Friday, January 04, 2019

People are Not Statistics - But Statistics Help

Sandra gave birth to her baby December 26, 2018
Baby Isaac was the last baby of 2018 for HMC
Let us look back on 2018 at the Heartline Maternity Center.

The tendency in doing any work is to look at the outcomes from a purely statistical approach.

How many? What categories? What cost per person? Was it "effective"?

At the Heartline Maternity Center we transparently report statistics and share our outcomes. Please always feel free to ask questions!

We also believe that some of the best things that happen, cannot and do not show up in a statistics report.

These numbers will never tell you how many hours were spent massaging backs, how many tears were shed over abuse, loss, or betrayal, or how many words of encouragement or prayers were offered.

The day to day work is incredibly relational. Because of the environment created by decades of material poverty combined with corrupt governments, the relational needs are intense. They are also  vital to the work of Midwifery.  It is not possible to work with a woman in child-bearing years (in Haiti) that has not had trauma.  That person does not exist here.

To know that the mother in labor has lost one baby to what she believes was a curse, and another to entrapment of the head during a breech delivery because of inadequate care, is to approach prenatal care and the birth with a unique empathy and tenderness that cannot be quantified with statistics.

The statistics do tell a story, they just don't tell the whole story.

Hopefully we have done a decent job of sharing a few of the stories this last year.  It is with the weight of responsibility that we share anything. Our hope and prayer is that we honor the women we work with, telling their stories is something we do with caution and intentional forethought and discussion.

The stats below will possibly mean more to people that work in the area of Maternal Health, and especially to those that work within a developing world setting.  We are so pleased with some of these findings and excited to continue to gather data in the years to come.

One note on our culture of care. Because our organization values Haitian medical professionals, we want to invest in, and employ as many as possible. We don't take students or medical volunteers from North America to get or have an experience here. We cannot help students get their clinical numbers. We need and want to be sure we are investing in the local workforce, doing career development and further training. They will always be in Haiti and their skills being fine-tuned to serve and help their neighbors is our first priority. Our goal is not to disappoint potential volunteers, our goal is to invest in the women that can make a difference in Maternal Health in Haiti for the long-haul. 

We welcome tours 6 days a week when an appointment is made and are happy to show you the Maternity Center and the work happening here. Email KJ or to set up a tour!

The only rare exception is for coverage when we have two or more staff members gone on vacation or an emergency situation. In that case we ask for CNMs or CPMs with Haiti experience and ideally some (Kreyol or French) language skills. If you are that person, and are interested in helping sometime in the future, please contact us to be added to our list.

We love what we do at the HMC and we hope to share our model with anyone that wants to copy it. Our next Starting Place class will likely be held in May of 2019. Details to come.


118 Babies were born to Moms that were in the Heartline Prenatal Program in 2018

(We made a mistake and counted wrong, we apologize for putting out a number that was not correct in late December.)

116 Babies lived
1 baby died due to prematurity at a hospital,
1 baby died due to a cord prolapse at the hospital
(we are working on meeting with that hospital)

53boys (2 passed away) 65 girls

0 Maternal Death 

Two years ago we started something new. We began giving any G1 or higher risk for Pre-E woman  calcium and aspirin every day for the duration of the pregnancy.  We needed to give it time in order to report the findings, but we now have three-year stats to compare and see how well it is working.

(SIDE NOTE - in 2015 we did NO Calcium and Aspirin and we had a 26% Pre-E rate)

The 3 year Pre-E rate for 2016-2017-2018 is 10.3%

2016 Pre-E  11%
2017 Pre-E  6.3%
2018 Pre-E 13.5%

For the last 3 years - The transfer (to another hospital due to complication) rate is 25.7%

Last 3 years rate for C/Section is 13.2%

In 2018 only we had a  - 2.5% PPH rate - due mainly to active management of the third stage

First time Moms made up  52.5.% of our clients

1,725 - Prenatal Visits in 2018
4,050 - Vitals Signs on Thursdays in 2018
Oldest Mom to Deliver  42 years old (in 2018)
Youngest  15 years old (2018)

The last three years: 3.3% Preterm labor (prior to 37 weeks)

10 people lost their spot in the program due to poor attendance. For us attendance is key. We don't allow anyone in the Prenatal program to miss a Thursday without contacting us first and having their consult rescheduled. When there is "buy-in" outcomes are so much better.  Coming weekly creates buy in!

In 2018 2 babies born at home (because Mom could not get out fast enough) and 1 baby born in the street in front of the MC.

830 Women received Family Planning (Depo Provera mostly) (just 2018)

2018 - 2.5% miscarriage rate

Average woman begins the program at 9 weeks gestation

3 year miscarriage total 16-17-18 - 3.4 miscarriage (loss of baby up to 20 weeks gestation)

0 - IUFD in last three years (baby that dies 20 weeks to term)

Biggest success story of the year, Baby Ruth born at 32 weeks and is thriving.

Biggest challenge of the year, Baby Wisler born at term in November - still hospitalized and undiagnosed .  (January 2019 update - he was released with a G-tube for feeding. He will have his surgery to close his palate when he is six months hold.)

2018 -  Two shoulder dystocia -- with resuscitation  - the more difficult one was 5 minutes long with a 4.5 min resuscitation

85% of the babies born at HMC were delivered by Haitian Midwives !!

We have increased the number of women we serve by 31% over the last two years - we will hold at these numbers for 2019.


2019 Births were kicked off last night:

Midwife Mica with Guetly in early labor

Guetly and her daughter right after she was born,
pictured with her sister