The maternity ward of the Juan Pablo Pina Hospital attends 600 births a month without hot water. Women labor on old plastic mattresses, electricity is sporadic, and relatives clean patients in crowded rooms at this public hospital in San Cristóbal, Dominican Republic. Although 98% of Dominican women had a skilled attendant at birth, the maternal mortality ratio was the second highest in the Caribbean when these photographs were taken in 2006 – 2007.
—Alice Proujansky

Brooklyn-based photojournalist Alice Proujansky has been working on a project about birth and culture for the last 6 years, documenting women and their birthing experiences in the Dominican Republic, Nigeria, the Navajo Nation, Massachusetts and Mexico. Proujansky explores midwifery, cultural traditions, the ever-present risk of maternal mortality in developing countries, and the universal intensity of giving birth. Delivery, shown here, takes us inside a hospital in San Cristóbal, Dominican Republic.