Lowering the Maternal Mortality Rates in Haiti

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PORT-AU-PRINCE, Haiti — In the developing world, both infant and maternal mortality rates are exceptionally high. This is due to poor health infrastructure and inaccessibility to adequate healthcare, which are two major components of abject poverty. In 2013, the World Report disclosed that the maternal mortality rates in Haiti are among the highest of the Western Hemisphere with 380 deaths per 100,000 live births. The government issued several plans in an effort to significantly lower and eventually eliminate the high maternal death rates.

At-Home Births in Haiti

In 2013, reportedly only 36 percent of births in Haiti occurred in healthcare facilities while the rest took place at home. These at-home births were typically in remote villages with unsanitary water conditions and poor transport infrastructure. Many women gave birth with the aid of traditional birth attendants, or matrons. These attendants are quite expensive for impoverished citizens. Costs include 500 Haitian Gourds ($5.26 USD) for girls and 800 Haitian Gourds ($8.42 USD) for boys.

Additionally, matrons do not often have proper training nor the equipment to safely deliver a child. The attendants are not always able to detect high blood pressure conditions such as eclampsia; this accounts for 17 percent of the maternal mortality rates in Haiti. Further, they sometimes lack awareness of the importance of cleansing hands prior to a vaginal examination and child delivery. Finally, matrons do not always cut the child’s umbilical cord with a sterilized blade.

Making Changes

To combat this issue, the Health Ministry of Haiti developed a network of maternity wards operated by professionally trained midwives and physicians. This network can serve as birthing centers and offer mothers both prenatal and postnatal care. The Petite Place Cazeau Hospital located in Port-au-Prince is a model example of how transformational and vital adequate healthcare facilities are. Within the first year of opening, the hospital experienced no maternal deaths. Amoin Soulemane, a midwife and U.N. volunteer, partially attributed the nonexistent death rate to consultations to detect pre-eclampsia, which is one of the leading causes of maternal death in Haiti.

The Marigot Centre de Sante, located 60 miles south of Port-au-Prince, is a clinic that serves a smaller, rural population. Although the clinic has plumbing and sanitation, it lacks some of the basic amenities and supplies typically associated with a maternity clinic due to its rural location. There are no sonography machines or a reliable supply of catheters. Additionally, there is also no pain relief medicine. However, these factors have not hindered the success of the clinic. The center opened in 2013 and there have been no maternal or infant deaths in the hospital. The success of the clinic and its nonexistent mortality rates are credited to the utilization of sterilized blades, competent health professionals and cautious care for the patients and their children.

Unsafe Abortions

Due to abortion being illegal in Haiti, some women have resorted to unsafe terminations. Illegal abortions have become a leading cause of maternal mortality in Haiti. They are typically performed by incompetent “physicians” that use unsanitary equipment, which has led to many complications and sometimes death. To combat this issue, the Health Ministry of Haiti promotes the use of contraception to avoid unwanted pregnancies.

The Haitian government has provided the Association pour la Promotion de la Famille Haitienne, a reproductive and sexual health care provider, with free contraceptives to distribute to its clinics. Additionally, many reproductive health advocates are working to transform the community’s attitudes towards reproductive health. Many citizens in Haiti reject the use of contraception for religious purposes. Therefore, reproductive health advocates have been working to build healthy relationships with Catholic and evangelical churches. In doing so, they hope to collaborate and promote family planning (including contraception).

Potential Reduction of Maternal Mortality

In 2011, a midwifery education program called the Institut National Superior de Formation Sage Femme opened. In 2013, the Haitian Ministry of Health instituted and supported a two-track route to midwifery. This track serves to educate and professionally train midwives. This also included a three-year track for new, non-licensed nurses and an 18-month track for licensed nurses who aspire to become midwives. Not only have these programs impacted the workforce shortages but they are also graduating professionally-educated midwives with the intention to eliminate the high maternal mortality rates in Haiti.

Arielle Pugh

Photo: Flickr

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