Real-Life ‘Call the Midwife’ in Haiti: Tara Livesay and KJ Johnson - Jen Hatmaker

Real-Life ‘Call the Midwife’ in Haiti: Tara Livesay and KJ Johnson

Episode 05

Our series on Powerhouse Women continues with two strong women who are helping women in Haiti get through the most powerful and vulnerable moments they will ever experience: giving birth. Midwives Tara Livesay and KJ Johnson are best friends who work with Heartline Ministries and, like Melinda Gates, they champion maternal care as a human right. As Enneagram 2s, Tara and KJ became fast friends, and they tell Jen why they decided to become midwives, about the birth story that brought them together (an unexpected twin!), what it’s like to offer maternal care in Haiti (it involves Tara driving a van on the rules-optional streets of Port-au-Prince—not for the faint of heart!). Tara and KJ are facing broken systems that are daunting for people in their line of work, and instead of walking away defeated, they are offering love to one person at a time—the kind of love we’d all like to receive in our own moment of need. And sometimes, that’s all we can do.

Episode Transcript

Narrator:  Hi everybody, my name is Remy. Welcome to the For the Love Podcast, with your host Jen Hatmaker, my mom. She writes books and speaks to crowds. But she mostly loves talking to amazing people every week on this podcast. Thanks for listening! We hope you enjoy the show.

Jen:   Hey, everybody, it’s Jen, your host for the For the Love Podcast. I’m really glad you’re here today. Welcome to the show.

The series is just sizzling. It is called For the Love of Powerhouse Women, so I guess I probably don’t need to explain at all why I love it. Just speaking to women who are powerful in their lives, in their careers, in their hearts, souls and minds. It’s so energizing and so inspiring.

We are talking to two women that I don’t just deeply admire but I also love, and they work in one of the oldest careers for women that has ever existed, which is, of course, maternal care. And there’s no one I’d rather put in front of you to discuss this work more than my very dear friend, Tara Livesay, and her dearest friend, Beth Johnson, who goes by KJ.

Okay, So if you’ve been around me at all, you know that Tara is one of my closest friends and we travel together, we make time for each other, we have this group of friends that is very, very dear and precious to one another, and we have logged a lot of miles together, and we have logged a lot of life together, So let me tell you a little bit about them.

Tara and KJ work for Heartline Ministries, which is an organization in Port-au-Prince in Haiti, and their primary umbrella aim is to empower Haitian families, and they do that through this very holistic, wrap-around way that focuses on maternal care, education, economic opportunity, that sort of outreach. And it’s brilliant, effective work. And So I’ve actually gotten to watch Tara and KJ and their team lift up these families and I mean really just change lives, I don’t know how else to say it.

And so if I could duplicate Heartline and put one in every single fragile community on earth I would do it tomorrow, and we’re actually going to talk a little bit about that, so stay tuned for later in this episode. But Brandon and I, we have an organization called Legacy Collective. We are a giving community, we’re a funding community, and we’ve actually worked with Heartline and granted them a big grant to continue the amazing work that they are doing. They are the real deal.

So here’s one reason why I am excited to talk to Tara and KJ today. Their work is a bit of a call back to our episode with Melinda Gates, the first episode of this series. These are boots-on-the-ground women showing us why and how it matters to invest in women and to invest in families and whole communities. Not to just show up once, but to do the hard work, to keep showing up. These girls live in Haiti. This is their work, their whole lives are located there.

So their personal stories behind why what they do are utterly fascinating. You’re going to love hearing from them today, how they got into midwifery, how they got to Haiti, some of the challenges of Haiti. Haiti is a very challenging country to live in and work in, especially in maternal care, and so they’re going to unroll all of that for us today.

Two of the greatest women that I know and they’re strong in mind, body and soul, and they are serving women in a vulnerable place with such dignity and such great care that they are, honestly, two of my heroes. And So I’m so pleased to share my conversation with my beloved friend, Tara Livesay, and the outstanding and amazing, KJ Johnson.

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Jen: So this is a really happy day for me to have both of you on here. So Tara and KJ, welcome.

Tara: Thank you.

KJ: Thank you.

Jen: Everybody already knows, but like we’re friends. I got to meet KJ exactly one time, and that was at Evolving Faith last year, right?

KJ: Yes. It was.

Jen: And kind of just wanted to put my hands on you because you are like our honorary friend. Right, Tara?

KJ: Yeah. Thank you. I feel the same way about you.

Jen: Yeah. Yeah. Like if you hear about us half as much as we hear about you, let’s just . . . we’re already on second base together. Let’s just keep going.

KJ: Right.

Jen: So anyway, I’ve told our listeners a little bit about who you each are and kind of your background. But I wonder if, when we start right here, out of the gate, can each of you tell everybody, number one, why you went to Haiti, because that’s a big choice, that’s a big step. And then, two, how long did it take for each of you to be like, “Okay, this girl is my person. This is my kindred soul here in this country and in this work.”

So KJ, you want to start?

KJ: Sure. I had been in Haiti prior to going to midwifery school. And after midwifery school I had a practice in Texas, and I had gone to midwifery school kind of with the idea that I wanted to be practicing in the developing world, but after I left midwifery school in the Philippines, I was just like, “Ugh, I need a break.”

And I’d gone to Haiti to visit some friends and connected with Tara there just because it was, you know, a midwifery thing happening in Haiti. And that was the first time I met her and I kind of went to Haiti thinking like, “Oh, maybe I’ll get there and really want to be there,” but I was like, “Nope. I’m not ready to be back in the developing world. I love my practice in Texas,” and then she started bugging me about coming.

Jen: For sure, I’m familiar with her tactics.

