Senate Standing Committee on Health and Human Services

Calling the Health and Human Services 1:00pm calendar. This meeting is being streamed live on YouTube. In the unlikely event that we have to abruptly end this hearing due to technical difficulties, the Committee will reconvene to discuss any outstanding business on Monday, May 17, 2025 at 1pm in room 225. Your audio will be muted and video disabled for those who are on Zoom shortly before it is your turn to testify. Each testifier will have one minute to testify.

That's because we have a drop dead time of 3:40pm. Okay, so if there is a technical glitch during your time to testify, we may have to move on to the next person due to time constraints. If we do not have quorum for decision making, which will likely happen if this, for some reason this goes beyond 3:45pm.

The decision making is going to be on Monday, May 17, 1:00pm in room 225, in which event there will not be any additional testimony that will be allowed. So please be be brief. I have read, I have read that much written testimony. I will be reading a list of individuals who submit written testimony for each measure.

We apologize if the closed captioning does not accurately transcribe the names. If you're interested in reviewing the written testimony, please go to the Legislator's website. You'll find a link on the status page for the measure. We appreciate your understanding. And remind you the Committee does have your testimony, that I have reviewed them.

So I encourage you to use your time to either add additional comments or you can stand on your written testimony. So first up, DCCA. Come on up. Right there on the lectern. Please proceed. Is the, is the mic on? Can someone turn on the mic? Okay. Okay, thank you. Yes, please proceed.

Good afternoon, Chair. My name is Alexander Pang, Executive Officer for the Department of Commerce and Consumer Affairs Midwives Program. We stand on our written testimony and are available for questions. Thank you.

Okay, thank you very much. Next up, we have Addison Bullason, Kauai County Council, in opposition. Jen Kagewara as an individual, providing comments. Hawaii affiliate of the American College of Nursery of Nurse Midwives, providing comments. Who is here? Come on up.

Like I said, if you have registered to testify, because we have 900 people who have testified, please start lining up. And as soon as I call your name, just go right on to the mic. Thank you. And for those who haven't registered, there will be time after. Those who have registered to testify. Okay, please come on up.

Hawaii affiliate of the American College of Nurse Midwives. Please. We have one minute.

Good afternoon. My name is Annette Menad. I'm a certified nurse midwife and the president of the Hawaii affiliate of the American College of Nurse Midwives. I have been in continual practice as a certified nurse midwife for 40 years. I live in Honoka, Big Island. Our affiliate represents certified nurse midwives and certified midwives throughout the Hawaiian Islands.

As President of our affiliate, we are. Commenting on the bill and standing by our written testimony. We appreciate this opportunity to address this bill and acknowledge the hard work that. Many have invested in its creation. The most important goal of our affiliate is to move the health and wellbeing of families and communities through the.

Development support of the profession of midwifery. Families and communities need access to our. Professional care, and Hawaii needs to improve. The health of women and newborns. As an affiliate, we want a comprehensive bill to move forward that is complete in supporting the practice of midwifery by the certified midwife. Certified midwifery is a type of midwifery practices.

Thank you very much. Next up, we have Ohia Midwifery Wellness providing comments. Please proceed.

Be careful. There's a step, everyone.

Yes. Okay. Please proceed.

Thank you, Chair. Thank you for this opportunity to speak on this very important topic. I speak on behalf of Ohia Midwifery and Wellness, a private midwifery practice on the island of Hawaii. We stand by our written testimony and offer comment. We appreciate all the attention that has been paid to the significance of midwifery.

We know midwives play an integral role in the betterment of our communities. We support regulation which carries a vision that Hawaii can attract, sustain and grow our own midwives. We are acutely aware of how Hawaii faces ongoing provider shortages, and we want to be part of the solution.

This is why we continue to advocate for amendments to go beyond a narrow lens of harm reduction to genuinely address access to care. Midwives are culturally competent, cost effective, and deliver exceptional outcomes. Policy can address rural health concerns through inclusion of these valuable providers. Amend this bill to allow us to function in a collaborative system of care.

Thank you very much.

So next we have Rachel Colonel Spence of Gentle Beginning Beginnings Midwifery. Please proceed.

Thank you, Chair. I'm here to testify as a licensed midwife. The Midwives Alliance of Hawaii does not speak for me, and I would like to get the exemption reinstated for traditional birth attendance.

With the exception, I'd like to add the requirements for CPR and neonatal resuscitation, as well as what Representative Belatti had spoken to about anybody who had previously had any kind of litigation or things against them in other states that they're barred from coming here and practicing as an exempt provider.

I think that the communities have shown that they really need these traditional birth attendants and that they are valid and needed and hold cultural knowledge from the thousands of years that midwives have been trained by other midwives. And that is valid when schools have only been available for roughly 30 years. Thank you for your time.

Thank you very much. Next we have Rebecca Botello of Birth Believers in opposition. Rebecca. Okay, please proceed.

Thank you. My children will be joining me today.

Okay. And after Rebecca Botello is Dr. Ignacio. And after that is Kirsty Duarte of Hawaii home birth task force chair and collective. So please proceed. Rebecca.

Thank you. I'm a veteran doula and apprenticing midwife for 25 plus years representing 10,000 people and birth believers.

Could you please state your full name? Sure. Thank you.

May I start again?

Yes, please.

Yes, ma' am. Thank you. My name is Rebecca Stewart Botello, Veteran Doula and apprenticing midwife for 25 years, representing 10,000 people and Birth Believers. It is time to acknowledge that statistics on traditional midwifery prove extraordinary efficacy and safety. Doctors want to vilify home birth midwives but refuse to acknowledge the main harms that, many harms that they cause.

The doctor who ripped out my client's baby and broke her collarbone, the doctor who viciously twisted my client's baby's neck, sending it into respiratory arrest. It is time to acknowledge that western birth care is not superior to traditional midwifery, simply different. In closing, I would like to ask you to look at the faces of my children.

Do not condemn my daughter and my future son's wives to state sanctioned rape during their births at the hands of those you have licensed but they don't trust while criminalizing their tutuahine who has been a religious midwife for 50 years, and their traditionally trained aunties.

It's time to rectify the harms that were caused by restrictive457jing by voting no on HB 1194 unless it protects all birth choices. Mahalo.

Okay, thank you very much. Next we have Dr. Ignacio, Hawaii Medical Association in support. Kirstie Duarte, are you present for Hawaii Home Birth Task Force Chair and Collective in opposition? Please proceed.

Aloha. My name is Christy Dward. I'm the President of the Hawaii Home Birth Collective, which represents the largest membership of licensed midwives who will be negatively impacted if this bill passes as is. We respectfully remain in opposition with requests for amendments.

When this midwifery law passed in 2019 it stated in the preamble that the intent was the right for every woman to choose where and with whom she gives birth with. It also promised that over a three year period the Legislature would incorporate all birth practitioners.

But six years later they are still criminalized and our reproductive rights are restricted and stripped away. Attempts were made in 2020, SB 2428, 2021, SB 893, 2022, SB 2661, 2023, SB 1047, SB 2969. And then a lawsuit was filed by the Center for Reproductive Rights. There is no other year to do it. The time is now.

In closing, please protect and include the pet pathway and the birth attendant exemption with consumer protection requirements. Mahalo.

Thank you very much. Next we have Kim Cordery, Aloha Freedom Coalition on Zoom. Kim Cordery, are you present on Zoom?

Not present on Zoom, Chair.

Okay, come on up then. Kim Cordery. And after Kim Cordery is Le'a Minton. And after Le'a Minton is Ricardo Bravo. Okay, please proceed.

Aloha. My name is Kim Cordery. I'm representing Aloha Freedom Coalition. We have 21,000 followers and this bill, if passed, goes against our constitutional rights. I, I'm advocating for the rights of the people and all of those that testified earlier that they should have the right to birth a child in the form that they would like.

Many years ago I gave birth to my two daughters, 1985 and '86. At that time the issues were not forced upon medication, wasn't forced upon me. When I gave birth, I gave birth naturally. And if I was to do that today, I would definitely do an in home birth with a midwife or a doula.

And so I simply said, simply want to say that I believe that women should have the choice of how and where they would want to have their child. Thank you.

Thank you very much. Next we have Le'a Minton in support. Are you present on Zoom? Leah? Yes. Okay. Please proceed.

Okay.

Aloha. I'm Le'a Minton, the Board President for Midwives Alliance of Hawaii. We testify in strong support of HB 1194HD2 as is with no amendments. This bill addresses all important aspects to ensure safe midwife free care is provided to our mothers.

And Keiki in Hawaii, we have heard that the scope of practice for CPM should reference NARM and not the International Confederation of Midwives known as the ICM. It has erroneously been stated that the ICM is for undeveloped countries without credentialing bodies. This is false. The ICM has 136 Midwife Associations representing 117 countries, including the U.S.

Europe, Japan, New Zealand and more. NARM and other U.S. midwife organizations determined that the apprenticeship only model doesn't meet the educational standards set by ICM. NARM's responsibility is to administer the certifying exam. They address scope of practice by stating it's up to the midwife to determine it for themselves and that is not acceptable.

When we pass our driver's license exam, we don't get to decide for ourselves how we drive because the state has rules and this is the same for midwives. We support you very much. Thank you.

Thank you very much. Okay, Next we have Dr. Ricardo Molero Bravo of American College of Obstetrics and Gynecology in support. Are you present, Doctor?

I'm present.

Okay, please proceed. You have one minute. After Dr. Bravo, we have. Excuse me, let me just start naming Kiana Rowley and Bronson Silva. Please proceed, Doctor.

Good afternoon, Chair. The American College of Obstetricians and gynecologists strongly supports HV 1194. ACOG aligns with the United States midwifery education and regulation and Association organizations in requiring midwives to complete an accredited education program.

The regulation of midwifery has been recognized as a crucial step in protecting maternal and newborn health, as demonstrated by national and international standards, including those outlined by the International Confederation of Midwives. Proper licensure ensures that midwives meet essential competency standards, improving maternal outcomes and increasing access to safe community based birthing options.

Research confirms that states with stronger midwifery integration have better maternal and neonatal health outcomes. This bill will promote accountability, facilitate collaboration across healthcare settings and enhance safety by requiring adherence to established professional standards. So we urge you to pass HB 1194 with no amendments at this time.

Thank you very much. Next we have Kiana Rowley of Pacific Birth Collective. Are you present, Kiana Rowley on Zoom. Not present, on Zoom Chair. You're in person. Come on up. I mean, please proceed.

Aloha, Senators. My name is Kiana Rowley and I'm here in my capacity as the board President of Pacific Birth Collective. We are Maui based organization who serves a large volume of community, especially rural families. And I flew over today from Maui to strongly urge the representatives to consider the amendments that we've put forth in our testimony.

Specifically, our community is asking for a birth attendant exemption for religious and cultural practices to be protected for their reproductive rights to choose where and with whom they give birth. This is significantly important. You had 900 testimony people are showing up for this because they want that right to choose.

Additionally, the PEP pathway is half of the currently licensed midwives under HRS457J in Hawaii. We're asking for that pathway to continue. The bridge certificate does follow ICM standards. Please consider these exemptions and we stand on our written testimony.

