Big Island midwives and the Hawaii County Council are urging the state to remove a requirement that midwives must have a license in order to practice.
A 2019 Hawaii law, which stated that the regulation of midwifery was necessary in order to protect the health of newborns and parents, imposed licensure requirements on midwives, including the need to complete a formal education and training program.
While the law allowed for some exemptions to those requirements — largely for midwives who already were practicing when the measure passed — those exemptions ended in July 2023.
Some midwives and their advocates have been trying to get the licensure requirements repealed, with many concerned the law regulates traditional Native Hawaiian practices out of existence.
Now the County Council has weighed in, passing a resolution Wednesday urging the state to repeal the licensure requirements during the 2025 legislative session.
The resolution states the end of the exemption places traditional and indigenous midwifery practices at risk of criminality “or, worse, cultural erasure.” It adds that the 2019 law also requires Certified Professional Midwives (CPMs) to complete a course study at a Midwifery Education Accreditation Council school, none of which exist in Hawaii.
Hilo Councilwoman Jenn Kagiwada, who introduced the resolution, said the council had previously discussed a similar resolution that was included in an endorsement package for the Hawaii State Association of Counties. However, because that package failed to unanimously pass all four counties, the matter has been reintroduced as a standalone resolution.
Several of the women on the council strongly endorsed the resolution. Kailua-Kona Councilwoman Rebecca Villegas said it is important for women to be able to choose the manner in which they give birth.
“In a time when women’s reproductive rights are literally on the line, this is so important,” Villegas said.
South Kona and Volcano Councilwoman Michelle Galimba added that the resolution will help preserve Native Hawaiian knowledge that might otherwise be lost.
Several midwives also testified in support of the resolution. Kristie Duarte, chair of the Hawaii Home Birth Task Force, wrote that since the 2019 law was passed, “not one Native Hawaiian midwife has yet achieved licensure” due to the educational requirements.
Duarte added that an Oahu Circuit Court judge in July ruled in favor of a group of midwives who had filed a civil complaint against the state, arguing the law criminalizes midwifery practitioners.
“Supporting this means that families will have more choices about how they want to give birth, which can help them feel more comfortable and connected to their heritage and have safer birth outcomes,” wrote Kumelewaioluopaliuli Tigangco, a Kamehameha Schools student who was the result of a home birth.
However, not all support the measure. CPM Dani Dougherty said the state law has been subjected to a certain amount of misinformation.
“Hawaii’s midwifery licensing law does not regulate or eliminate anyone’s right to choose where they desire to birth, who they wish to be present at their birth, or who they choose to have as their care provider,” Dougherty said via email.
The 2019 law specifically includes language clarifying that it does not prohibit “healing practices by traditional Hawaiian healers engaged in traditional healing practices … recognized by any council of kupuna.”
Dougherty said she thinks midwifery should be held to a certain standard of care, and that those standards improve the legitimacy of the profession in the eyes of the health care world.
“Establishing a standard for a minimum level of competency for licensure is crucial for integrating midwives into the health care system, which ultimately provides more options for birthing families in Hawaii,” Dougherty wrote. “It’s important to me as a midwife that I am able to collaborate with hospital care providers and specialists to provide safe care.”
The council voted unanimously Wednesday to pass the resolution — although Puna Councilwoman Ashley Kierkiewicz was absent — but it is nonbinding.
Whether the state Legislature will introduce a measure repealing the licensure requirements next year is unclear, although some bills that would amend those requirements were introduced in 2024 but did not advance.
Email Michael Brestovansky at mbrestovansky@hawaiitribune-herald.com.