KJ: Yes. So then, I ended up going back to Haiti and said that I would be there for three months, just to cover for her while she was in the States. And so we didn’t have any crossover during that three months. I didn’t really know her very well, I’d only met her once, and then, just her bugging me on email. And halfway through my time, my three months there, she needed to finish some of her clinicals for midwifery and so asked me to stay longer once she got back. And I was really nervous about that because I didn’t want to be a teacher—like, I have to talk myself into teaching. So the first birth we did together was an insane birth.

Jen: Was it?

KJ: I was nervous about it. It was. So this was a surprise twin, we didn’t know that the second baby was there.

Jen: Oh, my gosh.

KJ: So the first baby came out, the mom started bleeding quite a bit. And I was like, “You’ve got to make her stop bleeding.” And so we’re trying all these to make her stop bleeding.

I put my head to the mom and then I’m like, “Oh, there’s another baby in here.”

Jen: Oh, my gosh!

KJ: Everything turned out beautifully, and both babies are amazingly wonderful and, like, four years old, five years old now. So that was a really intense situation. We worked beautifully together, and I think after that I was like, “Okay, well, that is the hardest birth I’ve ever done in my entire midwifery career, and I just did it with this person that I don’t really know. I think that we’re going to be okay.”

Jen: That’s awesome.

KJ: So I think that kind of kicked things off for us.

Jen: Uh-huh. And that was five years ago?

KJ: Yeah. Five-and-a-half.

Jen: Uh-huh.

Okay, Tara, how about you?

Tara: Okay, we first went to Haiti because we were adopting.

We were pursuing international adoption and had been stopped at the front door of a few countries and decided to look into Haiti, and so our first trip to Haiti was solely for adoption, and we ended up adopting Isaac and Hope, two of our kids, in 2002. And then we moved to Haiti full-time in 2006. That’s a long story we don’t need to go into today, but basically from the time that I saw Haiti until we moved there, I just constantly felt like, “There’s something we could do. Like, I don’t know what it is, but there’s something we can do there.” And so I just mainly had to get Troy to where he felt like that wasn’t insane.

Jen: Right.

Tara: And we had five kids when we moved there.

Jen: I mean, my gosh.

Tara: Nobody moves with five kids. That’s dumb.

Jen: No, and they were little.

Tara: Yeah. And it’s economically irresponsible. People who go to Haiti should be single and debt-free. And so we had lots of excuses, but we ended up there and when we first moved to Haiti we said we were going to do 18 months.

Jen: Sure.

Tara: Just have a little experience. But at the 18-month mark you sort of know what’s happening around you finally, so we just decided that it was dumb to leave since we were just starting to get the culture and the language.

Jen: Mm-hmm. All right. Because you went down without any Creole, right?

Tara: Yeah. Yeah. And I, to the second part of your question, when I started asking KJ to stay, she’s 17 years younger than me and now my very best friend. But at the time, she had so much more experience because she had worked in the Philippines and in Texas.

Jen: Right.

Tara: And I had to have someone who was able to precept me for the end of some clinicals that got messed up, and so I desperately needed her. And so I was going to like her whether I liked her or not, I was going to pretend to. But then it ended up that we just clicked. And we’re both Enneagram 2s with the same wing, so it’s weird. A lot of times we say the same thing at the same time, and we don’t really actually have to communicate with words during a birth anymore.

That first one was different. It was like only my 27th birth or something. I mean, it’s very early in what I had done but, you know, as the primary. And when she said, “Well, I mean, you’ve got to go and check for . . .” before we figured out there was a second baby, too, she said, “We’ve got to check and see what’s happening.”

And I actually put my hand in and said, “It feels like bones.” That’s just another baby.

Jen: “It feels like bones.” Well, yeah, I guess you were right. You nailed that diagnosis.
So let’s go back even a little bit further. You each alluded to it but you didn’t give us specifics. How did each of you find your way to working in maternal care? And I would just love to hear a little bit about what that has been like for you and why you chose it.

Tara: When we got to Haiti, we were doing a lot of administrative stuff and overseeing programs and, just boring stuff really, and I mean, good stuff but I started to see—

Jen: Right. You weren’t in midwifery at all.

Tara: No. No. I did all of my training while I was in Haiti and then took trips back to the United States for different things that I needed to do.

But basically, when the maternity center was started, I was working with Heartline Ministries and I was kind of acting as a clinic administrator, and I was just like, “You guys deal with the placentas. You do that stuff. I’m going to do your paperwork.”

But as you sit there and watch the way that the world works there and how great the need is, you just end up feeling . . . and especially as an Enneagram 2, I was just like, “Well, this is dumb. Am I going to sit here and fill out charts when I could actually be helpful to everyone?”

So I decided, and after the earthquake in 2010, I decided to start training, and it took me all of 2011, ’12, and ’13 to finish. I finished at the end of 2013.

Jen: And how about you, KJ? Because you were in it sooner.

KJ: Yes. I had gone to Liberia, West Africa, when I was a teenager. And when I came back from there, I was so shook by the state of health care in the developing world. I knew that maternal health care was such a huge need around the world, and I think that experience in Liberia really made me want to do something in the developing world.

I was familiar with midwifery because my mom had all of her births with midwives, so I just started digging into that more. And the more I dug into it, then I found a school in the Philippines that was training midwives specifically for the developing world. And I was dual enrolled in the midwifery school in the States, so that allowed me to go ahead and get my license in the US. But I got that developing world experience, so that was really wonderful.

Jen: That is so interesting. So I guess the whole structure of it is different than what you would have learned in the US, right? So you’re learning with what? Less facilities, less resources, is that what that means?

KJ: Yes. Exactly. Just less resources and higher volume and more complications than you would typically see with your typical midwifery client in the United States. Yeah, because we just work with a lot higher risk women in the developing world. That is what just pulled me towards midwifery care.

Jen: Okay. So it’s an interesting record that you hold, Tara, because you have two more children than I do, which is really saying something. I mean, just, congratulations, to essentially having a houseful of a million people.