Thank you very much, Ms. Rowley. Next we have Bronson Silva, Democratic Party of Hawaii in opposition. Lahaina Strong in opposition. Kyopu Riellis, Papa Olal, providing comments. Andrew Carson, Hawaii Patriot, Republicans in opposition. Dr. Michael Ching, American Academy of Pediatrics, Hawaii Chapter. In support. Paige Choi, Healthcare Association of Hawaii and support Chamber of Sustainable Commerce.

Tanya Anisian, in opposition. Bryn Potter of NARM in opposition. Early Childhood Action Strategy and support. Jessica Diaz, Free Citizens of Mauna Lua, in opposition. Echo Yarbery Mahina. Midwives in opposition. Catherine Ritter, Hawaii Aquifers in opposition. Nicole Yesi Calgias, are you present? Okay, please come on up. After Nicole, it's Diana Cantu and Sierra Arakaki.

So please start lining up. Please proceed.

Aloha. Thank you so much. Chair. My name is Nicole Kalegas and I go by Yesi. I stand on my written testimony and want to highlight a few more points.

The Midwives Alliance of Hawaii does not speak for me and I took the path of midwifery of a 10 year apprenticeship combined with distance learning through a meek accredited school. I am a certified professional midwife licensed since 2013 and for the last three years serving families on Maui.

I am here today to strongly oppose HB 1194 without additional exemptions and considerations because it restricts access to midwifery care disproportionately harms rural and indigenous families and criminalizes safe traditional birthing practices and paths to becoming a midwife. This bill does not expand access, it takes it away.

One of the biggest problems with HB 1194 is that it disregards the portfolio evaluation process, a proven and legitimate pathway to midwifery licensing danger. PEP allows midwives to train in their own communities, learning hands on.

Yeah, thank you very much. Thank you so much. I just want to make sure you folks know I want you folks to be to cooperate with all the other people testifying. Like I said, I have a time cut off and 900 people to go through. Okay? So please be mindful. Dinah Cantu, Diana Cantu, please proceed.

And after Diani is Ciara Arataki and Janessa Adams. So please proceed.

Hello, Committee Vice Chair. Chair. My name is Diani and I am testifying in opposition to this bill as an indigenous individual. Just a couple of highlights from my written testimony. I wanted to expand on Rep. Belatti's points.

In the last House floor session, the introducers made a vague exemption in the bill for Native Hawaiian birthing practices, which could still criminalize it. But what about other indigenous and cultural birth practices and practitioners? Native Hawaiian birthing practices are not the only sacred home birth practices in Hawaii.

I have not yet seen a Samba, Lola, Hilot or any Jewish doulas offer support for this bill. If you're not familiar with these identities, they are traditional Japanese, Filipino and Jewish birth workers. None of these many birth workers were acknowledged in any of the hearings by committees or in the language of the bill.

It's easy as a non indigenous and or a person who is not a cultural birth worker to jump to the we need stronger midwifery training and standards for Hawaii position. But that is easier said than done.

If you care about combating inequity in medical professions, start acknowledging that local and indigenous low income individuals will have a significantly harder time accessing non pep midwifery programs.

Sierra Arakaki is next in opposition. Sierra, are you present? Next we have Janessa Adams in opposition. Janessa, are you present? Kayolani Bowers in opposition. Come on up. And after Kayulani we have Alohi and Whitley Rose, all in opposition. And Nicole McNamara in opposition. Please proceed.

Aloha. My name is Kaiolani Bowers and I am in opposition of this bill. It goes against our constitutional rights and our God given rights. I gave birth to Poliahu in August at my home with the help of Dr. Yi. And it not only was the most amazing experience, but it was empowering and completely natural.

It's the most amazing thing I've ever done. And I've been a lifeguard for 16 years helping people. So this is something that I think all women should have a choice to do and the place that they want to do it with the people they want to be with. Thank you for the time.

Okay, thank you very much. Next we have Alohi A. Are you present? Alohi. Okay, next we have Whitley Rose. Are you present? Weekly okay, Nicole McNamara. Okay, come on up. After Nicole McNamara we have Garrett McNamara. And after Garrett is Nicole Miyamoto.

Hello. Thank you. I'm just a mom and I've had three beautiful children at home. And on my last one with Fay, who's three right now, my cousin was also pregnant and she went the medical route in the hospital and she died and her baby's face was Cut during the process.

Also, through all of this, I don't hear anybody talking about the maternal mortality rates in our country and how those are all in the hospital. All of us here have had beautiful, beautiful home births. I'm asking you to take this as a reproductive right, that my daughter, when she comes to the.

That she's going to have a baby. She has a choice with who and where she has her child, because it's not pregnancy and birth is not a medical condition that needs to be controlled. Thank you.

Thank you very much. So, Garrett McNamara, come on up. Garrett, are you present? Okay, next we have Mikomiyamoto. And after Nicole Miyamoto, we have Haley Clark. Kawaii Manitin Naki. Laura Casio. I didn't see her. Kylie Adolfo. Taylor Hamill. Jessica. Dr. Cassandra Simonson in support. Dr. Simonson, are you present on Zoom? Yes. Please proceed.

Okay, let me get my video. It's the fable. It said. Okay, I'm Dr. Cassandra Simonson. I'm a pediatrician in Maui. I'm speaking in support of HB 1194, representing myself, not anybody else. I'm going to stand on my written testimony. You know, I know people are. Have had bad experiences in hospitals, but childbirth is very, very dangerous.

What I see is the results with the baby. The moms can often be helped, and when there's a bad experience, they can be treated, but the babies will have devastating effects just by a few minutes of not receiving oxygen, Cerebral Palsy, strokes, seizures.

I think it is a woman's right to have a choice, but there are ways to do it safely, and this bill helps do that and to try to minimize any harm to the baby, which we do see happen. And so not thinking about the baby's rights as well.

Thank you very much. Much. Dr. Simonson, Haley Clark, are you present on Zoom? Kawaii Manitun Naki, are you present on Zoom? Laura Cassio, are you present on zoom? Taylor Hamill, are you present on Zoom?

Not present on zoom. Chair.

Jessica, are you present on Zoom?

Also not present on Zoom.

Mikima Glatt, are you present on zoom? No. No. Jordan Hawker, are you present on zoom? Penelope Mackenzie, are you present on Zoom? Are you trying Penelope? Okay. Yes, sir. Okay. Penelope, are you trying to. I'm gonna go on to the next person on Zoom, and when you finally get on, you let me know, okay?

Kelsey Amos, are you present on Zoom? Karen. Karen Omahoney, are you present on Zoom?

Not present on zoom? Chair.

Brett Colbus, are you present on zoom? Is that okay? Brett Please proceed. I saw someone.

Yes, thank you. Thank you, Chair. Stand by deter and Committee Member. Hang on. All right. Sorry, Forgot to start my video. My name is Brett Colbus, 26 year Navy veteran living at the beach. I urge the impose. I urge you to oppose HB194.

This bill threatens native Hawaiian cultural birthing practice, undermines reproductive autonomy and restricts licensure pathways for midwives serving rural communities by requiring western centric education licensure. AP1 1194 races apprenticeship based and traditional models disproportionately harming Hawaiian practitioners and families who rely on them to rely on.

The bill's ambiguous exemptions fail to protect native Hawaiian midwife practices violating your constitutional ability to preserve cultural traditions. Current licensure requirements are inaccessible to many local community midwives. Excuse me. Forcing them to seek costly off island training. This reduces care options.

Thank you very much, Brett. Thank you. Penelope, are you finally on? Are you still trying to get on, Penelope? Okay, I'm going to go to the next person. Also on Zoom, Jan Ferguson, are you present on Zoom, Julia Cape?

Yes, I am.

Okay, turn on your radio and turn on your audio and you have one minute and you're not. And you're in support. My video. Okay?

Yes, I'm in support. Mahalo for the opportunity to testify. My name is Jan Ferguson. I've been a certified professional midwife in Hawaii for 33 years. I support HB 1194 HD2 without amendments strongly agree in the standard for midwifery licensure to be a Meek accredited education.

NARM developed the portfolio evaluation process in the early 90s as a means to certify the first certified professional midwives. At that time there was no formal midwifery schools for CPMs. Unfortunately, the PEP system of mentorship allows possible gaps in foundational education and knowledge of updated standards.

Currently there are seven nationally accredited school schools that offer distance learning and many preceptors throughout the islands able to train student midwives with hands on portion of their education. Licensed midwives in Hawaii are autonomous health care providers for women and newborns. It is essential there are no deficiencies in education.

All regulated healthcare professions in our state are required to have accredited education to national standards. Thank you very much. Be different. Thank you.

Thank you. Penelope, Is that you? Penelope Mackenzie? Okay, next one is Julia Kappen. In opposition. Are you Julia? Okay, please proceed.

You have one minute. Turn on your audio.

Hi. My name is Julia Capen. I had the pleasure of having a home birth with my first child, and now I wouldn't want to give birth any other way. Hospital births can be peaceful and beautiful, but I strongly believe that the type of birth a woman has is her choice. I do not understand taking away the rights of women to give birth and get reproductive health care the way that benefits and serves them best.

I am currently pregnant with my second child, and the thought of not being able to choose what kind of birth and pregnancy experience I want breaks my heart for the generations to come. Let's protect everyone's right to choose. If it's not for you, don't choose it. But don't take away the opportunity for somebody else. Thank you for listening to my story.

Okay, thank you very much. Melissa Chong in support. Melissa, are you present on Zoom?

Yes. Thank you, Chair.

Please proceed.

I'm Melissa Chong, LM, CPM, and home birth mom of four. Thank you for the opportunity to offer testimony in support of HB 1194. I stand on my written testimony and want this passed with no amendments. This clarifies the definition of a midwife and does not include everyone who attends a birth.

This is only a way to license a profession. The people can choose who and where they want to give birth with and who and where, just as they did before licensure. And this gives the title protection for the term midwife so that that offers clarity to the public and people will continue to attend as TBAs. And thank you.

Okay, thank you very much. Uala in opposition. Uala, are you present?

Not present on Zoom, Chair.

Caroline Marongiu Flowers in opposition. Are you present on Zoom? Okay. Bianca Isaki in opposition. Are you present on Zoom, Bianca?

Also not present on Zoom, Chair.

Ronnie Texeira in support on Zoom. Ronnie, are you present? Okay, please proceed.

Aloha, Members of the Committee. I'm Dr. Ronnie Texeira, and I'm a chief of OB at Straub in Kaneohe. My testimony is not representative Straub, but as a physician, mother, Native Hawaiian, and concerned community member. I strongly support HB 1194, which does not prevent home births. It just allows midwives that are adequately trained to obtain a license.

It also allows Pale Keiki to continue practicing, which they were always allowed to do under the Constitution. HB 1194 requires midwives to complete an accredited educational program and upholds the gold standard of care of midwifery training. This is important as health is changing. We're dealing with diseases that our former practitioners didn't have to deal with.

We can't rely on years of experience or going through an apprentice program like PEP. All of the bad outcomes I have encountered were preventable and were from a clear lack of knowledge. We can't lower the bar and need to keep the standards high for women of Hawaii and support HB 1194. I look forward to working with licensed midwives through HB 1194 to help provide care to mothers in Hawaii and help facilitate safe transfers to the hospital. Thank you for your time.

Okay. Thank you very much. Okay. Pahnelopi Mckenzie, are you present on Zoom? Penelope?

