
Volunteer Spotlight: Jen Ballard Provides Care for Expectant Mothers in the Dominican Republic
Neonatal and obstetric care is challenging in the Dominican Republic – nearly all births in the nation of 10.7 million take place at hospitals, yet many hospitals lack the space and equipment needed to meet the high number of patients. With help from volunteers like obstetrician Jen Ballard, Project HOPE is working to reduce the Dominican neonatal mortality rate and provide care to expectant mothers – many of whom are still teenagers.
“I had been seeking an organization with a plan for life-long improvement of health, instead of a drop-in clinic where the resources disappear when the volunteers leave, and Project HOPE definitely fit the bill.”
Jennifer Ballard is no stranger to volunteering in difficult international circumstances.
In 2010, after the devastating earthquake that rocked Haiti in January, she made her third volunteer trip to the country with a family health nonprofit. Her team had to sleep on the roof of the building they were staying in — the architect feared its foundation wouldn’t be strong enough to handle aftershocks without crumbling inwards.
After moving her practice from Boston to the D.C. area in 2015, Jen wanted to get back into volunteering, ideally in a place where she could have a greater long-term impact on a country’s health care system. This interest, combined with her professional experience, made her a natural fit for volunteering with Project HOPE.
“As an OB/GYN, I could easily relate to Project HOPE’s mission to improve maternal and infant health. I felt that the overall goal of making lasting improvements in women’s and infants’ health was a true possibility.”
Even as a seasoned medical doctor with years of experience volunteering in rough conditions, Jen was taken aback by the challenges she witnessed when she got to the Dominican Republic to start her work assessing hospitals for Project HOPE.
“There are some serious safety, equipment and staffing deficiencies that were surprising…In one location, electrical power was so unstable that when it goes out, nobody even blinks!” she told us.
“Due to the lack of space, women were frequently sharing the same space or bed, and frequently would provide comfort to each other – as strangers…The overall sense of each L&D [labor and delivery] unit was a production line.”
Understanding the risk of giving birth in the Dominican Republic

Much of the overcrowding in hospitals and clinics is caused by pregnant women from neighboring Haiti who cross the border to give birth. Delivering a baby is safer in the Dominican Republic — especially since the 2010 earthquake, from which Haiti still has not recovered. Hospitals also provide care for patients with or without documentation.
The prevalence of teenage pregnancy in the Dominican Republic compounds the problem. Nearly one quarter of women between 12 and 19 years of age have been pregnant — the highest rate in Latin America and exponentially higher than teenage pregnancy rates in the United States.
All of these circumstances, combined with outdated equipment and a shortage of properly trained health care professionals, has raised the risk of giving birth in the Dominican Republic. The country has the second highest rate of neonatal mortality in Latin America and the Caribbean. And at the Renee Klang Viuda Guzman maternity ward in Santiago, the Dominican’s second-largest city, the neonatal mortality rate is 40% higher than the national average.
Without the expertise, patience and generosity of volunteers like Jen, Project HOPE would not be able to do its part to overcome these challenges.
Volunteering for babies and their mothers in a Dominican delivery clinic
Statistics are one thing, but hearing about the experience firsthand is a much better way to understand how it feels to volunteer in a maternity clinic full of young, frightened, expectant mothers.
“There is a culture of only allowing the laboring women into Labor and Delivery, so many women were alone, afraid and having pain,” Jen told us. “There were several women who threatened to walk out if they did not get a C-section because they could not manage the pain of labor adequately.
“As a volunteer, sometimes I would talk to the mother in labor and provide her with some coaching to ease her discomfort…Every single woman whose hand I held or whose ear I spoke into or whose baby I reported updates on was truly appreciative, and I was rewarded with a smile.”
She was particularly moved by her experiences with one very young mother who went into labor prematurely and gave birth to a child with low birth weight.
“Not only was she there as a young teenager alone…she was ultimately going to deliver her baby at an age at which [it] was not likely to survive. I think terrified would be the best way to describe her…I got to be present and support the mother by talking her through the delivery process, and was able to provide updates on the baby when he went to the nursery and she was in the delivery room. I was happy to be able to provide the mother support, a sense of dignity and control of a tough situation.”
Making a difference with HOPE
“I am incredibly grateful for the support and kindness of the entire Project HOPE team, who listened, provided suggestions, and supported me throughout my time there…it was also the most organized volunteer experience I have participated in.”
With more volunteers joining Project HOPE in maternity clinics throughout the country, we hope to continue making mothers and their newborns safer and more comfortable in the Dominican Republic. Strides have already been made — we’ve helped train over 1,300 hospital staff and have assigned over a dozen new nurses to NICU units throughout the country, all the while focusing on creating supportive, welcoming environments for our international volunteers.
We also work to equip leading maternity hospitals with upgraded equipment such as radiant warmers, vital sign monitors and incubators, and are supporting the Ministry of Health in establishing a post-graduate education program for nurses on obstetrics and neonatal care.
“I am incredibly grateful for the support and kindness of the entire Project HOPE team, who listened, provided suggestions and supported me throughout my time there…it was also the most organized volunteer experience I have participated in.”
Read more about our work in the Dominican Republic
How you can help
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