Tara: Thank you.

Jen: And so I know you very well, and there’s this sort of running theme through your life of just opening up your arms really wide, like past the point of normal, past the point of reason to other people. Have you always been formed that way? Is that how you have always operated in the world? Why is your heart tender like that? Can you point to any spots along your story where you were like, “This was the moment where I was deeply affected, and it kind of altered my trajectory toward this very inclusive life.”

Tara: Right.

I don’t think that I necessarily would have ended up where I am today if it hadn’t been for two unplanned pregnancies when I was young. My first one was when I was, I actually was pregnant 16, but my first daughter was born when I was 17. And lots of people have that story, that’s not so unique. But I married her dad and we got divorced really quick for all the normal reasons: too young, too immature and not able to handle the things that you need to handle. And I recognized that some people get married really young and do fine, like you and Brandon did, but we didn’t.
And as soon as we weren’t together, I had another boyfriend and I got pregnant again. I went through just a lot of shame and just spiraling downward. And once I was like, “Oh, I have two kids from two different dads,” And I’m like,  “I don’t know.” For me, I felt like, “Oh, I am broken and gross,” and I really was a mess for about five years. And it’s not like I ever did tons of drugs or anything of that, but I did lots of partying and just ignoring the future because I felt like my future was wrecked.

But I got to experience, because I was raised in an evangelical Christian household, I got to experience a little bit of what it feels like to be an outsider in that culture.

Jen: Sure. Sure, of course.

Tara: They were great people. I’m not saying that there weren’t people who really loved me. But there was definitely a lot of feeling like, “Oh, there’s that girl with the kids,” you know, where you just felt like you didn’t belong any more.

I even remember after Paige was born, my second daughter, I was wanting so much to get my life back on track, and the way I chose to do that was to get back in college and try to go to a Christian college. And it was really hard doing interviews at Christian colleges in 1993 and ‘4.

Jen: Oh my gosh. I cannot imagine.

Tara: I went and sat down with three men, older men, who informed me, if I chose to go the college, I wasn’t going to be allowed to date because they couldn’t tell donors that asked them why their precious Christian son was dating a single, divorced mom.

Jen: Wow. Really? Gosh.

Tara: So that was in the interview at one of the colleges, which I obviously left there and sobbed in my car, like, I’m like, “I’m not going to go to that school. They hate me already!”

Jen: Gosh.

Tara: So then I just was like, “Oh, this is not what love looks like.” And I think that’s sort of the turning point for me. I don’t have a conscious, like, moment but that was definitely a big part of it.

I got tired of it and had to get to the point where I started going to counseling and figured out how to care about myself and not see myself as broken permanently. And then meeting Troy after a long break from dating, meeting Troy, he’s such a wonderful human being.

Jen: He’s literally the greatest.

Tara: And he loved both of my girls unconditionally from the moment we met. And then, obviously, within five years Troy and I were pursuing adoption, and your heart opens up when you start to pursue things that aren’t within your normal cultural day-to-day life.

And so going to Haiti changed us a lot. We went six times during the seven-month adoption. I went every month. So I was spending one week per month in Haiti during Isaac and Hope’s adoption, so I got to see a lot, and that’s really how the seeds were planted to end up back in Haiti.

Jen: How did you pick Haiti? I’m not sure I know that.

Tara: Colombia turned us down because we didn’t meet the qualifications to adopt. And Guatemala, I don’t know if you remember, they had a bunch of scandal and closed.

Jen: I do.

Tara: And they had gotten very expensive. I think it was like $25,000 to adopt in Guatemala. And we had two kids and not tons of money, and so we needed to adopt from a place we could afford, just practically speaking. And so we started looking at countries that were less expensive, and Haiti was one of them at the time.

Jen: And close, easy to get to.

Tara: Yeah.

Jen: One thing that you wrote on your blog, Tara—and by the way, everybody listening, we’ll link over to Tara’s blog because she’s a really beautiful writer, and has documented years of work and observations in life over on her blog, so we’ll have that in the notes.

But one thing that you wrote is this: “God is not made manifest in our ability to fix or heal, but in our need to be healed. We are not fixers of people or countries or things. We are here trying to extend empathy, love, and grace to others the way it has been extended to us.”

I love that. I know for a fact that is the way that you operate. I have learned so much from you. You are one of my best teachers on this. And I’m wondering if you can talk more about that idea, because I think it’s something we’re in desperate need of here, in like kind of White Savior Americaville, and I love the way that you wrote that and that you’re raising the flag for this.

Can you talk a little bit more about it?

Tara: Sure. We’ve been in Haiti 13 years, and I would say at about the six-year mark we had had our butt handed to us enough that I was like, “Light bulb. This actually has nothing to do with us. It doesn’t matter if we’re here or not here. We’re not going to change very much. It’s just going to be individuals offering love and mercy and meeting them where they are and not expecting to see them suddenly prosper or suddenly have a huge change in their lives. It’s not our job.”

And just watching the way those first five or six years here in Haiti, just group after group after group coming in and thinking that they’re bringing the thing that no one else has ever brought, that’s ridiculous. And Haiti, especially, because Haiti has the highest short-term mission rate than any country because it’s so easy to get to.

Jen: Yeah.

Tara: So it’s basically just watching how off the path we were in our approach to Haitians and our approach to their culture and their lives, is really what led me to that place. It made me like, “Oh, we actually just are here to love people. That’s it.”

And the result, I don’t even care. I have a really hard time if people ask, like, “Can you . . .” We can quantify in maternal health, we can totally quantify what’s happening.

Jen: Right.

Tara: But if people were to say like, “You know, have you seen people’s lives change a lot? Can you tell us . . .” you know, and they want, like, those hard and fast facts, like, you know, “I can tell you that she felt loved the day that her husband beat her up and she showed up at the maternity center and needed someone to love on her.” I couldn’t call the police because they don’t care. I couldn’t have him arrested. There are so many things you can’t do in broken systems. All you can do is love the person and offer them the love that you would hope to be offered at that moment. And that’s it.

