Hawaii
A few midwives seek to uphold Native Hawaiian birth traditions. Would a state law jeopardize them?
HONOLULU — 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.
Ki’inaniokalani Kaho’ohanohano poses on Wednesday, June 12, 2024, in Honolulu. She is a Native Hawaiian cultural practitioner who is among those suing over a Hawaii law they say penalizes anyone who provides advice, information, or care, during pregnancy, birth, and postpartum who does not have a specific state license. Credit: AP/Jennifer Sinco Kelleher
Until last summer, the law provided an exception for “birth attendants,” which allowed Kahoʻohanohano to continue practicing Native Hawaiian birth customs. With that exception now expired, however, she and others face the licensing requirements — which, they say, include costly programs only available out of state or online that don’t align with Hawaiian culture and beliefs.
In 2022, the average cost of an accredited midwifery program was $6,200 to $6,900 a year, according to court documents filed by the state.
Attorneys for the state argued in a court filing that the law “undoubtedly serves a compelling interest in protecting pregnant persons from receiving ill-advice from untrained individuals.”
State Deputy Attorney General Isaac Ickes told Judge Shirley Kawamura that the law doesn’t outlaw Native Hawaiian midwifery or homebirths, but that requiring a license reduces the risks of harm or death.
Supporters of a lawsuit challenging a Hawaii midwife licensure law gather outside a courthouse in Honolulu on Monday, June 10, 2024. Credit: AP/Jennifer Sinco Kelleher
The dispute is the latest in a long history of debate about how and whether Hawaii should regulate the practice of traditional healing arts that dates to well before the islands became the 50th state in 1959. Those arts were banished or severely restricted for much of the 20th century, but the Hawaiian Indigenous rights movement of the 1970s renewed interest in the customary ways.
Hawaii eventually adopted a system where councils versed in Native Hawaiian healing certify traditional practitioners, though those suing say their efforts to form such a council for midwifery have failed.
Practicing midwifery without a license, meanwhile, was banned until 1998 — when, lawmakers say, they inadvertently decriminalized it when they altered the regulation of nurse-midwives, something the 2019 law sought to remedy.
Among the nine plaintiffs are women who seek traditional births and argue that the new licensing requirement violates their right of privacy and reproductive autonomy under Hawaii’s Constitution. They are represented by the Center for Reproductive Rights and the Native Hawaiian Legal Corporation.
“For pregnant people whose own family may no longer hold the knowledge of the ceremonial and sacred aspects of birth, a midwife trained in Native Hawaiian traditional and customary birthing practices can be an invaluable, culturally informed health care provider,” the lawsuit states.
When Kahoʻohanohano was unable to find a Native Hawaiian midwife to attend the birth of her first child, she turned instead to a Native American one, who was open to incorporating traditional Hawaiian aspects that Kahoʻohanohano gleaned from her elders.
She surrounded herself with Hawaiian cultural practitioners focusing on pule, or prayer, and lomilomi, a traditional massage with physical and spiritual elements. It all helped ease her three days of labor, she said. And then, “two pushes and pau” — done — the boy was born.
The births of her five children in various Maui communities, Kahoʻohanohano said, were her “greatest teachers” in herself becoming one of the very few midwives who know about Native Hawaiian birthing practices.
She is believed to be the first person in a century to give birth on her husband’s ancestral lands in Kahakuloa, a remote west Maui valley of mostly Native Hawaiians, where her daughter was born in 2015. The community is at least 40 minutes along winding roads to the island’s only hospital.
Kahoʻohanohano testified about helping low-risk pregnant women and identifying instances where she transferred someone to receive care at the hospital but said she’s never experienced any emergency situations.
Among the other plaintiffs are midwives she has helped train and women she has aided through birth. Makalani Franco-Francis testified that she learned about customary birth practices from Kahoʻohanohano, including how to receive a newborn in kapa, or traditional cloth, and cultural protocols for a placenta, including taking it to the ocean or burying it to connect a newborn to its ancestral lands.