I'm here. I'm here. So sorry. So I just want to thank you for this opportunity. And I oppose HB 1194, H 22. With the inconsistencies and principles of cultural practice, reproductive autonomy, equality, religious practice and non-discrimination, it threatens to exaggerate the maternal health inequities in our state.

There's zero CPMs that are Kānaka Maoli that are licensed in Hawaii and this is a serious problem. We must change this. Hawaii needs to commit to better collaborative care and that includes everyone. That includes OBs, midwives, traditional midwives, religious practitioners, cultural practitioners for the best care for the maternal health that we have.

HB 199 is based on clinical midwifery, and that's the exact cultural erasure that's gotten us to this point at this time. HB 194 is not written for the safety of mothers and babies. It's written to maintain power and control of a system that's hurting moms and babies. We need to be able to have Japanese, Polynesian, Nigerian, Muslim, Norwegian, Christian, Filipino, Mexican, and Chuukese midwives that are not criminalized. MEAC accredited schools should not be the domination, the PEP pathway must be...

Thank you very much, Pahnelopi.

Please vote no on this. Please vote no on this.

Next we have Makalani Franco-Francis in opposition. Makalani, are you present on Zoom? I mean, are you present? Okay, come on up.

Aloha. My name is Makalani Franco-Francis. I'm here today from Maui. I'm here in opposition, and I stand on my written testimony. But I wanted to also add to request the amendments with the exemption of the cultural and religious exemptions as well as the PEP process.

I'm here as a home birth mother of three, traditional student midwife, and a plaintiff in the state against the case against the State of Hawaii. And I just want to put a face to how this directly affects me in all of those ways as a Kānaka cultural practitioner. But most importantly, my daughter is 16 years old.

She's at the age of she could be a mother, and I'm here to protect her reproductive rights for her future. We are smart as wahine. We have naʻau. We can choose for ourselves. We don't need to be regulated. That's the power that we have as wahine. Mahalo.

Thank you. Next we have Marissa Katz Bellani. Marissa in opposition. Marissa, are you present? Okay. Next we have Alana Siaris in opposition. Alana, are you present? Next we have Roslyn Manawaiakea Cummings in opposition. Are you present? Okay, come on up. After Alana, it's Roslyn. After Roslyn, it's Kaioluhia Miguel Hamakua. Okay, come on up, Alana.

Hi. Aloha. Aloha kākou. My name is Alana Siaris. I'm a resident of Kalauao, Oahu, where I recently birthed my daughter in our home. My Kane was able to catch our daughter as she met us earthside, and he said that it was the best day of his life.

And he wholeheartedly says that every parent should be able to share that experience that we had. Without the extensive knowledge and resources provided to me by the community of birth workers and Native Hawaiian healers, I would not have experienced the sovereign and spiritual birth that I had.

The 'ike of our kupuna pale keiki and the knowledge that has been passed down for generations, that's recorded in the puke Hawaii, different books, and different nukepa and dissertations. That was the first line of resources that I had throughout my pregnancy and throughout my birth. And this is the kind of knowledge, the wisdom that we seek and the kind of care that we look for. For many of us, the first and foremost type of knowledge.

Thank you. Next we have Roslyn Manawaiakea Cummings in opposition. Roslyn? Okay, Kaioluhia Miguel Hamakua in opposition. Kaioluhia? Karese Miguel-Hamakua in opposition. Come on up. After Karese, we have Sara Kahele and Kelly Stern.

Hi. Good afternoon. I'm in opposition of HB 1194. I just want to say that my midwife throughout my pregnancy emphasized emergency preparation, making it clear that if I needed to transfer to the hospital, she would fully support my decision. I understand how critical it is. I'm a paramedic with over 10 years of experience.

Having her be supporting me if I needed to go to the hospital and having the ability to monitor my unborn baby is of utmost importance because paramedics do not have that ability on the ambulance. We don't have that training. This bill threatens the continuity of care from home to ambulance to hospital. Also, doctors, it's really upsetting to hear all these doctors in support of it because doctors do not make medical decisions for their patients.

They only give their expert opinion. The patients are the ones that make the final call. So it's upsetting to hear that doctors are taking choices away from their patients when they should not be. That's unethical. So I encourage you to vote no on this bill. If you do vote yes, I encourage you to have the same conviction when speaking to mothers about who can and cannot be in the birth room during their most vulnerable moments.

Thank you very much. Sara Kahele, are you present? Come on up. And after Sara is Kelly Stern. And after Kelly is Pua O Eleili Kelsi Pinto.

Aloha. My name is Sara Kahele. Kahale is my last name. I'm from Ewa Beach, and I went to Iolani. All the things that you fear from Hawaii, you want to know. I'm normally I testify as a mom, but today I'm testifying as a birth worker who's been doing birth work and attending births for almost 16 years.

When the law changed, 2019 or whatever, I went back to school after already doing three years of school because the school that I went to already for three years and paid for was unaccepted by the state. So I went back to school and paid another $20,000 to be in accordance with your new law.

And that school went under a new director, and that director ignored all my emails when I tried to get some more counseling. And again, after paying these $20,000. Okay, so that's the school that you guys approved, and that's the school that I had asked me to. They would not help me. They would not help me.

And so I'm unable now to help women. I've turned away multiple women because I can't obtain, get what I need to do from school. And three of those women last year said, okay, fine, I'll just do it by myself. And so that's what's happening now. Okay. All right. Thank you.

Thank you so much, Sara Kahele. Okay, next we have Kelly Stern. Kelly, are you present? Pua O Eleili Kelsi Pinto, are you present? Come on up.

Pua O Eleili Kelsi Pinto is my name, and I'm a Native Hawaiian cultural practitioner of childbirth. And this bill, the language and this bill of the scope and the definition of what midwifery is extremely problematic and it makes me feel unsafe. And these thoughts and feelings are reaffirmed by lawyers like ACLU and Native Hawaiian Legal Corporation that this we are not actually protected in this law and we are we are subjugated to criminalization.

The reoccurring statement in this bill, the Legislature affirms that the practice of midwifery under the act does not include Native Hawaiian practice is also deeply problematic. While it is often framed as a protection statement for Native Hawaiian practitioner, it actually delegitimizes our practices by implying that they are something other than midwifery.

The reality is that Native Hawaiian traditional encompasses a form of midwifery that out of people that our people need and continue to ask for. Furthermore, the assertion that the practice of midwifery according to the act does not impede one's ability to incorporate provide cultural practices overlooks the fact that...

Come on up. Also in opposition. After Ghia Borges, we have Dr. Rachel Struempf in opposition. Please proceed.

Hi. My name is Ghia Borges. I am living in Hau’ula in the Ko’olauloa district, and I strongly oppose HB 1194. I am a mother of two and I gave birth to both my babies at home in Hau’ula safely and beautifully in the care of my skilled and qualified midwives, including a traditional midwife. And also when I was pregnant with my firstborn, I received dual prenatal care.

One from an, I saw my OBGYN as well as my midwife. And my experience, I experienced firsthand why so many mothers and families choose a home birth over hospital birth and choose midwives and cultural birthing practices practices over Western medical models. This bill does not protect our reproductive freedom and it also fails to expand access to midwifery licensure, which is critical care that our mothers and our communities need and deserve. Thank you for your time.

Thank you very much. Next we have Dr. Rachel Curnel Struempf, CPM in opposition. Dr. Rachel.

Licensed midwife Rachel, not doctor, but thanks. Okay, so Rachel Curnel Struempf, licensed midwife. MAH does not speak for me, the Midwives Alliance does not speak for me. But who does is North American Registry of Midwives. So I'd like to take a second to read Brynne Potter's testimony as the Director of the North American Registry of Midwives who credentials the CPM. NARM is the credentialing body that issues certified professional midwife credentials to midwives in all 50 states who have met the standard eligibility requirements and passed the NARM exam.

The CPM credential has been accredited by the National Commission for Credentialing Agencies. Who does the ACNM as well, nurse midwives. For 23 years, the NCCA is the same accrediting body that oversees CNMs and CMs credentials. And this accreditation validates NARM and follows the quality assurance standards for all of its processes to determine eligibility to take the NARM exam and become a CPM and recertify every three years.

NARM also issues a bridge certificate which allows CPMs to demonstrate additional skills and knowledge to align with the US merit consensus statement regarding the CPM education for states that do not have MEAC accredited schools. The portfolio evaluation process is specifically designed to ensure that there is a pathway for NARM to evaluate candidates.

Thank you very much, Rachel. Okay, next we have... Excuse me, Dr. Nguyen in opposition. Dr. Ye Nguyen, are you present?

You called my name, Kelly Stern. I stood in line, but I didn't hear you call me up so I can... I'm Kelly Stern. Yeah. I mean, I'm in strong opposition of this bill, HB 1194. I've had, I've had three births at home, all of which have been in the comfort of my own home with no licensed professional. That was my choice and that's how I birthed to feel safest in my own body.

I think it's important for all women to choose what makes them feel safest and not be altered by any sort of governmental or external idea of what's safest for them when it's their own personal body and their own personal choice of what they're doing. I have a daughter. This is a reproductive rights issue, and I want her to be able to choose whatever she wants for her birth and how she feels safest. I'm grateful to be here today with all the other people who are opposing this bill.

Thank you very much. Okay, next we have... Excuse me. In person, we have Erika Fantop. Are you present, Erika? Oh, I did. I'm sorry. Dr. Ye Nguyen. Okay. Sorry.

That's okay. Thank you, Senators, for being here. I just want to say that I'm a licensed naturopathic physician, a home birth mama of two. I have a 15 year old and 11 year old, both of whom were born at home. I was also not only supported by my naturopathic midwife sisters, but also by my OBGYN.

She never once called me geriatric or put the fear of birth in me, so for that I am forever grateful. It is important to know as lawmakers where your bias is around childbirth. Are you coming from trauma? Are you coming from fear? That's the one thing that I've noticed in this bill, this bill clearly divides.

It comes from fear, trauma, and control. We need to work together. When somebody hires me, I tell them, I said, you have to leave your ego at the door. Like the baby chooses. And if we need to go to the hospital, we will go there, and we need to be accepted with open arms.

Thank you, Dr. Nguyen. Okay, Erika Fantop, please proceed.

Hello. My name is Erika Fantop. I live on the island of Maui. I am a student actively participating in the apprenticeship program with a NARM certified preceptor. I'm also a home birth mother of five children. I'm dedicated to supporting my community and women's reproductive rights. And without the PEP process, I'm not able to do so.

I urge you to recognize the PEP process because it's a legitimate and valuable route to licensure, NARM certified. And by supporting House Amendment 2, you allow me and other aspiring midwife students to pursue their passion, their dream of supporting our community. Thank you.

Okay, thank you very much. Excuse me. Before we go on, do we have any questions of DCCA so that we can excuse them? Okay, you're excused. We don't have any questions for you folks at this time. Thank you. Okay, next up on Zoom, we have Violet Aarona. Are you present, Violet? Summer Yadao on Zoom. Are you present, Summer?

Not present on Zoom, Chair.

Neither one of them are, huh? Okay, next we have, of those who have registered... Okay, come on up. Your name?

Alohi Aea.

Okay, thank you. I apologize.

I'm sorry. Thank you so much. In a Kānaka, in ʻaumakua, if you feel that this bill, HB 1194 and all those who vote for it are protecting the health, safety, religious, and reproductive rights for you, your partners, or your keiki, protecting you, put your hand up. Stand up and put your hand up.

