ECU Birth Companions was established as an Albert Schweitzer Fellowship project, with additional funding provided by the ECU Health Foundation and was modeled after UNC-Chapel Hills’ Birth Partners program. Our project work began in February 2022 to lay the framework for a hospital-based volunteer doula program at ECUHMC, the sole provider of high-risk pregnancy care in a rural 29-county region. Volunteers were recruited from undergraduate, graduate, and health campuses. The selection process includes a written application, interview, and onboarding through ECU Hospitals Volunteer Services Department. To enhance sustainability, we developed an in-house training curriculum mirroring professional doula certification programs like DONA. This comprehensive training consists of a three-hour childbirth education course, 12 hours of doula support training, and 4 hours of breastfeeding and postpartum support. Our program officially launched in October 2022 with an initial cohort of 20 volunteers.