Certified Professional Midwife (CPM) Ninotte Lubin came to Vassar’s Rockefeller Hall on Wednesday, Oct. 10, to talk about her efforts to establish the Grace Community Birth Center in Haiti. Lubin discussed how she dreamed of bringing positive change to Haiti through a compassionate approach to birth, motherhood and community. Oct. 10 also happened to be her own birthday, so Vassar students celebrated her by singing “Happy Birthday” after the lecture.
Even though Lubin had led Visiting Assistant Professor of Greek and Roman Studies Tara Mulder’s History of Midwifery course the previous day, the lecture was still packed with students. Introducing Lubin, Mulder said that the two have known each other since 2011, when Mulder and her mother went to Haiti to volunteer in the aftermath of the 2010 earthquake that killed nearly a quarter of a million people. Mulder’s mother is a CPM and helped with Mother Health International, where Lubin worked as a translator.
At that time, Lubin was already planning on building a permanent birth center after she was inspired by the work of the midwives at Mother Health International. “I saw the care that they were giving to women. They were so compassionate, so loving, so human,” Lubin reflected. “I started right away to help the women.”
Though she holds a degree in business management, midwifery became her passion. According to Mulder and Lubin, the latter is the only Haitian CPM and has been since she earned her certification in 2015. There is, however, a long history of traditional midwifery in Haiti.
Traditional midwives, or matrons, deliver about two-thirds of births, meaning only about 36 percent of births in Haiti take place in a healthcare establishment. Traditional midwives receive little or no formal education, but, as Lubin explained,“[I]t’s a rich cultural tradition, [and] they are important figures within their own community.”
Midwives thus fulfill a crucial role in Haiti, which has the highest infant and maternal mortality rates in the Western Hemisphere. Lubin said the challenges Haitian mothers face go beyond the simple explanation of traditional birthing practices being unsafe. Access to clean water, sexual education and urban healthcare centers are all factors that contribute to these statistics.
Grace Community Birth Center aims to include the traditional midwives in their services. As Lubin explained, “We won’t phase them out; we’ll offer them training. The training will be a two-way process with both parties learning from each other.”
For Lubin, midwives offer what medical facilities in Haiti lack. “What’s unique about the traditional midwives is they are a support group. When a woman is in labor, they have plenty of women around to support that person. In the hospital, you’re alone, nobody is there for you,” she said.
After the lecture, Kamakshi Kanojia ’19, who is currently in Mulder’s History of Midwifery seminar, asked about how Lubin’s project plans to handle complicated pregnancies. Lubin said that they would work with mothers and would not turn them down for lack of money. Kanojia responded, “That’s the heart of midwifery—you’re there to give to people and to help them. If you say no because of money, then they can’t get the services.”
As Mulder reflected, “[It is important that Grace Community Birth Center be] a fixture of the community, that people believe in it and use it, that it becomes like health care here where you don’t just have a pop-up hospital after a disaster that is then out of volunteers a few months after.” Though she was part of this cycle of temporary, foreign aid after the 2010 earthquake, Mulder said that her experiences in Haiti convinced her that solutions had to come from within the country.
Mulder recalled a day when her Mother Health International group went to the beach, and, as they swam, Lubin explained her fears about foreign administrators failing to understand the needs of local communities. After that day, Mulder realized, “We needed to get behind Ninotte, because she has the skills, she has the vision, and that’s when we really started to think that if a project is going to be successful here, it has to be a project that is conceived by and developed by a Haitian person.”
During the lecture, Lubin explained how Haiti’s historically fraught relationships with other countries and its natural disasters have led to poverty and corruption. NGOs, she said, come with good intentions, but do not disrupt broader, historical systems of power. Corruption and people’s fears of it have been continual hurdles for Lubin’s project. She said that the most common question people ask her in the United States is, “Are you sure you’re going to use the money the way you should?”
Haiti remains the poorest country in the Americas, but Lubin said that the birth center is one way to improve quality of life. “Pregnancy, though it should be something exciting, is one of the reasons for poverty in Haiti,” Lubin said. In 2016, the Grace Community Birth Center provided 20 women with prenatal and postpartum care. They served 30 women in 2018, in addition to providing community workshops and sexual education.
The workshops have included topics as diverse as women in business, family planning and gardening. Some of the girls walk miles to come to the center, so the garden started as a way to feed them, but it also teaches self-reliance, explained Lubin. She said that in the same way that she had dreamed of opening a birth center, the garden provides a way for young children to realize they are capable of creating something.
When asked about the men in the community, Lubin said some have been helpful, but not all. Some men resisted her attempts to educate them; she explained, “We are dealing with a lot of violence. Sexual violence is one of them, and people don’t even think of that as violence. They feel like it’s normal life.” Working with more boys and young men is a continuing effort for the Grace Community Birth Center.
Lubin explained that she chose the name “Grace” for the birth center because she was thankful for all of the support the project has received. The center is located in Terrier Rouge in the northeast of Haiti and was made possible by a donation of three acres of land. “I have received so much from friends, supporters, even those who were reluctant to support me but felt like they should. I felt I was giving back through grace,” Lubin said.
Member of Vassar Haiti Project (VHP) Medical Advisory Board Dr. Kimberly Heller, who specializes in maternal fetal medicine, talked with Lubin after the lecture. “We make a lot of noise in this society about how much we love children, yet we don’t even give children health insurance, so there’s a lot of work to be done everywhere,” Heller said.
Attendees gained valuable insight from Lubin’s presentation into community-based health care, in addition to finding resonances with courses and student organizations on campus. Heller, for one, saw the lecture as an opportunity to learn more and better contribute to VHP. As she expressed, “When I heard that she was coming, I hadn’t worked with her, but I wanted to find out as much as I can, be as supportive as I can, use her knowledge to help us with our project that we work with in Chermaitre in the north of the country.”