Kaniwa Kupenga-Tamarama

Midwife

Ko Hikuranga te maunga
Ko Waiapu, Mata, me Makaote ōku awa
Ko Te Whānau-o-Ruataupare, Te Aitanga-a-Mate, Te Whanau-o-Rakairoa ōku hapū
Ko Ngāti Porou te Iwi
Ko Kaniwa Kupenga-Tamarama tōku ingoa

Whakanoa with Kaniwa Kupenga-Tamarama

The 2nd - 8th of August was Breastfeeding Awareness Week. Breastmilk is the nourishment of life for our youngest and most precious, however, breastfeeding can be difficult for both māmā and pēpi to get used to and learn. Breastfeeding is an incredibly beautiful experience, but it is not without its challenges, so it is important for whānau to have the right information and support.

In this issue of Atea, we spoke to Kaniwa Kupenga-Tamarama, a Māori midwife, who learned and worked in Tāmaki Makaurau and is currently based in Gisborne.  We discussed how to promote, maintain and encourage breastfeeding in our Māori māmā and whānau. 

Kia ora Kaniwa, tell us about your journey to becoming a midwife?

After doing an early childhood development class at high school, where we learnt about the first 1000 days of development and I was completely fascinated with embryonic and fetal development. My dad at the time was encouraging me to be a wahine Māori undertaker, but I'm the type of person who would scarper to the kitchen and help out in the wharekai rather than be with the Tupapaku at Tangi. So at 16 years old, I knew Midwifery would be a big focus in terms of career opportunities, but needed more life experience and maturity to be ready to enter University. I qualified as a Midwife in 2011 at the age of 25. I started my Midwifery training at AUT University in 2007 and it took me 5 years with a degree extension to complete my degree as I was a māmā to two babies. At graduation, I had a 22-month-old and a 35-month-old!

How do you feel about being a midwife, particularly for Maori māmā and whānau?

I love Midwifery as a healing profession because you are working from a space that celebrates the creation of life and works with predominantly women to empower them through the transformations that hapūtanga and motherhood requires of them. It’s a very sacred space, as a Midwife you are honoured to be a part of women's lives. You know that you will be part of one of the most vulnerable, intimate and sacred spaces of the continuum of whakapapa. In 2015 I joined Birthroots Midwifery, where I practised as a community "private" Midwife in South Auckland for 3 years. I predominantly looked after whānau Māori, but also had the privilege of looking after other whānau from other cultures.

Working with whānau Māori is very rewarding, especially when you become the Midwife for the whānau. I have had the privilege of looking after sisters, sister in-laws, cousins through whānau referrals. You really get to know the whānau unit better.

It’s different when you go into whānau homes, do your necessary check-ups & stay to kōrero more about other things that are important, i.e., watch a Matatini group, have a cup of tea together or discuss what’s trending on social media!

What do you think is important for your mahi, particularly around health promotion?

When you build these kinds of relationships, you can do more effective health promotion. For instance, I've had several māmā whose older tamariki have had really bad rotten teeth and after telling them they needed urgent dental assessments (that would be free) that are important for protecting their holistic wellbeing or being able to understand their other needs (housing, financial, clothing for baby, kai etc).

Sometimes you would be able to probe deeper into sensitive questions surrounding domestic violence issues, empowering women to stand up against workplace discrimination or prejudice. You become a protector of women.

What do you believe you offer differently as a wahine Māori working as a midwife?

There was no matauranga Māori incorporated into training as a Midwife and very few Māori Midwives to offer mentorship when I was training to be a Midwife. A lot of us (Māori midwives) feel isolated because we are far and few between, so when you find another wahine Māori who is a Midwife, you naturally gravitate to each other for cultural support.

Nowadays, social media has helped to bridge that gap and each generation of trainee midwives have helped to inspire other wāhine Māori to enter the workforce. There’s definitely a karanga that your wairua hears to go into Midwifery. Just as you hear the karanga to enter Midwifery, you hear the karanga to mātauranga Māori and transition your Midwifery practice into a kaiwhakawhānau practice. Eventually, there will come a time when you hear the karanga to return home to live and work amongst your own whānau on your own whenua.

How has your journey as a midwife and combining matauranga Māori manifested?

I heard the karanga to return "home" in 2017 when I travelled to Toronto, Canada to attend an International Midwifery Confederation Conference. I attended indigenous Midwifery workshops and knew I had to return home to practice. Within the 3 weeks before leaving to go to Canada, we buried my koro and then buried my husband’s kuia. It really rocked us to our cores and I made the bold decision to actively look at relocating back home. When we travelled to Toronto, I was 3 months hapū with our 4th child and by the time she was 8 weeks old, we moved into our new home in Turanga-nui-a-Kiwa. Being a 'young' Māori Midwife, it has definitely helped me to understand and experience the same life issues, my client’s journey through. I have looked after 1000s of women and babies during my career and delivered probably close to 500 babies myself. Sitting and listening to all these wahine, we all experience similar issues, but don’t always share our struggles or ask for help for fear of judgement and rejection.

After training as a Life Coach, I started my Kia Kaha Mama page. Throughout my midwifery career, I have learnt that I am more aligned to an eastern philosophy of health to which kaupapa Māori resonates closely with.

My practice as a kaiwhakawhānau at this stage is reclaiming the maramataka to empower the holistic health of wāhine, who as whare tangata can be taught how to care for themselves and heal intergenerational trauma they've inherited and stop the transfer of trauma onto their tamariki.

This way, I get to help wāhine who are not my 'clients' to normalize self-love, self-care and personal development. What triggered this was a deeper exploration into why māmā develop pregnancy complications during pregnancy or labour, and most times it's due to unresolved issues within the whānau bubble, with the wāhine not being honoured as te whare tangata or being cared for post-birth when she goes home because the priority of working overrides maternal holistic health.

I’ve just completed my post-grad in Midwifery and it definitely has sealed my professional (& personal paradigms in regards to māmā & pēpi care). I'm excited to say that in my new role, I will be helping to co-create a kaupapa Māori service that will focus on the first 1000 days of development for pēpi. I'm most excited about including rongoā into the service and accessing mirimiri for hapū/new mama, promoting breastfeeding as rongoā, as well as muka and wahakura as other resources that are kaitiaki of our whakapapa and normalizing other traditional hapūtanga/whakawhānau practices such as oriori, karakia, karanga in the birthing space, whenua ki te whenua, wāhine wānanga and continuing our local promotion of "tapu whilst hapū".

What are your thoughts on breastfeeding, and promoting breastfeeding?

Breastfeeding is vital to strengthening our whakapapa and is a right for our pēpi. It’s a live food, with our DNA and has rongoā in it. That’s why you will hardly see a breastfed pēpi in hospital, māuiui from the flu/cold. I encourage all my māmā to breastfeed for at least 2 winters to help build their immune system. We've just seen how overwhelmed our hospitals were trying to deal with RSV amongst our communities after our borders opened.

It shows us that we need immune systems that can handle illnesses that travel globally, nationally and regionally into our communities and whānau.

Breastfeeding helps us as māmā provide the first line of medicine to protect our pēpi.

When you work as a Midwife, you assess systemic issues and move into positions to help resolve those issues to improve the service for whānau accessing the service, which can be a frustratingly snail-slow paced environment to be in. For the last 3 years, I have been working as a community midwife with a very small caseload and moved to work as the Mokopuna Ora Coordinator for Hauora Tairāwhiti, focusing on SUDI Prevention, which really is the first 1000 days! I’m a midwife with the services that are a part of the māmā & pēpi realm and working with whānau!