If you feel this bill is protecting you and your rights and your safety. Please note. If you feel like this bill is not and all those who vote for it are not protecting your health, your safety, your religious, your cultural, your reproductive rights for you, your partners, your families, your keiki, put your hand up. If you feel that this bill is violating you, stand up and put up your hand. How do we not see this?

We see this. We hear it. Thank you very much.

Please do something about it then.

Thank you. Is Tara Mattes in opposition present? Tara? Next we have Olivia Manayan on Zoom. Olivia, you present on Zoom? Okay. Dani Dougherty, CPM, Island Mamas Midwifery in support on Zoom. Are you present?

Hi. Yes, sorry. Olivia Manayan is present. Hi. Good morning or good afternoon. I'm Dr. Olivia Manayan. I'm an OBGYN practicing in Honolulu. I'm in strong support of HB 1194, HD 2 without amendments. My written testimony is as stands. I've chosen to provide oral testimony on behalf of my patients to ensure that they receive the care they're entitled to in choosing a midwife. In my last five years as an OBGYN, I have taken care of a number of patients who have sought care at a hospital after a home birth attempt.

In many of these instances, there have been negative outcomes that could have been preventable if they had been recognized by a trained provider. This bill is not meant to restrict a pregnant person's choice on who she has present at her delivery. It's meant to empower her so that if she chooses a licensed midwife present at her delivery, she can be confident that the person she chose is trained to a standard of care that allows for a safe, caring environment for both mom and for baby. Thank you.

Okay, thank you very much. Next we have Jaymie Lewis in opposition. Jaymie, are you present? Okay. Come on up.

All of you, thank you for being here to stand up for all of those who cannot be here. Thank you. Thank you for taking the time to listen to all of our testimony. Very appreciative. My name is Jaymie Lewis. I am a, I was a community birth worker. I am a mother. And what I really want to sort of drill in this time as my probably 10 millionth testimony on this bill over the past 10 years is that this noise that we've been bringing to the Capitol has never been about anti-licensure.

It's actually about equity. It is about ending the criminalization of birthing people's choices, ending the politicalization and the weaponization of women's bodies. Reproductive justice does not end at abortion rights. It is about honoring a woman's entire reproductive journey. Thank you so much for letting me speak.

Thank you very much. Next we have Malama Na Pua O Haumea, Kii Kahoohanohano in opposition. Are you present, Kii? Okay. Oh, you're a present in person.

I was able to make it. Yes. Mahalo nui for the opportunity to testify. I appreciate so much all of you being here. And to Senators, mahalo for hearing us. I know that this has been an issue ongoing for over a decade. I do remember when it first was introduced calling you specifically, Senator San Buenaventura. I was referred to you because I was told that you are the reproductive justice champion. And today there's many things I could say. I stand on my testimony, but I'm begging you and pleading you to stand in who you are as that champion.

We need you today and as we move forward to assure us that we have the protections to cover our cultural practices, our religious exemptions, and for pathways for those that come after us. Right now, when I started this, it was to fight for my elders that would be illegal even as CPMs because they were PEP midwives. I also want to say the midwives that you hear testifying in support, they're all PEP midwives.

Okay, thank you very much. Next we have Trinette Furtado. Trinette, are you present? Trinette Furtado. Next... Is Trinette Furtado present? Next we have Allie Biggerstaff. Are you present on Zoom? Either Allie or Trinette. Okay. Please proceed. You need to speak up, Allie or Trinette, and identify yourself.

Hello. This is Trinette Furtado. Can you hear me? Aloha mai. I am a Kānaka, a mother who had a midwife from my birth, a cultural practitioner, and a Kahu. I stand on my written testimony, and even with a minute each, I believe we will all make our voices heard to this proposal as presented. I ask that you present thoughtful and prudent amendments to it.

I am disgusted at the attempt to completely wipe away centuries of traditional and cultural practices that have witnessed and guided the births of many of our Kupuna, and some of us alive today with a we know better than you for you mentality that isn't a good look on a public servant.

This proposal is an attempt to colonize, westernize, and criminalize indigenous birth practices. When Ohana have birth sovereignty, the entire experience is one that feels safe, gives them confidence, and is attuned to the family unit as a whole. It is imperative that the Ohana have access to anyone needed to safely conduct this practice. Imperative for my daughter to have...

Thank you so much, Trinette. Next is Allie Biggerstaff, also in opposition. Ali, please proceed.

Hi there. I was pregnant with both of my children for 41 weeks and birthed them both safely at home with no intervention from my amazing and skilled midwife. This bill would take away my choice to birth at home if I'd be pregnant over 40 weeks. I trust my God given ability as a woman to know what my body is capable of. Please vote no and support our rights as mothers.

Thank you very much. Next is, we have Margaret Ragen, CM, LM, MS, providing comments. Margaret, are you present? Please proceed. And after Margaret is Noelle Campbell.

Please, please don't start the timer yet. Thank you to the... Thank you, Chair. My name is Margaret Ragen. I stand by my written testimony and wish to provide comment on the certified midwife. I urge you to consider HAA suggested amendments to bring this bill into alignment with ACNM standards and incorporate existing Hawaii Revised Statutes and administrative rules to reflect certified midwife credentials equivalents to the CNM. We need to get it right in the statute.

It's unfortunate that the DCCA leadership has left, but as you may know, we have worked very hard the past three years to adopt interim rules and correct inadequacies in Act 32. Of the advocates that are here, many of us have worked diligently with DCCA to try to address change. It has to be correct in the statute.

We need to move forward to integrate these valuable providers who do not wish to remain as outliers. Codified midwifery service to be eligible for reimbursement to expand access to care, support Hawaii based pathways for midwifery practice and accommodate choice by establishing a...

Thank you. Noelle, are you present?

Not present on Zoom, Chair.

Thank you very much. Next we have Kehaulani Avicolli. Kehaulani, are you present? Come on up. In opposition.

Aloha mai kākou. I'm testifying today in strong opposition to bill, HB 1194. I'm a mother of two, birth worker, and lactation counselor for almost 10 years now. This bill is discriminatory and restrictive and has no place in our birth community. Birth is sacred, individualized, and during one of the most transformative times of our lives. We deserve the right to choose how we want to birth and with whom we want to be supported by.

There needs to be exceptions for all of us to practice our religious and cultural beliefs as it honors our very natural being as people. We need the pathways for midwives to be accessible and recognized so we have practitioners of all backgrounds to best support all families. I have had the pleasure of working alongside many of these midwives whom I call friends.

They are highly skilled, trained, knowledgeable, hardworking mothers of healthy families and servants of their communities. I have seen firsthand over and over how home birth outcomes exceed standards because not only are the families thoroughly taken care of all throughout pregnancy, they are supported far to the... Mahalo.

Momi Nobriga. Also in opposition. Momi, are you present? Momi? Okay, coming. Okay. Come on up. After Momi, we have CJ Macias. Please proceed, Momi.

Aloha. So I cleared my schedule today of my work so I could be here from Big Island to come and testify in opposition unless there are going to be, as it stands, and encourage amendments. I've birthed three children at home. And my midwife, who proceeded over 3,000 births, is now criminalized and would be continued to be criminalized under this bill. All my babies are happy and healthy.

And I felt supported, not only during my pregnancy through my labor, but in the critical period of postpartum. She came to my home the day after my birth to make sure me and my baby were okay. She came to my home once a week for the weeks after the birth to make sure my baby and I were okay. And we still have a relationship. She has a relationship with my children today. Thank you.

Next we have... Sorry, Wyonette Wallett in opposition. Okay, CJ, come on up. I'm sorry. I did... I apologize. Please proceed.

Aloha. My name is CJ Macias, and I'm in strong opposition of HB 1194. I'm an uncle, a massage therapist. I'm an uncle to two sweet girls in here and to every child that I meet in this life. I'm a massage therapist, health advocate.

I've spent countless hours breaking down scar tissue, holding space for traumas and injuries that mothers have suffered from being pressured into unnecessary procedures in the hospital during the birthing process, which is not a health condition that needs intervention.

I strongly urge whoever it is that has the power to stop this bill to look at the numbers of mortality rates in the hospital. It's ridiculous to continue this protocol based on the efficiency. It's a sacred matter of life and death. There are consequences for disrespecting the laws of nature.

Please, for the sake of humanity, stop this bill that defiles the most sacred right of man and woman that there is. There's good wisdom in the Hawaiian people. Let them do their thing, give people the options, and don't press them into God knows what. Thank you for listening.

Okay, next we have Rebekah Moyer on Zoom, also in opposition. Rebekah, are you present?

Not present on Zoom, Chair.

Okay, next is C. Lynn Velasquez in opposition on Zoom. C. Lynn, are you present? Okay, next we have Christy Kalama in opposition on Zoom. Christy Kalama, are you present?

Not present on Zoom, but C. Lynn Velasquez...

Okay, next we have Brissa Christophersen in opposition on Zoom. Brissa, are you present?

Aloha. Yes, I'm present. Aloha. Brissa Christophersen. Mahalo for the opportunity to share my strong opposition to HB 1194. I recently gave birth in August of 2024 in the only Maui hospital that we have here to deliver babies. And I had a very traumatic experience. The doctor who delivered my baby was trained in the OBGYN practice. I talk more about it in my written testimony, but he created a scenario that was filled with harm. And I plan to have more babies in the future.

This bill would infringe on my rights to choose who I would like to birth with. As Kānaka Maoli, it's very important to me to perpetuate traditional practices upon naʻau and not have to worry about being criminalized or for my Pale Keiki to be criminalized either. I want to birth with whomever I feel safe with. Please support Ohana's right to choose with or choose who they choose to birth with and where. Mahalo.

Thank you very much. Next we have Krista Brunty in opposition on Zoom. Krista, are you present?

Not present on Zoom, Chair.

Okay. Mieko Aoki for Aoki Birthing Care in opposition on Zoom. Are you present Mieko? No.

She is present, Chair.

She is? Okay. Please proceed.

Okay. Can you... Is my unmuted? Okay, great. Hi. My name is Mieko Aoki Stewart. I'm a licensed midwife, and I strongly oppose HB 1194. Midwife Alliance of Hawaii does not represent me whatsoever. I stand on my written testimony. I want to make sure you understand that midwifery is a way of life and that our life is built on birth culture. And that for us to continue to breathe life into the birth culture or really your ohana and community, we have to nourish our lineage for the future.

And I raise midwives like our keiki, like in our home, in close relations through direct life experience. And that is traditional education. We don't need any more ACOG, AMA, compartmentalized, linear, limited standardized thinking. Right. Like 65th in maternal mortality and morbidity. That's their record. We need something different. And you can respect this way of life and how you can do that is to amend the bill to include the...

Thank you very much. Maeha Bush, are you present on in opposition? Maeha Bush on Zoom? Okay. Alana Koa. Did we talk to Alana Koa on Zoom? Okay. Next we have... Anne Dericks, are you present in opposition on Zoom? Anne?

Not present on Zoom, Chair.

Okay. Carie Kwan in opposition on Zoom. Are you present, Carie?

Chair, Anne is present.

Okay. Turn on and identify yourself.

Hi. My name is Dr. Anne Dericks. I'm not able to turn on my video at this time. I'm a licensed physician here in Hawaii. I'm a mother of three, all born with midwives, both licensed and traditional. And I have specialized training in midwifery. And I want to be clear that I strongly oppose HB 1194. For one, family should not face criminalization for supporting their loved ones during birth. We should have the right to choose who attends us.

