The Maui County Committee on the Status of Women (CSW) and so many in our birthing community stand in full support of the proposed changes to Act 32 or SB893, a bill currently waiting to be heard at the State legislature. The proposed changes put forward by the Hawaii Home birth Collective requests to exempt “Traditional Midwives,” who are trained according to culture with experienced midwives and “Direct-entry” Midwives from being criminalized.
The passing of Act 32 into law (requiring licensure of midwives in the State of Hawaii) last year has had severe consequences for our local birth workers. Midwives who have been practicing for years and even decades will now be sanctioned and punished. There is no justification for such strict regulations, in fact, when compared to hospital births, the outcomes for home births with midwives showed better results.
The amendments suggested in SB893 will have no impact on the already Certified Professional Midwives but would create a way to recognize the training and expertise of local Traditional and Direct-Entry Midwives. The Hawaii State Legislature passed the “well intentioned” law last year after being lobbied intensely by those who would benefit. They strongly based their decisions on individual horror stories of home birth outcomes, that are terrible, but not the norm. Report after report from Hawaii and from across the country show that home birth is safer than hospitals. And there are now new reports, especially during the pandemic, of the value of having home birth as an option.
Women have a right to choose not to go to the hospital where outcomes often include a higher rate of unwanted medical interventions, cesarean operations, evacuation births, and even forced sterilizations, particularly in BIPOC (Black, Indigenous, and all People of Color) women. In fact, Act 32 as it stands disproportionately affects BIPOC who are statistically proven to have worse maternal outcomes in a hospital. Furthermore, it does not address that the needs of women living in Hawaii are diverse. For example, women on Moloka`i and Lāna`i are forced to move to either Oahu or Maui a month before their due date, at their own expense, to give birth in a hospital without their support systems.
Act 32, as it currently stands, also disproportionately affects Hawaiian midwives and Cultural Practitioners because there is no midwife certification program in the State. They would be forced to travel to the continent to get certified, which is both costly, timely, and impractical. In addition, there are very few preceptors available to supervise the students locally. Most of these preceptors are white, intensifying the effect on BIPOC students.
In my opinion, the 2020 Hawaii State Legislature did not consider the data, testimony, and information provided by midwives fairly in comparison to the information provided by the American College of Obstetricians and Gynecologists (ACOG). Birth is a natural process and has been happening in home settings since the very beginning of time. Birth is a moneymaker for hospitals. Cultural and Traditional Midwives, as well as Direct-Entry Midwives, need to be allowed a pathway to practice and ultimately be recognized as professionals and experts in their fields in the State of Hawaii. Please call your senators today to let them know you support SB893 and urge our Maui Senator Roz Baker (808) 586-6070 to schedule the hearing!
Image Credit: Cadencia Photography