by Haley Callahan, PBC Board Member

As a home birth Mama of two, I will be the first to tell you that I am by no means a hospital birth expert. But I have supported a number of birthers at Maui Memorial Hospital–and walked quite a few women through their healing journeys afterward–and I’ve learned a few things through those experiences that I feel are valuable. 

To start, it must be said that people choose to birth out of the home for many reasons. Whether you are choosing to birth in a hospital for personal, medical, financial, or political reasons, my hope is that you feel confident in your decision and that you are going into these spaces with clarity and gratitude for what they provide, rather than fear or doubt about your body’s abilities. Wherever it is you decide to give birth, you deserve to feel prepared, empowered and supported by your birth team.

That said, when planning a birth outside the home, the setting is no longer yours–meaning, across the board, other people are capable of controlling variables and making decisions. For many who choose to birth in the hospital, having others make decisions for the wellbeing of their baby can feel like a relief, and having access to knowledgeable and medically-skilled professionals gives them a sense of safety. This is helpful for the medical aspect of birth, but not necessarily for the emotional, spiritual or physiological aspects of birth. For those aspects, you want to ensure that you have incredible extra members of your birth team to round out the medical side. Remember: just because the setting is no longer yours does not mean that the experience is not. This is your rite of passage; your big day; one of the most important events in your lifetime. There may be people in the room who hold expertise in differing areas, but you are the expert of your body and your baby, and you hold a powerful, irreplaceable, intuition. Everyone attending your birth should recognize your place as the expert in the room.

One of the things I  work on most with the birthers at Hapai (Pregnancy) Circle is simply being capable of voicing our wants and needs. As western women, we are so often told what it is we will be receiving rather than being asked what it is we desire.

For many women, Hapai Circle is the first time they have truly been asked the question, What is it you desire for your rite of passage? 

Going through the steps of those desires, we can begin to form some ideas for how your birth space will look and feel. We own our power and take back our voice–first in the safe space of sisterhood, then perhaps with our birth teams and our families, and eventually with the providers lucky enough to bear witness to our sacred journey.

Knowing your options. 

Many people don’t know that they are able to refuse cervical exams, that they can receive a heparin-lock rather than a connected IV, or that they can request intermittent and/or portable fetal monitoring so that they can experience some relief from the many cords and straps that the hospital places. Most don’t realize they can request to have the lights dim or ask for a tour of their placenta. Almost everyone doesn’t realize a form needs to be filled to be able to take their placenta home. 

Knowing your preferences and having them written down is important and valuable regardless of where you plan to birth. Plan to discuss all of the pieces of your birth plan with your birth team at a visit, and discuss everything in detail, sharing your feelings. If you aren’t sure about something, ask people you trust, join a pregnancy circle, or read up on the subject. Everyone’s preferences are different, so don’t be afraid to be honest about yours. Most importantly of all: don’t ever forget that YOU are the expert in the room. You can trust your intuition, your body and your baby. Don’t be afraid to make your wants and needs known. You deserve to have an empowered and enlightened birth experience.

By Mariah Strong 

This poem was inspired by the life-long work of my mother, who is my deepest inspiration and teacher. My mom has served families on Maui for over 40 years as their ally and midwife in autonomous birth. She has birthed her eight children at home, with fellow midwives, her friends and family, into water, or into her own hands. She has welcomed her grandchildren in the same way, with the same values. Her life work has been to hold space for birthing families and their choices, to educate and empower. She is a traditional midwife, and has held that role my whole life, inspiring me so deeply that I have chosen to walk this path by her side, as a midwife. 

The words below came to me in an inspired uproar, when I was told my mother would not be "allowed" to call herself a midwife after four decades of holding that title. That the State of Hawai'i would be taking that ageless designation under a new law, and only let it remain for a certain few. In most cases, these few will be birth workers who have been privileged enough to afford midwifery school and to travel out of the state to complete it. Without an amendment, this law would make all others, the traditional and cultural midwives, the direct-entry midwives and even licensed midwives from certain states, unable to serve our families legally and strip them of the title "midwife.” If they continue to use the title, the position that their community and actions bestowed upon them, they would be legally persecuted. The option to choose our care providers and birth support team would be dramatically minimized, and in some areas extinguished. Once again, our bodily autonomy and medical choices would be taken away and put into the hands of the state. 

We must preserve the wisdom and teaching of those that are outside of the white-washed education system.

