With rituals, knowledge and care, Alaska Native birthworkers support families through the birthing process

While the postpartum herbal tea was brewing, Nungasuk Abra Patkotak filled a small tub with warm water, dried cedar leaves, rose petals and Epsom salts. She placed the tub in front of Sara Thomas, sitting on the couch with her newborn son Sequoya.

“Make sure it’s not too hot,” Patkotak said. “You just need to be gentle on your body when you’re healing.”

Originally from Utqiaġvik, Patkotak works for the Alaska Native Birthworkers Community, an organization that helps families during conception, pregnancy, birth and postpartum — and makes sure that Native families don’t feel alone.

When an Alaska Native woman gives birth, she is traditionally surrounded by aunties, sisters and her mother, who all help her transition to motherhood. Today, most Alaska Native women fly to Anchorage to give birth and often don’t have their support system with them.

“Traditionally, our people had rites of passage and societal structures that really demanded that a new family be cared for by everybody surrounding them,” Benozaadley Lena Jacobs, with the Alaska Native Birthworkers Community, said during the Elders and Youth Conference last month. “A lot of us are really hungry to reclaim those ceremonies and relearn that knowledge and reclaim those roles to support each other as sisters, aunties, mothers.”

A grassroots organization, the Alaska Native Birthworkers Community offers biweekly virtual talking circles, prenatal childbirth preparation retreats, assistance at birth, postpartum support and trainings for Indigenous birthworkers.

“We figure out what kind of support a family needs, and then we’re just available for their pregnancy,” Patkotak said. “And if they want us to be at their birth, we can be at their birth too.”

Birthworkers don’t work for the Alaska Native Medical Center, but the hospital allows them to assist families during birth as doulas. This was the case for new mother Thomas, who had lived in Utqiaġvik since she was a child before moving to Anchorage in 2020. She hopes to move back up north eventually.

“We had an amazing birth experience and Abra being there — it makes all the difference,” Thomas said. “It’s just a wealth of knowledge and support and Indigenous worldview.”

During the postpartum period, Patkotak said she visits some families, dropping off groceries, bringing them tea and massage oils and helping them with doing dishes, folding laundry or cleaning. At Thomas’ house, Patkotak made a footbath for the mother, helped burp the baby and made sure the dogs didn’t break through the gate outside the house.

“I’ll just see what the mom needs,” she said. “It looks really different for every person.”

“One of my favorite things about the birthworkers group is just the quality of their preparation,” Thomas said. “All of it is so intentional and special — just the ceremony of it all.”

During prenatal time, Thomas burned sweetgrass in her house every morning and her husband, Michael Thomas, made tea for her.

“It’s like, a beautiful way for dads to be involved,” Thomas said.

To grow the network of Indigenous birthworkers across the state, the community offers free trainings for Indigenous childbirth educators, Indigenous lactation consultants and Indigenous doulas.

“Our best care,” Jacobs said, “is designed by our people, and it’s offered to our people, really grounded in our values and our teachings and our respect and love for each other.”

Some of the people who go through trainings end up becoming birthworkers with the Alaska Native Birthworkers Community, Patkotak said. Having more birthworkers would help fill the need in the Alaska communities.

“Traditionally, everyone always had someone there for support, who was from their community, who knew them, who knew their stories, who knew how to support them in that way,” she said. “We want that for our families.”

Existing specialists with the Birthworkers Community are staying busy. Patkotak alone has been to 30 births in the last year.

“It’s really picking up in the last few months,” she said. “We’re definitely getting more and more requests for support.”

Before starting the Birthworkers Community together with Jacobs, Charlene Apok, Margaret David, Stacey Lucason and Stefanie Cromarty, Patkotak used to run the Pre-Maternal Home for the Arctic Slope Native Association in Utqiaġvik. She said that in her family lineage, some of her ancestors were also birthworkers.

“So it’s important for me in reclaiming family knowledge,” she said. “Being a doula is what I really wanted to do.”

The community offers services to people from across the state — including Utqiaġvik and the North Slope, where Patkotak is from.

“Barrow is 750 miles from Anchorage, so if families are far from home, and they see me, it’s a familiar face for them and they feel less alone,” Patkotak said. “My favorite part is being able to support my community members and my family members and to make those connections if they’re really far from home.”