HeartSpace…What does that mean? Who are those drawn to HeartSpace Midwifery?

Who are the people who walk through this door, settle in on the couch, feel the HeartSpace vibe and decide that this is where they belong? There is no one “type” but there is certainly a common thread. That thread is faith: faith in the process, faith in themselves, faith in growth, faith in the ability to learn. This is not necessarily the norm in the world as a whole. Homebirth and midwifery in general attract people who want something different than mainstream offerings. HeartSpace in particular attracts those who are ready to step into a deeper trust of themselves.

We are not the midwives who are necessarily going to coddle or foster dependence. We tend to attract women who are ready to challenge themselves to stand solidly in their beliefs, whether they are conscious of it or not. We have certainly had clients who signed on even though they still had some anxiety about what lay ahead. But, by the time labor rolled around they were solid in their conviction that they had made all the right choices and were ready to welcome the process of bringing a baby into the world on their own terms. This evolution is my favorite part of this work: watching doubt transform into faith.

This doesn’t mean that there’s aren’t glitches along the way. Everyone experiences moments of doubt, times of fear, occasional anxiety. All of that is part of the journey.

In every consult we say that we are not the ones who takes care of the client’s pregnancy. We are merely guides, resources, someone who checks in. The client is the one doing her own care. The woman carrying the baby is her own primary care provider; she makes all those small decisions that determine how this pregnancy will grow. She decides what to eat, how much stress is in her world, how to support herself spiritually, how to maintain her own mental health, how she moves her body, and a million other decisions all day long. All women do this but not all are conscious of it. At HeartSpace we promote health through consciousness. We strive to foster the grit in each woman to dig deep and figure out what will support her best in this time of immense growth (no pun intended).

The first time people walk through the door we often hear, “This space feels really comfortable”. That sense of immediate comfort and belonging is the first clue that something is different in this model of care. From this familiar place we can do great work together.

Ha! Loving this learning!

Last night, after a wonderful date with my husband made possible by the generous offering of a restaurant gift certificate from a client,  I stopped by the independent book store in town.  I was hoping to find something along the lines of  Entrepreneurship for Women’s Small Business in Health Services for Dummies.  Instead I walked out with Business Secrets of the Trappist Monks: One CEO’s Quest for Meaning and Authenticity. I can hear those of you who know me well saying, “Of course you did!”.

This morning I found the answer to the question I posed in my last post; “How is it that I own a successful business?”  In the first few pages I found the following: “…authentic success—whether personal, professional or organizational—is usually only the by-product, the trailing indicator, of serving a mission that is bigger than yourself.”    That is EXACTLY how I find myself in this position.  I never set the goal for myself to own a business.  My goal has always been to serve others and the way I have found to do that is through midwifery.  I remember early in my apprenticeship telling my mentor that it felt as though I was remembering how to be a midwife rather than learning it.  I have since heard this sentiment from others in midwifery as well.  There has never been a question for me about whether this was what I was supposed to be doing.  It just IS.  There have been times when I would have liked to walk away to become that person who waters the flowers in the medians, or the person who delivers your organic milk to the door, or maybe the toll taker on the interstate, but midwifery has never let go of me and I wouldn’t really be good at any of those other things.  So, here I am, serving in the only way I know how.  I am excited to dive into this book and find what other treasures it will offer up.  I am grateful today for finding another validation for this crazy, circuitous path.

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Thoughts on Solo Midwifery Practice

As the New Year has come around I’ve been thinking a lot about the idea of solo practice midwifery. I find myself, through no intention of my own, the sole proprietor of a thriving home birth practice. As strange as it sounds, the reality of this has snuck up on me. I have always practiced in partnership with at least one other midwife. The transition from this model to solo practice has not been an easy one as it was never a goal of mine to have my own business. Yet here I am doing the work I am called to do, just in a way I had not envisioned. As I was contemplating this on New Year’s Eve, and anticipating the changes to come, I realized quite clearly that the concept of “solo” practice is really in no way accurate.

No midwife I know is truly a solo practitioner. We all rely on so many others to support us as we support the families we serve. This path is one that, by its very nature, cannot be walked alone.

First and foremost, our families’ support is critical to our success. I could never do this work without the support of my husband and the cooperation of my children. I can be a midwife to others only because they are independent, flexible and strong. I am sure that being the spouse or child of a midwife is not easy and yet my family has been very gracious in their support of what I am called to do in life.

