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) – If you’re headed to Kaua’i and looking for a unique farm-to-table experience, Hualani‘s at Timbers Kaua’i serves creative dishes and drinks made with local ingredients and hyper seasonal produce grown on their farm at Hokuala.
Alex Amorin, executive chef at Hualani‘s, and Cory Dotario, Timbers food and beverage director, joined HNN’s Sunrise to talk about their fresh, sustainable philosophy and upcoming Ha’aheo o Kauaʻi events, meaning “pride of Kauai” because talent and ingredients are sourced from the Garden Isle.
Among their signatures: honeycomb and goat cheese salad with a lemon vinaigrette (tapping into fall citrus season on their farm and honey from their own apiary) and a Barrel Aged Old Fashioned using their signature “Nagao of Never” bourbon named after a longtime employee, David Nagao, as a way to usher in the holiday season.
Ha’aheo o Kauaʻi lets guests enjoy a hands-on harvesting experience at The Farm at Hokuala and learn about Kauai produce, seafood and meats, and wine pairings.
Amorin talked about the farm’s organic and biodynamic practices.
“There’s a nuanced beauty to selecting produce in its prime seasonality. The delicate flavor profiles take artistry to celebrate and enhance as the star of the plate. Similar to the artistry of working with watercolors and the delicate skillset that’s involved with mixing paint colors, working with vegetable-forward dishes takes the same approach and it’s ingredients sourced at peak ripeness that allow me to create culinary works of art,” said Amorin, an avid waterman and fisherman.
The next Ha’aheo o Kauaʻi farm-to-table dinner is on December 19 and can be booked on Open Table or by calling (808) 320-7399.
For more information, visit timberskauai.com/eat-drink/hualanis or follow on Instagram @timberskauai.
Copyright 2024 Hawaii News Now. All rights reserved.
Hawaii
No. 10 North Carolina runs wild to overwhelm Hawaii on national TV | Honolulu Star-Advertiser
Gov. Josh Green is likely to appoint a new Hawaii Supreme Court chief justice next year, his third pick for the five-member court.
On Friday the Judicial Selection Commission posted a vacancy for the position, currently held by Chief Justice Mark Recktenwald. By law, judges and justice in Hawaii are mandated to retire at age 70, an age Recktenwald will reach in 2025.
Applicants must be residents and citizens of Hawaii and licensed to practice law here for not less than 10 years preceding their nomination.
The term of office of the CJ, as the position is known in shorthand, is 10 years. The annual salary is $248,124.
The Judicial Selection Commission will publish the list of all applicants to its website, and the public will be invited to provide comments. The commission will then forward not less than four names and not more than six names to the governor for his consideration.
A justice’s nomination is then subject to confirmation by the state Senate.
A year ago at this time the Senate confirmed Lisa Ginoza and Vlad Devens to serve on the court.
Recktenwald was named CJ in 2010, after Gov. Linda Lingle’s nomination of Appeals Court Judge Katherine Leonard was rejected by the Senate for lacking leadership and management experience.
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