Case: Kahoʻohanohano v. State of Hawaiʻi
1CCV-24-0000269 | Hawaii state trial court
Filed Date: Feb. 27, 2024
Closed Date: Oct. 17, 2025
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Case Summary
This case involves a challenge to midwife licensure restrictions in Hawai’i.
In 2019, Hawai’i enacted the midwifery restriction law (HRS § 457J), which imposed licensure requirements on midwives in the state. Individuals practicing midwifery without a license, or working alongside unlicensed midwives, faced criminal penalties. The law had an exemption that allowed the practice of midwifery without a license through July 2023.
On February 27, 2024, nine individuals–midwives, midwifery students, and women who were or planned to be pregnant–filed a lawsuit in the Hawai’i state trial court, challenging the licensure restrictions. The individuals sued Hawai’i, the Hawai’i Attorney General, the Department of Commerce and Consumer Affairs, and its Director. The individuals argued that, by defining midwifery broadly, the law required a license for essentially any one providing care, advice, or information during pregnancy, birth, and postpartum. They also alleged that Hawai’i used arbitrary and discriminatory criteria in deciding eligibility.
Represented by the Native Hawaiian Legal Corporation, the Center for Reproductive Rights, and private counsel, the nine individuals alleged that the midwifery restriction law violated multiple rights guaranteed by the state constitution: the right to reproductive autonomy; to equality of rights; the right to pursue one’s profession free from government interference; and freedom of speech and expression. They also alleged that the law violated the state’s affirmative duty, as laid out in the state constitution, to protect Native Hawaiian traditional and customary practices, and that it was unconstitutionally vague and overbroad.The individuals sought declaratory relief, as well as a preliminary and a permanent injunction.
Judge Shirley M. Kawamura was assigned to the case. The court held a hearing on the motion for a preliminary injunction on June 10th through 14th.
On February 28, 2024, the plaintiffs moved for a preliminary injunction on three of their constitutional claims: the right to privacy, overbreadth, and Native Hawaiian rights. On July 23, 2024, the court granted in part and denied in part the plaintiffs’ request for a preliminary injunction. The court found that the plaintiffs were unlikely to succeed on their right to privacy or overbreadth claims. However, the court found that HRS § 457J did unconstitutionally interfere with Native Hawaiian cultural practices, particularly as it provided no “actual and meaningful pathway to exercise their traditional rights.” As the court found that the plaintiffs were likely to succeed on the merits and the law was causing them irreparable harm, the court granted a preliminary injunction enjoining penalties against individuals who practiced and taught traditional Native Hawaiian birth care but had no practical pathway to obtain a right to practice under the statute. The court stated that the injunction should remain in effect until a tenable recognition pathway for such traditional practices was formulated. It held that the existing Native Hawaiian practice recognition pathway under HRS § 457J was, in practice, unconstitutional. The court denied all other preliminary relief requested by the plaintiffs.
On May 5, 2025, the Hawai’i state legislature passed new, permanent legislation regulating midwifery that replaced HRS § 457J. The new legislation explicitly affirmed that the “practice of midwifery does not include native Hawaiian traditional and customary practices.” HB1194 HD2 SD3.
On October 13, 2025, the parties executed a settlement agreement that fully and completely resolved the plaintiff’s claims against the State. The agreement stipulated that there would be no criminal penalties for practicing unlicensed midwifery under Hawai’i law, and that apprenticeship-trained midwives would be eligible for a midwifery license. On October 17, 2025, the court approved the settlement agreement.
As of April 16, 2026, this case appears to be closed.
Summary Authors
Avery Coombe (9/29/2025)
Audrey Li (4/16/2026)
Documents in the Clearinghouse
Docket
Docket sheet not available via the Clearinghouse.Case Details
State / Territory:
Case Type(s):
Healthcare Access and Reproductive Issues
Key Dates
Filing Date: Feb. 27, 2024
Closing Date: Oct. 17, 2025
Case Ongoing: No reason to think so
Plaintiffs
Plaintiff Description:
Midwives, midwifery students, and women who were or planned to become pregnant.
Plaintiff Type(s):
Attorney Organizations:
Center for Reproductive Rights
Public Interest Lawyer: Yes
Filed Pro Se: No
Class Action Sought: No
Class Action Outcome: Not sought
Defendants
State
Hawai'i
Hawai'i Attorney General
Hawai'i Department of Commerce and Consumer Affairs
Defendant Type(s):
Case Details
Causes of Action:
Other Dockets:
Hawaii state trial court 1CCV-24-0000269
Available Documents:
Outcome
Prevailing Party: Plaintiff OR Mixed
Relief Sought:
Relief Granted:
Preliminary injunction / Temp. restraining order
Source of Relief:
Form of Settlement:
Court Approved Settlement or Consent Decree
Content of Injunction:
Order Duration: 2024 - 2025
Issues
Discrimination Area:
Discrimination Basis:
Affected National Origin/Ethnicity(s):
Affected Race(s):
American Indian/Alaskan Native
Affected Sex/Gender(s):
Medical/Mental Health Care:
Reproductive rights:
Counseling (reproductive rights)
Reproductive health care (including birth control, abortion, and others)
Case Summary of Kahoʻohanohano v. State of Hawaiʻi, Civil Rights Litig. Clearinghouse, http://www.dev.clearinghouse.net/case/45843/ (last updated 4/16/2026).