AUTHOR=Mosley Elizabeth A. , Pratt Michelle , Besera Ghenet , Clarke Lasha S. , Miller Heidi , Noland Tracy , Whaley Bridget , Cochran Jennifer , Mack Amber , Higgins Melinda 

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

JOURNAL=Frontiers in Global Women's Health

VOLUME=Volume 2 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2021.655409

DOI=10.3389/fgwh.2021.655409

ISSN=2673-5059

ABSTRACT=Refugee women face numerous and unique barriers to sexual and reproductive healthcare, and can experience worse pregnancy-related outcomes compared to U.S.-born and other immigrant women. Community-based, culturally-tailored programs like Embrace Refugee Birth Support may improve refugee access to healthcare and health outcomes, but empirical study is needed to evaluate programmatic benefits. This community-engaged research study is led by the Georgia Doula Access Working Group including a partnership between academic researchers, Emory Decatur Hospital nurses, and Embrace. We analyzed hospital clinical records (N=9,136) from 2016-2018 to assess pregnancy-related outcomes of Embrace participants (n=109) and a comparison group of women from the same community and racial/ethnic backgrounds (n=915). We controlled for race, language, maternal age, parity, insurance status, pre-eclampsia, and diabetes. Embrace participation was significantly associated with 48% lower odds of labor induction (OR=0.652 p=0.025) and 65% higher odds of exclusive breastfeeding intentions (OR=1.65, p=0.028). Embrace showed positive but non-significant trends for reduced Cesarean delivery (OR=0.83, p=0.411), higher full term gestational age (OR=1.49, p=0.329), and reduced low birthweight (OR=0.77, p=0.55). We conclude that community-based, culturally-tailored pregnancy support programs like Embrace can meet the complex needs of refugee women. Additionally, community-engaged, cross-sector research approaches could ensure the inclusion of both community and clinical perspectives in research design, implementation, and dissemination.