PBC Advocacy Mission & Intention
We are a community-based non profit organization advocating for birth & wellness choices across Hawai'i. This includes supporting the choices of Birthing People to access a full range of reproductive services including the right to choose where and with whom we give birth.
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What's the problem?
Access to midwives and midwifery education is extremely limited in Hawai'i. There are no Birth Centers and limited community birth providers who are currently not covered by insurance. This creates equity and access issues for birthing people especially in our remote communities who have a difficult time finding care.
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What's at stake?
Increasing barriers to community-based maternity care not only put mothers and babies at greater risk of harm but also threaten the loss of hands-on knowledge and cultural wisdom passed down through generations. When access to midwifery and traditional birth support is restricted, we lose more than just essential care—we lose the deep-rooted practices, ancestral teachings, and community-based skills that have sustained families for centuries. Protecting community-centered maternity care is about safeguarding both the health of mothers and babies and the cultural knowledge that connects us to our past and future.
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What Pacific Birth Collective Supports
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Women and birthing people's right to informed decision making and to discern for themselves what care provider is right for them.
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Community accountability and transparency about care outcomes available to consumers for the provider they are choosing.
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Insurance reimbursement for midwifery care.
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Expanded access to diverse midwifery practitioners and diverse accessible pathways into practice including apprenticeship training.
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Expanded collaboration between medical organizations and diverse independent care providers.
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The Evidence
Evidence shows that access to midwifery care improves health outcomes for all birthing people and their children. This especially true for Black, Indigenous, and People of Color who experience worse health outcomes and have less access to midwifery education and care.
How to Exercise Your Civil Rights
Take Action
State regulations have blocked the development of freestanding birth centers in Hawai'i since the 1980s. Hawai'i community groups are actively collaborating to propose regulatory updates to the Department of Health and Congress to allow Birth Centers Across the state. We will be updating this content over the coming months as new info becomes available.
Community voices are vital to these ongoing negotiations.
Initiatives We Support
Home to Hospital Transfers
PBC supports initiatives such as the Smooth Transitions program from Washington state that promote the health and safety of mothers and babies when a transfer from the home or birth center is needed to the hospital by ensuring collaborative care.
VBAC Policy Update
VBAC stands for Vaginal Birth After a Cesarean, and currently most outer island hospital policies do not allow for VBACs. These policies are outdated and do not reflect national standards. We are looking into this issue to engage stakeholders to review their VBAC policies.
Free Standing Birth Centers
PBC advocates to see Free Standing Birth Centers become a norm throughout our state. Please see the section above with our community survey to share your thoughts.
Medicaid Coverage for CPMs, CMs & LMs, and Doulas
Midwifery licensure is new and with this the systems and regulatory structures are still being developed. One of these is medicaid coverage for midwifery services and an appropriate reimbursement rate.
Expanding Educational Pathways for Professionals
Assisting those interested in a career in supporting women and families in pregnancy, birth and postpartum are important to us. Please see our Community Birth Project for funding assistance for midwifery students and lactation consultants.
These are just some of the initiatives we support, please reach out with other policy topics of interest.
Get Involved
If you are interested in any of these topics, please email policy@pacificbirthcollective.org and include the topic title in the subject line.
Bills We are Tracking
Here is a list of bills we are tracking during the legislative session that relate to pregnancy, birth, postpartum care, and family wellbeing in Hawaiʻi. This page last updated February 2026.
HB2208/SB2427 - Relating to Food Security - Farm to Families
HB1879 - Free Rides for Keiki (Free Public Transit for Kids)
Women's Legislative Caucus Package
SB2843/HB1959: Relating to Domestic Violence
Extends for five years certain provisions from Act 19, SLH 2020, and Act 238, SLH 2021, relating to abuse of family or household members, including establishing a petty misdemeanor offense of abuse of family or household members, clarifying penalties for violations, and allowing a deferred acceptance of guilty plea for misdemeanor and petty misdemeanor abuse of family or household members offenses. Effective 6/29/2026.
Requires the Department of the Attorney General to develop a Human Trafficking Awareness Training Program to educate and train workers in the transient accommodations sector. Requires transient accommodations employers to periodically provide the human trafficking awareness training to certain employees and contract workers; keep records of the training; post signage; and develop and implement a human trafficking prevention policy that includes procedures for the reporting of suspected human trafficking. Establishes penalties. Requires the Department of Labor and Industrial Relations to adopt rules.
Prohibits persons from interfering with another person’s access to or from a health care facility or disrupting the normal functioning of a health care facility. Makes violations a petty misdemeanor. Establishes a private right of action for individuals and health care facilities harmed as a result of interference with a health care facility. Authorizes the Attorney General to bring an action for injunctive or other equitable relief.
Establishes an exemption from mediation in parentage proceedings where there are allegations of domestic abuse. Clarifies the exemption from mediation in divorce proceedings as it relates to domestic abuse.
Establishes the nonconsensual disclosure of intimate or private images as a criminal offense. Amends the criteria for an extended term of imprisonment to include an offender whose act of attempting to commit or committing the nonconsensual disclosure of intimate or private images against a minor or vulnerable adult resulted in the victim’s death.
Affirming and supporting the requirement that hospitals provide life-saving emergency care to pregnant people, including reproductive and abortion services, when such care is medically necessary to stabilize a patient under the Emergency Medical Treatment and Active Labor Act.