The Birth of Esther

Summer has arrived at MHI. It was only 7:00am and we were already feeling the intense heat of the sun as a woman arrived at the clinic in active labor. Though her contractions were strong she seemed grateful to finally be doing the necessary work. She’d spent the night in the dome a week ago thinking that it was her time only to have labor stop.

We settled her in the dome and began preparing for her birth. Sweat was pouring down all of our bodies, hers most of all as her contractions intensified. The mother asked if she could birth outside. It was a beautiful quiet Sunday morning. We rigged up some sheets to give her privacy. She was without family as her husband is a preacher and needed to be at church. We took turns massaging and encouraging her.

Before long the woman’s voice changed and we knew she would soon begin to push. Her membranes ruptured revealing copious dark meconium. Baby’s fetal heart tones were normal and since we could tell birth was imminent, we prepared the equipment to help the baby if needed. The woman really wanted to be sitting upright as she began to push so Melinda got behind her to hold her up. Soon Melinda needed support and she asked my daughter, who was working in the garden to lend us her back. Tara positioned herself with her back against Melinda’s and pushed against the concrete wall with her feet and hands.

As the baby’s head emerged, Kari, the student midwife and myself acted quickly to suction, unwrap the umbilical cord and get the baby up to her Mama’s waiting arms. The baby was slow to start but came around thanks to our combined skill. I felt all of us praying, each in her own spiritual way as we welcomed baby Esther. As she began to come into her own her little voice joined the chorus of distant voices singing in their morning worship service.

Women helping women birth their babies is as ancient as our existence. What a privilege it was to be a part of baby Esther’s arrival. She is another beautiful light in our world.

Kathi Mulder, CPM. Volunteer Midwife at MHI, Jacmel, Haiti

Employment Opportunities

Mother Health International Job Openings
On-Site Midwifery Coordinator
Jacmel, Haiti

Mother Health International has two On-Site Midwifery Coordinator positions available. The MHI On-Site Midwifery Coordinator’s primary responsibility is being the primary midwife NARM preceptor at the MHI birth clinic. This is an amazing life changing opportunity for someone who wants to work within a traditional midwifery model of care.

Primary duties include:

• Works with the Volunteer Medical Advisory Board President, Clare Loprinzi, Traditional Midwife, CPM on the educational program for the apprentices and overseeing this on the ground in Haiti.

• Attends births working within the MHI protocols and upholding the MHI model of care.

• Works with the Administrator of MHI on maintaining the midwifery side of the clinic.

• Maintains all NARM protocols for apprentices.

• Communicates on a bi-weekly basis in an email or skype with the President of the Board of Directors as it pertains to this job.

• Welcomes and orients volunteers to the clinic.

Additional details:

• Teaches apprentices while following the MHI protocols, helps improve the clinic day efficiency working alongside the MHI administrator in the clinic to help identify and find solutions to the midwifery related issues that pertain to clinic.

• Working with volunteer midwives and Haitian apprentices to create prenatal education that the Haitian apprentices teach the moms on prenatal days to include healthy pregnancy, breastfeeding, nutrition, peaceful parenting, labor, birth and postpartum care.

• Oversees the midwifery care we give while working and abiding to the MHI protocols; communicates with the Administrator and the President of the Board of Directors on ways to improve the care we give and reports back the weekly updates on the happenings at the clinic as it pertains to this job.

• Sets the tone and protects the space for all births to be seen as a sacred right for the mother, child and family attending.

• Teaches apprentices to do monthly clinic statistics

• Facilitate study time on a weekly basis in a formal setting/interactive “classroom” discussion time

• Facilitates and encourages volunteer midwives to teach students in clinic and outside clinic times

• Orients volunteer midwives to clinic systems and supplies, meds, etc. Explains and goes over the protocol book and all current systems pertaining to the clinic. Orients volunteers to the house and Jacmel, laundry, meals, clean up, changing money and overall cultural norms in Haiti.

Requirements:

• A willingness to live in our volunteer birth clinic for a minimum of eight months of time preferably a year in Jacmel, Haiti as the primary midwife on duty.

• This position requires NARM preceptor certificate/approval. Midwife may be a direct entry, traditional, certified professional midwife or certified nurse midwife willing to work within a traditional midwifery model of care.

• Must bring in a list of supplies needed for the clinic plus help raise money for the clinic.

What MHI will provide:

This position will be given a small monthly stipend for spending money. All on ground expenses are paid for including housing, food, and high speed Internet. Unpaid vacation time.

Mother Health International’s Mission

Mother Health International is dedicated to respond and provide relief to pregnant women and children in areas of disaster and extreme poverty. We are committed to reducing the maternal and infant mortality rates by creating healthy, sustainable holistic birth clinics using the midwifery model of care with culturally appropriate, education for the health and empowerment of women. With every healthy birth there is a positive benefit for the communities that we serve and the world as a whole. Our ultimate mission is to empower and educate the local clinic staff, with gender equality, to become the health care providers for their community

Volunter Administrative Team
Heather L. Maurer, Co-Founder, Executive Director


The Medical Advisory Board’s Mission

The Mother Health International Advisory Board is a broad collaboration of practitioners advising and supporting Mother Health International to create the bridge between high technology obstetric care and the excellent outcomes provided by the low technology, hands on midwifery model of care in impoverished and disaster stricken countries. The collection of our data will provide inspiration for birthing centers worldwide.


