HONOLULU (KHON2) -- Pilar Hererro, a senior staff attorney at the Center for Reproductive Rights, has dedicated her career to advocating for reproductive autonomy, particularly after her own experience as a young mother. Her personal journey encompassed navigating pregnancy and motherhood while also contending with external pressures. These experiences helped Hererro realize just how vital reproductive choices are for an individual’s future. Get Hawaii's latest morning news delivered to your inbox, sign up for News 2 You Her career, and her current work in Hawaiʻi, reflects her commitment to ensuring that every person has the ability to make their own decisions about their body, their pregnancy and their future. Hererro sat down with KHON2.com to talk about reproductive rights. She emphasized that the right to choose should not be limited to decisions about whether to end or continue a pregnancy. "It’s really important that we affirm that pregnant people have rights to make decisions throughout the entire pregnancy," she said. "That includes decisions about their reproductive healthcare, who they give birth with, where they give birth and how they give birth." This holistic view of reproductive rights acknowledges that the needs of pregnant people extend well beyond the moment of conception and that individuals must retain the power to make decisions that align with their values, culture and personal circumstances. However, even in Hawaiʻi where reproductive rights are generally seen as being more protec, there are still significant challenges to maternal health and reproductive freedom, according to Hererro. Hawaiʻi is facing the same issues that other U.S. states encounter, including systemic failures in the healthcare system that disproportionately affect Native Hawaiian and Pacific Islander women. According to Hererro, these women are not only less likely to receive adequate prenatal care, but they are also at greater risk of pregnancy-related death. "It's really troubling," Hererro noted. "And, you know, some of this has to do with access to care; but it also has to do with ensuring that the care that is provided is actually respectful of pregnant people's decisions and their culture." Rural communities, in particular, often face challenges in accessing the obstetric care they need and sometimes require them to travel long distances to reach qualified providers. Unfortunately, Hererro pointed out that “stories about coercion and mistreatment in the healthcare system are far too common” and have a particularly damaging impact on Native Hawaiian peoples. In response to these systemic health challenges, Hererro advocates for a more inclusive and culturally sensitive approach to maternal healthcare. An appraoch that recognizes the importance of midwives and traditional birthing practices. "Midwives are really critical to promoting better birth outcomes and birth equity," she stated. "They provide holistic care that is tailored to the individual pregnant person and is also respectful of their autonomy." For many families, midwives are integral to ensuring a safe and positive birth experience. Midwives provide personalized care and often bring services directly to communities as they enable individuals to practice their traditions, including home births surrounded by loved ones. However, the passing of Hawaiʻi’s midwifery restriction law in 2019 threatened to cut off this vital form of care. This law, which mandates that anyone providing advice, information or care during pregnancy, birth and postpartum must have a state license. The result has led to inadvertent harmed to the very people the law sought to protect. Without a state license, midwives who had served their communities for years could face imprisonment, fines and other legal penalties. The law's narrow criteria for obtaining has a license made it difficult for many long-time practicing midwives to become licensed, and it has had particularly devastating consequences for Native Hawaiian midwives. "The law not only halted their cultural practices," Hererro said, "but it actually threatened to extinguish them because they couldn’t practice or teach the next generation of providers." The law’s impact has been profound in the birthing community and has left many pregnant people without the trusted care they had relied on. Hererro and the Center for Reproductive Rights have been at the forefront of challenging this law. "From our perspective, the law wasn’t adding any resources; it was just taking away choices and providers from communities," she explained. "It was cutting pregnant people off from the care they need." In response, the Center, alongside other organizations, filed a lawsuit against the State of Hawaiʻi in February 2024 that aimed to protect the right of pregnant people to make their own decisions about pregnancy and birth. The lawsuit, Kahoʻohanohano v. State of Hawaiʻi, focuses on securing the right of pregnant people to choose their own midwife, whether that midwife is licensed by the state or not. Hererro highlighted that the law doesn’t just impede reproductive rights. It also infringes upon indigenous rights. “It’s really a serious threat to reproductive rights, to indigenous rights," she said. In June 2024, after a week-long hearing, a judge issued a temporary order blocking the enforcement of the law’s penalties against individuals who practice, teach or learn traditional Native Hawaiian maternal health practices. Hererro described this as a major victory: "The court held that the part of the law that was purporting to protect Native Hawaiians was unconstitutional." The ruling allows Native Hawaiian midwives to resume their work, offering much-needed care to the families that depend on them. However, the law is not entirely repealed; and there are still significant hurdles to overcome. Hererro is clear that the struggle is far from over. "We are committed to defending our clients against unconstitutional laws that limit their reproductive autonomy," she said. "But how the litigation proceeds is going to depend a lot on what the legislature does now." Looking forward, Hererro sees an opportunity for the Hawaiʻi legislature to craft a more equitable solution, one that ensures access to quality care while respecting indigenous practices and traditions. "There are many ways lawmakers could work with their constituents to create legislation that balances people's needs for access and culturally aligned care with the concerns of the health system," she stated. For now, the temporary injunction has provided a lifeline for many families. Pregnant people in Hawaiʻi who wish to access traditional midwifery care can now do so. "We know that many families are very, very glad to have their providers back," Hererro said, "to experience pregnancy and birth with the full support of their traditional practitioners." Yet, as Hererro made clear, this issue goes far beyond the state of Hawaiʻi. It’s a matter of reproductive autonomy, of ensuring that every pregnant person has the right to make decisions that align with their values and needs. And that, according to Hererro, is a fight worth continuing. "Our goal is to ensure that every pregnant person in Hawaiʻi has a recognized right to make their own decisions about pregnancy and birth, not the State," she concluded. You can watch the full interview here. You can click here to read more about the case. Click here to find a midwife in your area. Get news on the go with KHON 2GO, KHON's morning podcast, every morning at 8 Hererro’s dedication to reproductive rights and her tireless work to defend these fundamental freedoms represents a crucial step forward in ensuring that every person, regardless of their background or where they live, has the autonomy to decide what happens to their body. In the end, it’s a matter of not just reproductive rights, but human rights.