Ka Wai Ola - Office of Hawaiian Affairs, Volume 23, Number 3, 1 Malaki 2006 — Cultural birthright or ‘infectious waste’? [ARTICLE]

Cultural birthright or ‘infectious waste’?

Hawaiian parents turn to the Legislature for help in gaining possession of their newborns' 'iewe, or placenta, the focus of an important life ritual

By Sterling Kini Weng Publicatiūns Editur The Hawaiian tradition of cleaning and burying a child's placenta, or 'iewe, is an important life ritual, one that will forever connect a keiki to its homeland. Over the years, the practice has been regaining popularity among Hawaiians, after almost disappearing in the 1970s. But several families have recently been prevented from obtaining the 'iewe from hospitals, after the state Department of Heahh began to classify the placenta as infectious waste. Kalehua and Klhāpai Krug are one of these families. Kalehua said that after his daughter was born last fall, doctors at Kaiser Permanente Moanalua refused to let him take the 'iewe home. His daughter's 'iewe is now sitting in a freezer at the hospital's pathology department. "This is about the well-being of my daughter," said Kalehua.

"If I don't get the 'iewe, it will drive me crazy. I don't know what I'm going to do." The Krugs and others were hoping a federal lawsuit filed by the Native Hawaiian Legal Corp. would force the state to release the placentas. But with the lawsuit currently under appeal, the families are now turning to the state Legislature for help. There are bills in eaeh house that would change the law to allow the 'iewe to be returned to families after it was determined to not contain infectious diseases. The bills would also require that the Heahh Department establish rules for the proper handling and transfer of the 'iewe. In her written testimony for one of the bills, Heahh Department Director Chiyome Leina'ala Fukino said that the department would prefer to adopt new rules to address the release of the placenta instead

of passing a law. She explained that the department's current rules for the disposal of infectious waste doesn't allow 'iewe to be given back to families. But some Hawaiians say that the department's broad interpretation of its infectious waste rules prevent them from pursuing a very important cultural practice. In Nānā i ke Kumu, Hawaiian scholar Mary Kawena Pūku'i wrote that Hawaiians cleaned the 'iewe of blood to ensure that the keiki's eyes wouldn't be weak or sore. The 'iewe, she said, was later buried, usually under a tree, to keep the keiki connected to their home and to prevent the child's spirit from being homeless or hungry after he or she died. NHLC attorney Andrew Springer questions the Heahh Department's classification of 'iewe as infectious waste, noting that the department's rules

governing the disposal of infectious waste does not specifically mention placenta tissue. Several doctors have also pointed out that expecting mothers are already tested during prenatal examinations for the same infectious diseases - HIV and hepatitis - that the department's rules were intended to protect the public from. "Doctors already know from the mothers whieh placenta have to be treated differently because of diseases," said Dr. Marjorie Mau, chair of the University of Hawai'i Department of Native Hawaiian Heahh. "From a medieal perspective, there's no significant risk to the public by allowing this cultural practice." What makes the state's policy on 'iewe more baffling is that hospitals for years released placenta back to families. They didn't stop until last sununer, when the Heahh Department banned the practice. In fact, the Krugs received and later buried the 'iewe of their first two children, ages six and three. "I never knew it was going to be a problem," Kalehua said of getting his youngest child's 'iewe.

Another complaint about the Heahh Department's placenta policy is that it further complicates what is already a stressful time for families. After being told by doctors that they wouldn't be allowed to have theirchild's 'iewe, Nohea Stibbard and Klhei Nahale-a decided to have a home birth. "The hospital just left us on our own, they didn't advocate for us as their patients," Stibbard said. "So we had no ehoiee; we weren't going to sacrifice our practice. But the whole thing added more stress that we didn't need during the pregnancy." Circumstances eventually forced Stibbard to give birth at Kaiser Moanalua last sununer. Shortly before the birth, she and her husband initiated a lawsuit to force the release of the 'iewe, whieh was later frozen and stored in the hospital. NHLC is currently appealing the ruling after a federal judge disnūssed the case when the 'iewe disappeared from the hospital. As KWO went to print, both bills on the issue, HB 2057 and SB 2133, had passed second reading. S