The falling birth rate and shortages paint a worrisome picture for pregnant women in the province.
14ymedio, Julio César Contreras, Matanzas, 5 August 2025 –“All in yellow,” is how Yamila wants her baby to be born at the José Ramón López Trabane Provincial Gynecological and Obstetric Teaching Hospital in Matanzas. There’s still plenty of time until that day, but the 22-year-old doesn’t have a minute to waste. While she waits for her turn, she reviews the problems she must overcome at the city’s main maternity hospital due to the lack of resources, human and material.
Despite the prestige once enjoyed by what is commonly called the Matanzas Maternity Hospital, the situation in its consulting rooms, lounges, and hallways is very different now. Pregnant women who come seeking care know that, without a personal recommendation or a gift for the doctor, they are forced to resign themselves to waiting at the end of the line and sitting in a plastic chair that barely relieves their fatigue.
In the waiting room that Monday morning, the air was thick and the pages of medical records became improvised fans.
In the waiting room that Monday morning, the air was thick, and the pages of medical records became improvised fans. Among the sweating women was Yamila, 15 weeks pregnant. “In Ceiba Mocha, where I live, the family doctor’s office has been closed for two years,” she told 14ymedio. “I’m a first-time mother, I come from the countryside, and I don’t know any obstetrician who might treat me.”
While she waits, her mental to-do list grows: she’s already started buying syringes, sutures, gauze, and some regalitos — small gifts — for the medical staff. “A friend gave birth last month and even had to bring the gloves for the delivery. There’s nothing here,” she says, watching a woman cross the hall carrying a bucket and a homemade water heater. “I hope I don’t need a C-section. I’m scared,” she confesses.
Preparing the birthing bag, a long-standing tradition among Cuban women, has become more complex each year. While it used to include diapers, the clothes the baby would leave the hospital in, blankets, and cotton, it now includes cash and a wide range of items, from a pillow to food. Fans, cutlery, a bathing basin… the supplies “look like packing to move,” the young woman emphasizes.
Yamila is not alone in the almost dark hallway waiting for an appointment. A few steps away, Yanelis and her partner have been waiting outside the door for two hours. They suspect an unwanted pregnancy and want to know if there’s still time to terminate it. “My cousin used to do ultrasounds, but she went to work as a waitress because the pay in Public Health is so bad,” she laments. During that wait, they’ve seen cockroaches crawling on the stained walls, orderlies smoking at the windows, and doctors letting in those who arrive loaded with bags first. “When that door opens, we’re going in. Let’s see who can stop us,” she says, determined.
The deterioration isn’t just material. Leticia, with a high-risk pregnancy due to her diabetes, warns: “I started bleeding this morning. I told a doctor, hoping she’d see me quickly, and here I am.” She holds back the urge to go to the bathroom because the only restroom “doesn’t flush.” For her, experiencing her second pregnancy, “it all depends on what you can give; if you have the resources, they see you faster.” Her brother, from abroad, has already promised to send her money every month to speed up her medical checkups.
Her brother, from abroad, has already promised to send her money every month to speed up the medical check-ups.
This health crisis is occurring in a province where fewer and fewer children are being born. In recent decades, Matanzas went from registering almost 8,000 births per year to just over 4,000 in 2024; it is the province with the fifth worst birth rate (6.6 per 1,000 women). Experts point to migration, especially of young women, and an economy that discourages motherhood as the main causes: lack of housing, high prices for basic goods, and wages that are barely enough to get by. According to the National Statistics Office (ONEI), the birth rate in Cuba has been fewer than two children per woman since 1978, insufficient to maintain the population in a country that, moreover, does not receive migrants to help alleviate the situation.
Selective out-migration, which is shrinking the age brackets between 20 and 35, exacerbates the imbalance: fewer births and more older adults. Even though programs such as the Maternal and Child Care Program (PAMI) promote health campaigns and support for couples struggling to conceive, maternity hospital wards show the other side of the crisis: pregnant women without priority care, births requiring supplies brought from home, and overwhelmed or unmotivated professionals.
In the heat, expectant mothers wait their turn while sheets of paper continue to flap like fans. Between fear and resignation, they all know that giving birth here isn’t just about bringing a life into the world; it’s also about surviving an increasingly deteriorating healthcare system.
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