Jen: Totally. That is it. And if you don’t know that, you just go live in Haiti and then you will know it because it’s such a hard country. It is such a hard place, and all those systems are so fractured and they definitely do not favor women. We’ll talk about that in a minute.

But I would love to hear you chime in there, KJ, because you’ve worked in more than one developing country, and I’m curious if your approach to your work, has it changed over the years? Like, kind of toward what Tara’s talking about.

KJ: This quote is so profound for any Enneagram 2, because if we can just get through to our heads that we are not here to fix things or heal things, you know, that’s not on us, that’s not all about us. It’s huge.

And I think that I did go into working in other cultures and in the developing world where maternal health, we can honestly say, this is such a huge need. And I did go into it thinking, like . . . I was so young, too. [I thought,] “I’m going to change the world.” You know?

Jen: Of course.

KJ: We don’t like to think that. But after a while, because it is so hard and you are working in a broken system, it feels so discouraging. Like, “I’m never going to see this place look better. I’m probably never going to see the maternal mortality decrease in this country.”

And I think that if you go back to that empathy and love and grace and realize, “I can only give what I’ve been given.” And I have been given so much empathy and love and grace. And then you just arrive at the place that, like, “This is what can actually be done, is empathy and love and grace.”

And you can, sure, save the mom in front of you from hemorrhaging and dying. But the system as a whole is really, really difficult. And if you don’t focus on empathy and love and grace, then I just feel like you really do get discouraged.

Jen:   Let’s talk about the work that both of you do at Heartline. You guys say that maternal care is a human right, and I agree, and I think most people know this. But as two people who work on the front lines of maternal care in a developing country, I’d like to hear your perspective more on this and why this matters, and why this is an idea that we all need to know how to speak about with authority and with influence. Can you talk more about maternal care as a human right?

Tara: Sure. Sure.

Melinda Gates talked about this when she was on your podcast. We got a chance to listen to that recently, and just the fact that women really do carry societies, especially developing world countries, women have the bulk of the responsibility. They care for the children, they do the cooking and the cleaning. And a lot of times they’re scrappy and figuring out how to sell mangoes and make enough money to pay the school fees and, you know, there’s a problem with some countries have a really high rate of fatherlessness and just dads that don’t stick around to help support them.

So maternal health is so important because when there’s a high rate of maternal death and women die in childbirth after they’ve had three or four kids, it’s not just leaving the new baby as an orphan, it’s leaving that whole family orphaned. And so preventing maternal mortality is huge. In the developing world women die at a far, far, far higher rate. So the US isn’t doing so great in maternal health, but in Haiti you have a 1 in 80 chance of dying in childbirth or after childbirth. It’s more like 1 in 365 in the US. And then in the best countries in the world, that are doing the very best, it’s 1 in 1,000.

Jen: Okay.

Tara: Our vision for Haiti and for the developing world is just that every woman would have a birth where she’s respected, and she receives high quality prenatal care. It’s hard to hear this, but when you walk into a maternity hospital in a materially poor country, it’s like a warehouse of beds where women are lined up giving birth, and the next lady’s an arm length’s away. And there’s no privacy, there’s no dignity, there’s no love. And actually there’s not enough caregivers, so then because the caregivers are overworked, they become short and abusive and curt.

And we just think every woman deserves to have a private birth in a place where she’s loved and cared for, and she’s not going to get swatted on the thigh for getting too noisy, you know? We envision that world, because that’s how moms and babies will flourish, if they’re treated with love and respect and . . .

Jen: That’s right.

Tara: I mean, birth can be really traumatic for anyone because things can happen that you cannot prepare for, because you just can’t know. But you certainly have a better chance of having less trauma in a private place where you can move around and you’re not required to hold your ankles and stay on the six-foot table, you know.

Jen: Yeah, exactly. How do the women that you serve, how do they find you or how do you find them? How do you get connected with them? Can you talk a little bit about your front door and who the women are that you serve and how they get to you.

KJ: Yeah. It’s all really like word of mouth. The first class that the maternity center ever had we just went around the neighborhood knocking on doors and saying, “Hey, we’re having a prenatal class at the maternity center. If you know a pregnant person, send them,” and since then it has all been word of mouth.

Haiti is a very relationship-based culture, and so we often have like a woman that delivered with us and then she comes and says, “My sister’s pregnant. Can you take her into the program? My aunt is pregnant.” You know, so it is all word-of-mouth, and we have more women than we can possibly take care of.

Jen: Right. Totally. And you have served really fragile women who are—some of them girls, really young girls. Some of them abused, some of them raped, some of them in really fragile medical care, and it’s extraordinary what you do.

And back to your point, Tara. And you’ve told us this for years but, it’s extraordinary the effect that loving kindness and care with dignity has on even a really fragile mom. Like, ones that you would assume, “This is just never going to work.”

Do you have like a particular woman that you have served or that has really impacted you, that you were like, “This woman is fire, like, she is so strong.”

Tara: Absolutely.

Jen: I’d love to hear one.

Tara: Okay.

KJ: I do.

Jen: “Me, me, pick me, we have so many!”

KJ: Oh, my God.

Tara: Okay. I’m not going to use her name here, I’m just going to use her first initial. But in 2012 a young girl came in. She had been assaulted by a neighbor man. She was 15 years old at the time, and she became pregnant as a result of the assault. Her mom is a great mom and worked really hard to help her through the trauma of that, which is very rare in Haiti. Like, trauma is every day in Haiti, and people aren’t often able . . . It’s just a privilege to be able to go get counseling. But her mom reported it, which is also hard because everyone’s afraid of retaliation. There’s no real justice system.