Secondly, a midwife must depend to some degree on her community of sister midwives. We are blessed in this region to have so many midwives who are connected. We all rest in the knowledge that we can call on each other at any time. We have learned so much from each other and, although we may all have different styles, we can and do support each other in times of need.

There are times when midwives must reach outside our own practices to consult with or refer to other professionals in the area. Locally we have so many wonderful practitioners who support midwifery and home birth. There are hospital-based midwifery practices, maternal/fetal medicine doctors, physical therapists, chiropractors, family practice docs, acupuncturists, nutritionists, OBGYNs and so many others who we work with on a regular basis. These relationships are vital to our ability to provide comprehensive, holistic care to our clients. I am eternally grateful for these relationships.

Then there are friends, including many past clients, who are always at our backs to hold us up when we are in need; the ones who will cook a meal for our families, who offer us a couch to sleep on after a long birth in their town, who will be there for our kids when we cannot be ourselves, who offer a cup of tea or a massage at the end of a long week, offer business and technical skills and insights. These are the people who believe so deeply in the midwifery model of care and who support it in any way they can.

The assistants who are learning the midwifery way of life and who are willing to help in exchange for experience are invaluable to the midwives they help. This relationship is mutually beneficial and a gift to both midwife and assistant. I am so happy to have such an amazing group of dedicated women stepping up to fill this need and I am looking forward to supporting the paths of more women coming into the field of midwifery.

So, it is becoming increasingly clear that the concept of “solo” midwife is truly a myth. There is no such thing. We could not possibly do this job without many people giving us the support we need to make it work. As we begin another trip around the sun I am very grateful for all of those who are a part of HeartSpace Midwifery and who are the reason I can keep doing this work I love so much. I am happy in the realization that I am not a solo practitioner. I have a huge support network. Thank you all!

A HeartSpace Mom Tells Her Birth Story

Ivy Kathryn-July 4, 2012

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I started with Owen and Nathan’s birth stories not only because I wanted to record them, but because I wanted to portray the vast differences between their births and Ivy’s. Consider yourself warned, this is really long!

I had wanted to try home birth after Owen was born, but understandably so, Jesse and I couldn’t really come to an agreement on it. In June of 2011, we decided to move to New York where Jesse would begin working with his brother in his custom cabinetry business, Steinberger Woodworks. To help ease this transition, Jesse’s brother Justin, and his wife Zoe, and their 2 children, Myles and Elliot, selflessly allowed us to move in with them. Zoe was expecting her third, a girl, whom they named Olive, in September.

Jesse and I knew we wanted to have one more child, but I was insistent that I didn’t want that 3rd one to come until Nathan was at least potty trained. I was keeping track of my ovulation via natural family planning, and doing pretty well with it. In October, I mixed up my dates, and the day I ovulated and realized I had confused my ovulation days, I conceived. I was naturally kind of disappointed about it, but the disappointment didn’t last long. I was thrilled to have another one, even if it was way before I wanted it. Through a chain of events, Jesse informed me he would be okay with my having a home birth. I was elated. I contacted the midwives, HeartSpace Midwifery, and we began monthly visits.

I endured the next 20 weeks with the usual intense morning sickness, this time seemingly a little more difficult since I was also taking care of Owen and Nate, but I am so grateful that we were living with Justin and Zoe still, as Zoe was a big help during this time. I was due July 11. We found out she was a girl in February. The baby girl I had prayed and longed for. We also found out that I had what appeared to be placenta previa. Placenta previa is where the uterus imbeds over the cervical opening, and almost always indicates bed rest towards the end of pregnancy (in case of preterm labor) and c-section. I was only 18 weeks along, meaning the uterus and baby are still quite small, and it’s easy to mistake a placenta previa. But still, precautions had to be taken. I was told I needed to be careful about doing too much and straining too much, and no sex. Eight agonizingly long weeks later, we had another ultrasound, and this ultrasound indicated that the placenta previa was entirely gone. The ultrasound tech showed me the obviously clear cervical opening, and then he traveled halfway up my stomach and revealed the placenta way up at the side. I cannot express the relief I experienced at that point! In March, we moved out of Justin and Zoe’s house and into our own apartment, about a mile up the road. 