Volunteer Medical Advisory Board
Clare Loprinzi, Traditional Midwife, CPM, MCH certificate
Carol Roedocker, CNM
Dr. Jade Patti McGaff, MD,OB/GYN
Dr. Mathilde Costa, MD, OB/GYN
Dr. Misha Kassel, MD, Emergency Medicine
Dr. Joseph Kassel, ND, LAc.


Words from Melinda McClaren, Current On-Site Midwifery Coordinator

I came to Haiti not knowing what to expect or who to believe about the
situation here. The news and people coming back from the quake shaken
land told stories of horror and sorrow, of danger and strife. However
the story I now know of Haiti is one of love, strength, humor and all
good things among the hardships faced in a 3rd world country rocked by
injustice on every level. I am proud to say that I came to Haiti with
an open heart and have been given one back by each person I met.
Haitians have moved into my heart and soul in a way that no other
peoples have. I must say “thank you” to my dear friends here in Jacmel
for embracing me and wanting me to “become” Haitian, to be able to see
life from their perspective. I am honored. Now down to what I do
here.... Well, if you haven't heard there is this amazing birth center, the
Mother Health International birth clinic, that started up in Jacmel just
after the earthquake of 2010. I was living in Canada when I came
across the work that MHI was doing in Haiti and I just knew that this
was it for me. I saw the website and my heart was set. I have worked
overseas several times and the thought of doing midwifery in a developing country
set my heart on fire. I know the difference one midwife can make
in the life of a family. I know that just simple sharing of knowledge
regarding hygiene and nutrition can make the difference for a mom and
baby. Education is the key to empowerment and empowerment is just what
Haitian women need. At the MHI birth center we have woman from all
over the place coming to us for care, some are city folks, others are
from the boonies (jungle-country side) and there is a vast difference
in education between these two groups. Teaching people the basics on
breast feeding actually can save a baby’s life. There are quite a few
mothers that were feeding their babies sugar water until their “true”
milk came in. This a dangerous practice and we get an opportunity to
share with women how they can effectively care for their wee ones to
prevent all sorts of problems sugar water can cause. This is just one
example and there are so many to tell!

Women empowerment.... This is another great aspect of doing
midwifery in Haiti. You know being a midwife can allow you access into
a woman’s and families life in a way that very few professions allow.
Being present with a woman through the childbearing process allows you
the most intimate window into her life an the potential to be a close
friend and guide when she needs it most. It is to come alongside her body,
spirit and soul and believe in her innate capabilities,
believing in her as a mother, as a co-creationist in regards to her
child but also the direction of her life and energies. Becoming a
mother changes a woman and has the potential to inspire significant
life changes for the betterment of herself, her family and her
community. Love is a very strong driving force that can move a woman
from one state of being to another. This is what I live to see in
Haiti, and this is what I have been seeing in the women we care for.
This what makes this work of consultations and birthing so rewarding.
I see new life being born, not just in the newborn, but it is in the
woman becoming a mother, a more aware, responsible and stronger being
that is being born also.Haiti can make it, can rebuild itself, if we start working together
one life at a time, one relationship, one situation at a time, change
can happen and is happening everyday. Like it, live it, see it! This is an opportunity
that will change our life as a midwife and allow you to travel deeper into the
tradition of midwifery. This work and time with the Haitian people is one of the
greatest experience and gifts I have ever received. And it has profoundly
impacted my life in a beautiful way.

Mother Health International has first set of twins!

 First set of twin, baby girls, born at the 

Mother Health International birth clinic, November 2010.

I was up early and went downstairs to have some tea and was laying in the hammock when Sherline came down and said there was a laboring woman at the Dome. Marie Antoinette was up at the clinic helping the woman get settled in and told Sherline to send for me. So although Melinda was going to be considered "first-on" that day I figured I was up so instead of waking her to do a labor assessment I thought I would go up there to check in. I knew Sabine had had a multip birth in the night so I went up to check on everyone. 

When I arrived I could see that the mom was in a good active labor (G4P2) - close contractions and vomiting - so I set up and settled in with Marie Antoinette and Sherline. It was about 6:15 a.m. at this point and the mom said that she had been in labor since 5 a.m. - so really not long at all.

Marie said she would like to catch the baby so I got her a pair of scrubs and put her in receiving position at the foot of the bed. I asked what she needed and Marie replied, "just to have you by my side." 

The birthing mom's Godmother was there and I could see that she had a knowledge of midwifery, an inherent skill and sense of the mom and baby and the process - she had that energy and wisdom of a wise woman about her. I found out that she had attended births as a midwife over the years. I liked her very much.

