Cuban maternity homes: a model to address at-risk pregnancy.

Like a tropical lullaby, the rocking chairs lay down a languid rhythm accompanied by laughter, bits of gossip, and gripes about the heat. Olga Lydia, 39, anemic, and preparing to give birth to her fi rst child, wonders aloud what it will be like to have a son, when in her heart of hearts she wanted a daughter. Meanwhile, Loreta, 18, and expecting twins, rocks quietly alongside, a smile on her fl aw-less face. Olga Lydia and Loreta are two of the more than 67,000 at-risk expectant mothers[1] served by Cu-ba’s network of over 300 maternity homes, receiv-ing comprehensive care and childbirth education in either live-in or ambulatory modalities. Since the fi rst 15 such homes were founded in 1962 in the eastern part of the country, the system has evolved into a national program employing a uniform practice for women presenting certain risk factors during preg-nancy. The strategy has helped the country achieve a nearly 100% in-hospital birth rate[2] and lower in-fant and maternal mortality rates, and partly explains why Save the Children ranks Cuba as the number one developing country in which to be a mother.[3]