In Port-au-Prince, Haiti, every movement poses a risk. For thousands of women, seeing a doctor, obtaining contraceptives, attending prenatal check-ups, or receiving care after sexual assault has become fraught with obstacles. 

In a capital where armed violence is undermining an already fragile health system, access to sexual and reproductive healthcare is increasingly limited. Yet such care remains essential at every stage of life. 

A collapsing health system  

One recent morning, a 29-year-old woman was admitted, barely conscious, to the Isaïe Jeanty Maternity hospital, which is supported by Médecins Sans Frontières (MSF). She had developed postpartum eclampsia – a serious complication that can be fatal without prompt treatment – after giving birth at home a few hours earlier. 

Her stepfather accompanied her on a motorcycle from Cité Soleil, a commune of Port-au-Prince, with her newborn baby in his arms. 

“I was shaking when I arrived; I thought it was a lost cause,” he says in the maternity ward, where about 15 women are being monitored by medical teams. “This morning, she looked as if she were dead. But now she's almost smiling. It's as if she had been brought back to life.”  

Haiti has the highest maternal mortality ratio in the Americas. The World Health Organization estimates that it stood at 328 deaths per 100,000 live births in 2023, compared to 197 globally and 58 in the Americas region.¹ 

These numbers illustrate the gradual collapse of a health system weakened by the expansion of armed groups, institutional instability and chronic underfunding of public services. In Port-au-Prince, many health facilities have closed their doors, thus severely reducing access to essential healthcare — especially for women and their sexual and reproductive healthcare. 

Many pregnancies are not monitored by trained professionals, and births take place at home without medical assistance. Without timely access to healthcare, complications, such as eclampsia, haemorrhages, infections, or neonatal distress, may be detected too late. 

“We had to refer a woman at eight months of pregnancy to give birth to her baby who died in utero,” says a midwife at an MSF mobile clinic. “She had never been able to receive prenatal check-ups. This should not be happening. These are preventable complications that become fatal without medical support.”  

Multiple obstacles to face 

For many women, reaching a health facility has become an ordeal. Armed clashes, shifting frontlines, checkpoints, roads blocked by mountains of rubbish, transport costs and forced displacement complicate every consultation. 

“Patient transfers are extremely difficult: transport is limited, and functional maternity and neonatal units are scarce,” says Naomi Lubin, an MSF supervising midwife. 

Added to this is another challenge: some women are reluctant to leave their neighbourhood for fear of being identified with their place of residence. In a city divided between neighbourhoods controlled by armed groups and others by the authorities, an address can be enough to stigmatise a person or lead others to suspect them of having links to an armed group. Leaving one’s neighbourhood to go to hospital can then become life-threatening. 

“My two-year-old child hasn't been vaccinated for a year and a half because I can't leave the area,” says a woman and MSF patient. “I don't want to go out with my identity card with my address indicated. I'm scared. You could get killed.” 

Like many other women living in Port-au-Prince, violence is disrupting many aspects of her life, including access to healthcare.  

Maintaining healthcare despite the crisis 

In response, MSF has set up mobile activities to bring care closer to the communities. Every week, medical teams provide general healthcare in former schools or churches, in multiple neighbourhoods, offering consultations for several hours.  In the first half of 2026, they provided 4,500 sexual and reproductive health consultations. 

To strengthen the continuity of care in the long term, MSF is also investing in the rehabilitation of the Isaïe Jeanty Maternity hospital in Cité Soleil, an existing public facility.² Working alongside the Ministry of Public Health and Population, the teams provide emergency obstetric care, including caesarean sections, as well as contraception and care for victims and survivors of sexual violence. 

In the first half of 2026, staff assisted with 929 deliveries, including 285 emergency caesarean sections. 257 patients were also referred, with their newborns, to other health facilities for the management of serious complications. 

Despite these efforts, people’s needs remain immense. Insecurity continues to limit the movement of patients and medical staff. 

“When clashes affect our medical facilities, we have to suspend our activities and evacuate the premises,” Diana Manilla Arroyo, MSF head of mission in Haiti.  “This has happened twice in the last two months. These suspensions drastically reduce referral options and complicate the management of obstetric emergencies, as well as many other sexual and reproductive health needs.” 

Ensuring continued access to this care remains essential to safeguarding the health and lives of thousands of women and girls in Port-au-Prince.