The birthing mom said that she had felt the baby move but not really that morning and I thought I would check for heart tones just for reference but I was having difficulty finding where to hear them best so I am gently palpating her belly in between a couple of contractions and it's was a bit confusing - feeling for sure there's a back here but there also seems to be a lot of "fullness" on the other side as well but doesn't seem posterior (you know, that train of midwifery thoughts and "hmmmmms..." that go through one's mind). 

I catch a bit of heart tone and it sounds good and labor is progressing really well so I just set back, get everything prepped and ready. I support the Mamma and Marie. Marie suggested to the mother to get off of her back and possibly walk or change position but the mother reported that she was shaking too much and couldn't do it. She had told Marie when she first arrived that this labor felt "strange", different from her other labors.

Sabine, who came up to check on her post partum mother, came in to help us out when she heard that the mother was pushing.

The mom starts pushing around 7:15 a.m. and it 's obvious progress but the baby isn't flying out, in fact, it's coming slow enough that I just consider the possibility of big shoulders (as the mom's belly was quite big) and then watch and observe. So slowly and beautifully a head emerges and after a couple of contractions and it rotates to an posterior position and comes out the rest of the way.....hmmmmm, I'm thinking, that sure is a small baby for a term gestation - a little baggy and wrinkly - possible IUGR - but it is a vigorous little baby and we put her on Mom's belly. It has a pretty short cord. She rests a moment and touches her babe when she seems to push again, or really, scrunch up her face as if she's getting an approaching contraction. Marie says, the placenta is coming and I think, "Gee, that's an awfully strong contraction for a placenta, and so soon after the baby!" 

So I look down and I see a bulging BOW and a head behind and I say, "that's not a placenta, that's another baby!"

Marie was really surprised and jumped back a little reporting later that she didn't know what was coming - at first she thought, placenta but then thought something "worse" but she looked into her heart and told herself she would not be afraid, she would not run away, she would stay and do her job. So as the baby emerged out gently, completely in the caul, I received that babe and laid it on the bed and then removed the membranes. This child was the most peaceful looking babe in the caul - you could see her perfectly and you could tell she was doing great. The baby was small enough that it did not break the amniotic sac at all on the way out and the baby was completely encased in the sac. It was like getting a peak into the womb. The placenta came with the baby. She barely bled at all, uterus was great, I had given her some Yunnan soon after the first babe came out just to be sure we didn't get an extra bleeding but her body was really doing all the right things.

Second baby was smaller but actually "pinked" up more quickly than the first although both babies were really quite vigorous! We got them to breast pretty quickly and it was bit of a juggle but it was also all so smooth. One couldn't have asked for a smoother twins birth. Both baby girls, fused placenta, two amniotic sacs, both head down, baby #1 5lbs and baby #2 just over 4 lbs, and both babies and mom were so strong!

Looking back at her chart I saw that her last baby died because it came prematurely....she said that she already had 2 boys at home and her family told her not to come home with anymore boys so she was pretty happy that she balanced everything out with 2 girls! She got an extra spirit to come back to her after the loss of one - it was all just really beautiful. Sherline reports that the mother told her after the babies were born that she had had a dream earlier the morning of the labor of two girls, her girls, playing outside of her home.

I asked the Godmother if she knew there were two babies because I could just see that wisdom in her being and she said that yes, she could tell but that she never said anything to the birthing mom because, as is tradition to Haitian culture, you don't tell a woman because you don't want her to be afraid.

I looked back at her prenatal chart and no one had ever suspected twins and she had been measuring appropriately and she went to term.

Anyway, there was never any hitches and after several hours everyone was ready to go home. We talked about keeping the babies warm, nursing them plenty, and having them sleep together. They were the most vigorous little babes I've seen who were that small. I never once doubted their strength, or moms, it was all flowing smoothly.

The babies are now 9 days post partum and came in for their first visit since the birth. Both babies have gained weight and are over their birth weights by about 300 grams. The mother has no complaints and her body feels good. She says she isn't too tired and finds that nursing two babies is not too difficult. Everyone who was at the birth reports feeling blessed and thankful to have been a part of this beautiful experience. One couldn't have asked for a more perfect birth to welcome the first set of twins to Mother Health International, Haiti!

Emily Baker, volunteer midwife

Tata's Story-Mother Health International Jacmel, Haiti

My father and mother died when I was 21 yrs old. I had only God in my life. I now have 6 daughters and because of this I work hard to give them an education. My husband work is seasonal because he is gardener, so my children depend more on me. I also take care of my 2 nieces, which gives me a total of 8 children. So that is me, I love my life! I love my children!

 Tata in the MHI kitchen.

I know I am a good cook and it is my pleasure to cook for the midwives and to clean the house, clean the kitchen. I am so happy to do this for the midwives. I pray that MHI will be able to stay here in Haiti and have a long life.

I have a good ear on the community in Jacmel and what I hear is that people are very happy with us. The clinic gives good care because of the way midwives work and spend time each woman in labor. They are gentle with the women and that is what they need. I am proud to work for MHI. Thank you for coming to Haiti.