When Navajo Midwife Nicolle Gonzales talks with Native American women about birth, there’s a sense something is missing, she said in this week’s Friday Podcast. “But,” she said, “we don’t know what it is.” Gonzales grew up and remains on a Navajo Reservation in New Mexico. She became a midwife and founded the Changing Woman Initiative (CWI) to address unmet maternal health care needs in her community. She is of the Tl’aashchi’I, Red Bottom clan, born for Tachii’nii, Red Running into the Water clan, Hashk’aa hadzohi, Yucca fruit-strung-out-in-a line clan, and Naasht’ezhi dine’e, Zuni clan.

Providing quality midwifery care requires an intimate understanding of a community’s traditions, said Gonzales. For example, the Navajo Nation is a matrilineal society. This history affects Navajo women in ways that Western activists miss. “There’s this whole wave of white feminism, talking about empowering women,” said Gonzales. “Like me as a Diné [Navajo] mother and a woman, I’m already empowered because I walk side by side with my culture, my community.” The focus of Indigenous feminism is thus not forging a new egalitarian societal system but returning to the pre-colonial system in which men and women were already equal, she said.

Native American and Indigenous communities have also been shaped by past trauma, said Gonzales. The legacy of colonization has separated Native women from traditional birthing practices for two generations, leading them to lose a sense of self, she said. In addition, rates of substance use, physical and sexual violence, and mental illness are high in Native American communities. This reality poses challenges to new parents, as they must balance healing their personal traumas with the demands of child rearing, said Gonzales.

Failing to acknowledge this historical and social context has devastating consequences. In the United States, Native American mothers die at a rate two to three times higher than non-Hispanic white mothers. While tragic, these numbers are not surprising, said Gonzales, noting missed opportunities to support women during and around childbirth. “And so when we fail our women like that, of course, you know those numbers are going to look terrible,” she said, referring to maternal health outcomes.

However, when the proper, culturally informed support is provided, the birthing process can be transformational for Native American and Indigenous women, said Gonzales. By guiding families through ceremonial birthing processes, which can include using herbal medicines and birthing in a hogan (traditional dwelling), Navajo midwives help parents reconnect with their cultural heritage, serving as a bridge between a lost past and a healthier future for Navajo families.

Including communities in maternal health care is essential. Given the diversity of Native American and Indigenous communities, services must be tailored to each tribe’s customs and needs. “How is it possible that people from other states and other communities and even like organizations can make policy decisions for Native communities who’ve never been there who don’t know what our problems are, who don’t know, our traditional systems?” said Gonzales. “That doesn’t feel okay to me.”  

Some progress is being made. Representative Deb Haaland is the first Native American to be appointed to serve in a president’s Cabinet. This representation is incredibly important for Native American and Indigenous communities, said Gonzales. When Representative Haaland goes into spaces that are all white and she wears her traditional clothing and moccasins, she said, it’s like she’s always bringing her community along, wherever she goes.

This commitment to community is at the center of Gonzales’ work. In every space, she makes the conscious effort to represent her people and “bring her ancestors into the conversation.” By doing so, she challenges the Western narrative that frames Indigenous communities as relics of the past, by focusing on the “death” of Indigenous languages, peoples, and cultures. “We’re not dying,” she said. “We’re not thriving either, but we’re trying to.” Returning Indigenous midwifery to Native American communities, is part of this effort to thrive.  “Yes, there’s lots of death, but birth and mothers bring life into community,” said Gonzales. “And I help with that. Midwives help with that.”