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Page 2 .B. NO. <br /> 1 The purpose of this measure is to fulfill the legislature's intent to allow all birth <br /> 2 practitioners to practice legally, while continuing licensure for CPMs and CMs. The legislature <br /> 3 finds that licensure for CPMs and CMs is beneficial, with the addition of locally-accessible <br /> 4 pathways to these practices, such as the Portfolio Evaluation Process (PEP) certified by the <br /> 5 North American Registry of Midwives (NARM), and certain technical updates, such as <br /> 6 alignment of CM statutory verbiage with established CM professional requirements. <br /> 7 The legislature also finds that for many people, decisions about pregnancy and birth are <br /> 8 informed by their personal or community history and culture, and are experiences of great <br /> 9 social, cultural, and spiritual significance,not primarily medical events. As such, there are a <br /> 10 wide range of traditional practitioners—for example,pale keiki, traditional church midwives, <br /> 11 lola, and senba—and birth-related service providers, including doulas, lactation consultants, <br /> 12 birth coaches, chanters, nutrition support people, spiritual practitioners, and others whose care <br /> 13 and advice are important in the well-being of birthing people and their families. <br /> 14 The legislature finds that the Midwife Licensing Program established by Act 32 (2019) <br /> 15 and enacted as HRS 457J was an important step toward recognizing the practice of professional <br /> 16 midwifery. <br /> 17 The legislature also finds that the implementation of HRS 457J provided valuable <br /> 18 insight into the complexity of community birth settings in Hawai'i. Some of the urgent needs <br /> 19 identified in this process include the following: <br /> 20 1. Safety. Research evidence highlighted by the Centers for Disease Control and <br /> 21 Prevention(CDC) and in The White House Blueprint for Addressing the Maternal Health Crisis <br /> 22 (June, 2022) suggests that legal access to culturally responsive care of the birthing persons <br /> 23 choosing, including traditional practices of that persons culture, is strongly correlated with <br /> 2 <br />