Court Rules in Favor of Native Hawaiian Midwives

A Hawai‘i state court on Tuesday temporarily blocked part of the Midwifery Restriction Law, which prevents pregnant people in Hawai‘i from using traditional midwives for their pregnancies and births. The lawsuit was filed by the Center for Reproductive Rights, the Native Hawaiian Legal Corporation, and the law firm Perkins Coie on behalf of nine plaintiffs, including six midwives and student midwives, as well as three women who wish to access care from traditional midwives.

Plaintiffs include: Ki‘inaniokalani Kaho‘ohanohano, Kiana Rowley, A. Ezinne Dawson, Makalani Franco-Francis, Kawehi Ku‘ailani, Moriah Salado, Morea Mendoza, Alex Amey, and Pi‘ilani Schneider-Furuya. 

“Since July 2023, when the law went into effect, many traditional midwives have not practiced for fear of penalties and criminal liability. This ruling means that the law’s threat of prison time and fines for individuals who practice, teach, and learn traditional Native Hawaiian healing practices of prenatal, maternal, and child care—or pale keiki, hoʻohānau, and hānau—is halted as the case continues. However, the court did not block other parts of the Midwifery Restriction Law, meaning that some midwives who trained through other pathways still face penalties for serving their communities,” according to midwife advocates.

This ruling comes after the court heard testimony from six plaintiffs in mid-June over the course of a four-day hearing. The parties have 30 days to decide whether to appeal this decision. Timing for a full trial has not yet been announced by the court.

In her ruling, Judge Shirley M. Kawamura wrote: “If Plaintiffs, especially student midwives, and other pale keiki and hānau [birth] practitioners, educators, and apprentices are not able to practice, teach, and learn, they will lose the opportunity to gain knowledge from the kūpuna [elders] to pass on to future generations.”

“Today, we are once again able to stand in our own ancestral knowledge and serve our community with skills and traditions passed down through generations. In a nation scarred by colonization, I can now resume my path toward becoming a midwife, preserving the wisdom gifted to us by our kūpuna,”said Makalani Franco-Francis, who spent five years apprenticing as a student midwife in Maui before the Restriction Law went into effect and made her training illegal. “This ruling means that traditional Native Hawaiian midwives can once again care for families, including those who choose home births, who can’t travel long distances, or who don’t feel safe or seen in other medical environments. We are now free to use our own community wisdom to care for one another without fear of prosecution.” 

“The court’s decision reaffirms the State’s constitutional duties to protect Native Hawaiian traditional and cultural practices and to ensure that such practices are not regulated out of existence,” said Kirsha Durante, Litigation Director, Native Hawaiian Legal Corporation. “For now, cultural practitioners may continue serving the pregnant and birthing members of their community without fear of criminalization or civil fines and the transmission of this specialized ʻike (knowledge) of birthing practices can resume before more ʻike kupuna (ancestral knowledge) is lost.”

“Today’s ruling recognizes that the Midwifery Restriction Law fails to provide the meaningful protections for traditional Native Hawaiian birthing practices that the Hawai‘i Constitution demands.” said Hillary Schneller, Senior Staff Attorney at the Center for Reproductive Rights. “Decisions and practices around pregnancy and birth, including to birth at home with the people you choose, are among the most private, personal, and culturally significant. As the court acknowledged, the state does real damage to Indigenous peoples’ health, safety, and culture when—instead of filling the many gaps that already exist in Hawai‘i’s maternal health care system—it takes away trusted midwives. Although the court stopped short of blocking the Law’s penalties across the board, today’s ruling is a relief for many of our clients and for families who will have more options for trusted care.”