The man ended up, that hurt her, ended up fleeing Haiti, which was great for her to feel safer. She came to the maternity center and got all her prenatal care with us. She had her baby when she was 16 in 2012. She told me, after she had her baby, that her dream was to some day become a doctor and maybe even work at the maternity center. So this is, you know, she’s really young, and I’m like, “Yeah, yeah. That’s lovely. It will be cool if that happens.” That sounded far off.

She finished high school at the top of her class, Heartline was able to help her a little bit through that. We had donors that specifically gave to her schooling. She applied for medical school in the Dominican Republic. She’s currently just finishing her first year of med school, so she’s an adult now. Her son is being cared for by her mom while she’s across on the other side of the island. But I fully expect that one day, soon, in about three years from now, we’re going to sit and watch her graduate from med school, and I do think she’ll come work for the maternity center.

Jen: That’s amazing.

Tara: That’s her plan and so this person who was abused and assaulted is going to become an obstetrician and help women in her country.

Jen: Oh, my gosh. I have goosebumps. I love that story. Women are so resilient and strong. They’re so capable and smart.

Did you have a story, KJ?

KJ: Yeah. It’s very similar to that one. Actually in 2013, we had a mom come to the maternity center. And she wasn’t quite that young, but she had been date raped and just came in, like, so hopeless and feeling like she didn’t want to carry this pregnancy but knew she was too far along to consider an abortion. And she was like, “I’ve just got to get through this pregnancy, and I want to give this baby up for adoption.”

And we were like, “Okay, that is absolutely fine. We will walk with you through this, get you the care that you need. And if you have this baby and want to give it up for adoption, then we will support you in that.”

And she went on to have her baby and had, like, the hardest postpartum experience. She had every complication in the book, and she just fell completely in love with this baby during this totally hard postpartum experience. And I think because she had the support of the maternity center, she was able to both walk through those complications while still bonding with her baby. And she ended up just working with us. She fell in love with the maternity center, and she started just attending births with us. And then she decided she wanted to go to midwifery school and she did.

Jen: That’s crazy.

KJ: And now she is back at the maternity center and she is our strongest Haitian midwife, for sure.

Jen: Really?

KJ: She’s amazing, and we adore her, and it has been so wonderful to just watch her gain confidence. I think there’s something about when you have a baby, as a woman, you feel like you can do anything.

Jen: Totally.

KJ: You just brought life into the world, and if you can do that with people alongside of you that are supporting you and loving you and saying, “Look at what you just did. You just created this human and you brought it into the world and you have the ability to nourish this child and keep it alive.” You feel like a superwoman, right?

Jen: Totally.

KJ: It’s just been so wonderful to watch her gain confidence and just go for it.

Jen: That’s the greatest.  What’s her name?

KJ: Mica.

Tara: Mica.

Jen: How many Haitian midwives do you work with?

Tara: We have six full-time.

Jen: Yeah. That’s a lot. So there’s you guys. Does that include you—or there’s six Haitian midwives plus you two?

Tara: We’re two more.

Jen: So even with eight midwives, you’re at capacity, right? I mean, if you had more midwives, you could have more moms.

Tara: Yeah. Yeah. I mean, you have to be there 24/7 so to spread out the hours so that people still can have their family. A lot of times in resource-poor countries, people have to work six days a week, 12 hours. And we have made it our goal to have a normal working week the way that people can have a life and go see their kids and several of our midwives are moms. So we work about a 40-to-45-hour week.

Jen: That’s great.

Jen:  Let me ask you both this question, kind of two parts.

I would love to know, first of all, what qualities do you love and celebrate in Haitian women, specifically? And then, additionally, working in Haiti is hard. What would you say is the hardest, or one of the hardest, cultural trappings to overcome, specifically in your work? Because it’s not a duplication of American culture at all. And there are rooted systems and practices and even beliefs in Haiti that you constantly bump up against.

And so I’m wondering if you can kind of give both in. Like, “This is the greatest part, this is what we celebrate, this is the most amazing part about women in this culture. And then this is the thing that we really have to work, we’re challenged by on a daily basis.”

KJ: Haitian women are so insanely strong, and they are so amazing at just focusing on a relationship, even though their life is so complicated. Everything that they do is so complicated. They have to walk a mile to get water. They have to wash their laundry by hand. They have to create a fire to cook. Everything is so complicated compared to our lives in Haiti, and yet they do such a great job just focusing on relationships.

Tara: Yeah. It’s really, like, the world could be crumbling around them—which in 2010, the world did crumble around them.

Jen: Yeah. That’s right.

Tara: And it still, like, you’re climbing out of rubble and you get up and you walk down the street and you see your friend, and you say, “How are you? How’s your family? Give me the latest.” I think in poverty cultures or cultures of material poverty, there is often a thing where everyone’s just trying to survive so they can’t really take care of each other, but that’s not really true with Haitian women. They look out for each other, and they’re concerned about one another and one another’s families, and they rally around each other. It’s been super inspiring for us to watch.

Jen: Totally. I know so many of y’alls stories. I mean, they’re just bananas. Sometimes Tara comes in and tells us, just, “It’s just like a Tuesday,” and she just rattles off how the Tuesday’s gone down, and I’m like, “What are you talking about? Like, if that happened to me one time in my life, I would never stop telling about. I would never, ever stop talking about it.”

So I mean, your daily just life, period, in Haiti, is hard, but also your work is. Like you mentioned, you go against the grain here: the way that you provide care, the way that you think about women and moms and birth. And so I’m just . . . If you had to just put a finger on something and say, “This is the thing that we have to work hard to overcome,” what would it be?

