After assisting dozens of refugee women during labor, Birth Companion Susan Kim, BSN, RN, has become a non-verbal communicator.

Sure, she knows how to say several labor-appropriate words like “breathe” in Swahili, Arabic, and Nepali. But sometimes a look or a touch says more. She remembers an African woman who did not speak English. “Every time she had a contraction, she would just look at me. That was her way of going through the pain,” says Kim, a master’s in public health student at the Johns Hopkins University School of Nursing (JHUSON).

In addition to the tremendous emotional and physical challenges that come with displacement and resettling, pregnant refugees in the U.S. must also face an unfamiliar, often scary, medical system.

Enter the JHUSON’s Birth Companions program. Since 2010, nursing students like Kim had provided pre- and post-natal support to Afghani, Somali, and Bhutanese refugees, among others, thanks to a partnership with the International Rescue Committee (IRC) in Baltimore. To enhance the IRC’s existing pregnancy support program, students also act as doulas—a vital service considering the IRC’s pregnant population has more than tripled since 2008.

“We believe that the women at the IRC are in greatest need of our services,” says associate professor Elizabeth “Betty” Jordan, DNSc, MSN, RNC, FAAN, who co-coordinates the program. “Our students work very closely with the IRC staff to provide these women with information about what it’s like to give birth in this country.”

In addition to being doulas, Kim and other Hopkins nursing students adopt other roles when acting as birth companions to IRC clients.

Pre-labor, Kim, who is also the liaison between Birth Companions and the IRC, is an educator. “These women often don’t have the option of epidurals or other technological interventions in their home countries,” she says. “They are used to the idea of laboring at home and having the female relatives help.” So she tells her clients about how U.S. hospitals are organized and their options for pain management.

Then, during labor, Kim is also a patient advocate. She helps facilitate communication between hospital staff and moms. For example, doctors may not fully explain procedures to laboring moms who do not speak English. So Kim may gently ask the doctor to tell them what is going on. “Giving birth is so much easier for the moms if there is someone there who they’ve talked with before,” she says.

By building this strong relationship with the IRC’s clients, the 16-year-old Birth Companions program has come full circle. It was started by a group of returning Peace Corps volunteers in 1997, and today still attracts nursing students who are interested in international health.

“Our students often bring a strength to the program in that they have international experience,” Jordan says. “Working with the IRC is a way to align some of their previous experiences with nursing and women’s health.”

Learn more about the Department of Community-Public Health.

Learn more about the JHUSON Birth Companions program.