Women of Wednesday: Nicolle Gonzales on Midwifery and the Decolonization of Healthcare

WOMEN OF WEDNESDAY is a weekly micro-interview series featuring women of color in various industries and walks of life, focused on highlighting their pursuits and making it easy for readers to support their endeavors. If you would like to be featured, please submit your answers to the below five questions here.

Nicolle L. Gonzales, 36, BSN.,RN.,MSN.,CNM, Diné (New Mexico)

1. Tell us about the work you’re doing and why it’s important.

What set me on the path to midwifery was seeing my community struggle and feeling the necessity to step up and do something about it. Nine years later, I have a better understanding of the underlying inequality and human rights issues that have placed American Indian women and communities in a position of vulnerability. I also recognize the delicate and complicated relationship tribes have with the U.S. Government. These centuries old treaties basically outlined the U.S. Government’s obligations to provide education and healthcare for the land and resources they took from the tribes, at the time they were establishing themselves in what is today North America.

Since the 1950’s, Indian Health Services has been the primary healthcare delivery system for American Indian people in the United States. It is well documented that IHS facilities are chronically underfunded, which continues to create further disparities in the services available to serve over 500+ federally recognized tribes in the United States.

Although health disparities have been well documented in Indian country, I believe solutions to these issues need to be reframed through the lens of reinforcing and reintroducing traditional Indigenous wellness teachings from conception and through the lifespan. The non-Indigenous perceptions about healing place value in disease management through the implementation of Western medical practices. Indigenous worldviews teach that healing and wellness is not just a physiological process; rather, that wellness requires a balance between spiritual, mental, physical, and emotional forces. The imbalance between these things can manifest as illness in the body, mind, and spirit.

The principles of midwifery actually take into account all of these things, thus working with women and families becomes an opportunity to implement wellness teachings that promote a healthy lifestyle at a time that is most critical. In the last 20 years or so, there has been a growing movement to reclaim Indigenous birth practices and restoring Indigenous women’s medicine to heal our communities and our selves. In many Indigenous cultures, women are recognized as the “life givers,” the “healers,” the “keepers of water and earth.” Helping women return to the knowledge that has sustained us as American Indians is a vital step in the direction to heal our communities from historical trauma.

My work through the creation of Changing Woman Initiative is to be a catalyst for transformation. Over the last 3 years I have been actively working to create a Native American Birth center and wellness clinic, which will be a place of healing and transformation for women and families. The use of plant medicines harvested from our traditional territories is a dying practice, as well as the language we use to support our women during all her life cycles. I believe by reintroducing these two important elements during pregnancy and all the stages of life, we reinforce a woman’s role in her community and her relationship to the environment. Many Indigenous communities, creation stories, life way teachings, and ceremonies teach us how to care for each other, mother earth, and ourselves. Many conversations with women in my short career has lead me to believe that this model of wellness from an Indigenous perspective is not promoted or supported in our mainstream healthcare systems, which is why building a separate physical space and wellness framework is necessary.

2. What has been the biggest challenge you’ve faced in pursuing the work that’s important to you?

I am a visionary: I see the bigger picture and I am not satisfied with how things are. I believe as sovereign nations, our tribal communities are not exercising their sovereign rights. We have relied on an imperfect healthcare system like IHS for so long that many are unable to see and create a healthcare delivery system that actually reflects the communities they serve. Which means, as I am learning to be a businesswoman, creating a non-profit, I am also educating those in my community about this “vision” of a healthcare system that actually can meet our needs. I feel I am often learning and doing multiple things at once. I have learned that I cannot be an expert in everything. I also work full-time as a full-scope Nurse-Midwife in a small town, where I am on-call 24/7 for my clients. Finding balance between my work with this non-profit, my work as a nurse-midwife, time with my family, attending ceremonial and traditional obligations in my Native American community, and time alone is very, very difficult. I find many days there does not seem to be enough hours in the day.

Additionally, creating resources in healthcare shortage areas or in places where there is not an infrastructure to support a wellness center that we are envisioning with Changing Woman Initiative, requires brainstorming and leveraging what we have to get what we need.

Being a leader in this means we have to think ahead every day. We have to build a road where there is none. Which means we have setbacks and challenges that are hard to plan for, but we are expected to navigate and overcome. I try not to spend to much time thinking about all the reasons we “can’t” rather I spend my energy on how we “can.”

3. What do you need in order to continue your work in the way you envision?

As we begin to grow as an organization, we will be strategizing and problem solving with our community. I hope that when we are done and we have our beautiful birth center and wellness clinic, we will also have a motivated workforce and community beside us. Creating and maintaining a community presence is, in my opinion, vital to our sustainability. A critical problem we have right now is the lack of Indigenous midwives working in the United States. Educating American Indian women about midwifery as a career option and funding to support them on their educational journey is important. The vision to create a Native American birth center and wellness clinic is shared by many American Indian women across the country, but there is a lack of Native American midwives practicing in the United States today.

I envision, in the near future, funding to support a cohort of American Indian women committed to the midwifery path and each of us as midwives teaching them the art of midwifery so that they can return to their communities or even work at the birth center we are creating.

Funding to work with local farmers, create mobile clinics in geographically hard-to-reach areas, and home visiting programs created to meet the needs of American Indian families are additional areas we will be focusing on with Changing Woman Initiative.

4. Where and how can we support you to make #3 happen?

You can follow us on Twitter, Facebook, and check out our webpage. We are working on releasing a quarterly newsletter to give our supporters updates on all that we are doing. If you would like to make a donation, you can write it to Changing Woman Initiative and mail it to 9 Urraca Lane, Santa Fe, NM 87506. We are working on a PayPal link on our website. We also welcome suggestions for grant foundations and companies interested in partnering with us to fundraise.

5. What is your favorite quote?

“I alone cannot change the world, but I can cast a stone across the waters to create many ripples.” –Mother Teresa