Editor’s note: As part of Reckon’s coverage of Native American Heritage Month, we are focusing our reproductive justice reporting on the courageous work of indigenous midwives, and the barriers they face in providing care to their communities
In the United States, high maternal mortality rates among people of color reveal the systemic racism that pregnant people face when trying to access care. For indigenous pregnant people, whose rates of pregnancy-related death are twice as high as those of white women, one proven solution has been found within their own communities: culturally competent Indigenous midwives.
Yet despite the proven successes of the holistic services offered by indigenous midwives to their own communities, Indigenous pregnant people and midwives alike face high barriers both to access and provide care.
These struggles are particularly pronounced in Hawaii, where the compounding effects of climate change, and lack of healthcare providers in rural areas exacerbate the ways in which pregnant people and their families experience birth.
This summer, a law that advocates say allowed Indigenous midwives–who are legally referred to as birth attendants– to practice without state licensure ended, putting many at risk of legal challenges if they continue to practice.
Navigating maternal care on the island
Hawai’i, like many rural communities across the US, faces a shortage of physicians, which means that pregnant people are forced to travel long distances to reach a maternity ward or birthing center. For Indigenous people and others pursuing midwifery, increased restrictions in obtaining licensure is creating additional barriers to practice.
“We’re generational family healers,” said Ki’i Kaho’ohanohano, a pale keiki, or Native Hawaiian traditional midwife, and founder of Mālama Nā Pua o Haumea. “We are the ones who fill in those gaps.”
The three-year exemption period of Act 32 ended in July, requiring those using the midwife title to…
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