Thinking Big With Haitian Midwives

In Haiti, midwives are offering a feminist approach to maternal health—helping to address the high maternal mortality rate and increase the capacity for births on the island.

Foundation for Advancement of Haitian Midwives (FAHM) supports Haitian midwifes through education and outreach. One example is Grace Community Birth Center, the only birthing center in Haiti run and owned by a Haitian midwife in the entire country. (Instagram)

Haitian author Évelyne Trouillot’s award-winning novel The Infamous Rosalie tells the story of a young, enslaved woman who is the proud descendant of a rebellious midwife. The midwife stood trial for daring to defy the logic of the violence of slavery and colonial rule in Saint-Domingue during the 1700s. As the author explains, the midwife’s story is entirely factual, and what interested Trouillot was the humanity and dignity of characters facing impossible choices in the context of slavery.

I thought about Trouillot’s novel and the audacious 18th century midwife as I spoke with Martine Jean-Baptiste, the founder and executive director of Foundation for Advancement of Haitian Midwives (FAHM), whose mission is to partner with and support Haitian midwives through education and outreach. Founded in 2014, the organization is dedicated to supporting and aiding Haitian midwives, midwifery associations, education programs and midwifery students living in Haiti, where there are high rates of maternal and neonatal morbidity and mortality.

Their work is urgent today while Haiti is in political turmoil, and unrelenting assaults by paramilitary groups have led to severe insecurity in the capital of Port-au-Prince. Like others, Jean-Baptiste reminds us that Port-au-Prince is not all there is to Haiti—which the work of FAHM is a testament to. Although women have been giving birth to babies in Haiti for centuries, the professionalization of midwifery did not occur until the 1970s to address the maternal mortality rate and increase the capacity for births on the island.

Jean-Baptiste explained to me how FAHM—whose acronym is pronounced like the Haitian Kreyòl word for women—was born out of her combined commitments to Haiti and to women’s health. Part of what makes FAHM unique is that it is a Haitian-women-led organization with a board made of predominately of Haitians who are also midwives themselves.

Having worked as a childbirth advocate (now referred to as a doula), a nurse and a midwife, Jean-Baptiste knew that working with other Haitian maternal health advocates would be her calling. Her work was bolstered during a conference in Canada for International Day of the Midwife when she began making meaningful connections to midwives living in Haiti.

FAHM’s work is informed by a Black feminist approach that emphasizes collaboration, communal care and partnership. With partners in each of Haiti’s 10 departments, they work together to leverage the experts in the Haitian community. “The country has experts!” she said passionately at one point during our conversation, emphasizing that FAHM is only as successful as these partnerships. It requires careful listening to their partners first and only moving according to what they say, then working together to leverage the opportunities. These opportunities include sourcing locally as much as possible to also fortify the local economy.

Listening to their partners who are on the ground is especially important in this moment, as they must find innovative ways to work around the current conditions daily. Foregrounding partnership and collaboration is also a principle that recalls the Haitian model of collective work or konbit, which Haitian feminist activist and co-founder of Nègès Mawon, Pascale Solages, described as fundamental in collective organizing.

Jean-Baptiste told me that part of the reason she went into midwifery is the due to the philosophical approach to women’s bodies which champions their bodily autonomy: “I knew I did not want to be a doctor because the philosophy of care is so different. … I went to school and got a license, but this is your body,” and women should be recognized as experts over their bodies.

In this post-Roe moment when reproductive rights are under attack, her words resonated profoundly as it occurred to me that the midwives are also offering a feminist approach to maternal health.

Midwifery is work done out of love and care that champions people’s rights, human rights, choice, unity, respect.

Martine Jean-Baptiste, founder of Foundation for Advancement of Haitian Midwives

FAHM is unique in its approach because they have created a different model focused on building relationships with the midwives and the students. This flexible model is sometimes difficult for others to grasp because of how it works to preserve the culture and thrive on connection. Most importantly, the Haitian midwives are the ones who are leading the work.

One inspiring example is Grace Community Birth Center, the only birthing center in Haiti run and owned by a Haitian midwife in the entire country. FAHM is primarily focused on midwifery education and promoting the profession, but by necessity they also work to address gender-based violence. Concerned with the entirety of women’s health they have also been providing cervical cancer screening and even have flourishing youth programs that teach about sexual health.

When I asked Jean-Baptiste what we can learn from Haitian midwives, she was unequivocal in her response that midwifery is not just about catching babies: “It is a political statement, is a feminist statement. … Most people who are drawn to this want to produce safe competent, evidence-based care and to respect people’s voices, preserving the honor and dignity of every human being.”

She also lamented that “women are called poto mitan [central pillar of society] but they are not respected as they should be.”

Nor is there enough regard for the educational part of what women offer their communities: “Midwifery is work done out of love and care that champions people’s rights, human rights, choice, unity, respect. It aims to always honor the dignity of the mother and the child, never telling people how to define their bodies or their care.”

In her view, being around birth makes you have more respect for humanity and for life. As a scholar of Haitian history and literature, I recognize that this profession has always been here—our ancestors include bold women like the midwife Évelyne Trouillot described in The Infamous Rosalie.

There is no denying that the reality of working in Haiti today is a challenge. And as Jean-Baptiste noted, “Every day there are new neighborhoods being attacked, new places being destroyed.”

In the thick of that heartbreaking reality, the need for people to have access to healthcare remains. At one point she told me, “We need to think bigger. For example, what if rather than just feed people, we empower them to grow crops so that they can feed themselves?”

That kind of capacious worldview and steadfast intention to think beyond the confines of what appears to be available reminds me of the midwives she has described, as well as those midwives from our rich Haitian history.

As we approach The International Day of the Midwife on May 5, I am inspired by the work of Haitian midwives, of FAHM, and of Martine Jean-Baptiste.

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Régine Jean-Charles (@reineayiti) is professor of Africana studies and women, gender and sexuality studies at Northeastern University. She is the author of Conflict Bodies: The Politics of Rape Representation in the Francophone Imaginary and A Trumpet of Conscience for the 21st Century: King's Call to Justice.