the smell of my desperation has become a stench

Portraits of strength

In 2009 when I was 30 weeks pregnant with Marlo I experienced a not so insignificant, life-altering realization about motherhood. With only ten weeks until my due date I hired a doula and began preparing myself for an unmedicated childbirth, a privileged decision made possible because I was lucky enough to be born in a part of the world where women have options. Ten weeks later I was fortunate to have the exact childbirth that I had wanted, an experience that totally transformed me.

I wrote about the experience (here and here) because, well, this is what I do. I tell stories about my life. But I also wanted to let other women like myself know that they, too, had options, options they might not even be aware of. It wasn’t so much a religious fervor I felt as it was a duty: take charge of your experience. We live in a country where, god forbid anything should go wrong, we have access to critical help. But too often we’re told we don’t know anything about our bodies and then turn over the birth of our children to doctors who sometimes are more concerned than they should be about beating traffic home on a busy weekend.

This empowerment that I feel a lot of women lack in terms of their role in childbirth was underscored when I became involved with Every Mother Counts, an organization that seeks to bring new audiences into the conversation about maternal mortality. 90% of maternal deaths during childbirth around the world are preventable. 90%, a number that could be slashed merely by providing women access to basic prenatal and postnatal care. Too often and in too many places not only do women giving birth not have options, they have no one present. Too often these women go into this experience unarmed, deprived of the knowledge that they will be healthy and safe at the other side, all of them more than deserving of the basic care and right to the care that would ensure their survival.

Every Mother Counts started as a campaign in advocacy and awareness but has now moved into a new phase, one in which it raises resources and donates 100% of it to effective life-saving programs around the world. In 2012 they partnered with Midwives for Haiti to increase the number of skilled birth attendants available to assist pregnant women in Haiti. EMC’s grant supported the training of 15 midwives who every year will provide prenatal care to nearly 1,500 women and deliver between 120 and 240 babies. You can learn more about the impact of this work in the film series “The Making of a Midwife.”

I was lucky enough to attend the graduation of these midwives last month, and then I spent a few days on the ground in Haiti learning about existing and very recently improved medical facilities. There is still so much work to be done, but even in incremental steps like these more women are being empowered. In fact, more women are empowering other women.

Many people have asked me what my impression of Haiti is, and this is one of those rare instances when I am unsure how to respond. As I look through my photos I realize that in the moment I did not immediately understand the generosity and spirit of its people, the bravery they wear as proudly as their best Sunday dress. I have several memory cards worth of photos, many of them documenting the staggering beauty of Haiti’s tropical landscape. But today I wanted to feature some of the portraits that I took that will give you my impression of Haiti better than anything I could write.



























Many of you have also asked what you can do to help with this cause, and are we ever so glad you’re interested in doing so. There are several ways to lend a hand:

1. Sign up for the free Charity Miles App and walk or run for EMC. Every step you take will help to support another mom.

2. Order your Holiday cards through Minted and share this link with your friends. 10% of your purchase will benefit EMC programs.

3. Earlier this week EMC began a fundraising campaign to raise money to support Midwives For Haiti’s construction of a birth center in Saltadere. Saltadere is a rural, underserved area which MFH currently visits with their mobile clinic, but the need is greater than just the mobile clinic can fulfill. EMC will be matching all donations dollar for dollar.

4. Even if you’re simply interested in learning more about this issue, EMC has compiled several educational toolkits including stories and videos that help illuminate all the many facets of this giant puzzle.

  • chuck

    2013/12/05 at 3:43 pm

    “But too often we’re told we don’t know anything about our bodies and then turn over the birth of our children to doctors who sometimes are more concerned than they should be about beating traffic home on a busy weekend.”
    I have been saying this for years. I was so upset when my sister’s OBGYN used a vacuum to deliver my nephew bc he “had an appointment elsewhere.” My nephew’s head is misshapen to this day, 15 years later.

