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.
Hawaii
Florida woman dies in possible drowning in South Kona – West Hawaii Today
A Florida woman died Saturday in an apparent drowning at Honaunau Bay in South Kona.
According to police, at 11:47 a.m. Kona patrol officers were dispatched to Honaunau Boat Ramp following a report of a swimmer in distress.
Police learned that 65-year-old Mindy Morris of Panama City had been snorkeling in the bay with family members. As Morris returned to shore, she reportedly began experiencing difficulty breathing before losing consciousness.
Bystanders initiated life-saving measures until emergency responders arrived.
Morris was transported to Kona Community Hospital, where she was later pronounced dead.
Police have initiated a coroner’s inquest investigation and ordered an autopsy to determine the exact cause of death. No foul play is suspected.
Police ask anyone who may have witnessed the incident to contact Officer Cody Sheddy of Kona Patrol at (808) 935-3311 or via email at cody.sheddy@hawaiipolice.gov.
Hawaii
Man killed while changing tire after crash in South Kohala
HONOLULU (HawaiiNewsNow) – Hawaiʻi Island police are investigating a traffic collision that claimed the life of a 59-year-old Waimea man on Sunday afternoon.
At 1:22 p.m., South Kohala patrol officers responded to the collision and determined that a black 2008 BMW sedan was traveling eastbound on Kawaihae Road when it veered onto the south shoulder and collided with a parked, unoccupied gold 2004 Toyota Camry sedan that was facing east on the shoulder.
Police identified the victim as 59-year-old Sione Tilini of Waimea.
At the time of the collision, three individuals were outside the Toyota Camry on the passenger side of the vehicle, changing a front passenger-side tire.
Tilini is believed to have been positioned between and partially underneath the passenger-side wheels of the Toyota when the collision occurred. The impact caused the Toyota to fall onto him.
Tilini was transported to Queen’s North Hawaiʻi Community Hospital, where he was later pronounced dead at 2:47 p.m.
Two additional individuals, a 19-year-old man and an 11-year-old boy, sustained minor injuries after being struck when the parked vehicle was pushed forward during the collision.
Both were transported to Queen’s North Hawaiʻi Community Hospital for treatment and later released.
The driver and sole occupant of the BMW, a 22-year-old Waimea man, was transported to Queen’s North Hawaiʻi Community Hospital and remains in critical condition.
The BMW driver was arrested on suspicion of negligent homicide, negligent injury, driving without a license, no motor vehicle insurance, and operating a vehicle under the influence of an intoxicant.
The Hawaiʻi Police Department’s Area II Traffic Enforcement Unit has initiated a negligent homicide investigation.
Police ask anyone who witnessed the collision or has information relevant to the investigation to contact Officer Dayson Taniguchi at dayson.taniguchi@hawaiipolice.gov or at (808) 326-4646, ext. 229.
This was the fourth traffic fatality within five days and the ninth traffic fatality on Hawaiʻi Island in 2026, compared with 12 at the same time last year.
Copyright 2026 Hawaii News Now. All rights reserved.
Hawaii
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