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Testimony of the Hawai'i Home Birth Task Force Chair
and Board President of the Hawai'i Home Birth Collective
Hawai'i County Council Meeting
Wednesday December 18, 2024
AGENDA ITEM: Resolution 26-25 URGES THE HAWAII STATE LEGISLATURE TO AMEND CHAPTER
457J, HAWAII REVISED STATUTES, RELATING TO MIDWIVES, TO PERMANENTLY EXEMPT BIRTH
ATTENDANTS FROM STATE LICENSURE REQUIREMENTS AND TO EXPAND THE ELIGIBILITY
CRITERIA FOR MIDWIFERY LICENSURE
Aloha Chair Inaba and Hawai'i County Council Members,
My name is Kristie Duarte and I am the Chair of the Hawaii Home Birth Task Force created by Act 32
(2019). 1 am also the Board President of the Hawaii Home Birth Collective (HIHBC), an organization with the
largest voting membership of licensed midwives across the state. In addition to our licensed midwife
membership, our membership includes over 30 more birth practitioners. We are dedicated to the preservation,
perpetuation, and diversity of home birth practices and autonomy in home birth midwifery care and will always
support a person's reproductive right to choose who is with them at their birth. Resolution 26-25 is a resolution
which URGES THE HAWAII STATE LEGISLATURE TO AMEND CHAPTER 457J, HAWAII REVISED
STATUTES, RELATING TO MIDWIVES, TO PERMANENTLY EXEMPT BIRTH ATTENDANTS FROM STATE
LICENSURE REQUIREMENTS AND TO EXPAND THE ELIGIBILITY CRITERIA FOR MIDWIFERY
LICENSURE. We are in full support of the resolution and the draft bill that is referenced as attached as
"Exhibit A" in Resolution 26-25.
Act 32 (2019) created a licensure program to regulate midwives with the intention to "allow a woman to
choose where and with whom she gives birth," while providing the benefits of licensure. Act 32 (2019) stated
that, "by the end of the three-year period (2022), the legislature intends to enact statutes that will incorporate all
birth practitioners and allow them to practice to the fullest extent under the law." While significant efforts were
made through proposed legislation every year since 2020, this goal has not yet been achieved.
In response to these birth practitioners not being incorporated as promised in Act 32 (2019), the Center
for Reproductive Rights and the Native Hawaiian Legal Corporation filed a case against the State of Hawai'i
challenging the Midwifery Restriction Law that was preventing pregnant people in Hawaii from using skilled
midwives for their pregnancies and births. On July 23, 2024, the Honorable Judge Shirley Kawamura ruled in
favor of Native Hawaiian Midwives by placing a temporary injunction to stop the criminalization of Native
Hawaiian practitioners and their students. The court found that HRS 457J violates the Hawai'i State
Constitution's protections for Native Hawaiian traditional and customary practices. The injunction is currently
in place.
It should also be noted that in the five years that the midwifery licensure program has been in effect, not
one native Hawaiian midwife has vet achieved licensure. due to Continent -based schoolina reauirements that
are highly preferential to people from outside Hawai'i. Knowledgeable local practitioners are criminalized for
serving their underserved communities while any midwife licensed in another State may transfer that license to
Hawai'i, even without meeting the educational requirements that are set for residents in Hawai'i. It is a highly
discriminatory system that must be fixed. Comoro. TOA
lw_
Ref. To:
Ref. Dote DEC 1 8 2024
This licensure program has run for five years and will sunset on June 30, 2025 which makes the 2025
legislative session the perfect opportunity to pass a law that:
1) Still allows for the licensure program to regulate certified professional midwifery and certified midwifery,
which utilize prescription drugs, modern instrumentation, and techniques
2) Still allows for the legislature's intent of Act 32 (2019) to be fulfilled by allowing all birth practitioners to
practice legally; and
3) Still allows a person the reproductive freedom to choose where and with whom they give birth with, by
ensuring the legality of all practices engaged with by any birthing person.
Mahalo for your support over the past years of legislation related to expanding access to midwifery
licensure and increasing accessibility for reproductive healthcare access, especially in rural areas!
Respectfully,
Kristie Duarte
hawaiihomebirthcollective@gmail.com