Birth keeper Kiʻi Kahoʻohanohano is fighting for reproductive justice and the preservation of native Hawaiian traditions.
Motherhood changed everything for Kiʻi Kahoʻohanohano.
At the beginning of her healing practice, Kahoʻohanohano utilized modalities like lomi lomi (traditional Hawaiian massage), lāʻau lapaʻau (working with medicinal Hawaiian plants) and hoʻoponopono (Hawaiian practice of reconciliation and forgiveness). After the birth of her first child over 20 years ago, the scope of her service to the community has expanded to include her role as pale keiki.
“I’m a kanaka maoli birth keeper trained by my kūpuna and other elders here in Hawaiʻi and so my foundation is a cultural practitioner,” she said. Her practice was formed by combining this cultural knowledge with her first-hand experience as a mother to five children, all of whom were born at home on Maui.
“When I was searching in my first pregnancy for answers, my kūpuna only had so much to offer as far as their answers because they, very much by design, had been stripped of their practices and their cultural identity for a few generations at that point,” Kahoʻohanohano explained.
Her mission is to achieve reproductive justice, heal generational trauma, return the ea (sovereignty) to local families and provide access to cultural traditions, which should truly be a birthright for all who choose to hānau (give birth).
But recent changes in legislation stand to prevent Kahoʻohanohano, and most other birth workers in Hawaiʻi, from being able to legally provide their services.
When Act 32 passed in 2019, it established requirements for midwife licensure like recognition from the Midwifery Education Accreditation Council, which is a level of education and training that doesn’t exist in Hawaiʻi. Though there was an exemption for birth attendants and pale keiki, that exemption has been set to expire July 1.

“Everybody that is calling me is due after July at this point, so I have already had to turn [them] away,” she said, noting the last birth she attended was on Molokaʻi in February.
For a lot of these families, Kahoʻohanohano has been there for the birth of all their children, and those are some of the people she’s having to turn away. “They’re not my clients, we’re ‘ohana,” she said with tears welling in her eyes. “We’re at every birthday party, we’re there every step of the way. They call us every time they have a cough or a cold or an ear infection or their teeth are coming in. I mean, anything, we guide them through their whole childbearing experience.”
Kahoʻohanohano has been involved in the legislative process for 15 years in hopes of remaining legal, and this fight goes all the way up to the United Nations, which she plans to meet with later this year about the injustices against Hawaiʻi and its people.
“I’m not just advocating for reproductive justice in our communities,” she said. “I’m advocating for honoring our people and our home and our lands and our waters. … Our wellness is a reflection of the wellness of our ʻāina and so if we don’t care for our ʻāina, we don’t care for our waters, we don’t protect those things that give us life and perpetuate life, then we really have nothing.”
Once the exemption expires, Kahoʻohanohano plans to continue her fight against restrictive legislation as well as her work with various organizations that are aligned with her mission. This includes entities like Hawaiʻi Women’s Coalition, Hawaiʻi Home Birth Collective and Maui-based organizations Mālama Nā Pua O Maumea, of which she is the founder, as well as the Pacific Birth Collective, which is opening a healing reproductive justice center in Haʻikū.
The brick-and-mortar is slated to celebrate its grand opening on Labor Day. It will be open to the public and offer services like private healing treatments, birth keeper trainings, natural birth education classes for home and hospital support, wellness clinics, support circles, prenatal yoga and much more.