Council backs state‑level fix to broaden midwifery licensure after hours of testimony

The Hawaii County Council on Oct. 2 adopted a resolution endorsing state legislation to expand access to midwifery licensure and to protect traditional and apprenticeship‑trained birth attendants. Supporters told the Council the changes are intended to increase access to culturally competent maternity care, especially on neighbor islands and in rural communities.

"This bill that you have included in your legislation package would greatly increase the ability of our state's families to have access to midwifery care," said Rachel Cornell Strumpf, who described herself as the state’s first licensed midwife through the 457J pathway and a member of state midwifery committees. Several other licensed and apprentice midwives told the Council that Hawaii’s current law effectively excludes many practitioners who were trained through apprenticeships or portfolio evaluation processes.

Advocates emphasized that the issue also has an active legal history. "In February 2024, a lawsuit was filed challenging Hawaii's midwifery law on numerous constitutional grounds," said Christie Duarte, chair of the Hawaii Home Birth Task Force, citing a July 2024 court order that limited the state’s ability to criminalize traditional Native Hawaiian midwives and found existing pathways created access barriers. Counsel for advocates has argued that other states recognize apprenticeship or portfolio pathways; witnesses testified that 25 states allow licensing via comparable portfolio or apprenticeship routes.

Licensed practitioners described concrete rural access problems. "When a woman in Ka'u has to give birth, her options are limited," said Tara Compejos, a licensed midwife, noting drives of 1½ to four hours to the nearest hospitals and hospital policies that restrict VBAC and some vaginal births. Mieko Haoke Stewart, also a licensed midwife, urged the Council to preserve the portfolio evaluation process (PEP) to keep training options viable for rural and culturally based practice.

The Council incorporated the item into its legislative priorities (Resolution 630-24) and approved the package, as amended. The resolution will be transmitted to the Hawaii State Association of Counties and the state legislature as the Council’s set of proposed bills and priorities.

What happens next: the Council's action is advisory to the state legislature. Sponsors said the county will continue to work with lawmakers to refine statutory language, including pathways to protect traditional birth attendants while preserving public‑safety standards.