During labor mothers were surrounded by family and nurtured so as to promote a harmonious relationship between mother and baby. Present in the room besides Kahuna pale keiki was usually Mother, Grandmother and Husband. The rule of thumb employed by the pale keiki was Ho’omanawanui, meaning patience (Sarah).

During early labor the mother was encouraged to walk or pace (Sarah). It was considered an ill omen for the baby hear sounds of pain so mothers were expected to control themselves. If pain got too intense the Kahuna could transfer pain onto self or others.
The mucus plug that came forth of both ali’i and commoner was used to predict sex or size of the baby. The dark fluid called ‘ina ’ina appeared, birth was approaching.   If this was reddish, the baby was a boy.  If it was brownish, a girl was coming. If the was large, the ’ina’ina would thicken and come in large chunks like dark starch.

Both ali’i and commoners had the same Herbal remedies and treatments.   Hau tree (Hibiscus tiliaceus) Tea made of bark and blossoms were eaten when the pain was severe.  It was also believed to make the baby slippery (Sara).   The mother would find relief in hot water baths (Sarah).
Pule or prayer was made to Ku and his wife Hina (Sarah).”

Labor Techniques when labor began included Squatting kneel ing, grabbing hold of a rope hanging from a roof beam , and wrapping her arms around the midwife for support.  The Midwife would push on the mothers abdomen gently when the mother was pushing from the front.   The midwife‘s assistant or a family member would support the mother from behind.   The baby’s arrival was announced when its eyes were seen.