Marnie Cooper-Priest’s Work
with Fondwa Midwives

marnie cooper-priestMarnie Cooper-Priest and Kate Wiegert spent six weeks in Haiti during the summer of 2011 conducting research with traditional birth attendants under the auspices of Family Health Ministries. Marnie, herself a midwife, was humbled by the dedication of the Fondwa “matrons” or midwives who walked as much as two hours each way to attend four weeks of sessions, three times a week.

During the sessions, the matrons participated in a program that reviewed and assessed measurable skills related to childbirth. Kate Wiegert, who worked with Cooper-Priest, was in charge of surveying the community to learn about current childbirth practices and outcomes.

Marnie realized from her previous meetings with the midwives that she would need lots of pictures to communicate effectively. She made up chants and sang songs to help her students learn and remember. And, she brought metronomes to help them understand appropriate heart rates.

Cooper-Priest then delighted in helping her Haitian colleagues hear a baby’s heart rate for the first time. “They really didn’t know that it was possible, which was a complete surprise,” says Cooper-Priest.

By the end of class, each student had a loose-leaf binder filled with plastic sleeves containing important information about pregnancy, childbirth and information about complications that need quick responses and/or referral to a hospital.

During the sessions, the nine male and seven female matrons participated in pre and post assessments, which will include assessments six weeks and six months after the first training to assess longer term retention of the knowledge and skills originally presented. Marnie and Kate wondered if their students would study for their follow up post-test. Not only did the students study, but they decided to form an association to come together monthly so they could continue to share with each other what they are learning from using their skills.

During their six week follow up visit, Kate and Marnie collected stories and impressions from the Haitian matrons on their experiences with their new blood pressure cuffs, stethoscopes, and fetoscopes. Said Emelien, “I realized that I was like a car without the lights on in the dark. Now I am proud because I am learning to be a better assistant.”

Jean commented, “Prolapsed cord. Formerly, if I had a case of this, I would not know what to do. Now I have some idea of what to do while trying to get the patient to a hospital.”

When asked if they had used any of the skills from their training program, Emanie responded, “Resuscitation. I used the pump (resuscitator). Congratulations for the pump. The baby is well.”

Rodinese explained, “I had a baby with stuck shoulders. I used the baby’s back to turn the baby and I thank you.”

One of the lessons the American graduate students learned is that there is no “typical” birth attendant in Fondwa. Some can read; others cannot. Some had difficulty understanding blood pressure numbers; counting is not part of their repertoire.

One man in his seventies had delivered close to a thousand babies; another participant had brought five children into the world.

Some of the Haitian participants had been to midwife training early in their careers. Most, however, were either self-taught or had learned their skills from a family member. Marnie and Kate were not surprised at the wide range of experience; they learned before traveling to Haiti of skepticism about the capabilities of traditional birth attendants (TBAs). However, given what the Duke students learned about the matrons’ dedication and interest in forming an association, it may be premature to give up on the TBAs. After all, for many rural women, the matrons are all they have.