Photo Courtesy of Kalauokekahuli

Birthworkers and birthing people in Hawaiʻi are faced with the sobering reality of systemic problems, which perpetuate disparities in prenatal, birth, and postpartum outcomes for Native Hawaiian and Pacific Islander birthing people and their infants. Not only are socioeconomic circumstances a factor, but cultural barriers may often obstruct community access to high-quality, culturally-based perinatal support as well. 

As demonstrated by the Office of Hawaiian Affairs’ Haumea-Transforming the Health of Native Hawaiian Women and Empowering Wāhine Well-Being reports (2018), “Native Hawaiians have the highest rates of infant mortality in Hawaiʻi-2.3 times greater than Caucasians. There are 8 Native Hawaiian infant deaths per 1,000 live births versus 3.5 deaths for Whites in Hawaiʻi. Alarmingly this infant mortality rate for kānaka pēpē is higher than the U.S. rate of 5.9 deaths per 1,000.” 

OHA continues to report that, accumulated over the course of 10 years, Native Hawaiian mothers in low-income communities birth 45% of extremely preterm births in Hawaiʻi. The extremely preterm births in Hawaiʻi by Native Hawaiian women younger than 20 years old make up 63%, while 76% are Native Hawaiian women younger than 20 years in low-income communities.

Revitalizing ʻŌiwi perinatal practices by foregrounding ʻike kūpuna and indigenous knowledge positively impacts maternal and infant outcomes and empowers Kanaka Maoli and Pasifika birthing people and their families. By centering education, care, and support within a cultural framework, we strive to collectively make a positive impact on our birthing parents by addressing the above disparities.

To these ends, wahine ʻŌiwi birthworkers and advocates founded Kalauokekahuli in 2019, which is a nonprofit organization that supports Native Hawaiian and Pacific Islander birthing people and their families by offering culturally-based perinatal workshops, classes, and services. Further, we seek to enhance the well-being of Kanaka and Pasifika ʻohana with holistic and multi-generational care by drawing upon traditional and cultural practices. Ultimately, Kalauokekahuli endeavors to breathe new life into current perinatal care to huli (overturn) negative birth and postpartum outcomes for Native Hawaiian and Pacific Islander families.

We are grateful to our many community partners past and present, including Hawaiʻi People’s Fund and HMSA for supporting our work, which has given us the opportunity to grow our servicing capacity through our “Ka Laʻi o Hauola” program. With this program, we are able to offer culturally-rooted and high-quality one-on-one prenatal, birth, and postpartum koʻokua (doula) services to Native Hawaiian and Pacific Islander families. These services are provided both in-person and virtually, depending on each client’s specific needs.

We invite you to visit to learn more about our organization and to apply for free services.