Maison de Naissance opened in 2004 with the intent of breaking down barriers to prenatal care and safe delivery for women in rural southern Haiti. After almost 8 years and over 3500 deliveries, no mothers have been lost in a region where maternal mortality is distressingly common. Though initially the concept of American physicians, the protocols and procedures have been adapted by the Haitian staff of expert certified nurse midwives. Constant effort to support the local community by hiring local builders and workers, purchasing supplies in the nearby town, and interviewing patients, neighbors and community health committee members has produced a clinic and delivery service which are prized by the national health department as the reference for maternity care in Haiti. Next steps include expanding HIV care to include case management and nutrition, and integrating assistant midwives into the care team.