Legislation to regulate midwives in Hawaiʻi has highlighted a divide among home birth advocates.
A state Senate bill approved Friday by the Legislature and moved to the governor will license midwives and make it illegal for cultural and traditional practitioners to provide midwife services after 2023, The Honolulu Star-Advertiser reported Monday.
Only 339, or 1.8%, of about 18,000 children born in Hawaiʻi in 2015 were home births, according to a 2017 state auditor's report recommending regulation of midwives.
Some midwives with professional certification do not view cultural and traditional practitioners as their peers because many are self-trained and have not completed any formal education or apprenticeships, according to Le'a Minton, board president of the Midwives Alliance of Hawaii.
"It comes down to the fact that because we have not regulated this profession for the last 20 years, currently anybody can call themselves a midwife and advertise that they are providing midwifery services," she said.
Cultural practitioners have said that even though they did not undergo Western training, women should be able to choose the circumstances of their children's births.
"Not everyone views it as a medical event," said Jaymie Lewis, a traditional midwife who began practicing under an apprenticeship with a naturopathic doctor in 2010.
Advocates say the situation is made more difficult because there are no midwife schools in Hawaiʻi.
Alohi Ae'a, who used cultural midwives to deliver two of her three children, said many traditional midwives "have obtained their training and experience through ways other than the American medical model."