Indigenous Rebirth

Indigenous Rebirth A Return to Traditional Birthing Practices and Maternal Care

Margaret David pregnant with Tala David getting an herbal foot bath at a blessing ceremony to prepare for her home birth.

Photo by R honda Grantham.

Alexandra Carraher-Kang

Founded three years ago, the Alaska Native Birthworkers Community is a small, grassroots, volunteerbased organization in Anchorage, Alaska, whose members call themselves “midwives, healers, mothers, customer-owners of our Tribal health care system, community/social justice activists, artists, doctoral students, researchers, sisters and aunties.” Together, they represent more than a handful of Tribal Nations within Athabascan, Iñupiaq, Yup’ik, and Siberian Yupik cultures. Margaret David (Koyukon Athabascan), Helena Jacobs (Koyukon Athabascan), Abra Patkotak (Iñupiaq), Charlene Apok (Iñupiaq), Stacey Lucason (Yup’ik), and Stefanie Cromarty (St. Lawrence Island Yupik) are the founders and lead volunteers behind the initiative. In the words of Jacobs, the Alaska Native Birthworkers Community is made of “Native women who offer care to pregnant people, including other Native women, in the same way we have cared for one another for millennia. We are seeking to reclaim our ancestral knowledge, as well as learn new knowledge to grow the capacity of our local caregivers to call back these roles.”

A laska Native Birthworkers Community’s vision is that “every Alaska Native birthing person feels supported, well cared for, and full of the information they need to make confident choices around reproductive health, birthing, and parenthood... to reclaim as well as create new ceremony and heal our ancestors and future generations who may have been harmed through the colonization of our bodies, healthcare, and birthing practices.” The Community’s approach to perinatal support focuses not only on the medical aspects of giving birth and being a parent, but also on Indigenous cultures and the reclaiming of Indigenous bodies. “Birth itself is considered a ceremony,” Jacobs says, “and the specific ways each of us practice holding this ceremonial space differs greatly.” The Community provides on-call volunteer service for women at all stages of reproductive life: women just coming of age can be tattooed in an empowerment ceremony, women considering pregnancy can receive peer counseling, women who are pregnant receive support while birthing, and women who have given birth receive postpartum care. The Community is available to help women with their mental health and family wellness, in addition to collecting and redistributing donated newborn items, pregnancy care packages, and food bundles.

The impacts that pregnancy and early childhood have on both mother and child cannot be overstated. The Community believes that pregnancy is an opportune time to work with families “because a pregnant person is especially motivated and open to healing and to positive health changes for the benefit of their child.” Formalizing a network of Alaska Native birthworkers who value the role that Indigenous culture plays in pre-and post-natal health is critical. In the words of the Community, “our young women want aunties to guide them through their transition into womanhood, our mothers want support to navigate pregnancy and childbirth, our sisters want

someone to sit beside them while learning to care for a newborn and grow their families. For millennia our social and community structures demanded ceremonial rites of passage, that a new mother be cared for by everyone surrounding her, and that care was offered locally by women whose wisdom and medicine passed on from generation to generation.”

However, this kind of birthing environment for Alaska Native parents is no longer the norm, making the work of the Community essential. Most rural Alaska Native mothers are displaced from their homelands and required to travel by plane, often separated from their families and wider communities when giving birth. The Community points to numerous clinical studies which have shown that “the continuous support of a professionally trained labor companion at birth results in shorter labors with fewer complications, increased satisfaction with the birth experience, reduced need for medical interventions, including a significant decrease in requests for pain medications . . . [and] that parents who receive this type of perinatal support feel more secure and cared for, are more successful in adapting to new family dynamics, have greater success with breastfeeding, have greater self-confidence, have less postpartum depression, and have lower incidence of abuse.”

Jacobs’ own experience demonstrates the importance of community support while giving birth. “I had excellent care during all three of my pregnancies and had really positive, empowering, beautiful birth experiences,” she recalls. “I felt safe, well cared for and full of the information I needed to make informed choices about my care. The more I got into this work, the more I realized that I was very privileged to have these experiences, and that is a primary motivator for my dedication to this work.” Later, when attending a birth, Jacobs describes meeting the mother-to-be for the first time while she was in labor at the hospital. “Before arriving I felt really nervous about how I might offer care and be able to support her. As soon as I arrived, we immediately connected and I was able to be present for her in the way she needed by following her cues. She was so grateful to me for being there for her and I was so grateful to her for inviting me into that sacred space and honoring me with the gift of witnessing her birth and being one of the first people to meet her baby. This

Food bags restocked by the Alaska Native Birthworkers Community ready for distribution to pregnant families receiving care through the Alaska Native Medical Center, in support of the efforts of individuals in the OB clinic who have been

distributing food for decades. Photo by Margaret David.

solidified how important peer care is and how the bond of sisterhood can be formed instantly in these moments.”

M ost health care professionals who work in the Tribal health system are not Alaska Native, and therefore are unable to provide culturally-matched care and ceremony that reflects ancestral knowledge and cultural values during pregnancy and birth. While attempting to fill the gap and provide Alaska Native women with the support they need and deserve, the Community calls on all Tribal health facilities to hire Indigenous birthworkers (midwives, doulas, peer lactation counselors, etc.) and offer additional birth support to parents through doula and other peer support programs.

In 2017, the Community hosted the Indigenous Midwifery Ancestral Knowledge Keeper Gathering, where women from the United States and Canada hosted different parts of the agenda. The event focused not only on birth helper skills, but also on ancestral knowledge and Indigenous tradition. Agenda topics included birth helper basic knowledge and skill building (reproductive physiology, preconception health, support during pregnancy, labor, and birth); reclamation of birth ceremonies; and the revitalizing efforts of women’s coming of age ceremonies and rites of passages that work to assist in rebuilding lifeways and healing our nations, storytelling, breastfeeding support, ancestral knowledge, and plant medicine making. This fall, the Community plans to host two more trainings: Indigenous Breastfeeding Counselor Training and Full Spectrum Indigenous Doula Training. In addition, the Community continues to evaluate the needs of the Alaska Native community by surveying healthcare systems statewide to better understand what care and resources are being provided locally to Alaska Native women. This data will help guide the Community in fulfilling its vision and purpose of bringing the Indigenous experience back to birthing.