KJ: I think for me, specifically, in our work, the hardest thing is getting access to higher-level care. So we don’t do like caesareans at the maternity center. We don’t have a NICU. So just getting access to that care, and that is so difficult because the medical system is so broken. And that isn’t necessarily specific to Haitian culture—that it’s a developing world thing, for sure. But, you know, we have a mom that needed to be induced a couple of weeks ago, and she sat outside the hospital for three days because they didn’t have a bed for her, and her situation wasn’t serious.
So for me, like that is a thing that is the most stressful knowing like, “There’s this woman who just, she needs care, and I cannot do anything to give her the care that she needs.”

Jen: Totally.

KJ: It’s just constantly a fight.

Jen: Oh, my gosh. I feel like the worst stories that Tara tells us are those. The ones when a mom needs to be transported to the hospital, and then it’s just like eight times out of ten, it just goes sideways.

KJ: Yeah.

Jen: It’s so hard to get that piece over the finish line.

What would you say, Tara? I mean, obviously that also for you, I’m sure.
Tara: Yeah. Well, it’s something where it’s like, only one who’s had a baby, you remember how miserable you are at the end. You just hate it, it’s terrible. Everything hurts. So to bring a 42-week mom that absolutely has to have a C-section be just based . . . you know, breech, whatever else is going on, there’s lots of reasons that you know sometimes someone needs a C-section. And then say, “You’re going to sit.” She doesn’t just sit in a chair. She’s sitting on the cement, on the ground, for three nights.

Jen: No.

Tara: And so she slept sitting up for three nights, and we kept pushing to try to see if they were going to get a bed. But of course from their perspective, they have women coming in that are hemorrhaging, or ceasing, so this woman with the breech baby that needs to be delivered by induction or by C-section isn’t as serious as the bleeding people and the seizing people. So they have a point, but you can’t sleep at night because this is a person you’ve come to care about.

Jen: Of course.

Tara: The whole system of midwifery is relationships. So she ended up coming back into town and we organized for a C-section at this little tiny hospital, you wouldn’t even believe it had, that where we were, had and OR, and she got a C-section at another place.

But it’s exactly what KJ said. You want the best for these ladies. And if they run into a complication that doesn’t allow them to stay at the Heartline Maternity Center, then you have to fight a system that is . . . It’s not a system, like, you can’t even call it a system.

Jen: Right. Right, and then we can just talk about even just driving there because I think some of, frankly, Tara’s worst rage stories are just in the van. I mean, the van is a source of such trauma.

Tara: KJ got to know me really fast on one of those routes. I don’t think we’d worked together very long and I leaned across the passenger and rolled the window down and had a few choice words for somebody out the window, screaming like a maniac, and she was like, “Wow. . .”

Jen: Haiti is so aggressive. The driving situation there is just really, really off the rails. So the fact that you have to drive around women who need to get to hospital . . . I just can’t handle it, and nobody follows the rules. There aren’t any. There’s no system. It’s crazy.

Obviously, there’s a lot of ebb and flow in any career in any sort of space where you’re working, but, I would love to hear from both of you just two things. Currently, what is the biggest joy that you are receiving in your work? Where’s the wind at your back, right now?

And then also, I’d love to hear what your hopes are for women coming behind you in midwifery who are listening, whose ears are perking up, who are like, “This is work that would really make me come alive.” So think about the women who will be doing this work in the next 10 to 20 years and what you hope for them.

KJ: It has been such a joy to see these Haitian midwives that started working with us fresh out of school just come into their own. And Tara and I don’t do a lot of births any more. In the beginning we were doing all of the births.

Jen: All of them.

KJ: Yeah. Now we have [a] staff that is wonderful and they’re so solid. And I love, specifically in our setting, just being able to see these women just relate to and provide an even next-level personalized care to women in their own culture. And it’s just so wonderful. I love it. And I’m just so proud of them and feel like, “Oh, my word. These women are amazing,” and how wonderful that the women coming into the Heartline Maternity Center get midwives from their own culture.

Jen: Yeah. It’s amazing.

KJ: Yeah. Yeah.

Tara: A lot of times, KJ and I will be at the birth and one of us is charting and one of us is the assistant, and we’re working with whatever Haitian midwife is on that day for that shift, and KJ and I are like, across the room, looking at each other, like, having tears like proud mothers watching their children take their first steps.

Jen: Totally.

Tara: I mean, they all had tons of training and they’re very capable, but they are still just getting so excellent and it’s so wonderful to watch. There’s no reason that it should ever depend on a foreigner being there.

Jen: That’s right.

Tara: And that’s what we want, is to not have to be there.

Jen: I love that arc. I mean, sincerely. It’s mostly Haitian staffed at this point, and so it’s fabulous. And I love the example that sets for the moms who are coming in, to see that possibility. I mean, obviously, you’ve got at least two that you’ve just told us about: one that has already come back to you, and one that probably will. Because you intercept women, if you can, at the very beginning of their pregnancy, right? And that’s very different-

Tara: Yeah.

Jen: So most Haitian women who are not going to come through a program like yours, they’re going to go and see a doctor when they’re delivering. Is that about it? Is that their maternal care?

KJ: Yeah. Occasionally, it will be like one prenatal per trimester in pregnancy. But I think it’s about 65% of people that get like one prenatal per trimester in Haiti.

Tara: And 65% of people in Haiti still deliver alone at home.

KJ: Yeah.

Jen: Wow. Is that high?

Tara: Yeah, a very small percent of the population is able to deliver with a trained medical provider. Most are just pulling it off in the mountains and the hills, you know, with the next-door neighbor lady hopefully has a way to cut the cord that’s clean.

Jen: This is amazing work that you do, and it’s so full of dignity for women, and I love the trickle-down effect. You talked about that earlier, Tara, but healthy moms need healthy families. I mean, it’s just that simple. That is the cornerstone, that’s the building block of being able to flourish and thrive, and So really, your work has such a cumulative effect in your community, even though you’re mom-centric. What that really means is you’re family-centric. I mean, you’re keeping families together, and you’re keeping kids with their parents and in schools. It’s pretty outstanding and my listeners, for sure, are going to want to rally around you. They’re going to want to support your work.

