HONOLULU (KHON2) -- The freedom to choose how to give birth is a fundamental right for many families; and for three women from Hawaii -- Sara Kahele, Melissa Danielle and Tina Mau -- this right is central to their birth experiences and advocacy for future generations. These women have had different journeys in their childbirth decisions; but they all share a passion for ensuring that women can make informed choices about their births whether that means birthing at home, at a hospital or with the assistance of midwives. Get Hawaii's latest morning news delivered to your inbox, sign up for News 2 You KHON2.com explores the personal experiences and motivations behind their decisions, the challenges they’ve faced and why they are committed to the fight for reproductive rights and the freedom of choice. Sara Kahele's journey to homebirth Sara Kahele, from Hawaiʻi Island, began her motherhood journey at a young age. She was only 16 when she had her first child and had little knowledge about childbirth. "I was a baby having a baby, basically," she reflected. "I was just told to go to the hospital and do whatever the doctor told me to do." Her first birth involved a long induction with many interventions; but in the end, it resulted in a healthy baby, which was, of course, her main concern. Despite the challenges, she took the experience as a learning opportunity. However, it was after her second birth, just two years later, that Kahele started to realize that she had more options. "By the third baby, I actually went and got educated and took a childbirth class and realized that I had way more options than people were telling me," she said. This realization opened up a whole new world for her. She began to explore alternatives, such as working with midwives. When Sara was pregnant with her fourth child, her birth plan took a drastic turn when her healthcare provider suggested scheduling a cesarean because they thought her baby was going to be too big. Kahele had other plans. "I ended up giving birth in my driveway because my labor was only two hours and she was 10 pounds and two ounces," she recalled. Kahele's subsequent pregnancies were even more empowering as she continued to have quick and beautiful births which she described as a completely different experience from her first two. "I could have a different type of birth that felt like I was giving birth, not that birth was happening to me," she said. One of the most beautiful aspects of her homebirths was how her older children were able to be present and witness the birth of their siblings. "They've been around birth all their lives, attending the birth of their siblings," Kahele shared. This experience has deeply influenced Kahele's advocacy for others to have the freedom to choose their birth experiences. "We are done having kids," she said. "But the fight is for our children to be able to have that choice." Kahele emphasized that it’s crucial for her children to understand that birth is normal and safe and that they should have the ability to choose the birth experience they feel is best for them. "They have all expressed that they would like to birth at home," she added. "They’ve grown up around the fact that birth is normal and that birth is safe." Melissa Danielle’s path to homebirth Melissa Danielle, from Oʻahu, had a different journey but also recognized early on that she wanted to give birth at home. "I knew in my 20s that I was going to have a homebirth," she said, even though she did not conceive until much later. "I just knew that it wasn't going to be in a hospital." For Danielle, the desire to birth outside of a hospital setting was always present, even when she didn’t fully understand what it entailed. "Back then, I had no idea what any of that entailed," she reflected. Danielle’s path to homebirth deepened when she was diagnosed with polycystic ovary syndrome (PCOS), a condition that made it harder for her to conceive. "The health care system flags women over 35 as being, you know, high risk or unable to conceive," she explained. This diagnosis, coupled with the realization that the medical system often does not prioritize a woman's right to make informed decisions, motivated her to take extra steps to ensure that she could safely birth at home. "I knew that I would have to do more because of my health care situation to have the birth that I wanted," Danielle said. "I had to take extra steps to really educate myself and take care of my body and my health." The more Danielle learned about birth, the more she realized that women have the right to choose where and how they give birth. “Once you educate yourself about birth, you realize that you have options," she shared. "The option to birth at home can be safe; it can be affirming as long as you know what you need to do to have the birth that will give you that outcome." Tina Mau’s experience and advocacy for choice Tina Mau, who is from Lāhainā, had a significantly different first birth experience compared to Kahele and Danielle. At just 17 years of age, Mau gave birth in a hospital and felt uninformed and unprepared. "I didn't know anything," she said. Mau, like many women, was raised to believe in the medical system’s authority over birth. "I was raised in a family of fear when it came to birthing. My family was very, like, 'trust your doctors'." But this belief