Midwifery Curriculum for Auxiliary Maternity Nurses: A Case Study in the Dominican Republic


  • Jennifer Foster CNM, PhD,

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    • Jennifer Foster, CNM, PhD, is Assistant Professor of Nursing and Adjunct Assistant Professor of Anthropology at the University of Massachusetts, Amherst.

  • Yadira Regueira RN, PhD,

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    • Yadira Regueira, RN, PhD, is Assistant Professor of Nursing at the Inter American University of Puerto Rico.

  • Rosa Ipania Burgos MA,

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    • Rosa Ipania Burgos, MA, is Professor of Nursing at the Autonomous University of Santo Domingo, Dominican Republic.

  • Annemarie Heath Sanchez CNM, MSN

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    • Annemarie Heath Sanchez, CNM, MSN, is in full-scope midwifery practice in Springfield, MA. She was Assistant Professor in the Nurse-Midwifery Education Program at the University of Puerto Rico from 2001 to 2003.

to Jennifer Foster, CNM, PhD, Arnold House 314, The University of Massachusetts, Amherst, MA 01003. E-mail: jwfoster@nursing.umass.edu


Although most deliveries in the Dominican Republic occur within hospitals, maternal mortality in that nation remains high. In nonteaching hospitals, almost all of the vaginal births are attended by maternity auxiliary nurses. This article reports on a series of educational conferences for maternity auxiliary nurses in 1 hospital that were developed in response to the maternal mortality rate there. These conferences, taught by a team of midwives from the continental United States and Puerto Rico, used a midwifery curriculum with a participatory action methodology. The educational initiative has developed into a nongovernmental organization named Proyecto ADAMES to build capacity among auxiliary nurses. A qualitative evaluation of the effectiveness of Proyecto ADAMES in improving the knowledge, skills, and attitudes of the auxiliary nurses revealed positive behavioral changes despite weak documentation of their newly acquired knowledge and skills. Findings suggest that midwifery education for auxiliary maternity nurses in the Dominican Republic may contribute to maternal mortality reduction.