In Port-au-Prince, Haiti, gang violence has severely limited access to maternity care, forcing women like Françoise to risk dangerous journeys for medical help. Only a few health facilities remain open, often under threat.
Since the 2021 assassination of President Moïse, the country has faced escalating chaos, with many displaced and food insecurity worsening. Maternal mortality rates have increased as healthcare access declines.
Eight months pregnant, Françoise, 45, arrives early in the morning at a deserted school in Bel Air. The hillside neighbourhood in Port-au-Prince has been controlled by gangs since a violent takeover in 2019. Schools have closed, electricity has been cut off and food is scarce. Gunfights can erupt at any time.
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What was a school in safer times in Haiti’s capital has been turned into a temporary pop-up health clinic. The only light comes through the cracks in the boarded-up windows and over the sandbags stacked to stop stray bullets. A room lined with wooden benches is packed with newborns and their mothers and pregnant women seeking maternity services provided by the aid organisation Médecins Sans Frontières (MSF).
According to Human Rights Watch, the Trump administration’s suspension of USAID funding in 2025 deprived about 750,000 women and girls in Haiti of access to healthcare. On the rare occasion it is still available, women line up and wait for hours.
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Ten days before Françoise’s visit to the clinic, the area was the scene of a violent clash between rival gangs. Dozens of people were killed, including 10 children, a local human rights group told Associated Press.
In the final trimester of her pregnancy, Françoise feels she has no choice but to travel to the clinic, despite the risk. She has been diagnosed with a condition that significantly increases the risk of eclampsia, which can cause seizures during pregnancy and in the postpartum period. Left untreated, it can lead to coma, brain injury and, in some cases, death. If the clinic was not there, Françoise says, “only God knows” where she would go.
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After the assassination of president Jovenel Moïse in 2021, Haiti spiralled deeper into chaos. About 1.4 million Haitians have become internally displaced. More than half of the population now faces high levels of food insecurity, and more than 6 million people are in need of urgent humanitarian assistance.
The consequences for maternal health have been grim. According to MSF, between February 2022 and April 2025, the proportion of maternal deaths in hospitals rose from 250 to 350 per 100,000 live births.
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Only a fraction of health facilities in Port-au-Prince are still operational and accessible for women living in the poorest neighbourhoods, such as Bel Air and Tabarre. A clinic in Cité Soleil was forced to close in May due to gang violence. An estimated 60% of births take place in the city without medical care – at home, in camps or on the streets. Complications such as haemorrhage, infections and hypertension go untreated, making them the leading causes of maternal mortality.
The midwife treating Françoise says her baby will probably need to be delivered by caesarean section. Without it, she or the baby could die. She already has three girls, two of whom were delivered by caesarean section. If this is another girl, Françoise plans to name her Lovinska.
After several hours in the clinic, gunshots are reported outside. The medical staff start packing up their equipment, and the women at the clinic disperse. Françoise starts her long walk home through the unpredictable streets of Bel Air to the home where she lives with her husband and children in a camp for the displaced.
The situation in Port-au-Prince is rapidly deteriorating. Weeks after Françoise attended the clinic in Bel Air, heavy fighting erupted. Seven volunteers working with MSF were trapped inside a building for hours before they were able to evacuate. A former volunteer was wounded and died in front of the building’s gate. Once again, maternal health services were put on hold.
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