  • Kristan

    2013/12/05 at 4:03 pm

    Sounds like EMC is doing great work, thank you for giving it a signal boost. Also, so many of these photos made me smile. The kids are beautiful. 🙂

  • Clemence

    2013/12/05 at 4:09 pm

    I recently lived in Haiti for two years (and have been reading this site for longer!) and these photos make me very nostalgic. They’re beautiful especially considering that Haitians can be pretty sensitive about having their photograph taken by foreigners. You say that you are unsure what to respond when asked about what you thought about Haiti – the truth is, I think most people who have spent time there, whether a week or several years, don’t really know what to think of Haiti. It’s simultaneously beautiful and very tough. A wonderful, enjoyable place and also a very difficult and disheartening place to navigate. It challenges everything you’ve ever thought about friendship, trust, morality, compassion, empathy, inequality, privilege, etc. There are paradoxes at every scale and around every corner. A great read in this regard is Amy Wilentz’s “Farewell Fred Voodoo”. I really recommend it. Looking forward to hearing more of your stories from your visit.

  • Jennifer

    2013/12/05 at 5:24 pm

    Just curious if u requested permission for these pics? I have always been uncomfortable taking pictures of locals while traveling for fear they would take offense. Also are all Haitians so phenomenal looking?!? They could all be models!

  • Elizabeth

    2013/12/05 at 5:31 pm

    I’ve been reading you since Leta was a baby. I don’t really comment. But I have to say what you’re doing here, using your platform like this, is your best work. Every post you write about Every Mother Counts moves me on an incredibly deep level.

    So thank you.

    But don’t think this means you can stop writing about poop.

  • Katybeth

    2013/12/05 at 5:32 pm

    Oh my. The pictures say so much. Beyond words really. Touched to share and donate. Thank you.

  • Dr Smith

    2013/12/05 at 6:45 pm

    Dooce – I am a physician and offended by your comments regarding “beating traffic” to be over-generalizing and unfair. A decision to use vacuum, forceps or c-section is made when the fetal heart rate is plummeting. Your website has been spiralling downward and this was the ultimate straw. You have lost a long term reader.

  • RzDrms

    2013/12/05 at 8:13 pm

    I was wondering the same thing, but more about if they gave permission to have their images used on a public platform, and related to a particular cause. (Not being antagonistic, but genuinely curious.)

  • SK

    2013/12/05 at 8:50 pm

    I see this generalization all the time on the internet. I work in a hospital and not once have I seen a doctor try to rush things along for their personal convenience. In fact, most of the doctors I know work shifts, so they will be in the hospital at that time, no matter what!

  • EHG

    2013/12/05 at 9:36 pm

    I’m VERY glad that the two of you have been so blessed to have worked with professionals who make great choices. I’ve been an OB nurse for 7 years and worked in largely underserved areas. The bulk of my experience in hospitals as a new grad was working with doctors who often did not make such patient centered, evidence based decisions. Are all doctors making clinical choices based on their own needs/being burnt out/just getting a baby out safely? No. But to deny that these things happen (and happen often, primarily in the most underserved areas) is to deny a truth. This country doesn’t have the poorest maternal and fetal outcomes of any developed nation because the overwhelming majority of providers are making consistent evidence based choices.

  • Danalan

    2013/12/05 at 10:49 pm

    Imagine a world where women were truly empowered with safe, effective planning and support for births, instead of being little more than 2nd-class baby machines. A world where religion doesn’t support and ruthlessly advance bronze-age (or, sometimes, 19th century) ideas of women continuing to have children long after the age where it is safe or advisable.

    Not going to happen for a while, but bless you for your efforts.

  • kate

    2013/12/05 at 11:49 pm

    “We live in a country where, god forbid anything should go wrong, we have access to critical help.”

    Well, sure, if by “we” you mean “those Americans who are fortunate enough to have health coverage.” You explicitly acknowledge your own privilege in this post, which is great, but it would be even better if you could also recognize that it wasn’t just being “lucky enough to be born in [this] part of the world” that enabled you to have the birth experience you wanted with Marlo. It was being insured and financially comfortable. Many people, even in this part of the world, are not so lucky.

