For Native Birth Workers, That ‘True Detective’ Birth Scene Was Extra Meaningful

In reality, there’s a major shortage of Alaska Native midwives practicing in the state, and a new executive order threatens their existence.

by Kate Nelson

With a captivating plotline and complex characters, True Detective: Night Country has transported viewers to the fictional far-north Alaskan town of Ennis, where two detectives are investigating the disappearance of a group of scientists during the weeks-long period of darkness dubbed the polar night. The fourth installment of HBO’s acclaimed mystery drama anthology series has also highlighted the many issues affecting tribal communities in the wake of colonialism, including historical displacement, ongoing discrimination, environmental issues, the Missing and Murdered Indigenous Women crisis, and the fight to reclaim ancestral wisdom.

As detectives Liz Danvers (played by Jodie Foster) and Evangeline Navarro (played by Afro-Indigenous boxer turned actor Kali Reis) peel back the complicated layers of the case, it becomes clear that the recent vanishing is somehow linked to the unsolved murder of Iñupiaq activist and midwife Annie K. One particularly moving flashback in Episode 3 shows Navarro busting into a rural birthing center to arrest Annie for vandalizing a nearby mine, but she finds her in the midst of facilitating a water birth. Despite her reason for being there, Detective Navarro is then welcomed to join the circle of birth workers and community members who are singing and speaking words of encouragement to the expectant mother in the warm, candlelit setting. It's a moment that masterfully exemplifies the tension between modern-day interests and ancient Indigenous practices.

It’s a tension that resonates with real-life Native birth workers. “Being an Indigenous midwife is inherently political,” says Cowlitz midwife and herbalist Rhonda Lee Grantham, who in 2016 founded the Center for Indigenous Midwifery. “I appreciated the portrayal of Annie as a strong activist and also a culturally grounded Indigenous midwife, because the reality is that we live in a world where we’re constantly fighting for our rights and our land while still caring for our community members. I remember her saying something like, ‘You can arrest me later, but right now this baby needs to be born.’ I have felt that way so many times throughout life, trying to serve our community while also being on the front lines.”

“Being an Indigenous midwife is inherently political.”

Grantham was pleasantly surprised by the True Detective scene, which stands in contrast with past prejudiced depictions of Native birthing practices. “Midwife portrayals in the media are usually centered around tales of their persecution,” she says. “Indigenous practitioners, in particular, are either portrayed as ignorant or placed on this very unreal pedestal of being all-knowing. Watching this scene, however, I really appreciated that we had a strong, skilled midwife in circle with other community members who were supporting the birth giver.”

Of course, the scene wasn’t completely true to life, especially when it came to the infant resuscitation. Grantham points out several inaccuracies, such as a lack of umbilical cord cutting, the use of chest compressions on a newborn, and the baby’s near-immediate return to life and to its mother. But Grantham was glad to see an intelligent, capable birth worker shown resolving the complication, especially considering that media depictions of home births often end in tragedy.

Annie K, played by Nivi Pederson, talks to Evangeline Navarro, played Kali Reis, on the night of the homebirth.Michele K. Short for HBO

At her Washington-based center, Grantham is helping reclaim and revitalize Native birthing practices through birth worker training as well as community-based support services for expecting and existing parents. One of her current midwifery students is Iñupiaq birth worker Abra Nungasuk Patkotak, who co-founded the Alaska Native Birthworkers Community to offer free direct support to Indigenous families. Now based in Anchorage, she is originally from Utqiagvik, North America’s northernmost settlement and the loose inspiration for True Detective’s fictional town.

“People deserve to give birth in their communities surrounded by their loved ones.”

For Patkotak, it’s particularly troubling that the show centers around an Indigenous midwife being murdered, because in reality, there’s a major shortage of Alaska Native midwives practicing in the state. “The fact that we see Annie alive in this flashback but know from the first episode that she’s dead was really heavy for me,” she says. “Right now, there are only two practicing Alaska Native midwives here in Alaska, and we don’t have active birth centers in rural communities staffed by midwives. Home births with a traditional Iñupiaq midwife haven’t really happened since the ’90s, so I felt a deep sense of grief seeing that.” (She points out that there are many non-Native midwives offering services in Alaska, who tend to work in more urban areas.)

Further complicating things, Alaska Governor Mike Dunleavy (R) recently issued an executive order that stands to abolish the state’s Board of Certified Direct-Entry Midwives, thereby threatening women’s right to choose where, how, and with whom they’ll give birth. That’s particularly troubling in a state where midwives oversee about 33% of births, the highest rate nationwide. Birth workers and supporters are pushing back, but unless the order is struck down by the state legislature, it will go into effect later this year. The results, Patkotak says, could be devastating.

As is, expectant mothers in rural areas are often pressured to evacuate to Anchorage to give birth in a hospital setting, often without their support system in place there. “People deserve to give birth in their communities surrounded by their loved ones,” says Patkotak. “It’s extremely stressful for a pregnant person at 36 weeks or even earlier to have to pack up all their belongings, leave their families behind, and be alone while in labor. There are a lot of policies in place that just don’t support healthy births for Alaska Native people, which is why we created the Alaska Native Birthworkers Community with the goal of being there for these families.”

Patkotak is optimistic that one day traditional Alaska Native birthing practices will once again be thriving and better reflect what’s shown in that True Detective water birth scene. “It was so beautiful to see Iñupiaq women supporting other Iñupiaq people in their power during birth, with traditional practices, singing, and people speaking Iñupiaq to each other,” she says. “Historically, we had this wonderful transmission of knowledge with experts like Annie in our communities providing care, but colonization stopped those lines of knowledge transmission.”

“We have a long way to go in reclaiming our practices in Alaska, but we’re working toward a place of health equity and access,” Patkotak continues. “My ancestors delivered babies, and training to become a midwife has been incredibly healing for me. Maybe seeing [True Detective] will inspire other Alaska Native people to pursue a midwifery journey, too.”

An Alaska Native Tlingit tribal member, Kate Nelson is an award-winning writer and editor living in Minneapolis. She is currently the editor-in-chief of Artful Living, and has written for publications including ELLE, Esquire, Architectural Digest, Teen Vogue, Bustle, Thrillist, Saveur, Civil Eats, Andscape, and more.