Thursday, December 13, 2012

question & answer on prenatal day

Hi Tara, 
Can you explain a little more why you do not deliver walk-ins. I'm asking in order to once again learn. My instinct, as someone who has no idea what it takes to do the work you are doing, would be to take her in. You have such a hard job and I continue to pray for you, your family and those you serve. Thank you for doing what you are doing.


T & T Livesay said...

Thanks for asking!
Sure, I can explain ... There are a lot of reasons, and because saying "no" to walk-ins is hard and quite uncomfortable I hope I don't sound defensive when I explain some of the reasons.

The core of our program is education and relationship building. The women come every week for class. During the education time and the weekly meals - relationship is built. If they miss three times over the course of the pregnancy they lose their spot in the program. (The wait list is long and the spots are hard to get.) Without an attendance policy like that people would miss a lot and we wouldn't be able to provide the same program and quality care because they'd miss out on too much of the important education piece (and their vitamins and iron) just coming to class here and there. If we started to take walk-ins there would be no incentive to those that take the time to faithfully come every Thursday for class and prenatal care.

Even when we choose to drive a woman that shows up as a walk-in to the hospital we are setting ourselves up to become a ambulance service. Word of mouth is a powerful way of communication in Haiti. One woman tells a few women and all of a sudden there are walk-ins coming because word of mouth says that there is a service that can provide rides to a hospital. Delivering a walk-in would also be news that would spread like wild fire and we'd very quickly have babies being born day and night.

We're small (Beth, Tara, Wini are the only three here full time all the time and then Melissa is here about 75%+ of the time.) Besides labor and deliveries we have three days of classes we do at the Maternity Center. If we did walk-ins we couldn't do those classes and we'd never sleep or see our families. (We will grow our staff as our program grows but we're not to that place yet, still raising funds at this point.)

There are government hospitals and other non-government hospitals (that I admit are sometimes terrible) doing walk-in deliveries. They provide that option. It is not loving, warm, or respectful care  - but in truth it would be hard for us to provide that kind of care with a high volume of women too -- our model works because we know the forty-five women so well and we've had time to build two-way trust. When they walk in with contractions at week 38+ we know their names, their story, their fears, risks, etc.

With seeing the women every week we are more certain of their health, their prenatal care is better, we can be more aware of the risks in each individual pregnancy. When we enter into labor and delivery time we understand a lot more about what the possible risks are. (Reducing our liability and reducing our likelihood of losing a mom and/or a baby). If we delivered walk-ins we would lose all of that.

Liability (if someone dies - which has not happened to us in three years but honestly - statistically - it will happen) is somewhat of a concern. When you know someone (and vice versa) for 7+ months before delivery and know about their health risks it cuts Heartline's liability down quite a bit.

Thanks so much for your prayers -- we think our statistics are good for exactly that reason and we covet your continued prayers. 
With love and gratitude,
tara & the whole Heartline team

*Please feel free to ask questions, we'll answer and post the answers as time allows.