Living on the Edge of a Volcano

Midwife Roxanne Estes tells of living at the epicenter of the Big Island's volcanic eruption, losing her home and birth center, and continuing her practice under extreme conditions.

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It all started on May 3, 2018, during our quarterly childbirth class. I had several pregnant women and their partners that night, all sitting quietly in their newly learned relaxation positions in preparation for their upcoming natural childbirths. These classes were held at our lovely Luana Gardens location, a beautiful and safe birth home that was just what its Hawaiian name meant, “Place of Relaxation.” Luana Gardens was graced with a long, winding, tiled driveway bordered by flowers of every imaginable color and a sprawling lawn accentuated with a majestic magnolia tree and thriving, fragrant citruses. (Their health could be attributed to the occasional placenta buried close by.) Our warm, comforting interior was infused with powerful, yet gentle birth art and many, many photos of mothers and fathers holding their precious babies. It was truly a safe harbor for women and their families. We began to feel one subtle earthquake after another about every five minutes or so. I saw my clients’ eyes widen, but mostly, we dismissed the events, finished our group meal, and then disbursed. If we only we had known what was to come!

That day, Fissure 1 erupted, and large, expanding cracks appeared in many of the roads in our Leilani subdivision. Over the next 48 hours, about 300 earthquakes occurred. My husband, Sam, and I would wake up in our bedroom at night and say, “Was that another one?” and then go back to sleep. In retrospect, I ask myself why we would think this was normal when we were literally sitting on top the largest fissure (volcano) of the 2018 eruption, Fissure 8.

On May 4, Fissure 2 started spattering, and civil defense went door to door to notify residents on Luana Street that they should leave the area that night. I felt thankful I had delivered all of the babies that were due the preceding month and had no mothers imminently expecting. We grabbed a few personal belongings, and then I ran over to Luana Gardens and packed as many birth supplies as I could into my van, Birth Mobile, so I could continue my midwifery practice. Of note, we also gathered all of our cats except our oldest, Walter. He was sadly left behind because it was his habit to be away from home for several days at a time. Scared and anxious, we set off to spend the first night away from our sweet home of 25 years. Our destination was my clinic a few miles down the road in a safe area. We were in shock, but were thinking that this would all blow over soon.

“We made it to our driveway on foot, feeling like the ground could open up at any minute and swallow our car.”

It all started on May 3, 2018, during our quarterly childbirth class. I had several pregnant women and their partners that night, all sitting quietly in their newly learned relaxation positions in preparation for their upcoming natural childbirths. These classes were held at our lovely Luana Gardens location, a beautiful and safe birth home that was just what its Hawaiian name meant, “Place of Relaxation.” Luana Gardens was graced with a long, winding, tiled driveway bordered by flowers of every imaginable color and a sprawling lawn accentuated with a majestic magnolia tree and thriving, fragrant citruses. (Their health could be attributed to the occasional placenta buried close by.) Our warm, comforting interior was infused with powerful, yet gentle birth art and many, many photos of mothers and fathers holding their precious babies. It was truly a safe harbor for women and their families. We began to feel one subtle earthquake after another about every five minutes or so. I saw my clients’ eyes widen, but mostly, we dismissed the events, finished our group meal, and then disbursed. If we only we had known what was to come!

That day, Fissure 1 erupted, and large, expanding cracks appeared in many of the roads in our Leilani subdivision. Over the next 48 hours, about 300 earthquakes occurred. My husband, Sam, and I would wake up in our bedroom at night and say, “Was that another one?” and then go back to sleep. In retrospect, I ask myself why we would think this was normal when we were literally sitting on top the largest fissure (volcano) of the 2018 eruption, Fissure 8.

