In Hawaii, a contentious legal battle has emerged over the state’s Midwifery Restriction Law, prompting a group of midwives and their advocates to seek a preliminary injunction. The law, enacted in 2019, mandates that anyone offering pregnancy-related information, advice, or care must hold a state midwifery license, under penalty of imprisonment and fines.
Led by Kiʻinaniokalani Kahoʻohanohano, a Maui-based Native Hawaiian midwife, plaintiffs argue that the law criminalizes their cultural birth practices and exacerbates inequalities in maternal health care, particularly affecting underserved communities. Represented by the Center for Reproductive Rights and the Native Hawaiian Legal Corporation, they contend that the legislation disrupts collaborative networks crucial for providing essential pregnancy care across diverse ethnic groups in Hawaii.
The case, currently before Oahu Circuit Court Judge Shirley Kawamura, has sparked intense debate over the definition of midwifery and the inclusion of indigenous birth workers under regulatory frameworks. Supporters of the law, including Lea Minton of the Midwives Alliance of Hawaii, argue that certification is essential to ensure safety and quality in childbirth practices, cautioning against unregulated care that could potentially lead to emergencies.
Critics like Rebekah Botello, a longtime doula and childbirth educator, highlight significant barriers to certification for local birth workers, pointing out the absence of accredited programs in Hawaii that address Native Hawaiian cultural practices. Botello emphasizes the cultural importance of preserving indigenous birthing traditions without external regulation, decrying what she terms as “medical colonialism.”
Puaoeleili Pinto, another Native Hawaiian birth worker, underscores the community-driven nature of traditional birth practices, where approval and safety are affirmed by local recognition rather than formal certification. Pinto stresses the value of cultural autonomy in determining safe and appropriate birthing practices within Hawaiian communities.
The legal and cultural clash reflects broader issues of cultural preservation, healthcare access, and regulatory oversight in Hawaii’s maternal health landscape, amidst elevated mortality rates among Native Hawaiians and other marginalized groups. As the legal proceedings continue, the case remains pivotal in defining the future of midwifery practices and cultural rights in the island state.