The pathway to legal midwifery will be too restrictive, and this bill will criminalize traditional and cultural midwives. Midwives that our communities trust and seek out. History has shown us that criminalizing cultural and traditional midwives does not eliminate them. It simply forces them underground, just as it did in the past when midwifery was illegal in Hawaii. And if this bill passes, it will put women at risk.

By making it harder for midwives to provide safe, open, and legal support, especially in cases where they desire hospital transport. I want my daughter to have the right to choose who attends her birth. And that choice belongs to her and to all women and not the government. If this bill passes, it will be a step backward in our history. Please vote no.

Thank you very much. Next we have Daniela Martinez in opposition on Zoom. Daniela, are you present? Thomas Richmond in opposition on Zoom. Are you present, Thomas?

Not present on Zoom, Chair

Sarah Radke, are you present in opposition on Zoom? Sarah? Oh, Daniela, please proceed.

Aloha. Thank you for your time, Senators. There are... I oppose this bill as it stands. I'm a licensed midwife practicing on the island of Oahu. And there are three main amendments that if are made will resolve a lot of the issues that people are standing in opposition here today.

One, add in the birth attendant exemption that existed in the first three years of the current midwifery law as is. That will solve a lot of our religious, cultural issues at the moment. Number two, NARM is the credentialing body for CPMs, which is the premise for licensure here. NARM accepts two pathways to become a CPM.

PEP trained and a MEAC accredited school pathway. Let's accept the pathways that NARM, the credentialing body, accepts. And the last amendment is the bill currently states that CPMs must refer to the ACNM guidelines. We are not CNMs. We have our own professional organization, NACPM. Please adjust amend the bill so that...

Okay, thank you very much. Next we have Catherine Rault in support on Zoom. Catherine, are you present?

Yes, I am present.

Please proceed.

Hi, Members of the Committee. My name is Dr. Lulu Rault. I am a board certified OBGYN. I offer strong support for HB 1194, HD 2. Midwifery care is a proven strategy for addressing disparities in maternal health outcomes, particularly among historically underserved communities, such as rural areas.

This bill ensures that all midwives who provide maternity care meet professional competency standards. This bill does not take away options, it enhances them by ensuring that every pregnant individual in Hawaii has access to safe, high quality care. I respectfully urge the Committee to pass HB 1194. Thank you for the opportunity to testify today.

Okay, thank you very much. Next we have Evaluation Centre for Complex Health Interventions, April Nakaima providing comments. Are you present, April Nakaima? Please proceed.

Aloha mai kākou. Mahalo. I'm April Nakaima. Born in Kalihi on this island, graduated from Kamehameha, and lived in several countries working as an evaluator of health programs and population health. And in that capacity I learned about that there's very good evidence in favor of midwifery.

And in light of that, I think as a state we should be doing what we can to encourage midwifery and that we should make pathways that allow local midwives to flourish rather than restricting the pathways. So I encourage the PEP pathway to be put into the bill. Mahalo for your time.

Thank you very much. Next we have Jessica Brazil in opposition.

I'm sorry, I think you... I passed it by my name. My name is Wyonette Wallett.

Your name?

Wyonette Wallett. Yes. Aloha. Let me get organized here. Okay, sorry. Okay. I this pleading with you to oppose HB 1194. I speak from Wyonette. I speak from a voice of Hawaiian for my Hawaiian people. As a traditional Hawaiian practitioner and a student of Pale Keiki, this bill is... We created the...

It's completely flabby and it has a stench of racism, medical monopoly, and corrupt. This will violate my rights as an indigenous person to practice and have full self determination and full autonomy to practice what I need to practice. And supporting this would just perpetuate medical violence upon women and children and families.

And continuous on. As far as the PEP process, I would ask you to support that. There's many pathways to a, the same place. You guys are all PEP process people. You worked in the community, the community taught you. And now you guys are brilliant cabinet of people making...

Next is Camille Shelton in opposition. Camille, are you present? Next we have Juanita Delagarza in opposition. Juanita, are you present? Okay, on Zoom, we have Jessica Brazil. Are you present, Jessica, on Zoom?

Not present on Zoom, Chair. But we have Camille present on Zoom.

Okay, Camille, why don't you proceed?

I'm actually in person.

Okay, come on up.

Hi. I'm Camille Shelton. I'm a doula out here as well as a mother. My 2 year old son right there, and I'm currently 20 weeks pregnant expecting my second son. With my first birth, I unfortunately had to elect... I was forced to elect for cesarean because of hospital policy and lack of proper training where I could have essentially just had my breech baby with a midwife.

I am choosing to have a midwife this time for my second birth with the hopes that I don't have to be forced into a medical intervention that I don't need. I'm asking that you oppose this bill to support my reproductive rights as well as any other birthing person. And I stand by my written testimony I've already submitted. Thank you.

Juanita Delagarza. Juanita, are you present in opposition? Next we have Sheryl Uy in opposition. Anna Bell Nimmo in opposition. Anna, are you present? Okay. Next we have Dr. Merciful Ananda in opposition. Dr. Ananda, come on up. And after Dr. Ananda, we have Jennifer Barillaro.

Aloha. My name is Dr. Merciful Ananda. I am a licensed naturopathic physician and I attend home birth. I received my midwifery training in Oregon at medical school. I also have a medical master's degree in global health and was going to go train in Oaxaca or in Ghana with traditional midwives, with unlicensed midwives.

However, I graduated during the pandemic and all those programs got shut down, and I was able to secure a residency here on Oahu. And I attended 100 births out of hospital in a year. Because, in Covid times, there were many people that did not want a birth in the hospital because of all the policies, and they didn't want their babies or mommies to get sick and they wanted their families to be present.

Now we have measles going around, so we have lots of folks that are wanting to birth out of hospital. I had three babies at home with wonderful midwife teams, some traditional, some cultural midwives, and some licensed. So there should be more options, not less. Let's build bridges, not tear them down. Oppose 1194.

Thank you very much. Next we have Jennifer Barillaro. Jennifer, is that you? Come on up.

I'm Anna Bell Nimmo. You... Yes. Okay. I'm a mother of five, and I've had hospital births and home births, and the hospital births were a lot less favorable for me. I've spent a lot of money as a student midwife, and I want the right to practice here. And this bill will take away my rights as a mom and my family and it will take away the rights for me to practice in Hawaii. And I oppose this bill.

Okay, thank you very much. Next we have Jennifer Barillaro. Jennifer, are you present? Okay. Next we have Mary Healy on Zoom. Mary, are you present on Zoom? Okay, next we have... Okay, please proceed, Mary.

Here to ask you... Oh, okay. I'm here to ask you to vote no on this bill. I'm not a mom yet and I'm not a midwife. I'm here because I don't trust the professional competency standards this bill proposes. I'm here to support moms, babies, and those they choose to be present at the spiritual experience that is birth. Hawaii is the most remote island chain in the world. To echo earlier testifier, more options, not less. Thank you for hearing my testimony. Please vote no on this bill.

Okay, thank you very much. Next we have Carrie Ann Shirota of ACLU in opposition. Please proceed.

Aloha, Chair.

Okay. Okay. Please proceed.

Aloha. Carrie Ann Shirota, policy director, attorney on behalf of the ACLU Hawaii. We strongly oppose this measure. We have introduced and asked for amendments, and we're just going to get to the heart of this. This is about reproductive autonomy and freedom.

While the US Supreme Court and at the federal level, they're chopping away, taking away, a full on assault on our reproductive rights. The Hawaii Legislature should not be doubling down and joining them. We are relying upon you to continue our legacy of reproductive justice in Hawaii.

It is on you because we've gone to the House and they've ignored our messages for amendments. So we're looking to the Senate to uphold our constitutional rights, traditional customary rights, religious spiritual practices, and the PEP pathway. For some reason we're relying upon ICM international standards when we should look to NARM. Please, Senators, respect our protected rights.

Alfred Medeiros. Are you present, Alfred? Alfred, are you Alfred Medeiros?

Aloha mai kākou. I stand in complete opposition of SB 1194. First off, mahalo, wahine. Mahalo, mothers, midwives. I'm sorry you guys have to go to this continuously. Yeah, the people up there sitting up, you know, for us, you guys are all about votes to get into your guys seats. Over 900 people in opposition, right?

The votes stand for the people, for the wahine. So please make the right choices after all this. For everybody on Zoom that's talking about all this type of stuff that the nurses and this and that. They're indoctrinated to believe that the hospital is the only place where birth can be conceived to happen.

When natural birth is actually better than these hospitals. If you guys state the facts, you guys can see Tripler killed so many babies in Hawaii, right? You guys should know this, right? Why not help them instead of trying to criminalize them?

What is so wrong about wahine doing what they got to do to ensure that there's a life becoming of it, right? Why does the government always have to overreach and put their stamp on things to control things? Enough is enough. Regardless of what happens in this situation, wahine, I'm a part of three different ʻāina across, and you guys are welcome and free to do. Mahalo for you guys.

Desiree Mendez in opposition. Desiree, are you present? Okay, next we have Laulani Teale in opposition. Laulani, are you present? Come on up. And after Laulani, we have Ramona Hussey, also in opposition.

Laulani, please proceed.

My name is Laulani Teale. I come from Kolaupoko. And today I would like to speak as a student of A great medical Doctor, Dr. Richard Kikoni Blaisdell, who always taught that E is the one thing that our people need in order to restore our health. So I would like to point out some numbers.

There are Z who are licensed as midwives in Hawaii, who have ever been licensed in Hawaii. 97% of those who hold licenses are not from Hawaii originally. And those. And this bill would perpetuate and increase that. Are there horror stories? Yes, there are horror stories. And I'd like to say why.

The main reason is because of delays of transport. And the reason for those delays is because people are afraid to transport to the hospital when they're giving a home birth because of persecution. And this persecution began in 1893 with the persecution and it continues to midwives, and it's continuing today.

I ask you to stop that persecution, to be real, to support real safety, real transports, when the real things that our community needs. We have an extremely high maternal death rate. We need to bring that down. Not one of those deaths is associated with a home birth.

So these are the people who have served the fire victims of Lahaina. These are the people who serve our community, who keep our mothers safe. Let's be real about what's really happening here.

And we need to stop this right now and perpetuate the rights of those great practitioners giving birth, our Hanal practitioners, who have the right to determine who touches their private bodies during the sacred practice of Hanau Mahala.

Okay, so no one else having registered to testify, could you excuse me, your name?

Marissa Katz. I. I was called earlier Marissa Katz Balani.

Yeah. But anyway, after Marissa, whoever wants to testify that hasn't registered, could you start lining up? We have 500 in opposition and 50 in support, but please proceed.

Okay. I'm also in opposition of SB 1194. I am with my daughter here who is six and a half weeks old. I was. I'm also here with my doula and my midwife. I had a really safe experience through pregnancy and also with home birth and postnatal care, up to six weeks checkups.

And I am very, very much in support. I had a precipitous birth for a first time birth that's very rare. I had less than a three hour birth from the time she broke my water and was extremely safe in my own bedroom, on my own bed. I think everyone should have the right to their own reproductive rights.

Pre, Post and during their births. Thank you so much.