Besides the placenta previa and miserable morning sickness, the pregnancy continued without much event. Every month I went to see the midwives, Heidi and Maureen. The visits lasted an hour each time. They had a big comfy couch in their visiting room. As I sat there, we talked about every relevant topic (and some irrelevant :), got to know each other, developed a midwife/patient relationship, but also a friendship. They allowed me to talk freely about any uncertainties and worries, listened to me, and offered advice and encouragement. Any time I needed anything before or after Ivy’s birth, I could text them and they were always prompt with their responses, even several times going out of their way to rearrange their schedule to allow me to come to their office if necessary, or to stop by my home. They were kind and friendly, understanding, very knowledgeable about natural ways to approach pregnancy and anything else, and willing to help me with whatever I presented. 

For the next few weeks we settled into our new apartment and prepared for Ivy’s birth. Owen asked a lot of questions about Ivy and the whole process. Nathan was a little young to process it all, but even so, he’d point to my tummy and laugh and giggle. Both boys would rub my tummy, kiss my tummy, and thought it was hilarious to blow raspberries. Ivy would always start moving when they did that.

When I was about 37 weeks along, I was feeling the usual Braxton-Hicks contractions pretty often. Since my other births were like this, I knew that she would be coming soon. Around this time, the midwives came for a home visit to see what our apartment looked like and to talk about how the home birth would go down with Jesse and I. They also brought the birth tub, and encouraged us to set it up, fill it, and for me to get in it to see what it was like. They gave us a list of things that would be needed for the home birth, which I diligently set up on the dresser near to where the birth tub would be. Somewhere in this time, I woke up one morning feeling pretty intense contractions about 5 minutes apart. Justin came to pick up Owen and Nathan, and I called my mom to have her start heading over from CT. Unfortunately, by the time the midwives got to me, the labor had tapered off…false alarm. I was 3 cm dilated and not in active labor when they checked.

Even so, my mom came, and I was relieved to have her around. About a week and a half later, I was getting pretty tired of the Braxton-Hicks contractions that seemingly weren’t getting me anywhere. On July 3, my birthday, my mom gave me money to get a massage. I told the woman doing the massage to feel free to hit every labor pressure point. I also visited the chiropractor. I had visited the chiropractor every week for the second half of the pregnancy. That helped immensely, for every normal ailment related to pregnancy from heartburn to body aches to trouble sleeping, and for the labor itself to make sure everything was lined up properly and to shorten the labor.

Early on July 4, Nathan woke up crying, so I went into his room and noticed I was feeling that crampy, weird, not quite normal feeling that indicated the onset of labor with my other pregnancies. It was about 3:30 am, and I knew I’d be able to go back to sleep, so I went to bed. Around 6:30, my contractions were about 5 minutes apart, but not very painful and I was still able to sleep through them. I still texted my midwives to let them know I thought this was the real deal. About half an hour later, I got up and ate a little, but found that I was really tired, so I went back to bed. My midwives arrived around 8, and I was sleeping somewhat fitfully, waking up about every 5 minutes to a contraction that was intense, but I was able to breath through it. Heidi came in and asked if she could check me and found that I was 7 cm dilated. After that I couldn’t sleep much, so I got up and started to wander around. Jesse ran Owen and Nathan over to Justin & Zoe’s and then came back and started filling up the birth tub for me.

Leading up to this, I had been nervous that it was going to be awkward having the 2 midwives, Jesse, and my mom all sitting around in my little apartment waiting for me to have a baby. I found that this was not the case. Heidi and Maureen came in quietly, set up their things, kept a watchful eye on me, and talked in low tones. The atmosphere was calm and friendly and homey. I wandered around, stopping occasionally for a contraction, and talked and joked with everyone. The midwives showed Jesse and my mom how to apply counter pressure to my lower back during a contraction, and I found that this was so helpful. I couldn’t get on top of the contraction unless somebody was doing that. I spent the next couple hours mostly on my knees, draped forward over a birth ball, with someone applying counter pressure to my lower back through every contraction. I’d take a deep breath as I felt the contraction come on, then kind of huff and puff my way through it, and breath a sigh of relief when it ended. It felt so perfect to be surrounded by people I was completely comfortable with, in my own home with my own bathroom and bedroom. 

Around 10 am, the birth tub was full. The second I stepped into it and sank into the water onto my knees, it was the greatest relief. At this point I think I was around 9-10 cm, my contractions around 2-4 minutes apart. My water still hadn’t broken. While it is a good thing for the water to stay in tact, since it helps the baby to settle into the correct position in the birth canal, it also felt like it made the labor a little more drawn out.