On May 4, Fissure 2 started spattering, and civil defense went door to door to notify residents on Luana Street that they should leave the area that night. I felt thankful I had delivered all of the babies that were due the preceding month and had no mothers imminently expecting. We grabbed a few personal belongings, and then I ran over to Luana Gardens and packed as many birth supplies as I could into my van, Birth Mobile, so I could continue my midwifery practice. Of note, we also gathered all of our cats except our oldest, Walter. He was sadly left behind because it was his habit to be away from home for several days at a time. Scared and anxious, we set off to spend the first night away from our sweet home of 25 years. Our destination was my clinic a few miles down the road in a safe area. We were in shock, but were thinking this would all blow over soon.

Crossing the Barricade
On May 5 at 1 am, unable to sleep, Sam and I drove back into our subdivision. We were met by a police barricade, but Sam finally insisted that they let us in unless it was against the law. As we drove up Luana Street, we could see the now fountaining of Fissure 2. The sky was red, and it was as if fireworks were going off in our closest neighbor’s yard. Most unnerving were several large cracks across the pavement of Luana Street with intense, raw sulfur fumes wafting up. The ground felt uneven, and the roar of the volcano under our feet was frightening. We left the car, feeling like the ground could open up at any minute and swallow it, and made it to our driveway on foot. But with the earth shaking, the fumes rising from underground, and the volcano roaring right next to us, we both looked at each other, eyes bulging, turned at the same time, and ran back the way we came. Shaken, we returned to our clinic refuge. We didn’t talk much that night, nor did we sleep. The next day, as Fissure 8 started its journey toward becoming the main eruption, we grew increasingly concerned about Luana Gardens. With distraught hearts, we couldn’t stop monitoring Facebook posts, civil defense updates, and helicopter fly-over videos, including some drone shots.

Rescue of Luana Gardens
The air was thick with toxic volcanic fumes, the road was full of deep and widening cracks, and the roar of Fissure 8 was screaming when a young man, Demian Barros, whom I will always consider a kind-hearted hero and adventurer, courageously entered our Luana Gardens Birth Home one last time. I spoke to him on the phone while he was inside gathering birth equipment and supplies and whatever else he could carry, and I could hear the emotion in his voice as he tearfully shared beautiful memories of his toddler son being born underwater in one of our birth tubs surrounded by the lush vegetation and exotic flowers. Demian was also able to rescue a beautifully handmade cradle that my children’s father had made for them many years ago. His selfless actions ensured the sustainability of my treasured practice and enabled me to provide services to the women in the Pahoa and surrounding communities.

Roxanne Estes (far right) with clients at Luana Gardens.


On May 7, Sam made a last, harrowing entry to our home, gaining access by chopping through the jungle from a neighbor’s house and retrieved special belongings. Of great significance, Sam also grabbed Walter in his arms before he traipsed back through the jungle. My husband had fretted for days, thinking of our cat facing the volcano by himself.

Transitioning to a Home Birth Practice

With heavy hearts, my daughter, who is also my office manager and birth assistant, and I had to make decisions regarding our now-lost birth home; we had many women scheduled to give birth in the upcoming months. Initially, we looked for a new birth home, but after one disappointing lead after another, we decided to wait until the lava slowed and the housing market balanced. Complicating matters, although we were now staying at the vacation house of a good friend, without a personal home, it was hard to stabilize myself. The grief and the following depression were real and unavoidable, even as I tried to push the feelings away.

“With heavy hearts, my daughter and I had to make decisions regarding our now-lost birth home.”

We called our clients with the announcement that we were transitioning into an exclusively home-birth practice. Most of them opted for a home birth, although some with the resources relocated to the mainland to protect their little ones from the poor air quality and the stressful events. We were returning prepaid birth fees in the thousands. I know that midwifery is not about the money, but this was the sole means of income that secured our practice. We were and continue to be anxious for our future longevity as an independently run, private midwifery practice.

Lava Babies

I started on my quest to help our home birth clients plan their “best birth” and conducted visits to determine how and where each woman would choose to give birth. The visits, however, were unsettling to say the least. I have attended nearly 1000 home births in my career. Usually mothers and families have nine months to prepare their homes and minds. These women were scared, most were relocated from their homes, and all had little time to adjust as they were originally planning to birthe at Luana Gardens.