was challenged during her second pregnancy, which coincided with the COVID-19 pandemic. "During COVID, I just realized a lot of things didn’t line up with me," she recalled. "I had to look for other routes." This is when Mau began to explore midwifery and homebirth. Her friends and family who had experienced homebirths provided her with support and education. "I had friends and families who are around me who did have homebirth," she said. "They were able to educate me and just kind of push me and support me in knowing myself and my worth in my own body." This guidance empowered Mau, who had once been afraid of childbirth, to embrace the idea of birthing at home. The pandemic also highlighted the inadequacies of the medical system in Hawaiʻi. Mau shared a distressing experience with us. “After the fire, we didn't have ambulances, even after the fire. They said they could not get us an ambulance... It would be about a 2- to 3-hour wait.” She underscored the lack of resources in remote areas like Lāhainā, which makes the freedom to choose homebirth even more vital. Mau emphasized the importance of supporting a mother’s choice, whether that means giving birth in a hospital or at home. “There’s a lot of division when we should be working together,” she pointed out. “They’re both so important. Where the mother chooses, the birth is so important, where she is comfortable.” Mau also highlighted the importance of having a partner and support system that encourages trust in one’s own body, something she found through her own journey. For Mau, the choice of where to give birth isn’t just about preference. It’s about feeling safe and supported in one’s decision. She believes that midwives, especially in remote areas, should be seen as essential healthcare providers, especially when hospitals may be too far away or lacking in resources. "I just wish that it was-- I wish we could all work together for the people, for the mother," she concluded. The importance of respecting indigenous traditions and practices Respecting Native Hawaiian and Pacific Islander cultural practices is essential when it comes to midwifery choices, especially for future generations. Kahele explained that she wants her children to have the choices they need when it comes to childbirth and respecting their cultural traditions. She has five daughters and one son, all of whom grew up understanding that "birth is normal and that birth is safe". Now, she is focused on ensuring that her children, especially her daughters, can also "have that choice". Kahele emphasized the importance of feeling "safest" when choosing where and with whom to give birth. She explained that the most important factor for her was having people "that not only believed in me, but that I could trust with my life." In her case, she chose a traditional midwife, but Kahele noted that there are "tons of different types of midwives" and that each person’s choice should be respected. She expressed that the focus now is on her daughters, saying, “The fight is... for our daughters, to be able to have that same choice.” Her daughters have expressed interest in giving birth at home like their mother did. Kahele also shared stories about her husband David’s family. His grandmother was actually the midwife for their village," she explained. "For them, this was 'normal life', where midwifery care was an everyday part of the community. While the husbands were out fishing, the midwives took care of deliveries along with pre- and post-natal care." Kahele concluded with a powerful message: "birth is normal," and everyone should have the "choice" to give birth in a way that feels safest and most comfortable for them. The Importance of Choice For Kahele, Danielle and Mau, the ability to choose where and how to give birth is not just a personal decision, but one that affects the entire family. They all emphasize that birth is not an emergency unless complications arise and that it is vital for women to have the power to make their own decisions regarding their bodies and their births. As Kahele said, “The most important thing was having people there that not only believed in me, but that I could trust with my life.” For her, and many others, that means choosing a traditional midwife for her homebirths. Similarly, Mau echoed the sentiment that women must have the autonomy to make their birth choices. "Trust yourself," she urged. "What do you feel like?" And for Danielle, the more education a woman has about birth, the more empowered she becomes to make decisions that are best for her and her family. "Birth is our responsibility," she sayid. These powerful voices from Hawaiʻi stand strong in their belief that every woman should have the right to choose her birth experience, regardless of where she lives or her background. Their stories highlight the importance of trust, education and empowerment in the birthing process. You can click here to watch the full interview. You can click here to find a midwife in your area. Click here to learn more about the women's fight for reproductive choices. Get news on the go with KHON 2GO, KHON's morning podcast, every morning at 8 The reality of birthing freedom is not just about personal choice; it is about ensuring that future generations have the same rights and opportunities to birth in a way that feels safe, affirming and empowering.