For the next hour and a half, I leaned forward over the side of the tub as Jesse applied pressure to my lower back during contractions. The water made the contraction infinitely easier to handle. The tub was designed to have air in the bottom too, so the cushiony feel of it took a lot of pressure off of my knees. Jesse stayed close by me, always keeping my hair off of my face, holding my cup up so I could sip water from the straw, ready to apply counter pressure during a contraction, and lend any support I needed. The midwives were always nearby, quietly observing, waiting patiently, allowing me to follow my body’s cues for labor. It felt as if they were simply there to observe the miracle of birth and lend a hand if needed.

Eventually, I started wondering how much longer this was going to be. In a typical labor and delivery, when a laboring mother gets to this point of feeling like they have no more in them, she is pretty close to the end. The midwives were telling me that it was taking a while because my water hadn’t broken. They said it may help to get out of the tub and walk around a bit. Because the water had made my laboring more manageable, I was able to do this. I assume at this point that I was about 10 cm, my contractions still about 2-3 minutes apart. So, out of the tub I came. Jesse helped me to the bathroom and helped me walk around. This got tiring quickly, so I got back into the tub. I asked Maureen if she could break my water, so at the next contraction, she did. It broke with a painful whoosh, and I immediately noticed that my contractions were much more intense, and soon I felt the slight urge to push.

I leaned against the squishy side of the tub, kind of on my side, upright, one leg down against the bottom of the tub, the other knee up. Jesse was there with his arms around me, supporting me, my head on his upper arm and shoulder, giving me strength simply with his strong hold and presence. After a few contractions, when I could feel her head close, I took a deep breath and bore down on the next contraction. To everyone’s surprise and my great relief, her head came out! After Maureen checked to make sure the cord wasn’t around her neck, a few more little pushes, and out came her slimey little body into the warm water. Maureen lifted her out and handed her to me, then wrapped her with a warm towel. I wanted so badly to look at her sweet face and tell her how glad I was that she was here and how much I loved her. But my arms felt like jelly and all I could manage to do was put my head back, close my eyes, and savor the feeling of my little girl in my arms at last.

After a few minutes, I felt strong enough to get out and deliver the placenta. Ivy was handed to Jesse, who had removed his shirt so Ivy could have continuous warmth through full skin-on-skin contact, enabling Jesse to have a few moments with his baby girl. I got out and moved to my bed in my own bedroom. The midwives did everything I needed, helping me to the bed, setting everything up, giving me time to adjust. When I got to my bed, they handed Ivy to me and I nursed her and delivered the placenta.

For about an hour, Jesse and I were able to sit together by ourselves with Ivy. We talked about her birth and looked at her sweet little features. The midwives stayed close by in case they were needed. They weighed, measured, and checked her over. My mom brought me fresh home-cooked food, my dad came in with a balloon and flowers. Owen and Nate came in and were so excited to see her and kiss her. It was a nice calm day, celebrating Ivy around the people that loved her most.

When the midwives checked Ivy, they discovered that she was tongue-tied, and talked us through the implications. For the first 24 hours, she was able to nurse and got milk effectively, but it was very painful for me. The day after she was born, we went to Albany to a specialist of which there are few in the country, who removed the tongue-tie with lasers. After this was done, she nursed much better. For the next couple weeks, we had to stretch the tongue-tie back open several times a day so that it wouldn’t heal back together. This was really difficult for both Jesse and I, and I pretty much cried every time we had to do it. Now it is all healed correctly, and she nurses like a champ, without any pain to me!

The home birth was a beautiful experience, exactly as I had hoped for. Sure it was very painful, but I was able to manage with the freedom and relaxation of being in my own environment, with people I was familiar with, and a birth tub. The midwives stayed around for a while, until they were sure all was well, then left us with instructions, letting us know to call if needed. We were able to enjoy Ivy’s first days with no interruptions. My mom stayed around for a week or so, cooked and cleaned, helped me with Owen and Nathan, helping us all transition to life together.

I am beyond grateful that Ivy and I had the experience that I think was best for us. She is a beautiful girl, absolutely adored by her brothers, and a great sleeper and eater. The midwives checked in often over the next few weeks, and were always just a text or phone call away, which was very helpful when I got mastitis, then thrush. Their knowledge of very helpful and useful remedies for those ailments helped me get through both of those ailments quickly and successfully.

