Giving birth in the shadow of Haiti’s gang violence – photo essay

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.

• Françoise awaits a Doppler ultrasound in a clinic set up for a few hours inside a deserted school in Bel Air

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.

• The clinic in the abandoned school in Bel Air is operated by Médecins Sans Frontières

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.

• The government controlled Port-au-Prince district of Pétion-Ville

• A month-old baby girl, Luguiona, in the arms of Ruth, a friend of the child’s mother, Adeline, at the Bel Air clinic

• Residents in Pétion-Ville. About 1.4 million Haitians have become internally displaced and more than 6 million people are in need of urgent humanitarian assistance

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.

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.

• Prenatal examinations at the Bel Air clinic take place behind a screen by the light of battery-powered lamps because there is no electricity in the gang-controlled area.

• Clockwise from top left: A female patient is treated for a gunshot wound in her upper leg in Tabarre; women seeking healthcare in Cité Soleil; a baby girl, Gamalla, in the arms of her mother, Fabienne, seven days after being delivered at home; expectant mothers hold urine sample cups at the Bel Air clinic

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.

• Rollens, 5, and his mother, Eliphète, at a hospital run by MSF in Tabarre. Rollens suffered burns on his arms and legs when his foot got caught in the exhaust pipe of a motorcycle

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.