Rebekah Tigausiñia Kiliñik Villalon held her three-month-old son in her Anchorage home on a recent evening, nursing him and comforting him when he cried.
Villalon is Iñupiaq, from Utqiaġvik, and she gave birth to her son and her now-2-year-old daughter in Anchorage, where they now live. She said she can’t imagine what their births would have been like without her doula, from the Alaska Native Birthworkers Community, who supported her after two miscarriages.
“I was having so much anxiety,” Villalon said. “It meant the world to me that she was there to support me through all of that prenatal experience.”
The Alaska Native Birthworkers Community, or ANBC, is a collective of Indigenous midwives and doulas who work with Indigenous mothers, like Villalon, during pregnancy, birth and pregnancy loss. They aim to make the birth experience easier for mothers, including those living in rural Alaska who often must travel hundreds of miles to big cities or hub towns for care, sometimes separated for months from their families, communities and their culture.
Since ANBC's launch in 2017, the birthworkers have provided free care to hundreds of mothers. They attend medical appointments with them, advocate for them and connect them to traditional practices.
Villalon said she loved that her doula, Abra Nungasuk Patkotak — who is also Iñupiaq from Utqiaġvik — shared traditions about pregnancy and birth.
“While pregnant, you don’t stand in the doorway,” Villalon said. “You either enter or you stay out. And reason being: It could delay labor or impact labor in some way. And so, while pregnant, I would make it a point to either go in or go out.”
Patkotak has worked as a doula for 14 years and co-founded ANBC.
“A big part of our mission, and vision and values [is] reclaiming our practices and reclaiming what’s rightfully ours,” Patkotak said. “And traditionally, we all had people that were there to support us throughout our pregnancy and birth and even in preconception.”
Margaret Gee’eedoydaalno Olin Hoffman David is another founder. She’s Koyukon Athabascan and said one of the motivations for starting the collective was to support rural Alaska Native mothers who must travel for care during late stages of pregnancy.
“We were concerned just learning more about the rural, Indigenous rural birth experience of being sent away from home, oftentimes being here alone, completely apart from their families and support systems and communities and foods and lands and waters,” David said.
Patkotak and David said support for mothers can look a lot of different ways. It may include helping set up birth plans, advocating for someone with medical providers, or nuanced, emotional care. They’ve brought plants from the tundra when supporting someone from the Arctic, to help a mother feel more at home. And Patkotak said their work also includes cultural translation and advocacy, including interpreting body language.
“Alaska Native people speak with their eyebrows and their noses and their face a lot,” Patkotak said. “And health care providers might not understand that.”
Patkotak said ANBC’s long-term mission is to help all Alaska Native people access culturally-relevant care close to home, and part of that effort involves growing the number of Indigenous birthworkers. Research shows doulas improve birth outcomes and so does culturally-matched medical care.
Patkotak said, traditionally, every community had a midwife or someone who was knowledgeable about birth to support people.
“And now in Alaska, as far as we know, there are only two practicing Alaska Native midwives,” she said. “And that’s not enough, when we have 150- to 200,000 Alaska Native people in the state. They deserve culturally matched care.”
Patkotak is currently studying to become a midwife herself, through the Center for Indigenous Midwifery.
Villalon, the mother in Anchorage, said it was important to work with Patkotak and have the safety of nearby hospitals.
“I did not second guess myself in choosing to live and give birth here because of the resources that are available, because ANBC is here because if I needed surgery, it is available here,” Villalon said.
She did end up needing that emergency care. After giving birth to her son, she was rushed to a nearby hospital where a gynecologist removed her placenta manually. And she had complications.
“I lost a lot of blood, a significant amount of blood,” Villalon said. “I think they said that I lost three liters of blood, which is a lot.”
Patkotak stayed with her the entire time, and updated her family.
“It was so powerful,” Villalon said. “For me to have that type of support, to that extent, to that level is just — it just gives me goosebumps. I just feel so lucky and I feel so special and grateful.”
Villalon said working with Patkotak helped her see her ancestors were with her, empowering her to give birth.
Patkotak said the Alaska Native Birthworkers Community aims to help all the mothers they work with feel connected, even when they’re far from their ancestral home.