I am so grateful for my sweet kiddos and loving husband!

http://lifewith3littlesweeties.blogspot.com/2012/09/ivy-kathryn-july-4-2012.html

Caona’s Birth Video

We are pleased to unveil this special birth video. We feel so honored to share these moments with families.  This story highlights the power of intention.  This family had a vision of who would accompany them on their journey and  as you will see, each person shines in the role they took on.  Caona was truly welcomed with love.  Enjoy.

Freedom for Birth

Join HeartSpace Midwifery for a film and discussion at Chatham REAL FOOD Market on September 20, 2012 from 6-8 pm.

“FREEDOM FOR BIRTH” is a special 60 minute campaigning documentary calling for changes to the obstetric monopoly which, in many countries, is violating women’s rights to choose where and how they give birth. This documentary reframes childbirth as the most pressing global Human Rights issue today is launching with hundreds of premieres all over the world on the same day, Thursday 20th September 2012.

The documentary features a Who’s Who of leading birth experts and international Human Rights lawyers all calling for radical change to the world’s maternity systems.

Join The Revolution!

Stay informed by visiting: http://www.oneworldbirth.net

Haiti, 2012

ImageIn July, I had the opportunity to travel with Midwives for Haiti to Hinche, about 60 miles northeast of Port-au-Prince. Hinche is in the central plateau region of Haiti. Although it wasn’t physically damaged in the 2010 earthquake, thousands of survivors took refuge here, looking for food and shelter. This put a huge strain on the resources of Hinche, where 80% of people already live in poverty. Pregnant women and babies are at greatest risk in conditions like these.

Midwives for Haiti was created by midwives who believe every woman in the world deserves the knowledge and care to have a safe pregnancy and birth. With education and tools, community women can make birth safer and keep babies and mothers from dying. Midwives for Haiti educates women to become skilled birth attendants to provide prenatal, birth and postpartum care to their Haitian sisters. The organization teaches a curriculum based on the World Health Organization’s statement of objectives for skilled birth attendant training to reduce morbidity and mortality rates of mothers and babies.

Haiti has the highest maternal mortality rate in the Western Hemisphere, and 76% of all births in Haiti are not attended by a skilled birth attendant. Fifteen percent of newborns have low birth weight and 25% of children suffer from chronic malnutrition.  The World Health Organization has established that professional midwives’ knowledge and skills in preventative prenatal care, complications of pregnancy and birth, and teaching nutrition are imperative to turn these statistics around.

Volunteer midwives from all over the world precept with Haitian students delivering babies in St. Therese hospital in Hinche, working in prenatal clinics, working in mobile women’s primary care clinics, and augmenting teaching in the classroom.

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Mobile Clinics

Midwives for Haiti began using an off-road jeep designed to enable prenatal care and skilled birth assistance for women in some of Haiti’s hardest-to-reach villages. Every week, the jeep is packed with supplies, records and medicines, accompanied by two trained midwives (graduates of the program), students and volunteer preceptors and heads out early in the morning to surrounding villages. The jeep travels an average of 2 hours each way on difficult dirt roads and trails to arrive at isolated communities.

The Ministry of Health in Haiti has recognized that long distances, inadequate transportation, and lack of information all contribute to why women do not get to medical facilities in time to save their lives. Mobile clinic serves 16 villages per month that are in greatest need within reachable distance from Hinche. At each location, the midwives see an average of 30 women per day for prenatal and postpartum visits. Medications are distributed regularly, women with risk signs are encouraged to deliver at hospital, and community health education is provided to the women.

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Mobile clinic reaches over 5,000 women a year in the outlying villages of Hinche. I had the privilege of going with two Haitian midwives and a student midwife to the village of Roy Sec, near the Dominican Republic border, which took about an hour to reach. The site was a small two-room concrete building where 30 pregnant women were waiting to be seen by the midwives. I spent most of the day palpating bellies.

With help from our translator, I would describe to the mothers what part of the baby I was feeling, but often they didn’t seem to care. Out of 30 bellies that I helped to palpate that day, only 3 of those moms smiled and were interested when I described the position of their baby. From my experience, bonding with the baby is not necessarily encouraged. The Haitian midwives I spoke to suggested this was probably because there are many fetal demises and maternal deaths.

