One April night, 19-year-old Ilionelle* was struggling to give birth at her home in rural northwest Haiti. After several hours, she began having seizures, a clear indication of pre-eclampsia, a severe medical disorder that can lead to the death of the mother and the baby.

Tilma*, a traditional birth attendant helping Ilionelle, quickly identified the life-threatening symptoms and arranged for her transport to a hospital for emergency obstetric care. After being carried on a stretcher for four hours along a steep and treacherous road, Ilionelle arrived at Beraca Hospital in Port-de-Paix, where she safely delivered a healthy baby boy in April 2012.

“If it wasn’t for Tilma, both my son and I could have died,” said Ilionelle.

Tilma has been delivering babies in her community for 22 years. She learned this special profession from her late mother, who was also a traditional birth attendant. Through a health service delivery project funded by USAID and the President's Emergency Plan for AIDS Relief, Tilma received additional training on performing safe deliveries, identifying signs of high-risk pregnancies, and referring at-risk pregnant women to health facilities for care. This training was vitally important for Tilma, who works in Port-de-Paix, a region of Haiti where just 37.1 percent of births take place at a health facility.

Haiti has the highest maternal mortality rate in the Western Hemisphere with 350 deaths per 100,000 live births. To improve the country's maternal health, USAID trained nearly 2,300 traditional birth attendants from all 10 departments from August 2012 through April 2013. 

Tilma is grateful for the trainings that teach her new clinical skills. “Thanks to the project, now I know the procedures for a successful delivery,” she said.

*Full name not available.