We must stand up for the safety of the birth workers that have tirelessly served our families, helping us to not only birth our children, but honor and uphold our personal traditions and cultures. 

Now is the time to fight for our access to culturally appropriate midwives. 

The words below are my call to action.  

To learn more and add your voice and experience to the cause, check out Hawaii Home Birth Collective.  

“You can keep your label”

Midwife
A simple title 
Defining a truly selfless act 
A serving on the deepest level 
To the reflection of soul in another’s eyes 
Serving the highest power within 
To birth anew 

Midwife 
The attempt at labeling something that is nameless 
Something that is ageless 
A song of sisterhood
that has been sung since the birth of this world
When the goddess birthed her daughters 
Her midwife, the cosmos and the stars 
The ember of that holy service kept alive in the hearts since time immemorial
Forever this song was stirred hands into service 
The igniting of a dance that is performed by the side of a woman in labor 

The stage of this dance never the same 
A field, a cave, a home, a brightly lit room, the wake of a tsunami, the back of a car, a sterile room 
Regardless, we hone the ember of service 
Of care, devotion, love, strength
We welcome the new world 
That is birthed with each babes first breath

Even after all this time 
There are those that don’t understand 
They believe a label 
A word 
Is what we are 
Midwife 
In your confusion you burn us 
You jail us
You beat us 
You label us and try to hinder our service by law 
But you don’t know the song that is hummed in our bones 
The power that makes us dance 
swaying our hips 
Moving our hands
The dance of birth 
We will forever serve 
We will always be there when we are needed 
When in the cry of labor
In the dark of night 
A sister needs us 
We will be there 
No matter the label 
The word
The phrase 
The terminology you try to
Force on us 
Separating us 

We stand tall
Midwives 
Sisters 
Mothers 
Daughters

Regardless of name or label or law 
We know our dance and will
Keep rhythm as one until the end of time 

This organization was started with love and dedication for our community by a group of women experiencing what it was like to be in our childbearing years and mothering here in the islands of Hawaiʻi in the 2000s. Most of us were and are struggling on many fronts to juggle the needs of our growing families, make a living, navigate relationships, and within the mix of it all find time for the things that bring us joy. Daily reminders told us that the changes happening in our bodies were something to fear. Despite Google, unbiased and useful information felt shockingly hard to come by.   

We had to learn as we went, and found resilience and strength in each other. We shared a vision, that together this transformative, transitional part of our lives did not have to be quite as hard as it sometimes felt. We wanted it to be easier and more comfortable for families in our community to find resources and to feel empowered and supported on their journeys into parenthood. That's how the Pacific Birth Collective was born! Now six years later, it is continuing to evolve and grow. 

At the time we started, many people told us that there was no way, we would not be able to maintain it. We fell flat on our face a few times and received some harsh but necessary feedback over the years about the responsibility of holding an inclusive platform, to honor the past while adapting to the needs of modern citizens of Hawaiʻi. Culture is not stagnant, it is alive and molded by the practices, values and needs of individuals engaged in community. For us to successfully work together, we believe it requires a commitment to open non-violent communication, compassion for our struggles both personal and collective, and a willingness to embrace and respect differences in all forms. We are all in this together. 

For this first blog post I would like to share a little about myself and my dream for our collective future. My Name is Charlene Kiana Rowley,  I am a straddler of many things, including my heritage being a white woman who grew up in Hawai’i. I always felt a desire to fit in but had to face the reality that my white western ancestors perpetrated the decline of the culture, language, and sustainable life giving practices of Kanaka Maoli who have cared for these islands for thousands of years. Now at 37, I do feel that I belong to Hawaiʻi. I also feel a responsibility to acknowledge past wrongs and advocate for reparations and revitalization of traditional practices that sustain the health of our islands and her people.

Native Hawaiians and other indigenous peoples suffer from horrendous health disparities. Poverty, food insecurity, addiction and an out of control housing crisis that are killing and displacing them from their ancestral lands. This is not okay. In this uncertain world they hold the key to our survival!! The health of these islands is reflected in the health of her people, and until these disparities are corrected, none of us can thrive.  

This blog is a living breathing documentation by our community, for our community as we seek to elevate and empower our generation to care for our bodies, our families, our communities and our environment with the collective wisdom of our ancestors and the resilience that comes when we care for and believe in one another.  Mahalo nui loa to each and every one of you who contribute your best self to our community so that together we can proudly pass the torch to the next generation. 

With love and respect,

Kiana, PBC Vice President