The Center for Reproductive Rights and the Native Hawaiian Legal Corporation filed a suit in the First Circuit Court of Hawai‘i challenging a law that criminalizes the care Native midwives provide in the state. Under the Midwifery Restriction Law, Native birthwork practitioners could now face risk of fines and prison time if they are caught offering care, or even advice, to pregnant women and families in Hawai’i.
According to a statement from the Center for Reproductive Rights, the Midwifery Restriction Law prevents “pregnant people in Hawai‘i from using skilled midwives for their pregnancies and births, as they have for generations'' and endangers the constitutionally protected Native Hawaiian traditional birthing practices. The nine plaintiffs in the lawsuit, which include six midwives and midwifery students, as well as three patients, jointly filed the case against the state of Hawai’i on Tuesday after the government prohibited birth workers without a specific midwifery license (for which no education programs in the state meet the legal requirement) from providing maternal healthcare last year.
The lawsuit, which represents one of the first legal challenges aiming to protect Native Hawaiian healing practices, comes amid renewed calls for Indigenous self-governance following the Maui wildfires of August 2023, per the Guardian.
Ki‘inaniokalani Kaho‘ohanohano, a lead plaintiff and Native Hawaiian midwife who ended her decades-long career in the practice because of the Restriction Law, described a return to marginalization Hawaiians have long fought to overcome. “We were able to reclaim these practices that were stolen from us, we were able to heal some of the trauma of being treated as second-class citizens in our own land. Now, with this new law, history is repeating itself. We are again on the brink of losing our people’s knowledge of sacred birthing traditions,” Kaho‘ohanohano said in an exclusive interview with the Guardian.
Kaho‘ohanohano also shared in a statement from the Native Hawaiian Legal Corporation. “This law is preventing me from passing along the life-changing and life-saving knowledge and traditions that I was gifted. It is robbing the next generation of Native Hawaiians of our own ancestral healing knowledge and power. Our communities are experiencing a maternal health crisis in hospitals, and cutting off our ability to care for our families with our own traditions and practices is medical colonialism."
Currently, there are no education programs in Hawai‘i that meet the law’s requirements, essentially indicating that traditional midwives would need to travel thousands of miles to be re-educated through western programs, according the Native Hawaiian Legal Corporation.
Nationally, Native Hawaiian and other Pacific Islander people have the highest pregnancy related mortality ratio among all women of all races, with 62.8 deaths per 100,000 live births, compared to 39.9 for non-Hispanic Black women and 14.1 for non-Hispanic white women. In research published by the National Library of Medicine in January 2021, findings indicated that increasing midwifery interventions could avert 41% of maternal deaths, as well as 39% of neonatal deaths and 26% of stillbirths.
