Students Produce Video Series to Help Local Refugee Mothers

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Rollins School of Public Health student Mackenzie Leonard was watching a Congolese woman give birth in a Dekalb County hospital. The woman was trying to explain to her doctors that she did not want a Cesarean section. She passed a phone back and forth to the medical team, using a “language line” translator service to attempt to communicate her wishes. The hospital environment was scary and unfamiliar, and as a refugee mother whose husband was at work, the woman had little assistance in her pregnancy and birth.

This story is not uncommon among mothers who immigrate as refugees to the United States and land in the Atlanta area. Clarkston, Georgia, just outside the metro Atlanta area, is lovingly called “the most diverse square mile in America,” due to its large immigrant population. Half of the city’s residents are foreign-born, hailing from over 50 countries on six continents. In large refugee resettlement hubs like Clarkston, pregnant women and new mothers face additional healthcare challenges and barriers.

Enter Embrace—a program whose mission is to “support, advocate for and educate refugees throughout the pregnancy, birth and postpartum experience.” Embrace is a program of local non-profit Friends of Refugees. Partnered with Embrace and led by Leonard, an interdisciplinary team of students from across the the Atlanta area created a series of eight educational videos for refugee mothers. The team came from Candler School of Theology, Georgia Tech, the Nell Hodgson Woodruff School of Nursing, and Rollins. John Cranmer DNP, MPH, ANP in the nursing school advised the project.

The videos accompany Embrace’s eight-week course, which distributes free information and resources to pregnant refugees. Leonard’s project provides a new way to engage interactively with Embrace’s curriculum. In the past, the sessions were taught using PowerPoint and on-site translators. Using a different approach, Mackenzie and her team curated content from the community of mothers who had already been through the program. The videos have been integrated into the PowerPoint model to increase audience engagement and encourage discussion. For the initial pilot program, the videos were recorded in Swahili and Kinyarwanda, but Mackenzie hopes to expand to other languages.

“We filmed the entire series in one day, and some moms from the program volunteered to do role-playing and skits,” Mackenzie explained. “The videos were shot in the Simulation Lab at the School of Nursing, and we used loose structure and improvisation to produce the content.” This hands-off approach allowed the women themselves to really direct the series. “It’s not for us, it’s not about us, and I’m so glad that the moms got the chance to be involved,” said Mackenzie.

In the early videos, set in a living room, the mothers introduce themselves and talk frankly about navigating barriers to healthcare. One video shows a woman asking for advice because she cannot find childcare or transportation to get to her doctor’s appointment. Her friend explains that getting to the doctor’s office is crucial, and that Embrace can assign volunteers to provide these services.

Then, the videos dive into visits to the OB/GYN and the hospital. They explain everything from the importance of monitoring blood pressure to negotiating consent with your doctor for vaginal exams. Parts of pregnancy that seem routine and non-invasive to American patients can be scary and foreign to refugee mothers. Cultural contexts of pregnancy and birth vary widely, and different people have different experiences with the healthcare system in their former homes. Mackenzie’s videos help women develop confidence and strategies for support in order to advocate for themselves in medical contexts and get the best care possible.

The final videos in the series talk about the big day in detail—pain medication options in the hospital, dealing with “language line” translators, and maintaining social support systems after giving birth. In the future, Mackenzie hopes to expand the breadth of content to include contraception, postpartum care, and dealing with insurance coverage. “The project got really positive feedback and results from everyone who participated.”

Mackenzie applied for funding through the Healthcare Innovation Program, a joint venture between Emory, Georgia Clinical & Translational Science Alliance (Georgia CTSA), Georgia State University, and Georgia Tech that provides $5,000 student seed grants to interdisciplinary teams that examine healthcare services and clinical effectiveness. Another student group has already received an additional round of Healthcare Innovation Program funding to continue the project. Mackenzie graduated from Rollins in May, but plans to stay connected to Embrace and further her passions for improving maternal and child health among underserved populations.