Cambodian were traditionally placed near a fire.…”