Okay. Thank you very much. Okay. Identify yourself. And I just want to make sure. Did anybody who register that I'm. That I did not mention. Yeah. Sarah Radke. I'm sorry. Let the. Let the two people who raised their hands that have registered, and for some reason, I went beyond them. Rachel, I. I have three hats today. Okay.

Okay, Rachel. Other people talk first. Rachel, please.

All right.

And I know it came all the way from the island of Hawaii. It's okay. I'll test. It's my organization. Okay. So whoever registered that. That I forgot to name, please proceed.

You registered? I read.

And, yeah, no, but, Rachel, you're very top. So. Yes. Okay. Identify.

Aloha. My name. Aloha. My name is Tel Brandon, and this is.

Excuse me. Excuse me, Chair. We still have a few Zoom participants that didn't get to testify yet.

Okay. Okay. So one. We have this person who already identified himself testifying. Then we'll go on to the Zoom people. Okay, go ahead.

Aloha. My name is Telephero Brandon. This is Telephero, my firstborn son. That's my daughter, Oceana. A couple years ago, we gave birth to her, and I wanted to provide protection, and I wanted to honor our family by getting her into the best hospital in Hawaii, which I thought.

And they ended up forcing us to do a C section, and they broke her leg pulling her out. Breach anyways. And, you know, they didn't. Two days we were in the hospital, they didn't even know that her leg was broken. We had to find it out on our own while she was screaming in the night.

A couple of years later, we decided to have another baby and decided to go with our awesome midwives, Yee and Jamie. And they gave us a home birth that we cannot believe. Even though Teleferro was breached, we delivered him perfectly with no anesthetic, with no problem. Healthy mom, healthy baby. No broken baby, no broken bones.

And I tell you what, like, I will never, ever consider going back to a hospital, and I'm going to have my children at my house, and there's nothing nobody can do about that.

Okay? Thank you very much. Okay, so. Excuse me. It. Who's on Zoom? Could you have them identify themselves? We have Sarah Radtke. Okay. Paragraph. Please. Proceed. Identify yourself. And you have one minute, and we'll just do every other.

Okay, please proceed.

Well, my name is Alana Kori. I got skipped earlier. I come from Maui. I'm a mother. I'm a victim of the healthcare system. I am an apprenticing poly Keiki Midwife, inspired midwife, and I'm in strong opposition of HB 1194.

Without clear exemptions, persons attending the birth and engaging a religious or cultural birthing practice may be subject to monetary penalties and criminalizations, including a misdemeanor conviction conviction and subject to one year in jail. Someone such as myself that wishes to have a kupuna or hanai family on my birth journey, I.

Please, please ask if you add the PEP pathway. It is an accredited pathway in 23 other states and is the most real realistic pathway for myself. It also gives us more options to licensure and is more realistic, per Kanaka.

If you live in a real community such as myself or you live in a city, you should have the option for these pathways. I want to be licensed, but the only option I have is the Meek pathway, which is to travel outside of the state. Okay, thank you very much.

Which is unacceptable. Whoever is in line that registered and I failed to mention, please come up, identify yourself, and then we'll go back to Zoom.

My name is Ezinay Dawson. I'm a licensed midwife. I'm also a certified professional midwife and a narm preceptor. I'm a home birth mother as well. There's so many parts about this Bill that want to focus on, but in the interest of time, I'm just going to focus on the PEP process and just discussed that the.

By offering an alternative to formal education, the PEP addresses midwifery shortages, particularly in regions with high maternal mortality rates or limited health care infrastructure. Diversity. Diversifying entry routes helps meet growing demand for midwifery care. The apprenticeship pathway is crucial for maintaining midwifery's heritage, expanding equitable access, and ensuring culturally responsive care.

Its preservation supports a diverse, skilled workforce capable of addressing global maternal health. And I just want to highlight the fact that midwifery is growing. The demand for midwifery is growing, and we have to either fix this bill or kill this bill because we know bills such as these and hospitals cannot guarantee safety. Thank you.

Thank you very much.

Okay, who's next on Zoom? Please identify yourself. Sarah Radio. Okay, please proceed. Heather.

Sarah, please. Sarah.

Yes. Sarah.

Sorry, I had technical difficulties earlier. Aloha, Mai Kakou. This is Sarah Radke. I am strongly in opposition of this bill. I have had one healthy hospital birth and one healthy home birth. I had no negative experience with either one.

But I think that's the point is I had the choice and I would like to continue to have the choice. And I Don't think that the government or anyone else should have any power over where or who I would like to have at my birth.

It's just something that's just so sacred and should be held sacred in our own nao, in our own family to make those decisions and make those choices. And nobody has the right over that except for ourselves. So please strongly oppose this bill and let us make the choices for ourselves and our own ohana. Mahalo.

Thank you very much. Okay, next up, in person.

Aloha. Roslyn Ballis, mother of four. 2 cesarean, two home births. And I am in opposition of this bill. I hope to inspire those in charge to make the right decision and vote no on this bill because all women and future generations have their right to for their birthing freedom.

To think that almost 21 years ago, I was in an emergency room about to give birth to my first child just a month shy of my 21st birthday, thinking it was okay and normal to be induced at 41 weeks, constantly being encouraged by nurses to take the epidural, finally giving into it and getting induced, over induced.

I found myself extremely terrified, upset, and alone in a room filled with people I did not know. How was this Pono Flash forward. Five years later, I found myself again in a hospital giving birth cesarean C section to my second child. I realized something that was. It was no good.

Okay, thank you very much. Next person on Zoom.

I ended up having two home births at home.

Okay, thank you. Yeah. Okay. Next person on Zoom. Please identify yourself on Zoom.

I'm Danny Daugherty.

Okay.

I'm a licensed CPM practicing in Hilo, Hawaii for 15 years. And I believe the accredited pathway to the title licensed midwife can help provide a standard of knowledge alongside apprenticeship, which is required to become a CPM with or without the meek accredited pathway and will always be preserved.

And I believe that both are essential for midwifery practice in a rural community. And because we're outer island, we should be well prepared for scenarios that might require us to use our skills at full capacity, which means having a good foundation of knowledge.

And I agree that midwifery is indeed a calling and a way of life, and it's also a profession. And this bill is about licensing the profession of midwifery. It's not about saying where and with whom people can birth. And anyone can still choose to give birth unassisted, allowing their family Members to help them.

But it makes sense for licensed professionals to attend an accredited school. And also there's no shame in charging. Thank you Very much.

Next person. Next person in person, please proceed. Identify yourself.

Aloha Mai Kakou or Shereen Dallas Koinoa. Here we go back to our roots and can make our own choices. Please allow our midwives to give our give birth to our native Hawaiians and people who live in Hawaii. Please do not pass this bill because it is not the definition of midwifery. I am a mother of four children.

I personally wish I had the option for midwife as I was forced to have inducing medicine over induced for two children and a cesarean for my twins. Both position themselves breached. I wish I had that that option. I am still injured internally 30 years later.

Next person on Zoom, please identify yourself. On Zoom, please proceed.

My name is Kylie Adolfo. I strongly oppose HB 1194. I am a mother of two in a native Hawaiian who chose mid referee care from culturally and traditionally trained midwives that also integrated western medical care.

The four amendments that need to be made are one, to include the PET pathway to unburdened birthing practitioners that are seeking licensure. Two, to allow all native Hawaiian indigenous cultural and religious birthing practitioners to continue to care for mothers without being criminalized.

Three, to reinstate the Palikiki birth attendant exemption which has consumer protections in place and supported by the dcca. And four, most importantly, remember that we have the legal right to choose our own health care and the health care of our babies. I asked all of you to vote no on HB 1194. Thank you.

Thank you very much. Next person in person, please proceed.

Good afternoon honorable Senators. My name is Loretta Dubin. I'm a longtime labor and delivery nurse, retired now. Seen many ladies through labor and families used to be for the hospital scene. No more. I strongly oppose this bill.

1194 the practice of subjecting laboring moms to have only to deliver in a hospital setting with many potential interventions for the convenience of the staff and the physicians, I may add. Okay. Babies are generally conceived in love and they need to have that as a continuous all the way through conception, through pregnancy and delivery. It's absolutely essential.

So mom needs to be able to choose that family Member or community Member to be at her side during that time. I will say that this we've been doing childbirth for thousands of years. I'm a mother of two children. Thank you very much. Thank you.

Next person on Zoom, please proceed. Please proceed on Zoom. Identify.

Hi, my name is Melissa Seville. I'm submitting testimony in strong opposition to this bill. 1194. Pregnancy and Birth are deeply personal and Every mother deserves to feel safe, respected and empowered in her choices.

I was fortunate enough to have two very serene and undisturbed home births with exceptionally skilled, skilled, experienced and supportive team of midwives and doulas whose expertise and compassionate care ensured my empowering birth experience.

This Bill forces birthing mothers to work with providers they may not want or trust and criminalizes compassionate support of even myself, who now, as a hypnobirthing instructor, can assist them. I use the hypnobirthing method, an approach centered on relaxation, breath work, and guided meditation. I was able to birth my babies in a calm and peaceful environment. 3.

Sweet girl. The important thing here is that I had the choice. Whether at home, in or in a hospital, mother should have a choice. This HB 1194 takes away that in person.

Please proceed.

Did you understand what I said?

No, we don't. So I ask that you give me another minute to translate what I have said. A lot of people who have waited very long.

Do you all mind if I translate what I've said?

Okay. You have one minute then, to translate.

Thank you. My name is Keanuin Redisoto. I'm a Moo, a descendant of French. I'm from Makaha, and in October of last year, I gave birth to my son, Kamanali Ukai. I gave birth to him in the ocean, in the land where our people always gave birth to our Keiki.

I did not do this because it was a choice. I did this because I was called to do this, called by the land and called by my ancestors to return birthing, the art of birthing, back to where it is meant to be.

And so I strongly urge all of you to not let this bill pass, because it is important that we protect our right as native Hawaiians to access our cultural practices and to do it in the ways in which we have always done it. Mahalo.

Thank you very much. Next question on Zoom. Please identify yourself.

Aloha. My name is Violet and I'm here. They're not running this.

Please proceed.

I'm here in strong opposition of bill HB 1194. Although made with aloha, it is still not a solution. The amendments made to this Bill still do not allow for a pathway in Hawaii to become a licensed midwife.

The pet process, even though recognized by NARM and implemented in 23 other states, is still not being accepted here, which continues to support outsiders coming to Hawaii and not only pushing us out, but our traditions as well, along with taking the livelihood of already seasoned and loved traditional midwives here, this Bill does not allow for non licensed birth attendance and it will have the most severe consequences on native foreign families, diverse communities and rural areas who already face systematic barriers to health care.

Instead of providing more pathways to safe and culturally aligned care, HB 1194 would eliminate.

Thank you very much. Next person in line. In person, please proceed.

Aloha. My name is Olga and I want to share two different experiences with you. So my first experience was at the hospital. It was C section. Unfortunately, I didn't have another option other than C section because both my babies would breech. My second birth was home birth and it was a wonderful experience.

It was my dream and I so appreciate that I could like put my dream, you know, have my dream come true. So I really, you know, appreciate all the women who help other women to give birth and I think every woman has have to have a right to do what they want.

Sorry, I think I'm getting emotional, but I'm opposing this bill and thank you everybody.

Okay, thank you very much. Okay, next person on Zoom. Please identify by yourself.

