Council urges state changes to protect traditional birth attendants and expand midwifery licensure

The Hawaii County Council on Dec. 18 unanimously adopted Resolution 26‑25 urging the state Legislature to amend Hawaii Revised Statutes chapter 457J, Relating to Midwives, to permanently exempt traditional birth attendants from licensure and to expand eligibility criteria for midwifery licensure.

Kristi Duarte, chair of the Hawaii Home Birth Task Force and board president of the Hawaii Home Birth Collective, told the council that in the five years since midwifery licensure began, "out of 40 licensed midwives, 0 are Native Hawaiian, and only 1 is born and raised here." Duarte said the resolution seeks clearer statutory protection for Native Hawaiian traditional practices and new pathways to licensure modeled on standards used in more than two dozen states and recognized by the North American Registry of Midwives.

April Bailey, who identified herself as a home birth and traditional midwife practicing since 1978, told the council that criminalizing traditional midwifery "does nothing to support the community" and asked for support to decriminalize traditional birth attendants.

Sandy Ma of the Legal Clinic, a nonprofit that provides legal services and immigrant advocacy, testified separately on Resolution 27‑25 (intergovernmental agreements) but earlier raised concerns about protections for immigrant communities when law enforcement partners with federal agencies. The council heard multiple voices from the community and then debated the resolution. Councilmember Kaguyaana introduced Resolution 26‑25 and several council members expressed full support, citing access to care and cultural preservation as motivations.

The council voted in favor (recorded in the meeting as eight ayes, one excused) and the chair declared Resolution 26‑25 adopted.

What the resolution asks: It urges the Hawaii State Legislature to amend HRS chapter 457J to (1) permanently exempt traditional birth attendants from state licensure requirements, (2) protect Native Hawaiian traditional and customary practices in statute, and (3) expand licensure pathways that the proponents say are used in many other states.

Context noted in testimony: Proponents said the previous law had created barriers to licensure, that a July court ruling had blocked criminalization of Native Hawaiian midwives, and that the county resolution is intended to support state action when the next legislative session convenes in January 2025.

The council recorded the adoption of Resolution 26‑25 and thanked testifiers for bringing the issue to the record.