by Heidi Miller Copeland

Will you support me during my pregnancy because I didn’t have a good experience with my last birth? Will you help me change providers because I’m too intimidated to tell my doctor I want to switch practices? It’s not uncommon for us to get these types of questions from women coming to us at Embrace, but for some reason, a recent particular request struck a chord and reignited my passion for what Embrace is really here for- to help create safe space for women to birth in just, equitable, and empowered ways. 

She told me her first birth in a refugee camp was wonderful. She had a midwife who supported her and stayed with her throughout her birth. It only lasted 4-5 hours and was hard work, but wasn’t excruciatingly painful. She felt empowered and supported. But, her second birth, in a US hospital was quite the opposite. She was induced, was left alone most of her labor with only her husband in the room with her, and when the nurses and/or doctor were in the room, they were anything but kind to her. She said, “I know it was hard for my providers to take care of me, but when they were unkind, I felt the labor pains get worse and worse. It was awful. During my current pregnancy, I catch myself feeling shortness of breath and a tight chest. I’m afraid to go to the doctor.”

I told her that no one should be treated the way she was and that she has every right to change providers and that we would be alongside her throughout that process and try to find her a provider who could better care for her. 

Why is this situation so alarming? Over 30% of birthing people will have psychological trauma from the experience (Krysta Dancy, birthandtraumasupportcenter.org). Why is this the case? Is it because birth is just hard and painful? Is it because of medical interventions? The reason is more nuanced, but is centered in the fact that birthing people are in an extremely vulnerable place physically, mentally, and emotionally during pregnancy and birth. Birth can be the most empowering, strengthening, enlivening experience of a woman’s life if she has what she needs to reach that potential. However, it can also become a traumatic experience that haunts her for years after. Because of this, the support that a birthing person receives during pregnancy, labor/birth, and postpartum is extremely important. If a birthing person doesn’t feel empowered and supported during this process, they are exponentially more susceptible to experience trauma. 

This is why we do what we do at Embrace. The women we work with are often more at risk to experience this type of trauma and harm because of many of the barriers and inequalities they face. But, we at Embrace also know there is a different way for them to go through the beautiful process of birth, a way that is deeper and truer. We know that these women come from many generations of strong women who birthed in spaces surrounded by other women with long traditions and cultures of strength and empowerment, meaning and normalcy around the birthing process. We learn from this history, seek to protect this lineage and not have it destroyed by a medical system that is not set up for these women. And we seek to speak this truth to the system and perhaps little by little, birth by birth, we are showing a broken system that there is a better way. This is our hope.

​May this work continue to be done until every birthing person is empowered and supported in their experience. 

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Rahina Kamal is one of those women you meet and realize- she is changing the world. Rahina sees herself as reborn. She has gone through the fire and emerged so brilliantly strong and resilient. 

The beginnings of Rahina’s story start with her childhood in Burma. She has a very loving family of a mother, father, eight brothers and three sisters. When she was 16, she left home to move to Malaysia to be married. This is where things turned upside down. Rahina’s husband was very abusive and when she was pregnant within 3 months of arriving in Malaysia. He was very upset because pregnancy and birth in Malaysia as a foreigner are very expensive. He wanted to sell their child when she was born to make up for the costs, but Rahina refused to allow this. So he beat her and left her on the streets to die. Some very kind Chinese foreigners who had a shelter took her in, brought her to the hospital, and cared for her until she gave birth to her sweet little daughter, Yasmin.

During this whole process, the people who were caring for her helped her apply to come to the US as a refugee through the UNHCR. The people from the UN were very kind to her and helped her while she recovered with hospital needs, counseling, and other support and she is forever grateful for their kindness and support. This is how she came to be in Georgia. Rahina’s body and mind were very harmed because of everything she experienced in Malaysia and so her refugee resettlement agency helped her find resources to help with the healing process. 

Meanwhile, at Embrace, we had begun getting referrals for women from the Rohingya community and didn’t have anyone to help interpret. A few friends of Embrace referred Rahina to us as someone who could help, but who also needed some meaningful work. And so our partnership began. Rahina has since had another child in the US, supported by the team at Embrace and has helped create a blossoming, beautiful community among Rohingya mothers, supporting one another and leading each other to be empowered in their health journeys. When Rahina speaks about this experience of coming to work at Embrace, she says,

“I’m so happy now that I’m helping people. Before, I was having migraines all the time, but now my migraines are gone! And I’m so proud of the work I do at Embrace because I’m also setting an example for my children to be strong, overcome hardship, stand up for themselves, and care for their community. My mother birthed me once, but Embrace has birthed me anew again.”

By being employed at Embrace, Rahina’s whole life has changed- her body and mind are healthy again, her English has improved, she has a way to support her family, and she is raising her kids in a strong community that cares for one another well and doesn’t put up with abuse or mistreatment. Rahina is a strong force at Embrace and an even stronger force in her community. She is now taking the joy and strength of her rebirth and sharing it with her family and community. And she is changing the world because of it. 

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A few members of Rahina's Embrace Family - Heidi, Rahina, Virginia, and Aku

and allow the interpreters to share the information their respective languages. At one point, whatever I'd said generated a few giggles, then some louder laughs, and a finally a couple of questions from the women in the room. As I did my best to share what I knew, I realized I felt less a teacher in that space and more a student. Together, we shared that awareness of women's intuition and knowing about difficult things and our bodies that couldn't be perfectly translated, but could be more fully understood if we remained open to one another.  

