Zintkala Mahpiya Win Blackowl didn’t plan to have her sixth baby in a tipi on the windy plains of North Dakota during a historic resistance. Thousands of people had gathered for months in camps sprawled along the northern borderlands of the Standing Rock Sioux Reservation to protest the Dakota Access pipeline. But Blackowl already knew that she would birth her babies outside of a hospital, in the comfort and safety of a sacred space.

“So much of how women experience birth today has to do with how we are socialized,” says Blackowl, 36, whose first five children were born at home with the aid of certified and traditional Indigenous midwives. “We are told that you have to be hospitalized, that doctors know best, and that you can trust them with your life.”

In August 2016, having traveled from her home in Ashland, Oregon, to the Sacred Stone Camp on the Standing Rock Sioux reservation borderlands, she felt overwhelmed by the energy of the movement. Blackowl is Sicangu Lakota and Ihanktonwan Dakota, with origins and ancestral ties in the Dakotas, but she had spent most of her adult life in Oregon and Idaho. “I was pregnant, and I hadn’t been home [to the Dakotas] for 12 years,” she says, “but I saw that I was capable of coming to Standing Rock, and I had a responsibility to provide that support. It was about responsibility to my people.”

When she returned to the resistance camps in the fall, Blackowl was in her third trimester. Early on Oct. 12, while everyone slept, she delivered her daughter alone in her tipi, not long after her husband left to get female relatives. The baby girl was born without complication and in perfect health. She was named Mni Wiconi, “Water of Life.”

The arrival was a momentous event in the camps. But also in the larger Indigenous birth movement as Native American women take back their roles as life-givers and birth-workers and reclaim rights to their bodies, their traditions, and their birthing experiences. Interest is growing, from Indigenous certified nurse midwives—14 total, today, trained at the the American College of Nurse-Midwives—to mothers educating themselves and choosing to have unassisted births at home.

Measuring the complexity and scale of this grassroots movement is impossible, but evidence is plentiful. The Facebook page Indigenous Midwifery was launched in December 2013 and has since grown to almost 10,000 followers. Several popular artworks honoring traditional birth and motherhood, most notably by ledger artist Wakeah Jhane of the Comanche, Blackfeet, and Kiowa tribes, have been exhibited at the Smithsonian and the Santa Fe Indian Market.

Since the late 1800s, Native Americans’ lives largely have been dictated by federal government policies designed to stamp out traditions and create dependency on white institutions. Many traditions and ceremonies were outlawed, and families were separated as Native American children were forcibly removed from their homes to be placed in Indian boarding schools, where their language and culture were forbidden. Then, in 1955, the federal Indian Health Service was established to manage the health care of Native Americans. Birth became a medicalized affair and was, more often than not, directed by white male obstetricians.

But that morning in Standing Rock, intersecting movements for Indigenous self-determination and human rights created the backdrop for an extraordinary traditional birth with women at the helm.

“A lot of the time in hospitals, people don’t approach women in a way that says to them that they are the center of the birth, or in a way that gives the woman control,” says Nicolle Gonzales, 36, a Navajo nurse midwife from New Mexico who was nearby when Blackowl gave birth. “When a woman is birthing, it’s her space, and we have to honor that space. But nobody tells you that.”

Gonzales traveled to Standing Rock to show solidarity and to help provide culturally responsive and respectful care for women at camp. While working as a nurse for two years in an IHS hospital in New Mexico, Gonzales recognized a need for better prenatal and birthing care for Indigenous women, and this inspired her to pursue training as a midwife.

Gonzales is a mother of three and the founder and executive director of the Changing Woman Initiative, a nonprofit organization in Santa Fe working to renew Indigenous birth knowledge. The initiative is planning a culturally centered clinic and birth center committed to providing family-centered care where the woman is the decision-maker.

“Indigenous midwifery is not a new thing,” Gonzales says. “It has always been here. We’re just beginning to bring those Indigenous perspectives forward again.”

In the span of just a century on reservations, Indigenous women were stripped of their power as matriarchs.

In the span of just a century on reservations, Indigenous women were stripped of their power as matriarchs, once foundational to their communities—as knowledge keepers, decision-makers, and birth workers. Native American communities overall had been threatened by genocidal government policies from the early colonies to the 1970s. At least 25 percent of Native American women who received care in IHS hospitals were involuntarily sterilized, according to a 2000 American Indian Quarterly report.

But Indigenous women are trying to regain that power. Jodi Lynn Maracle, 33, a traditional doula from the Tyendinaga Mohawk nation, says the effort is fivefold. “We talk about reclaiming language, and ceremony, and tradition, but it’s also about reclaiming our bodies and our relationship to our bodies, especially as women.”

Maracle is mother to a 3-year-old boy. She is a doula with training from the Seventh Generation Midwives in Toronto and from the Six Nations Birthing Centre. She is pursuing a doctoral degree at the University of Buffalo in New York, centering her research on Haudenosaunee midwifery and birth work.

“During the boarding school era, there weren’t many choices for Indigenous people,” Maracle says. “Today, there are so many choices. I think the empowerment is just in having people say that you have a choice.”

Women who choose to have their babies in hospitals still have ways to incorporate traditions.

Women who choose to have their babies in hospitals still have ways to incorporate traditions. Simple adjustments can be made during birth: singing traditional songs; facing the bed toward the east, where the sun rises; squatting versus lying down; or cleansing the area with sage or other traditional medicines. The key is for women to ask a lot of questions and to educate themselves as much as possible about their options before, during, and after birth.

Yet reaching back to traditions, or decolonizing birth, is not so straightforward in many Indigenous communities. Some tribes have fewer teachings intact today, and it may not be as simple as asking an elder. Women may have to consult historical records or reach out to sister tribes, and above all, re-establish a relationship with their bodies and intuitive power as women.

After the births of each of her children, Blackowl chose to root her newborn babies to the physical world by burying their placentas in the ground—a tradition tied to Lakota/Dakota birth. During the Standing Rock resistance, Blackowl buried the placenta that nurtured Mni Wiconi near the place of her birth, at the height of a movement for Indigenous self-determination.