So how would you say, somebody listening, could best help you? How could we support your work, how could we come alongside Heartline? What is the way that my community can best serve you?

Tara: Okay. This is a great question. Well, one thing that we really wanted to share today is that our maternity center is one maternity center serving a small amount of women, and we believe that the model needs to be replicated everywhere. And Melinda Gates would tell you the same thing. And anyone working in maternal health care would say, “What we need is many small birth centers all around countries that are materially poor.”

And so our mission is to provide compassionate, high-quality, maternal health care by using the midwifery model of care to provide necessary services to the underserved women of the world. Our secondary mission is to share our model with everyone who works in the developing world setting, so we have a brand new initiative called The Starting Place, and The Starting Place is a manual that KJ and I wrote, and actually, our friend Sarah Bessey edited, and helped us put it together, and made it sound smarter than we are. And we are offering classes, so that you can come to Haiti and sit in a class and we are literally handing over our entire model, including protocols, to those who are working in other countries that want to see maternal health improved.

And for us, if we really do believe that birth is a human rights issue, we have to give women places to go and we need more maternity centers. And it doesn’t need to be called Heartline Maternity Center. Everyone that wants to work abroad and that has a heart for a certain country, could come learn this model and go implement it, and put their own twist on it because they’re going to be in a different culture.

Jen: Sure. So how would people . . . literally, what is the starting point here? If they’re interested in hearing more about that, if they’d like to know next steps toward either learning more about your model or figuring out how to learn more about your model, what do they do?

Tara: Okay. To learn more about our model, which we’re calling our model The Starting Place, and that’s what we’re calling the class that’s based off the Heartline model, and so we have 12 years of experience that we want to share with you and save you tons of money in mistakes.

Jen: Yes. Totally.

Tara: You can go to and look at the maternity center tab has a Starting Place drop-down, or you could email [email protected] or [email protected]. And we would love if you guys that are listening have friends that are midwives or labor and delivery nurses that have a heart for a country somewhere or travel often to visit another place or live in another place that you know has an issue, if you would tell them about The Starting Place and about us and ask them to try to find us, because we really want to get the word out about spreading this model of care.

Jen: It’s just amazing work what you do and I’m really, really proud of it.

And this is just a little aside, only just because you just listed the website as Heartline Ministries. Just in case you’re wondering, while Heartline does fall sort of under a ministry umbrella, I wonder if you can just very briefly talk about how that’s not . . . There’s no, “Come, get our services if you will read this Christian tract.” You know what I’m saying?

Tara: Oh, yeah. Yeah. No, anyone can come for an initial interview at the maternity center. We have women who are living in severe poverty, that they were, the entire pregnancy they wore the same clothes and we know that they cannot eat three meals a day, all the way to, our services are really excellent. They’re some, actually, I believe, they’re the best in Haiti, but, some of the best in Haiti, certainly. And we have women that can afford to pay for an obstetrician in the wealthier part of town, if they wish, but they choose our care because they believe in our outcomes and in our system. The only qualification is that you be pregnant. If you aren’t, it doesn’t make a lot of sense to come to our center.

Jen: That seems fair. It seems like a fair requirement.

Jen: Okay, we’re wrapping this up. Now these are three questions that we’re asking everybody in the Powerhouse Women Series, and So this can just be whatever comes to mind and we’ll just go, like, KJ then Tara.

Okay, here’s the first one. What’s something a woman that you admire has taught you that you’ve just not forgotten?

KJ: Right after midwifery school, I went to Texas and had a practice there, and I had just the most wonderful honor of working with the midwife that actually delivered me. She was still practicing.

Jen: Oh, my gosh. That’s crazy.

KJ: Yeah. And just getting to watch her and learn from her by being with her was so amazing. She just taught me how when you walk into the birth room, you take with you and to the birth room whatever you’re carrying. And so just walk into the birth room and to a laboring, a space with a laboring woman with just peace and just literally carrying the presence of God into the birth room. That was just so powerful to learn that from her by just watching her and how she does birth and . . . Yeah. It was really formative for me.

Jen: That’s outstanding. How about you, Tara?

Tara: Mine is very similar. In our early years in Haiti, before I was ever in midwifery school, I got to be very close with and work with a young pediatrician, Dr. Jen Halverson. And I watched her for years and saw the way that she interacted with people. She’s usually treating kids, so she would get down and be right at their level, eye-to-eye, and speak directly to them and softly, and ignore all the chaos that is often going on around. And her bedside manner taught me so much.

I’m a hothead and I lose my temper easily, and so when things are frustrating and six people are asking me for something, I can sometimes act like a jerk. And Jen is a person that I think of often because she, in the presence of a client or patient, she stays incredibly calm and is with that person only, and ignores all the rest of the BS around her. I’m still working on it.

Jen: How about this? What is your, I don’t know, maybe your greatest hope for the generation of women coming behind us, who you both serve and you’re also raising?

KJ: I think, specifically for Haitian women, that they would not just live under the oppression of the title “female,” you know.

Jen: Totally.

KJ: All of the oppression that is linked to being a female, and that’s true for women around the world, not just for Haitian women. It’s true for us, as American women. I genuinely hope that there will be equality for the next generation of women.

Jen: Me too. Me too. That’s a good one. Tara?

Tara: When I’m thinking specifically of Haiti, I would like there to be justice, just a small little thing. I would dream of a day where when a 15-year-old is raped, she would have the power to be safe, and right now that’s not the case. So I just dream of justice for Haiti, and that’s huge and it’s probably a long ways off, but I think that it would be wrong to give up hoping that for them and wanting that for them.