Aloha Chair. This is Shannon Matson of Puna. I'm a mama of two healthy home births. I've had multiple miscarriages. I'm currently pregnant as a surrogate. So I have. I'm carrying someone else's child. And so therefore I'm planning my first hospital birth, which I'm a bit apprehensive of.

It'll be in August of this year and I'm hoping we'll have a new law in the book so that I can have my doula attend me in the hospital. My OB has already okayed it, but technically the law does not allow for it. I want to be able to have my doula attend me without concern of criminalization.

And I believe that all birthing people deserve this choice or a similar choice. So please make amendments to protect our birth choices. Thank you so much.

Thank you very much. Next person, please proceed.

I'm Jonathan Barang from IAEA. I am a birth believer. 18 years ago I had my son in the hospital and it was colder in this room. It was crowded, it was uncomfortable and it was very long. I had three at home and it was warm, beautiful, comfortable and powerful.

As my youngest daughter came out, her head was under the water and my 2 year old son was around my back watching over my shoulder. My family will continue to birth how we choose. Thank you.

Anybody else on Zoom? Anybody else on Zoom?

No one else on Zoom Chair.

Okay, come on up. Go ahead.

Okay. Aloha. My name is Paul Isaac. I am a farmer and musician and resident in Waimanalo. I'm here with my Ohana today. As a father of two beautiful children who are both born successfully at home, I am deeply concerned about the impact this bill would have on families like mine.

If passed, it would make illegal for the midwife who supported us throughout our pregnancies to continue attending home births simply because she does not hold a midwifery license.

This restriction would not only limit the ability of skilled and experienced midwives to provide care, but would also take away my partner's choice to choose who she wants by her side during such a deeply personal and life changing experience.

The love, support and wisdom we received from our midwife during both pregnancies gave me the peace of mind and allowed me to show up fully for my partner throughout her birthing process. And most importantly, my partner felt empowered, safe, and supported to have two successful home births.

To think that this bill would prevent a midwife from being there for us is just heartbreaking. Every woman deserves the right to decide how and where she gives birth with the support team she trusts most. And I strongly urge you to protect that right and oppose this bill.

Thank you very much. Okay, next person on Zoom, please identify yourself. Zoom.

Aloha. My name is Maika Thompson. I am opposed to this bill. I am a mother of two. I also have a stepchild and I help raise two of my nephews. I had two births in the hospital. Both of them were very unsettling. First one was not the best experience.

The nurses and the doctors didn't even read my chart correctly. Second birth was even worse. I was forced into a C section because my son's life was at risk due to medication that was given to me from the doctors.

I never had home births, but I do believe us as women, during the sacred time of us giving birth, we should have the right and the choice to do what we please with our bodies. To take away that right is completely unacceptable. And, yes, I oppose this bill.

Thank you very much. Come on up.

Hello, Senators. Good afternoon. My name is Kaleo Kio. I'm a firefighter and EMT here in Honolulu for the last 15 years. I'm here on behalf of my wife, Leslie, who is of Tahitian descent, and my daughter, Orihere, who was born one week ago today in the comfort of our own home.

As a firefighter, I'm very familiar with the advantages of medical education and practices. And as a Hawaiian, I am very familiar with cultural practices and traditions and in the experience of the home birth of my daughter.

The biggest difference that I was able to recognize is the empowerment that my wife had in believing that she can birth her child wherever and whenever she can and that she's capable of doing that something that is not offered in the experience of doing it in a hospital. She felt she could do it.

She knew she could do it, and she was empowered to do it, and she did it. And I urge you, folks, please, in a world where women are constantly fighting for their choices and their bodies, please do not take that choice and that empowerment away from my daughter and the future moms in this room.

Next person on Zoom, please proceed. Identify yourself.

Hi, I'm Ricardo Molero testifying right now. I just wanted to bring up that the United States Midwifery Education and Regulation Association, organizations of which NARM is a part of, put out a statement a long time ago of legislative language for states developing licensure statutes for CPM.

And part of that language was for the licensure of CPMs who obtained certification after January 1, 2020. In states with new licensure laws, all applicants for licensure will be required to have completed an educational program or pathway accredited by the Midwifery Education Accreditation Council or meek and obtain the CPM credential.

So this is part of also NARM and what NARM has put out there. Thank you.

Thank you very much. Okay, next person, come on up.

Aloha. My name is Felicia Banks. I strongly oppose this bill. My baby Eco was born at home. I feel like the bill takes away women's intuition. My daughter had spoken to me in the womb and told me that she wanted to be birthed with a tribe of black women around her in the water. I had no idea.

And then all of a sudden, a couple weeks later, I found a tribal black women that could birth my daughter in the water. And so I feel like this Bill takes away my intuition. And I had both ways, too. I also seen an OB gyn and they kept telling me, you're unsafe, you're unsafe, you're unsafe.

So I had this constant struggle of being unsafe, but also trusting what was going on and what I was carrying in my own body. So please just look at it and just know that they're going to come and it's something sacred to us and that it's okay to that we can trust our bodies. I appreciate you. Mahalo.

Thank you very much. Next person, come on up.

Aloha. Mike Ako. My name is Marco Perez Estrada. I oppose, strongly oppose this bill, HB 1194 and I really believe that us, as humans, as people, we cannot be taken. We cannot be. We cannot have our rights taken away like this, especially for our women.

After experiencing the birth of my daughter, feeling the joy, the happiness, the love that I deserve, that everyone deserve to feel when a newborn is here on this earth. No one can take that away from me. No one can. And then I will ever, always will do it again and again, because that's. This. The amazing.

The most amazing feeling I had in the world. I would never trade that for anything. And for this people to think that they can just take the rights from us, from our women, just like that, just because it's not right. You have to look at it as. As a cultural thing.

Thank you very much.

And also.

Yeah, next person.

As your ancestors have been doing it for many years.

Yes. Please, you cannot say no to this. Let someone else have their story told. Thank you. Come on up.

Aloha. My name is Julia Hemi. I'm a student midwife as of the last four years. If this bill passes, my four years of study will not be recognized and I won't be able to practice in the State of Hawaii. I am in strong opposition to bill HB 1194. I was also safely born at home myself.

Please kill this bill and protect reproductive rights and freedom of choice in birth practices. Mahalo.

Thank you very much. I just want to make a couple of notes here. You're going to see Senators come and go. It's not because they're disinterested. It's because they have other hearings that they need to go to. We all have read the 900 testimonies. A lot of you have spoken to us outside of here.

So the fact that all of us are present, which is very rare, shows that we are very interested and we want to. Mahalo everyone who has come here. I know a lot of you have come from Outer island. And so please proceed. Okay? But I just want to make sure you know that the reason.

It's not because of this interest. It is because we are, in fact, very interested in whatever it is you have to say. So come on ahead.

Mahalo. My name is Pi'Ilani Schneider-Furuya. I testify in opposition of this bill. 1194. This bill threatens the safety of Hawaii's birthing community for many reasons I obviously don't have the time to address. I am native Hawaiian. I am a student midwife on the PEP pathway, studying to be a certified professional midwife.

Please protect the PET pathway. Please protect the reproductive rights of all birthing in Hawaii. And please protect indigenous birthing practices. Midwifery care is the solution. The midwifery motto of care is to care for the birthing family with our whole being.

And that's what we as a birth attendant community and midwifery community do for the community of Hawaii that chooses to birth at home. Please vote no on this bill. Mahalo.

Thank you very much. Is there anyone else on Zoom? No.

No one else on Zoom, Chair.

No one else. Okay. Come on up. Aloha.

Sorry. My name is Sovereign Duart, and I oppose this bill, and I'm asking for amendments for my generation. I am Kanaka Mali. One of my grandmothers is Filipino. But under this law, it is illegal for my grandmother to help administer care when I give birth.

On page 32, line 10, surgeon family Members are very clearly exempt in this law, while others are not. I also just want to urge you to think about us when you vote because you are affecting us with your decision. Don't think for a second that this.

By voting yes to this law, you are protecting women and protecting women's rights. Please. And criminalization for my generation so that we can choose who we trust and feel safe with when we give birth. Mahalo. Come on up.

Aloha, Kakou. My name is Jasmine Diaz, and this is Eli. I, as well as the generations of women that stand behind me, oppose bill HB 1194. I safely and ferociously brought my son into this world in the embrace of the makani and prayers of our home in Haleva.

It was there that I also opted to transition to the hospital for stitches, solely stitches. And I experienced trauma that I had not ever dreamt of. After begging my doctors to slow down simply for me to breathe, I was told to hold on. We're almost done.

I experienced pain and wounds that I'm still healing from in physical therapy. I'm also speaking on behalf of the women who have suffered from severe postpartum depression, postpartum anxiety, and postpartum OCD. Through the health and wellness of my birth team and community, my son and I are here today.

Thank you. Come on up.

Aloha. My name is Jasmine Merritt. I'm also a certified professional midwife. I'm also a black woman. I want to oppose HB 1194. Not only is this definitely not great for our community, but it also. It prohibits traditional birth practices. It doesn't protect birth sovereignty at all.

And so one of the things I want to say as well is that we need to look at this not only as a reproductive rights issue, but A public health issue. Okay.

When you look at all of these people in the community, you look at all of the things they've been through in their births, ask yourself, how would I want my child to be supported? How would I want my wife to be supported? How would I want my daughter to be supported? Be supported.

Another thing I wanted to mention is ACOG Chair Dr. Malero should not speak for NARM. Please read N's testimony, which is in full support of PEP on page 29. Thank you.

Thank you very much. I see somebody on Zoom. Could you identify yourself and please proceed.

Aloha Chair San Buenaventura former colleague and Senator Aquino, as well as Senator Keohokalole, thank you for your time today. I do very much stand in strong opposition to bill HB 1194. I hope you folks can really find it in you to continue to champion the reproductive rights that you have in the past.

Could you identify yourself? We can barely. Okay, so.

Laura Ocasio, former state Senator. Aloha, folks, thank you so much. Did you hear the beginning of my testimony?

We did. Yes, we did.

Or should I start over? No, you got 20 seconds. So, as a birth worker. As a birth worker in East Hawaii, as well as a mother, a home birth mother, as well as a former Legislator, I asked you to please uphold reproductive rights and look at the process that this bill has gone through in a.

In a democratic and transparent process for community. It's a public. Public health crisis, and we really do need your support. Thank you so much.

Okay, thank you very much. Come on up. Next person, in person.

Thank you. My name is Erica McMillan. I'm a home birth mother of five children. I'm a student midwife here in Oahu. I've been a part of the birthing community here for 30 years. And I just want to say I'm in opposition of Bill 1194.

If this bill truly served the needs, the concerns, if it acknowledge the voices of the people who it will affect birthing families, the women and the people that serve them, you wouldn't have all this opposition here. As it stands, please oppose it. It needs to be revised, redone these people. We're all willing to work with you.

If you present us with Legislature that works with us, that acknowledges our concerns and needs, needs and voices, and until that happens, please throw this one out and start over. Thank you.

Okay, thank you. Come on up.

Aloha. I am speaking this time on behalf of Hartswell Holistic Midwifery on Maui. My name is Nicole Colegas. I go by Yesi. I am a CPM, a meek accredited school CPM. I want to pick up where I left off and when I birthed at home 22 years ago. The midwife I chose was an apprentice trained PEP midwife.

