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A few midwives seek to uphold Native Hawaiian birth traditions. Would a state law jeopardize them?

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A group of midwives who focus on traditional Native Hawaiian birth practices are trying to block a Hawaii law that requires midwives to obtain licenses
Ki‘inaniokalani Kahoʻohanohano longed for a deeper connection to her Native Hawaiian ancestors and culture as she prepared to give birth to her first child at home on the north shore of Maui in 2003.
But generations of colonialist suppression had eroded many Hawaiian traditions, and it was hard to find information on how the islands’ Indigenous people honored pregnancy or childbirth. Nor could she find a Native Hawaiian midwife.
That experience led Kahoʻohanohano — now a mother of five — to become a Native Hawaiian midwife herself, a role in which she spent years helping to deliver as many as three babies a month, receiving them in a traditional cloth made of woven bark and uttering sacred, tremorous chants as she welcomed them into the world.
Her quest to preserve tradition also led her into a downtown Honolulu courtroom this week, where she and others are seeking to block a state law that they say endangers their ability to continue serving pregnant women who hope for such customary Native Hawaiian births.
“To be able to have our babies in the places and in the ways of our kupuna, our ancestors, is very vital,” she testified. “To me, the point of what we do is to be able to return birth home to these places.”
Lawmakers enacted a midwife licensure law in 2019, finding that the “improper practice of midwifery poses a significant risk of harm to the mother or newborn, and may result in death.” Violations are punishable by up to a year in jail, plus thousands of dollars in criminal and civil fines.
The measure requires anyone who provides “assessment, monitoring, and care” during pregnancy, labor, childbirth and during the postpartum period to be licensed. The women’s lawsuit says that would include a wide range of people, including midwives, doulas, lactation consultants, and even family and friends of the new mother.
Until last summer, the law provided an exception for “birth attendants,” which allowed Kahoʻohanohano to continue practicing Native Hawaiian birth customs.

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