Jen: I learned that from IJM that injustice, like a lack of justice, just goes hand-in-hand with oppressive poverty. And it’s interesting that when you introduce justice into a culture, how many other boats in the harbor rise. And so that is just a noble hope for that country.

Okay, last one. This is Barbara Brown Taylor’s question, everybody gets this one. What’s saving your life right now?

KJ: For me, we just spent a week in the Smoky Mountains, a friend of ours let us use her beautiful cabin, and so we literally had no agenda and we just sat and stared at the gorgeous Smoky Mountains for a weekend. It was so life-giving.

Jen: Oh, I saw your pictures. I mean, that is just a beautiful place. And it’s calm, and your life is never calm. And so it gives me a lot of joy to think of your guys just sitting in chairs, staring off into space.

KJ: It’s honesty a little bit hard to know what to do with the calm. We’re like, “We function much better in high-adrenaline situations.”

Jen: Totally, I’m sure.

Tara: I have several things, but I would say, right now, I have two 17-year-olds and Jen, you know, because we’ve talking a ton about launching these kids and how scary it is and wonderful, exhilarating, terrible, everything. And right now Isaac . . . I have two 17-year-olds and Isaac, especially, is bringing me a lot of joy because he’s figured out he wants to be a veterinarian some day, and he is getting amazing opportunities, and he just sends the most amazing messages. We’re in the United States right for a few weeks, and yesterday he sent a message telling about his day, and it was like, “And we went to an outlet mall and a baseball game, and we castrated goats, and it was just such a great day.”

I can’t get enough of it.

Jen: No.

Tara: He just said it, hilarious, but his life is hilarious and he’s just a joy-bringer.

Jen: Isaac Livesay is one of the greatest humans on the planet, and just being around him makes me laugh. Just his kind of wide-open way he looks at the world. Well, your kids have grown up in Haiti, and So when they come to the United States, they’re hilarious. I remember one time, Tara, you guys were here, this is probably a couple of years ago, and you told us that one thing, it was probably Isaac that said it, I can’t remember which kid, but they were like, just, in all seriousness, not trying to be funny, just like, “One thing that happens when you’re in America is that you just drive on like straight roads and it just keeps going.” Like that was so monumental, just to drive on a straight road.

Tara: Yes. yes.

Jen: They’re very delighted by very ordinary things here, and it was the cutest.

Tara: They love bathrooms in gas stations. Like, that, for road trips are great because every bathroom has a toilet that flushes.

KJ: And minivans are luxurious.

Jen: Oh, it’s just so great. I mean, everybody listening, these girls, on the regular, their power goes out in the middle of the night and they’re up with generators. So I mean this is . . . Haiti is just a hard place. It’s a hard place to live. And so if you want to come to America and be delighted by gas station bathrooms, well, just be amazed.

Okay. Before we sign off, just one more time where people can go, even just to read more of your work, to see more of your work, to find out more, all of it, where will you send them?

Tara: Okay. So we are on Instagram, both KJ and I, and we’ll give you those links. Instagram is definitely the place to follow both of us for the most up-to-date things happening at the maternity center. The website for Heartline is heartlineministries.orgThe Starting Place is the name of our new initiative sharing our model.

Jen: We’ll, again, have all that, you guys. So anybody listening, just go over to and I’ll have everything listed for you. You can follow them everywhere and do all the things and do all the reading and all the catching up.

So girls, thanks for being on the show. I know you’re in the middle of a ton of stuff, you just have a million moving parts right now. And so I can’t think of two women that fit a series called Powerhouse better than both of you. You are absolute warriors. You are champions for women and a country that fails women on the regular. And you give them dignity and hope, and you just bring a lot of joy to the women in your lives that you serve. And so I’m just really proud of you and I’m proud of your work, proud to be a part of it in any possible way. And so thanks for talking about, thanks for coming on. I love you both.

KJ: Thank you for having us.

Tara: Love you.

Jen: And there you have it. Tara and KJ, out here casually changing the world.

Oh, I love those girls and I love their work, and I’m very positive that some of you listening today, like your ears perked up. This is very specific work in a specific space, and for people whose hearts and skills and education lean toward midwifery and labor and delivery, and women and babies, these are your people. These are your heroes.

Don’t fail to go follow them, to follow their work. Take a couple of hours and backread some of Tara’s blog. She’s just a really, really gifted writer on top of all these other things apparently she can do, like drive a van with pregnant girls in it in Haiti, which is no small deal. I mean, really, honestly, but they’re fantastic, and supporting them in any way is just such a good use of your time, energy and resources.

So we’ll have, like I mentioned, all that over at under the podcast tab where Amanda builds out this amazing page for you, and So not only will we have all these links for you and additional resources, but we’ll have the whole transcript of this interview.

If you’d like to go back and read any interview ever, every single episode we’ve ever done has a huge resource page over there that Amanda has worked about a billion hours on. So definitely use that.

Share this, share this episode, share every episode that you love with your friends, with your social media sites, with people that you know will love to hear it. You always do that, thank you, and people tell me all the time, “My mom sent me this episode. My best friend made us all listen to this on a drive. We downloaded this podcast on our way to Colorado,” or whatever.

So anyway, I love that. Thank you for doing that and also thank you for subscribing. If you haven’t, go ahead and do it. You never, ever have to go find this podcast, it just shows up, it shows up in your phone. It’s amazing. It’s a good time to be alive.

More in this series, you guys, more women that you are going to be thrilled to hear from, to learn from, to listen to, to be inspired by. The earth is not short on powerful women, and so we are bringing them to this series and I can’t wait for next week’s episode.

Thanks for joining me, guys. See you next time.

Narrator: That’s it for today’s show. Hope you enjoyed this chat. Be sure to subscribe to my mom’s podcast and give it a “thumbs up” rating if you like it. From the whole Hatmaker family, hope you have a great week and see you next time!

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