A skilled midwife working in rural Haiti, Esthère Louis knows all too well the dangers mothers can face when giving birth. It seems to be a fact of life that nearly everyone in the island nation knows a woman who has died or lost a baby during childbirth."As a midwife, you are there so that you can help patients in need," Louis said. "You’re there to save them."Haiti’s maternal death rates are by far the highest in the Western Hemisphere. A woman in Haiti has a one in 90 lifetime risk of dying during childbirth, 16 times higher than a woman’s risk in the United States. Infant mortality is also extremely high compared to other nations. Out of every 1,000 children born in Haiti, 59 will die before their first birthday. In the United States, that number is just five.It's for this reason that Haitian women and their families often view birth with conflicting emotions: joy at the prospect of new life and fear that the worst may happen.But it doesn’t have to be this way. Maternal and infant deaths are largely preventable, according to the World Health Organization. Research has proven that skilled care before, during, and after childbirth can save the lives of women and newborn babies, yet not enough Haitian women are able to access this critical care when they need it.That's where Louis comes in. She is one of 95 skilled birth attendants who have graduated from a yearlong training program called Midwives for Haiti (MFH) . In the classroom and through hands-on practice, women like Louis learn to become skilled birth attendants in line with the WHO’s global standards In addition to traditional labor and delivery support, trained midwives screen pregnancies for risks, treat infections that could complicate labor or affect the baby’s health, and teach about nutrition and warning signs of pre-eclampsia — a treatable condition that is the major killer of expectant mothers in Haiti. The services these midwives provide seem basic but can be life-saving.And so far, it's working: MFH graduates now care for tens of thousands of women each year in five hospitals and 13 birthing centers across Haiti. The nonprofit even opened its own birthing center in a rural region of the country last November.MFH communications director Summer Aronson said training midwives has a ripple effect on the communities in which they live."Investing in mothers and skilled birth attendants pays off," Aronson said. "These programs not only save lives, they transform them."And compassionate, high-quality care from dedicated professionals like Louis will help more women in Haiti enter motherhood with joy instead of fear. Ahead, inspiring photos show how Haiti's midwives are empowering mothers and transforming their communities.Caption were provided by Midwives for Haiti. In this photo, skilled birth attendant Juslene Regulus holds a newborn during her rounds in the hospital ward.