Although outnumbered by women, male midwives are paving the way with a considerable dose of passion in the country
Ronaldo Jeanty still recalls the moment where a woman gave birth to a stillborn child in the waiting room of a hospital in Port-au-Prince on September 7, 2010.
While she was screaming and writhing in pain a few minutes before, an obstetrician-gynecologist allegedly ordered her to be quiet after telling her he could not attend to her case due to fatigue.
The woman died four hours later.
The next few minutes saw the woman’s angry husband burst into the establishment with a gun, with some doctors scrambling to scale walls to try to save their skins, according to Jeanty.
This tragedy led Jeanty to study midwifery in 2019. “I told myself that no woman should die while giving birth,” confides Jeanty.
Ronaldo Jeanty rocking a simulated baby at the National Higher Institute of Midwifery Training in Port-au-Prince in 2022.
Midwives take care of sexual and reproductive health, providing medical care for pregnant women and babies throughout pregnancy and in the postnatal period.
Recognized abroad as in Haiti, the field is considered the third medical profession after medicine and odontology.
But if they venture into it, male midwives suffer the repercussions of the profession, often mistaken for “matron” and where women are traditionally over-represented, according to half a dozen interviews conducted by AyiboPost.
Read also: Des Haïtiennes marginalisées, parce qu’elles exercent des «métiers masculins»
Matrons, also called “traditional midwives”, are midwives who tend to use magico-religious rituals in their practice. They assist women, particularly in rural areas of the country, generally without equipment and with fragmentary knowledge of their tasks, which very often inhibits them from preventing complications during childbirth.
Although outnumbered by women, men are blazing the trail with a considerable dose of passion.
“I am in the habit of triggering bursts of laughter when I introduce myself as a midwife,” says Jeanty.
Ronaldo Jeanty at the PROFAMIL clinic in Turgeau, Port-au-Prince, in April 2023.
The young man, who was already a student at the Faculty of Medicine and Pharmacy (FMP) of Port-au-Prince when he turned to the profession, was met with inappropriate remarks which he often chose to ignore.
“Although many people respect me, it often happens that friends at the medical school make fun of me and tell me that I only went to learn this profession to find women and make money,” underscores Jeanty.
Other remarks demonstrate the lack of comprehension from parts of the population. “All male midwives are homosexuals”, the professional often hears from the people he meets.
In Haiti, midwives seem to be held in low esteem compared to other medical professions.
“The situation points to a pyramid or hierarchy of healthcare professions in the country,” thinks Jeanty.
I am in the habit of triggering bursts of laughter when I introduce myself as a midwife.
Isemael Joseph says he has been subjected to condescending looks from health professionals in Haiti, who judge midwives based on the supposed superiority of medicine.
The young man, who currently works in a hospital center in the provinces, still rehashes an episode from 2022 where an aspiring doctor, a few meters from him at the Faculty of Medicine and Pharmacy of the State University of Haiti (UEH), shot him reproachful glances while he was chatting with a mutual friend.
A young woman who was then studying pharmacy revealed to the young man, a few minutes later, that the medical student told her “that he could not understand how a man could deliberately choose to be a midwife!”
Isemael Joseph examining a newborn at a maternity ward in Cerca-la-Source in the Plateau-Central on February 6, 2024.
Armed against these remarks, Isemael Joseph lives his proclivity for motherhood on a daily basis.
“Since I started, I have more than 200 deliveries under my belt,” the young man reveals to AyiboPost.
But, Joseph deplores the fact that even professionals in obstetrics, who should be, along with midwives, the two people in charge, often do not know the importance of the profession in the maternity process in Haiti.
Ronaldo Jeanty working on a baby mannequin at the National Higher Institute of Midwifery Training in Port-au-Prince in 2022.
Friction between professional midwives and doctors, who often view themselves as superior, regularly strain these healthcare workers’ relationship which should otherwise be smooth.
In 2019, a hubbub erupted between midwifery students and a doctor in the State University of Haiti Hospital (HUEH) maternity room.
According to Isemael Joseph, who was there, that day one of his fellow midwives was filling out a file for a woman in labor. The doctor then burst into the room and attempted to violently grab the file from him, after asking him “in what capacity he was questioning and providing care to the patient.”
As a result of the violence of the action, the file was torn. Due to lack of care that morning, two women gave birth in the maternity ward corridor, obstructed by the fierce crossing of words and the outbursts of both camps, according to Joseph.
Isemael Joseph working on a file for a patient at a health center in Cerca-la-Source in the Central Plateau on February 6, 2024.
Infant mortality and the lack of equitable care are striking hard in Haiti.
EMMUS VI data on mortality, morbidity and service utilization for the period 2012-2017 show that only 67% of the 91% of women who received antenatal care completed the minimum recommendation of four visits.
63% of births took place with the assistance of a trained provider in urban areas compared to only 30% in rural areas, while 60% of births in urban areas took place in a health facility compared to only 29% in rural areas.
Read also: Haiti: Only 25% of Pregnant Women Receive Recommended Prenatal Care, According to WHO
The National Higher Institute for Midwifery Training (INSFSF) was inaugurated on February 21, 2018 in Port-au-Prince, replacing the National School of Nurses and Midwives (ENISF) created in 1997 to train midwifery professionals qualified to meet the country’s maternal and child health needs and expand the range of care in health facilities in Haiti.
View of the premises of the National Higher Institute of Midwifery Training. | © Jean Gardy Bernard
Although the profession has become institutionalized, preconceived ideas about the “traditional matron” still seem to hover over the profession.
Ronaldo Jeanty still remembers an episode in April 2023 where he was turned away from a delivery room by an obstetrician-gynecologist after he was introduced as a midwife.
“He said, distinctly, that he could not understand the meaning of the presence of a midwife in the maternity ward,” Jeanty muses.
The name of the profession also seems to give a chill to men who wish to venture into it, according to St Louis Dexter Petersen Esaï, another midwifery student.
St Louis Dexter Petersen Esaï rocking a newborn at the SONUB maternity center, located at the Petite Place Cazeau Medical and Social Center in Port-au-Prince, on December 6, 2023.
Joseph Isemael’s 2016-2020 class at INSFSF had only 2 men among 37 women. That of Fénel Noncent, from 2015-2018, had 3 men compared to 37 women.
For Hermine Francesca Jean-Pierre, a midwifery student, and Saint Louis, the profession can be practiced by both women and men.
“The word “wise” placed before “woman” simply designates the fact that the professional has knowledge of women or will have to provide maternity care to women,” they emphasize.
St Louis Dexter Petersen Esaï at the SONUB maternity center, which operates at the Petite Place Cazeau Medical Social Center in Port-au-Prince, on December 13, 2023.
For Evaï Dominique, a former midwifery student at INSFSF from 2015 to 2019, the stunted presence of men in the midwifery profession does not only concern Haiti.
“In France where I live, few men practice this profession,” he reports.
English translation by Sarah Jean..
Cover image: Midwives working in a hospital. Image edited by AyiboPost.
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