    Obviously this doesn’t invalidate your post, or the work that EMC is doing in Haiti. But I think your message would be stronger if you didn’t seem to assume such that everyone in the US has access to the care that your privilege has availed you.

  • Kristen Howerton

    2013/12/06 at 1:47 am

    Every pregnant woman in the US does have access to critical help. Poor women are able to give birth in hospitals here supervised by doctors, if they desire, and Medicare subsidizes this. Heather didn’t say everyone here has equal experiences, but her statement, before you parsed her words, is totally true.

  • Heather Armstrong

    2013/12/06 at 8:28 am

    I never said that every doctor is overly preoccupied with things other than the safety and health of the patient. I said “sometimes” meaning in some instances. I’m sure you and most of your colleagues are dedicated to the best interests of those you are serving.

    However, you cannot deny that such physicians are operating in this fashion. The doctor who delivered Leta was one such doctor who, while I was in the middle of trying to push my child into this world, continued to complain that he had to get up in the middle of the night and drive in the snow to attend the delivery. Several times he waved off what I was feeling without explanation or concern. I did not know that I didn’t have to be subject to that kind of treatment because I thought, well, he’s the doctor. I guess he knows best.

    This goes on. And women should be educated about who is there to deliver their child.

  • Heather Armstrong

    2013/12/06 at 8:32 am

    I did request permission for every single photo. When language was a barrier I’d hold up my camera and communicate in other ways. A few times people made it clear that they didn’t want their photo taken and I honored that request.

  • Manisha

    2013/12/06 at 8:46 am

    I am one those women that benefited from the posts you wrote about your childbirth experience with Marlo. After reading your words, I chose to give birth naturally and I ended up getting the experience I wanted. My delivery doctor was not my regular doctor and she was heavy handed with pushing the drugs. At one point she said to me “You are 38, not 18. You need the drugs.” It was so offensive, enough so that I was even more motivated to do it without drugs. After, they drug-tested my newborn which was mind-boggling considering my refusal of all her legal drugs (I believe it was a racist move considering my brown skin). My regular doctor was pissed as well but in the end, she did not intervene. Nonetheless, I had a fairly miraculous experience. Thank you for all that you shared. It helped me get the experience I wanted.

  • Jen Wilson

    2013/12/06 at 10:18 am

    LOVE this. And Haiti. And your heart for helping women.

  • Jen Wilson

    2013/12/06 at 10:21 am

    A lot of them think it’s so FUN to have their photo taken! And then they bombard you after to see themselves in the review screen. 🙂

  • boomer

    2013/12/06 at 10:32 am

    Don’t you need a signed photo release to post these on your website?

  • Ron

    2013/12/06 at 10:44 am

    Amen, Heather!

    You’re right, not all doctors operate this way but they can’t deny that many do. And unfortunately, that makes people very apprehensive about doctors.

    I once had an oral surgeon perform an abscess drain on one my teeth, and he did it with such a hurried and impatience manner that he ended up causing more pain than was necessary. He was pissed that I had waited that long to have the abscess drained that he actually reprimanded me as if I were a child being scolded by a parent, even though this had happened during a holiday weekend, so I couldn’t get in to see any doctor. His treatment of me while performing the surgery was rough and angry. He was the most unfeeling and cold man I had ever met. Yet, he had diplomas and awards all over his office walls for being one of the best oral surgeons in the area.

    I made a formal complaint about him online. And it’s ironic, because last year I had heard he retired. And as well he should have, because he was obviously burnt out on his job.

    Sorry, but I think MANY doctors need to go back to medical school and take a course in COMPASSION. Healing has so much more to do than with just the physical.

    And on another note, I think it’s awesome what you’re doing with Every Woman Counts, Heather! Brava! Beautiful photographs too!

