SANTO DOMINGO — As spiraling violence in Haiti puts healthcare out of reach for most, Haitian mothers are seeking care at hospitals in neighboring Dominican Republic despite government policies there scaling up deportations.
The two countries share the Caribbean island of Hispaniola, but are divided by a heavily secured border, long-standing tensions and an immense wealth gap. Children born to Haitian parents in the Dominican Republic do not receive citizenship.
"I had my child here," Cineas Lionne told Reuters from a hospital in the eastern city of Punta Cana. "I don't think I would receive good care in Haiti because of the situation with the government - there is no government."
The U.N. found in October that less than a quarter of hospitals were operating around Haitian capital Port-au-Prince, while those elsewhere struggle to cope with flows of refugees fleeing gang attacks.
That assessment came before a spike in violence in late 2024, that saw gangs shoot and kill journalists gathered at Haiti's largest public hospital for a government press conference meant to announce a long-awaited reopening. Those plans have been put on hold.
The violence has forced the capital's airport and ports to repeatedly shut down, prompting hospitals to warn of a lack of supplies such as blood and oxygen. Aid group Doctors Without Borders temporarily halted services last year due to threats.
"The doctors here have treated me well," said Beatrice Agustin, who gave birth in a maternity hospital in the Dominican capital.
"In Haiti there are many gangsters. You can't give birth there, but also if you are here without papers," giving birth in the Dominican Republic is complicated, she said.
U.N. experts have warned in recent years that pregnant and postpartum Haitian women seeking medical care in the Dominican Republic have faced intimidation, detention and deportation, citing raids on public hospitals and arrests during check-ups.
The U.N. experts have called on neighboring nations to stop deporting Haitians back home, where over 5 million people are going hungry and over 1 million are internally displaced as armed gangs continue to gain territory. Many families are sharing homes or living in makeshift camps.
The Dominican Republic has pledged to deport up to 10,000 people a week as it deals with the brunt of the migration of Haitians fleeing conflict at home. It deported over 200,000 Haitians last year and nearly 15,000 in first two weeks of 2025.
Dominican politicians have accused Haitian migrants of fueling insecurity and said their country is already giving too much.
"Our infrastructure does not have the capacity to receive that number of people," Senator and former health minister Daniel Rivera told Reuters, saying the priority was expanding healthcare for Dominicans.
Local doctors said many Haitian women are afraid to attend prenatal checkups and tend to arrive late at night or when they are about to give birth, due to the risk of deportation.
National health service director Martin Ortiz noted that migration officials are not permitted to enter to make arrests inside hospitals.
"Our mission is to provide care," he said. "The same care is given equally."