A Clarkston woman’s mission to make it easier for pregnant refugees to navigate the healthcare system

Pregnant when she arrived in Clarkston from Afghanistan, Muzhda Oriakhil struggled to navigate the American healthcare system. Now she’s making it easier for refugee women who’ve followed.

Muzhda Oriakhil

Photograph by Audra Melton

Muzhda Oriakhil was three months pregnant when, in the spring of 2014, she moved to Clarkston from Afghanistan, arriving with her husband, who’d been resettled on a special immigrant visa reserved for Afghans who worked with the U.S. military. Though she spoke English, she found adapting to life in a new culture hard, particularly as her pregnancy progressed. “In my country,” she said, “we don’t speak about pregnancy or share our experiences.” She had no idea how to manage her intense morning sickness, let alone navigate the healthcare system in a foreign country.

While Oriakhil’s husband looked for a job, the couple had no insurance or car—which made it difficult to find an ob-gyn. Before coming to the U.S., she’d imagined that a country “with all these facilities” would make for a “dreamy life.” But she quickly realized that new arrivals faced a lot of barriers to access the kind of healthcare she needed. Then a friend introduced her to Heidi Copeland, the program impact manager of Embrace Refugee Birth, a nonprofit in Clarkston that guides refugee mothers through pregnancy and early motherhood. “It was the first time I realized I’m not alone,” Oriakhil said.

Since 2010, Embrace has assisted more than 500 newcomers from more than 30 countries. Its staff and volunteers help secure necessary items like baby clothes and car seats; connect refugees with doctors and provide transportation to appointments; and educate women on reproductive health, pregnancy, postpartum recovery, and parenting. “So much has already been taken away in the process of becoming refugees,” Copeland said. What her clients need is to “be able to be empowered again to know and listen to their bodies.”

Like many female refugees from restrictive cultures, Oriakhil had little knowledge of reproductive health. According to United Nations data, Afghanistan has the highest maternal death rate in the Asia and Pacific region, due largely to poverty and limited access to care; mothers there face a 1 in 52 chance of dying from pregnancy-related causes. With Embrace’s help, Oriakhil got an appointment with a doctor at Grady Hospital—nearly four hours round trip on public transit. “It was very hard,” Oriakhil recalled. “I was tired all the time.” When she was 22 weeks pregnant, Oriakhil started experiencing abdominal pain. Her husband was working out of state, so she called the only person she knew she could rely on: Copeland, who rushed her to the hospital. At the emergency room, Oriakhil learned she was miscarrying.

She recovered at home, feeling “very down.” One day a neighbor reached out and said she’d enrolled in one of Embrace’s healthy pregnancy classes, asking if Orkiahil would accompany her as a translator. Oriakhil, who speaks Dari and Pashto, figured it would be a good distraction—and found herself intrigued by the topics the classes covered: “I said, ‘That’s something I want to do.’ I want every pregnant woman coming from another country to know about this.”

After attending that first class, Oriakhil learned she was pregnant again—just six weeks after her miscarriage. “I had no idea that could happen,” she said. She continued attending the classes as a volunteer translator and as an expectant mother. Oriakhil says the courses taught her about her changing body and what to expect at doctor’s appointments, and helped her overcome the cultural shame of talking about her body—which enabled her to receive better care. In 2015, she gave birth to a healthy baby girl.

Today, Oriakhil is a mother of three and works full-time as Embrace’s community engagement manager and Afghan community liaison, building relationships with Afghan women and connecting them to the resources and education they need to have safe, healthy pregnancies. In the year since the Taliban retook Kabul in August 2021, she helped more than 70 pregnant Afghan refugees resettled to the Atlanta area. “I know, from living it, the trauma they have experienced,” Oriakhil said. “They trust me to be an advocate for them, help them find resources, and navigate the healthcare system.”

Embrace’s staff and volunteers support women throughout their pregnancies, from connecting them with doctors to providing education on parenting.

Photograph by Audra Melton

Khalida Ahmadi, who arrived in Decatur in the winter of 2021, was one month into her pregnancy when her immigration caseworker put her in touch with Oriakhil. Through a translator, Ahmadi explained how Oriakhil convinced her to attend Embrace’s classes despite Ahmadi’s fears that she wouldn’t be able to understand, since she doesn’t speak English and has no formal education. “Muzhda gave me confidence,” she said, explaining that Embrace leaders use resources like slides and pictures to overcome language and reading barriers. Ahmadi was able to come up with a birth plan, learn which foods to eat for a healthy pregnancy, and gain a better understanding of the medical care she was receiving.

“I think anyone would acknowledge that pregnancy and childbirth are a defining moment in a family’s life, and that that experience can be really wonderful,” said Embrace’s director, Virginia Voyles Tester. “But it can also be very daunting. I always encourage people, when they’re thinking about volunteering, to imagine what it’s like to give birth in a country where the language is not yours, the culture is not yours, and the medical practices, the instruments in the room, everything is totally unfamiliar.”

Being able to navigate the cultural differences among the refugee women Embrace serves—who come from places as disparate as Syria, Burma, and Sudan—is crucial to the organization’s success. Embrace’s community liaisons, Tester continued, “make sure a mom does not feel lonely, isolated, misinformed, or receive insensitive or inappropriate care.” Last year an initial study involving researchers at Emory University and Georgia State University confirmed that the community-based, culturally tailored programs offered by Embrace do lead to better health outcomes for participants when compared to other women from the same community with similar racial/ethnic backgrounds.

Oriakhil’s arrival in Clarkston not only saved her life from the Taliban. It also presented an opportunity: the chance to become newly educated about her health. And now she’s paying it forward. “When women start talking and asking questions,” Oriakhil said, “they get empowered.”

This article appears in our February 2023 issue.