  • Heather Armstrong

    2013/12/06 at 12:06 pm


  • Heidi

    2013/12/06 at 1:01 pm

    I had an experience much like yours, Heather, in that the doctor SENT ME HOME while I was in full blown labor because it was a holiday and he was not “supposed” to be there. He came in his wind pants and sweatshirt and without having spent more than 2 minutes with me, told me to go home…. I did because I was forced to, and ended up back at the same hospital an hour later by ambulance. It happens – far, far more than anyone cares to admit. Especially people in that profession.

  • April

    2013/12/06 at 1:30 pm

    I understand you are not a photojournalist, but to me these pictures and words fall very flat. I live in the West Indies, and honestly these pictures could have been taken just about anywhere in the Carebbean. You may call them “Portraits of Strength”, but they are of regular people getting out of/going to church and spending time at what looks like a community center. I’m not saying these people are not strong and have not struggled, but where are images OF the struggle.
    Where are the pictures of the women who spent countless hours, in most likely an un-airconditioned room, learning to be a midwife? Where is the graduation and the celebration of that? How about the mother’s who will now benefit from these services? How about the description of the medical facilities. I can guarantee you that they do no resemble what people are accustomed to in the US. That to me is the value of a trip like this. TEACH people and SHOW them what it’s all about. It’s not the smiles and bright colours of typical Ministry of Tourism photos and words.

  • KristenfromMA

    2013/12/06 at 1:46 pm

    I was just thinking the same thing: they’re gorgeous!

  • kate

    2013/12/06 at 1:53 pm

    “But too often we’re told we don’t know anything about our bodies and then turn over the birth of our children to doctors who sometimes are more concerned than they should be about beating traffic home on a busy weekend.” Wow. . .cheap shot and so disrespectful. I think if you’re going to make a statement like this, you may want to back it up with hard evidence.

  • Holly

    2013/12/06 at 9:34 pm

    Particularly when the post is supposed to be about women in Haiti and their lack of access to prenatal and postnatal healthcare. Heather, your experience really has no relevance, beyond the fact that as you had access to great medical care and the women you’re supposedly trying to help often do not.

  • Holly

    2013/12/07 at 9:58 am

    You’re so flippant, Heather.

  • SurprisingWoman

    2013/12/07 at 1:41 pm

    These pictures are amazing. The people are beautiful.

    My first child was born on an Air Force base. She was a month late. When she was born she had a pelt on her back, hair on her ears that made her look like Spock and the skin on her fingers was cracked and peeling. I was due June 9 and she was born July 8 on a Saturday. She weighed 9lbs1oz. They had me driving 40 miles each way to the base three times a week to make sure my placenta wasn’t detaching. In Texas. In July. It was great. **eyeroll**

    When they finally wheeled me into the delivery room the doctors were discussing their delivery experience. It was a training hospital and they were going to use forceps “for practice” for one of the doctors. The delivery nurse told them they better get over to me quickly or the baby would be born without them. I didn’t have to be used like a forceps guinea pig since my little girl was delivered so quickly. Thank goodness.

    I had a full natural childbirth. No drugs at all and I loved the experience. It was truly magical. My mother had told me how the baby feels like a fish slipping through your hands when it’s born and she was right. It was incredible.

    Looking back on it I am appalled but it being a Marine Corp wife I had no other options. There are as many kinds of doctors as there are people. I think it’s imperative that we take control of our bodies and our health. If I had it all to do over again I would have been more proactive but I was young and poor and didn’t know better. I think what you are doing in educating your readers is wonderful and so important.

    If “Dr. Smith” is feeling a bit defensive maybe there is a reason?

Heather B. Armstrong

Hi. I’m Heather B. Armstrong, and this used to be called mommy blogging. But then they started calling it Influencer Marketing: hashtag ad, hashtag sponsored, hashtag you know you want me to slap your product on my kid and exploit her for millions and millions of dollars. That’s how this shit works. Now? Well… sit back, buckle up, and enjoy the ride.

read more