The chances of dying from childbirth in Haiti were estimated by the World Health Organization as 1 in 17, mostly due to pregnancy-induced-hypertension, eclampsia, sepsis, and postpartum hemorrhage. Pregnancy and childbirth are risky for Haitian women, and many are malnourished, therefore it can be a time of increased stress and anxiety for women.

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St. Therese Hospital

The hospital in Hinche is free to the public, as it is funded by the government, but there are limited resources. Partners in Health have offices there and have been supplementing services as well, but it’s just not enough. There are three labor and delivery rooms, all funded and staffed by Midwives for Haiti. Often when one woman delivered there was another right there in the same room with her about to push. The postpartum room was out into the courtyard and into another part of the hospital. Shortly after a woman gives birth, the midwives help her walk over to the postpartum room for 12-24 hours. The woman’s family is responsible for bringing her food, water, sheets, mosquito nets, and rags to use for bleeding throughout her stay.  Most of the women have IV fluids near the end of labor, as they did not have enough to eat or drink in early labor. Over 50% of the population in Haiti suffers from malnutrition, and it becomes apparent in pregnancy and childbirth.

The hospital facilities are not at all what I expected. Concrete walls and floors, sometimes there is running water, sometimes not. There is no drinking water available in the hospital. Patients must bring their own, or buy it from a vendor just outside the hospital. There are no bathrooms, just make-shift bedpans. The electricity is turned off for several hours each night and midwives use headlamps to see. There are few supplies, as these midwives rely solely on the donations given to Midwives for Haiti. Some medications are accessible at the hospital’s pharmacy, but are not always available.

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The first day I went to work at the hospital, the maternity ward was full with one woman in early labor, one who had just delivered, and a woman who was just about to push. There were no postpartum beds for the woman who had just given birth, so she watched as the next woman gave birth. I noticed that the midwives were not checking for heart tones on the baby, and found out the doppler they had did not have a battery and was therefore not being used, so I went to get mine and was able to hear reassuring heart tones. I stroked the mama’s forehead and told her to take a deep breath between contractions. She would.  “Mes ami, mes ami,” (“my dear, my dear” or literally, “my friend, my friend”) she complained.  I told her she was doing a good job and soon she would meet her baby. She pushed for only ten minutes and the midwife placed the baby on her chest and I assessed the baby who had great tone, color and was crying.  I tried to get the baby to suckle, but a nurse took the baby instead and did a full assessment, administered vitamin K and eye ointment, wrapped the baby in blankets and kept him on the scale on the counter, where he stayed until the mom was ready to go to postpartum.  Although this is the way all babies are handled after birth at St. Therese, I did not let that happen again while I was there. I put babies skin-to-skin on their mamas and encouraged breastfeeding just after birth. These are important survival techniques which ultimately reduces infant mortality rates in developing countries.

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Maison Fortune

Maison Fortune is an orphanage in Hinche for children ages 6 and older. The orphanage is home to 250 children.  Some of the children at Maison Fortune have parents or grandparents that could no longer care for them because they could not afford to care for all of their children.

The girls and boys have separate living quarters. I visited the girls one afternoon and brought nail polish to paint their finger and toenails. They loved to touch my hair and hold my hand and touch my tattoo.  I pulled out my camera and we had a lot of fun taking pictures.

They took me for a tour, one girl holding my hand on one side, one on the other and then four more surrounding me and touching some part of me at every moment. There is no such thing as personal space in Haiti, and I was happy to give cuddles all around. Their house was bare, no toys, nothing hanging on the walls, but all of them had love in their hearts and smiles on their faces.

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It is an incredible experience to be truly faced with your own privilege. I thought that I understood what poverty was until I visited Haiti. Although I have read about Haiti’s history of European exploitation, its corrupt politics and cruel dictators, its broken infrastructure, lack of social services and basic necessities, none of that really prepared me for this journey.  I have come to understand the true meaning of the Haitian proverb “beyond mountains there are mountains”, which not only refers to the struggles and the tumultuous history of Haiti, but more so, the perseverance and determination of the Haitian people. Once you endure one challenge or solve one problem, another is waiting. It is difficult to articulate all I have learned, and even harder to fully process it all. I am so grateful I was able to travel to Haiti and expand my knowledge of the Haitian culture, and it was truly an honor to attend to mothers and babies during birth and postpartum…..

Ore vrwa, Ayiti! Until next time!

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