I received the care I needed from the woman I needed it from in my community. I worked in Colorado for many years as a midwife and we had similar outcomes with all of our PEP trained midwives, as we did with our meek accredited graduates. We would peer review together, share resources and share knowledge.

This is how we keep families safe. We talk story. We learn how each culture births and what the wise women have always known. This is how midwives can support each other instead of pointing out how we are different, complement each other's skill sets and honor the lineages that called us to this work. Midwifery is not a crime.

PEP trained midwives are not a threat nor our traditional birthing practices. But this bill will be a threat without further amendments.

Cooperate and make sure because everyone wants to have their turn to say their story. So if you've already testified, please be polite and allow somebody else to have a turn to tell their story. So come on up.

Aloha. My name is Clarinda Tsivoli. I oppose this bill. Thank you so much. I am a Samoan Fijian businesswoman. I'm a businessbconsultant, a home birthing mother of two. I gave birth to them safely at home in Waianae 10 years ago when I was pregnant with my first child. I was not seeking a midwife under your definition.

I was seeking the opportunity to practice my cultural practice. We are in Moana Nui Akia. We are in Pacifica. After my mother watched me give birth, she rejoiced. Why? Because medical remnants on bicepical women is generational and well documented. My mother had her first child killed by doctors 13 minutes after birth.

Her next child was deformed by forceps. Her next birthday her an episiotomy where they cut open her clitoris and she could never feel pleasure again. She knows we know who we need around us to be safe during birth. Using our tax dollars to criminalize those who support us in that is an overreaching and unnecessary experience.

It's unnecessary and inefficient. We do not need to justify or prove the validity or safety of our practices. You have to prove yours to us. And while we're waiting on that, thank you very much.

You can hear this bill.

Next person, Zoom. Could you please identify yourself? Next person on zoom. There's nobody else on Zoom. Okay, please proceed. Identify yourself.

Hi, I'm. My name is Zoe Durant. I live in Puna and I strongly oppose this bill.

I wanted to let you guys know that if you guys go forward with killing the bill, that I think that we need to think about our future children and their choice to be able to also exercise the right to be trained as a traditional midwife and express their own religion of sacred birth.

And that that choice belongs to our babies as well. And so please, if you do plan on amending this bill or redoing it, don't just grandfather in the people who are currently alive, please protect culture for the future generations.

So my daughters who were beautifully deserving of the experience that I had with my VBAC home birth with my amazing traditional midwife, I just think this bill matters so much and please, please think about just all of this.

I think it's not fair. It's not fair what's happening and the power belongs to us. And to see the. Thank you very much.

Next person in line, please.

Aloha. My name is Jilar Yular. I strongly uphold this bill. This is my ohana over here. Four out of five kids we have has been giving birth at home. For me, my belief is birth is a natural, natural thing. We've been doing it since the Garden of Eden. It is not a medical thing.

I feel like my, my fight stand here is for the future without being in that position. You know, we're a lot of us are not, you know, educated and until we're in that position.

So I want to keep these rights open for the future to be able to choose because when it was, until I was having my own kids, where I was start to look into and educate myself, what is the best possible way to give birth to my own own kids and how I want it to be bonded to this world.

So I strongly oppose it. I want to keep those rights open for the future, for when it's time for them to be educated and their choices to choose for themselves.

Hi, my name is Crystal Ilar and I oppose this bill as well.

I'm currently a doula and should this bill go through, you will be criminal, criminalizing me from being able to help and support the people that I love and that I care about and that even includes my future daughter in laws, my sons, when they have their kids.

This isn't just taking away from me, this is taking away from our generations. So we just please oppose this bill. Thank you.

Aloha. My name is Kabika Drummond. I'm a native Hawaiian. I was born at the old Kaiser Hospital here in the beach near Waikiki. And as I got older and, and was looking to have children, I did a lot of research on hospital birthing and I got pretty freaked out.

Since then I've had three successful home births, one in the UK and 2 here in Hawaii. And our last one was on Valentine's Day with my third daughter. And they were all very, with minimal intervention. And it's the most beautiful way to go.

And I just ask you guys, it's obvious like who showed up here and who cares? So just check your guys now when you're looking at what this is going to take away from so many people. Yeah. Thank you, guys.

Thank you very much. Next one.

I'm Terry Armbruster and I strongly oppose House Bill 1194. And I stand firm with all the hundreds and hundreds and probably even thousands that could even make it here today. They're in opposition to this bill because birth is sacred. And I go with, I would. It seems like you're only focusing on certificate and accredited training.

But I would trust any of these midwives here that they, they know this is a sacred right. And I, and I want to acknowledge that, remind you that as legislators you're supposed to be standing for our rights and freedoms, not to try to take them away and even remember what the Hawaiian motto is.

The life of the land is perpetuated in righteousness in Christ Jesus. And this is not a righteous bill. This is wrong. And, and I just say we stand for freedom in all areas. And I strongly urge you to do that because this is a God given right. He is. He's a beginner of life. Aloha. And that's life.

Thank you. Come on. Come on up. Identify yourself.

Liko Martin Kanaka Moly, Hawaiian National House Bill 1194 presents a constitutional crisis of the United States Constitution being used as a sword to trespass upon our neutrality within the Hawaiian Islands that protects all birthing practices.

House Bill 1194 embodies the suppression of inherent sovereignty runs contrary to the efforts of reconciliation initiated by the State of Hawaii and the United Church of Christ.

Contrary to the spirit of the apology on behalf of the people of the United States continues the deprivation of rights to self determination and disregards the conclusions of Congress to support reconciliation. The Law of Aloha, Hawaii Revised Statutes 5-7.5 directs the Legislature to contemplate and reside with the life force and give consideration to the aloha spirit. Mahalo.

Thank you so much.

Aloha. I just wanted to say that this is so heavy and it really doesn't have to be. My name is [unintelligible]. I was born and raised on the island of Maui, and I'm currently residing in Waianae. My husband, Samuela, our keikis, [unintelligible], Eden, and Humble are all present here and in strong opposition to this bill, HB 1194.

I myself have been blessed with many of my own birth stories, which this one minute will not allow enough space for. We oppose this bill in honor of our daughters, our goddaughters, the generations of wahine to come, our beautiful traditional Hawaiian practitioners and midwives. Mahalo.

[Hawaiian]. I'm Tongin and grew up here in Hawaii, in Tonga. It's normal, super normal to give birth at home and to see what's going on here. I'm sad, heartbroken. Hawaii has been fighting for many years, many years for different reason. And you're taking this away from our kids to be normal? We gotta go westernized. Enough already.

Give the wahine, my sisters, the opportunity to give what God have given them. Please Senator. Mahalo.

Aloha. This is a request to give oral testimony for Margaret Mejia, the Vice President of the Hawaii Christian Coalition, who was going to be here but had an emergency and was not able to be here. Is that acceptable?

Identify yourself.

My name is Rebekah Botello. Is that acceptable? Thank you, ma' am.

For Margaret Mejia, I represent 130,000 moms, dads and children who strongly oppose HB 1194 from many reasons. It violates the First Amendment right to freedom of birthing moms to exercise their religion. Violates indigenous cultural rights of Hawaiian and Pacific Islander families. Fails to provide a clear exemption for indigenous birth practitioners.

Criminalizes local midwives from Hawaii and favors mainland midwives. Criminalizes randmas and others who want to help moms during birth. Is very costly to local midwives because they would have to go to the mainland for midwifery training. In conclusion, it's government overreach and home births reduce the maternal mortality rate among Hawaiians and Pacific Islander women by 44%. If you want to. Mahalo. Thank you.

Hi, Aloha Chair, Senators, my name is Emily Sarasa. I'm testifying as an individual against this bill. I don't envy your position. I know that this is tough hearing from all these people. I think there's a form of paternalism that's innate to lawmaking. But I think this bill takes it too far.

There are a lot of stories shared here today, both against and for home birth. But those are anecdotes. At the end of the day, lawmaking should be based on data. There's no data showing that home births are more dangerous, that the pet pathway is more dangerous.

I think I would appreciate you all thinking about your own autonomy over your body and how you would want to, to bring a child into this world. Would you want the state interfering and telling you that something that is safe isn't, or.

And I also see that as a form of economic protectionism coming from the groups that are in support of this bill. So I think as a Legislator, as a constituent, and for me, as a constituent, I would ask for you to vote against it or amend it, as the people in this room have asked.

Thank you very much.

Next person on Zoom. Zoom, please identify yourself.

Hi. I've been unmuted, so I think I'm going. I'm Kelsey Amos, testifying as an individual.

At this point, my main concern actually is the fact that this bill has superseded and moved forward, even though there was another bill, HB 1328, I think that was developed in consultation with community, in consultation with Hawaiian midwives, in consultation with the home birth community.

And it's very frustrating and difficult to understand why the recommendations from that bill are not incorporated into this one and why this one is the one that moved forward in the first place. So I would encourage you folks to look back at that bill and listen to the recommendations that many are making.

I also stand on my written testimony that I think that this bill does the minimum to protect Native Hawaiian birthing practices without being aware of the actual on the ground challenges that practitioners are facing and which, you know, inform what should be done. So thank you.

Okay. Thank you very much. Okay, Come on up, Rachel.

Aloha. I'm here representing the Hawaii Midwifery Council as their President. As a membership, we have M\members or midwife representatives on every island save Ni'ihau. There's three things that we'd really like to address. First off, the International Confederation of Midwives is an NGO that has no authority over licensure or regulation of midwifery in the United States. Secondly, the traditional birth attendant exemption should be reinstated.

Thirdly, if this bill is about protection of the consumer, why are the certified professional midwives not being allowed to have limited prescriptive authority so that they can prescribe needed medications like Rhogam to help mothers get the medication that is needed to keep them safe in pregnancy rather than choose between buying the medication or putting groceries on their table?

Because without the ability to prescribe the medication, they have to pay for those things out of pocket. So also, the bill reduces the amount of postpartum care that is currently in 457J from eight weeks down to six weeks. That's not safety. We actually recommend increasing it to 12 weeks. Thank you.

Thank you very much, Rachel. Okay, anyone else on zoom? Okay, anyone else wishing to testify? I see [unintelligible] again. Okay. Last time. Okay.

Yes. Aloha Senator. I am testifying in my personal capacity on behalf of my family from Maui. We hail from Kapakalua to Ulupalakua to Waehu and Kapuna Valley. We are very far from the nearest hospital.

And some of you may have heard last year my niece, a first time mother, went to the federally qualified healthcare clinic and she was given a form to sign that if she decided to have a home birth and access midwifery care, they would terminate her as a patient.

That is what our medical establishment system now for those who want to choose that pathway, it's there for them. But that type of mindset is underlying this bill.

And so we are begging for you and on behalf of my family who's not here and my nieces on Maui where we're so far away from the hospital, this is about safety. This is about reproductive choice. And this is an opportunity to uphold those rights and end medical colonialism. Because this is what, this is what it's about.

And if we're going to bring in international standards, let's look at United Nations Declaration of Rights of Indigenous Peoples, this cultural genocide. Thank you

Anyone else on zoom? Okay, Members, any questions? At this time we are going to recess. There is a lot for us to discuss and I really would like the entire committee to be part of the discussion.

And so at this time we're going to be recessing until one o' clock on Monday, room 225 for decision making. Recess.