​As an Atlanta native, I feel right at home and halfway across the world while being in my neighboring community of Clarkston, often described as "the most diverse square mile in the United States." I am incredibly grateful for my experiences as a Morehead Scholar at UNC-Chapel Hill, where I pioneered an International Studies curriculum that gave me the opportunity to live and work in east Africa with women and their families. While researching my thesis on the HIV/AIDS crisis in Rwanda, I developed a love for maternal-child health and resolved that all women deserve access to culturally sensitive healthcare. As a Fuld Fellow at Emory University's School of Nursing, I recognized that nurse midwives have a unique opportunity to walk alongside women in pregnancy and childbirth, empowering them with knowledge to make healthy choices for their families. I then worked as a Certified Nurse Midwife with Kaiser Permanente at Northside Hospital, "catching" nearly 400 babies and helping countless other mothers throughout their pregnancy and childbirth.

Since that first experience at Embrace, I haven't been able to leave.  Jenny, Heidi, and the rest of the team have made me feel like a part of the family from day one. After the birth of my third daughter, I joined the advisory council at Embrace and the executive board of Friends of Refugees, serving as its chairperson from 2018-2020. I am thrilled to be with the Embrace family again in this new capacity as Director, and proud to introduce my three girls, friends and communities to all the wonderful people who continue to teach me and shape me in the most beautiful and unexpected ways. My hope is that our Embrace family can continue to grow and find those moments of mutual learning from one another that allow for all women and their families to thrive.

​In 2011, I met Jenny Cochran and Liz Johnson on the living room floor of my dear friend who had recently moved to Clarkston as a refugee from Burma. She had been a midwife in a refugee camp in Thailand and despite her limited English, my friend and I quickly became involved in Embrace. She became an interpreter for women from Burma and I, a birth support doula and childbirth educator. In those early days, I have memories of sitting on the floors and couches of many other refugee women from Somalia, Congo, Afghanistan, and Bhutan. 

​While I had become an Embrace volunteer to walk alongside refugee women through their pregnancy and birth experiences, I was often the one who was welcomed and cared for in ways that I will never forget. I remember sitting in doctors' offices with women and then returning to a joy-filled, cramped apartment to eat spicy noodles or drink sweet tea while my new friend would share stories about previous birth experiences in a refugee camp, clinic, or at home. I remember accompanying women to give birth in the hospital, one such time a Congolese mother quietly birthed her sixth baby while the nurse scrambled to put on gloves and call for the doctor. I learned a lot about the different traditions that surround birth and welcoming a new child into the world, such as the naming rituals common in Bhutanese tradition or the unique ways that women prefer to give birth in Somali or Karenni (a tribe from Burma) tradition. My support never looked the same; most of the time it involved helping to explain to a partner what a medical professional had said, or driving a woman and her family to and from medical appointments. Many times, my involvement was on the receiving endas I was continually invited into homes for meals, family celebrations, cultural holidays, and other special occasions.  Ultimately, It was an honor to be welcomed into these families' homes during one of the most intimate experiences of a woman and family's life: childbirth. 
~ Amber Oda, Embrace Volunteer 2011-2012

Back in 2009 Jenny Cochran, a labor doula and childbirth educator, and Liz Johnson, also a labor doula, were told of a refugee mom who had just given birth to her 7th child. This was her first US birth and she had experienced a two day induction which ended with a c-section. This story compassionately moved Jenny and Liz as they recognized a potential need within the refugee community. In 2010, they contacted a local resettlement agency (World Relief), offered their services as labor doulas, and Embrace Refugee Birth Support was born. They were immediately matched with three newly arrived moms: two young first time mothers and one mom who was scheduled for a repeat cesarean. 

Unbelievably both of the first time moms went into labor on the same day! They both labored at home and arrived at the hospital in active labor. Everything was progressing nicely for the moms and their babies until about 20 minutes into the pushing phase. Each woman’s doctor began yelling and threatening the women to push more effectively or face the OR.  No use of an interpreter or language line was used and no instruction was given on how to push effectively in either case. Jenny and Liz quickly jumped in and tried to teach the women how to push and both births ended up with healthy mothers and babies. However, after this experience, Jenny and Liz realized they needed to do more. Just showing up as support during labor and birth was only part of the solution.

Jenny recognized the need for childbirth education classes, advocacy, and the need for building relationships and supporting the moms throughout their pregnancies. In those first years, the classes were a total flop for a myriad of reasons and yet the women kept showing up.  Embrace’s first real breakthrough was when an American woman introduced Jenny to her Burmese friend who was a trained midwife. This woman became Embrace’s first community liaison. Further connections within the community of New Americans who spoke English and were leaders in their communities were made. It was then that the program really began to take off. 

Eventually Embrace came under the larger nonprofit Friends of Refugees as our program needed a funding base and an administrative structure. At that point Embrace was able to start receiving donations and volunteers which were critical to expanding the program to a greater number of women within the refugee/immigrant population. As of today, 2020, we have served over 400 mothers in the Clarkston community. It is our hope that with the continued support from our donors and volunteers that we would be able to serve these women another ten years with quality education, advocacy, friendship, and support throughout their journey of pregnancy and birth.

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Embrace has fundamentally changed the way I practice as a labor & delivery nurse. Working in the Atlanta area, I often encounter patients who do not speak English. Prior to Embrace, I would attempt to communicate in English if the patient seemed to understand. But now I have come to see the importance of interpretive services. Rather than seeing the language line as a last resort for those who “really don’t speak English,” I see it as a gesture of hospitality. I see it as a way to invite patients to participate in their own care, to truly feel heard, understood, and cared for in their native tongue. ​This change in my practice came because as an embrace volunteer, I find that healthcare providers often walk into the room and look past the patient and to me- the English speaker. I understand this tendency. It’s faster and easier for the provider, but it excludes the patient from conversations focused on them and can leave them feeling isolated and unheard. My goal as a nurse and a person is to make space for people to be heard and supported. So thank you embrace for helping me learn to do that well!
~Nila Underwood, BSN, RN