“The six women who birthed during this chaotic time experienced a host of challenges.”

One couple had been evacuated through their church group to a property that was crowded with several other people staying in various little houses and using the same bathroom. I helped this couple rearrange the furnishings and set up a birthing tub and made suggestions about cleanliness to make the space more conducive for the upcoming birth. An older woman expecting her fourth baby who was not evacuated owned her home near the edge of the volcano. Neither she nor her partner seemed fazed by the thick fumes or the steaming volcano in the background. I told myself that the newborn, whether born at a birth home or her own home, would be returning to this house, but I was unsettled by the conditions.

One first-time mama lived downstairs from her in-laws, who were unsupportive of her out-of-hospital birth plan. I arranged for her to have her birth at a hotel; the owner said hers would be the twelfth baby born there. (He remembered me from a birth years ago.) As a bonus, a lush jungle trail could serve well in labor. What was important to my client was that the hotel owners and staff were happy to have her there.

Staying Strong

I felt most normal during prenatal care clinic days. I started each day enthusiastically, wearing my borrowed clothing, gifted jewelry, and ill-fitting new shoes. Prior to clinic days, I used Facebook videotaped messages to update clients on the air quality, so they knew whether it was safe to keep their appointments. Sometimes, at lunch, we took gift bags of attractive feminine products to women in evacuation shelters. The days were draining, though, as one client after another had sad stories to tell of being evacuated, losing their homes, losing work, and making decisions to birth in a hospital setting due to financial constraints. Lots of tears were shed, but I tried my best to console the women and stay strong because, as midwives, we understand that the emotional stress of pregnant women can have far-reaching effects on fetuses and birth outcomes.

In the weeks that followed, I worked as if I were on autopilot, feeling that I had to portray some stability because the women looked to me for support. The six women who birthed during this chaotic time experienced a host of challenges. However, we had no serious complications, thank the birth goddesses! Two of the women experienced long, four-hour pushing stages; we transported one for failure to progress beyond two centimeters, and another’s milk never came in. These complications are rare in my practice. However, I did have a beautiful birth where I walked in the door and the baby nearly fell out in my hands. The mother was amazed; her previous birth had been a 27-hour affair. In retrospect, I think some of the mothers held fear and loss deep within their bellies, and this may have contributed to poorly positioned babies. The mothers and their families were well cared for, though, and I believe they experienced some healing through the joy of the birth of beautiful new life.

An Uncertain Future

The volcano continued to flow for more than four months with an intensity the likes of which have not been seen in Hawaiian history. Some suggested the volcano goddess, Pele, was looking for a place to birth her baby and found our lovely birth home. However, maybe she was angry that her midwife had evacuated the area. Well, this is how legends start.

The volcano and lava have now been quiet for at least four weeks. My neighbors and I in the Puna district of the Big Island of Hawaii have lived through an incredibly challenging and frightening time. Nearly 700 homes were destroyed, and we lost our beaches and special recreation spots, which provided well-being for our rural community. Friends and neighbors are suffering severe and ongoing depression, there have been suicide attempts, and many residents are just not sure how to start over or which direction to go. However, ever so slowly, we are moving forward. Some people have been helped by FEMA, some by the Small Business Administration, and some will take years to recover. My practice is still thriving, now exclusively with planned home births, prenatal care, and gynecologic care. We have opened a clinic in the nearby town of Hilo, as many of our clients have moved out of the Puna district, yet we keep our outpost clinic open for women’s care access. Although I still cry regularly, I am looking forward to securing a permanent home for myself, and I am so very happy with my midwifery practice! I cannot help but to remember the strength and courage that our pregnant clients demonstrated in the face of true adversity. Aloha

By Roxanne Estes, CNM, MSN, APRN
Owner, East Hawaii Midwife Service

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