Friday, July 1, 2016

The Servant Heart of a Midwife




Kitty Ernst turns 90 this year. And this is the story she told to new and old midwives in Alberquerque last month.

Kitty told of how when she first went to the Frontier School in Kentucky she had no intention of becoming a midwife. When she learned that the reason most students were there was to become a midwife she wanted nothing of it and planned to leave. The reason she did not want to become a midwife is because she had been exposed to "obstetrics". What she had seen up to that time of obstetrics left her with the image of doctors and nurses standing over suffering women and telling them what to do to get their baby out. She hated it. She was not going to do "obstetrics".

But a wise teacher told Kitty that she should at least see one midwifery birth in a home before she left the school. So very soon she was taken to a home where a woman was in labor. There were sleeping children in the small room where the woman was sitting up in her bed so everyone was very quiet. Kitty was amazed to see the midwife at the feet of the woman looking up to her talking softly. The midwife rubbed her feet, asked her if she wanted water, told her she was strong, and held her when she was in pain.

Kitty had lightbulbs go off in her head. THIS was MIDWIFERY????!!!!! This image of the midwife as a servant to the woman was something that clicked with her core values. She decided on the spot to stay at that school and become a midwife. And what a midwife she has been!

I was not the only one in the room that night that teared up when Kitty told this story. Jessica Jordan and I looked at each other with our blurred-from-tears vision and acknowledged that the story was pretty much pinging on every string of our soul.

One of the things we struggle with so much in Haiti is the culture of class that partly stems from their long history of slavery. In Haiti it is not uncommon to treat anyone who has not received as much education or make as much money as you as a lower-class citizen and worthy of your scorn. So one of the barriers to skilled care in pregnancy and birth is that Haitian women stay away from places where they are talked to and treated as if they are nothing.

We constantly tell our students to treat patients as if they were their sister, their mother, their friend. We talk about compassion, caring, gentle touch, and the importance of listening to women.
But the servant heart of the midwife is the hardest thing to teach. Especially if you have never experienced that kind of caring in your life.

We tell our volunteers repeatedly that if they do nothing else but demonstrate compassion to patients, then they have made a dent in the hearts of the staff and students and demonstrated true midwifery. This year I am thinking of what we could do for our students that would make them feel the compassion and gentleness of unconditional love. How can they show what they may have never experienced?

This picture is of one of our grads pouring water over her patient's head in an effort to cool her. She is being a servant midwife.

Every woman on this earth has experienced suffering in some form. It may have been spiritual, physical, or mental pain. She may have suffered alone or been blessed by caring sisters of the heart who held her up when she was down. The time of birth always hurts. No one can take away all the pain - although in some cases we have the means to come pretty close to painless. But most women in this world birth without access to medications so they rely on their family, their mothers, sisters, and significant others to see them through the deep waters of childbirth.

I try to remember this when I am with strangers in any setting. Here before me is someone who has suffered, especially if she is a woman. The statistics of domestic violence, rape, and trafficking are sobering. Every midwife has heard the stories, cried the tears, screamed inside at the injustices that women endure all over the world. Childbirth is just one time when women suffer.

Whether you are a man or a woman, you need someone to be your servant when you are suffering. I am learning that a lot of midwives get into hospice care when they stop catching babies. Care at the end of life is another form of servant midwifery. Some of you remember Brother Mike McCarthy who was a Xaverian Brother at the Maisson Fortune in Hinche. He was a gentle and sweet soul who let a lot of midwives cry on his shoulder after hard things happened to them in Haiti. When he left Haiti he told me he was finishing three months of training to be a hospice worker. I said, "Brother Mike. you are going to be a midwife to the dying!" He gleamed. He could not think of a greater thing than to join the ranks of all of the "servant" midwives.

This is Beth McHoul and her patient who is in labor. A midwife at Heartline Ministries in Tabarre, Haiti. A servant midwife every day of her life.


This is Rebecca Barlow, student midwife, demonstrating servant midwifery at St. Damien Hospital in Haiti. She is a Frontier Midwifery student.