The law has halted her education, Franco-Francis said. She testified that she’s not interested in resuming her midwifery education through out-of-state or online programs.
“It’s not in alignment with our cultural practices, and it’s also a financial obligation,” she said.
The judge heard testimony through the week. It’s not clear how soon a ruling might come.
HONOLULU (HawaiiNewsNow) – Over the last month, strong earthquakes of magnitude 6.0 and higher have rocked the Philippines, Japan, Venezuela, and even Hawaii.
Researchers have been closely monitoring the activity, and while it may seem like more quakes than normal, they say it’s about on par with forecasts.
“This is all pretty normal for earthquakes. On a given year, we expect around 15 between magnitude 7 and 8, and about 150 between magnitude 6 and 7,” said Helen Janiszewski, assistant professor at the University of Hawaii at Manoa’s Department of Earth Sciences.
The quakes are, however, hitting in more populated places compared to some large earthquakes in past years, making them more noticeable.
“A couple years ago, there was an actual very similar, sequence of earthquakes to the one that we had in Venezuela where it was, 7.8 and 8.1 in very close sequence, but it was here, where no one lives,” Janiszewski said, pointing to the Southern Atlantic Ocean on a map.
Despite advancements in technology, researchers say there’s still no way to precisely predict when and where the next big earthquake will strike. But some seismology enthusiasts believe patterns can be monitored, studied, and used to implement potential life-saving warnings.
“I think it’s something that could happen as well across the world if people, scientists got together and really understood what’s happening. And then governments also utilize this knowledge to better notify and warn their citizens,” Pahoa resident Bob Gentzel said.
There are upwards of 100 seismographs throughout Hawaii constantly monitoring for quake activity.
Very subtle energy from the Venezuela quake was mapped traveling through the continent.
Some hope investments will be made in early-warning technology, as well as individual emergency preparedness.
“I’m just trying to prove the point that they can be forecastable because I want to save lives,” Gentzel said.
Janiszewski added, “There’s a lot that we can do still in the interim, both on an individual scale for preparedness in your own home as well as investment at community and state levels.”
Copyright 2026 Hawaii News Now. All rights reserved.
HONOLULU (HawaiiNewsNow) – More than $10 billion in SNAP benefits paid nationwide in fiscal year 2025 were above recipients’ eligibility or went to people who didn’t qualify for the program, according to the U.S. Department of Agriculture.
An annual analysis shows the national payment error rate was 10.62%, well above the congressional threshold of 6%.
The error rate measures how accurately states determine who is eligible for SNAP and how much they should get.
In Hawaii, the payment error rate is higher than the national average at 10.92%
“These payment error rates are further proof that state accountability is severely lacking in SNAP,” Agriculture Secretary Brooke L. Rollins said in a press release. “USDA has taken historic action to help interested states curb SNAP waste, and I hope other states, regardless of political leadership, prioritize needy families and the American taxpayer over politics.”
States above the threshold must now pay back a percentage of their benefits and submit an action plan to the USDA explaining how the errors will be addressed.
Copyright 2026 Hawaii News Now. All rights reserved.
-
Pennsylvania1 minute agoFederal government sues Pennsylvania, others over SNAP data
-
Rhode Island4 minutes agoTarget 12: State of RI’s fire hoses
-
South-Carolina9 minutes agoMississippi State baseball lands Will Craddock, South Carolina transfer infielder
-
South Dakota16 minutes agoSouth Dakota Republicans reject censuring John Thune over stalled SAVE America Act
-
Tennessee19 minutes agoFlood watch in effect for Middle Tennessee: 2-3″ of rain expected Saturday
-
Texas24 minutes agoTexas state school board approves mandated reading list including Bible passages
-
Utah31 minutes agoUtah, Salt Lake County awarded grants for community cleanup
-
Vermont34 minutes agoWest Rutland man dies in hit-and-run, police seek vehicle
