Global Birthing Home Foundation
Larnage (Torbeck), Haiti
Betsy Wickstrom MD
Haiti is burdened with the highest country rates of maternal and newborn mortality in the Western Hemisphere. And within Haiti, the risks for mothers and their newborns is greatest in rural areas. Maison de Naissance (MN) was established to prevent maternal and newborn deaths by breaking down economic and social barriers that prevent mothers from receiving maternity care.
Maison de Naissance is a partnership between an American team of supporters and a Haitian staff. The program began with foundational research examining social and health conditions in a rural area in southern Haiti. This research included home visits with more than 10,000 residents.
These visits resulted not only in the acquisition of important baseline data, but also in community engagement – even before the opening of the birthing center. An active intermix of home, community, and facility-based programs continues to be the hallmark of Maison de Naissance.
After more than a decade, MN is now a locally loved and respected institution. Jim Grant, executive director of the foundation that supports MN, credits this success to “100% Haitian staff who provide high quality medical care in a welcoming and culturally appropriate environment, coupled with ongoing community oriented support, to ensure that our patients receive the best care possible.” MN has received awards from local community and government groups. It has met its own goals of shifting the balance of perinatal statistics and preventing deaths. The proportion of pregnant women in the area receiving prenatal care has increased. The proportion of births supervised by a trained birth attendant has increased. The neonatal mortality has decreased and there have been no maternal deaths at MN. Beyond birth services, significant accomplishments includes a notably high proportion of women in the area participating in family planning. MN’s mother’s club has initiated a women’s economic cooperative, a community garden, and a women’s small business loan program.
MN was the first birthing home in Haiti. Thus, it has had to forge political and cultural pathways in addition to logistical work to achieve the sustained delivery of healthcare options. Institutional licensing, midwife professional licensing, human resource limitations, fee setting and financing all continue to be challenges for this Haitian-American partnership. But the strong vision statement of it’s midwives continues to inspire resilience at Maison de Naissance.
At a recent community gathering, MN’s staff wore shirts with their chosen motto: “No mother should die to give life. No baby should die to come into life.”
Additional program notes
- Established in 2004
- Sponsored by Global Birthing Home Foundation (USA)
- Affiliated with the Episcopal Church of Haiti
- Staffing: 6 nurse midwives, 7 nurses or nurse assistants, support staff (total 34 FTE’s)
- Clinical volume: 50-60 deliveries per month, 400 clinic visits per month
- Pre- and post-natal care, deliveries, family planning, STD testing and treatment, women’s reproductive health, well baby care with vaccinations to 18 months, community health outreach, and purified water distribution.
- Almost one quarter of a million total consultations, including over 100,000 family planning consultations, and over 8,000 deliveries to date
- Has remained accessible to the local communities 24×7 for over eighteen years
- Home visits, community education programs
- Transfers: Hopital Immaculee Concepcion, Les Cayes, Haiti
- Home visits are conducted before, during, and following pregnancy.
- Transportation is supplied not only to the center for deliveries, but also postpartum so that mothers do not have to walk home or take a risky motorbike ride with their newborn.
- The property includes a traditional open air shelter where mothers like to gather for conversation and community. “We initially assigned appointments for the convenience of our patients,” reported a former director. “But none-the-less, all of the women appointed for the day arrive at 8:00am for prayer, singing, and to wait with each other until everyone has their consultation.”
- Maison de Naissance built latrines for its closest neighbors, converted its excess land space to community gardens, supplied street lights for students to study, and water wells for the community.
- HPV/cervical cancer “See and Treat” program