Being a servant midwife takes emotional and physical and mental energy. What midwives get in return for what they spend is the knowledge that there would be no soul in their work without servanthood. No matter who you are, if you helped someone who was suffering today, you are a servant midwife.

Let's all be a servant to each other. This world needs more servant hearts. Thanks for reminding us, Kitty!

Photo credits:

Photo of Marie Denise by BD Colen, Photo of Beth McHoul by Tara Livesay, Photo of Rebecca Barlow by Maribeth Quinn.

Sunday, April 24, 2016

To be or not to be? To be, of course, but how?

This is a painful thing to write because change is painful and change is inevitable. But change can bring good things, right? Right???

Midwives For Haiti is currently running its annual campaign for the Mobile Clinic Program that serves 600-700 women per month with prenatal care. Other years we had matching funds to help us reach our goal, but the organization that provided those funds has a limit of 3 years on their funding in order to discourage dependency. We understand that but--- what will happen if we cannot support this program after this summer?

It is a painful thing to have to give up something that has been really good and saved a lot of lives because of a lack of funds. Without enough money to run the mobile clinics, the BOD will have to consider the options. We have thought of them before- everything from disbanding the program all together to just reducing the number of villages we visit. There is a lot of fear about any of the choices. Who will get lost in the transitions? Will there be lives lost?

The church I attend meets in a 90+ year old building with a huge sanctuary, incredibly fine woodwork, stain-glass windows, an expansive organ that fills the front of the church, many rooms, and several annexes added through the years that make it a maze to newcomers. Everyone loves walking in those old historic doors knowing that hundreds went before them and everyone feels the responsibility to those who went before to carry on the work of the church.

But the congregation can no longer support the cost of the building, the upkeep, the maintenance, and the cost of heating and cooling such a massive structure. So they are facing some hard choices- namely leasing or renting out a large part of it or selling it and moving elsewhere. A lot of grief is happening and a lot of emotions with fears and hopes are being shared in the "town hall" meetings.

A question in everyone's mind is whether or not the church can remain the same church in a different space, in a different part of town, with different patterns to being together. Spiritual growth and support for it is one thing, but what happens to the projects the church has in the community like the weekend backpacks for the hungry children in the local school, the variety of services for the elderly in the two nearby retirement villages? Can the vision and mission of the church remain the same in a different way? And a big fear- who will get lost in the transitions? Will people we love leave us?

Same questions---If Midwives For Haiti has to stop the Mobile Clinic program can MFH maintain its vision and mission- to increase access to skilled care for pregnant women in Haiti? Can the wonderful midwives who have dedicated their lives to this work be put to work in a different setting? The problem is that anytime you limit a midwife in Haiti to one space you limit how many people she can reach because transportation is a huge obstacle for most women in Haiti. But can we perhaps do a better job  and give more thorough care if we limit the care to a specific place? The vehicle costs are killing us.

What if we just have to bite the bullet and stop the salaries of midwives and drivers?  There will be many family members that will go unfed and their children will have to stop school. And the many women they know need care will go without. Healthcare is just not sustainable work in Haiti.
Or anywhere for that matter. Without insurance a visit to the hospital could bankrupt some of us. In Haiti there is no way most women could pay for the services needed to have thorough prenatal care and a safe delivery. So very few could come up with the money.

And do not tell me they should just not get pregnant. You be the one to issue the decree there should be no more sex. Good luck with that. And even here in the U.S. where birth control is pretty much accessible to everyone- depending on what our elected leaders do next- people still have unwanted pregnancies. And pregnancy can kill women. It does every two minutes in this world. EVERY TWO MINUTES, PEOPLE!!!

It breaks our heart to let Mobile Clinic go. Because we know it saved lives. But there are other lives to be saved. And we cannot save them all. What steps can we take that will bring the most life to the most people with the funds we DO have?

Just like the church at Ginter Park, Midwives For Haiti will jump into this unknown place called the future. But we will do it while holding hands with each other and total faith that we are supposed to DO THIS WORK!! Hold tight!