The Magazine

Reclaiming Abortion as Sacred: An Act of Healing and Empowerment

December 9, 2024
By: Seren Friskie

For thousands of years, reproductive health care has been an essential part of Indigenous cultural practices, encompassing sacred rites, religious rituals, and the right to choose an abortion. This right to reproductive autonomy was woven into the fabric of our communities, respected as medicine for our spirits, and upheld as part of our connection to land, self, and future generations.

Such integration of medicinal and ritual care reflects the view that reproductive health is inseparable from our spiritual and cultural worlds. Abortion within this framework honors the individual and the community, allowing for decisions rooted in love, responsibility, and ancestral wisdom. Reproductive choices—including the right to abortion—are a sacred act of self-respect.

In 1973, the U.S. Supreme Court’s decision in Roe v. Wade established a constitutional right to abortion, framing it as a matter of privacy under the Fourteenth Amendment. This landmark ruling provided federal protections for abortion access, overriding many restrictive state laws and symbolizing a critical victory for reproductive rights advocates. However, on June 24, 2022, the Dobbs v. Jackson Women’s Health Organization decision overturned Roe, eliminating nearly 50 years of federal protections and leaving abortion access to the discretion of individual states. In the aftermath, 15 U.S. states have enacted near-total bans or severe restrictions affecting 18 million women and girls of reproductive age, creating a patchwork of access that disproportionately impacts equity-denied groups, including Indigenous communities.

The Dobbs decision intensifies the risks faced by Indigenous women, women of color, and those living in poverty, further endangering these already vulnerable communities. Over 60% of people seeking abortions in the so-called “United States” are from racial and ethnic minority groups. Indigenous women, who already face higher maternal mortality rates —up to three times higher than white women—are especially vulnerable. States with restrictive abortion laws are often rural or lack healthcare infrastructure, which exacerbates existing barriers for Indigenous communities.

For Indigenous people, the loss of federal protections further compounds the challenges of obtaining safe and timely abortion care, intensifying existing inequities shaped by colonialism and systemic racism. The Indian Health Service (IHS) delivers healthcare to over 2.6 million Indigenous people across the “United States.” However, its ability to provide abortion care is severely limited. Abortions are only permitted in cases of rape (if reported within 60 days), incest, or if the pregnant person’s life is in danger.

This restrictive policy, established by the Indian Health Service, meant that even before the recent repeal of Roe v. Wade, hundreds of thousands of Indigenous women faced significant barriers to accessing comprehensive reproductive healthcare, leaving them with fewer options compared to non-Indigenous populations. This disparity underscores the systemic inequities embedded within federal healthcare systems and their impact on reproductive autonomy.

Indigenous communities have long upheld culturally specific practices surrounding reproductive health, rooted in respect for bodily autonomy, interconnectedness, and the sacredness of life. This holistic approach to reproductive health has been guided by traditional knowledge and sacred practices, passed down through generations by Elders and knowledge keepers.

Traditionally, midwives, healers, and Elders provided care using plant medicines, ceremonies, and community support. These practices addressed physical, emotional, spiritual, and communal health. First Nations in North America used herbs like red cedar, American pennyroyal, tansy, and Canada wild ginger in reproductive care and as abortifacients. Similarly, Aboriginal people in Australia utilized plants such as giant boat-lip orchid, quinine bush, and blue-leaved mallee, which were ingested, inserted, or smoked alongside Cooktown ironwood. These practices were deeply connected to community care and spiritual well-being.

Abortion has long been an integral part of Indigenous healthcare traditions, deeply rooted in cultural teachings on wellness and sovereignty. Far from being a modern concept, it has been practiced for generations as an act of healing and balance, aligning with the holistic approaches of Indigenous medicine. Recognizing abortion as medicine affirms it as a form of spiritual care and a vital expression of bodily autonomy. For thousands of years, Indigenous practices have nurtured every stage of reproductive health—supporting menstruation, fertility, contraception, abortion, childbirth, and menopause—through approaches that honor the interconnectedness of body, mind, and spirit.

For Indigenous communities, the concept of choice is deeply tied to autonomy and survival, reflecting traditional values of self-determination and holistic health.

But colonization disrupted these practices, replacing them with policies that sought to control Indigenous bodies, especially those of women and Two-Spirit people. Forced sterilizations, denial of care, and the erasure of traditional knowledge have left lasting scars. As legal challenges like the Dobbs decision impact abortion access, the need to protect Indigenous reproductive rights and cultural sovereignty becomes more urgent.

One way Indigenous communities are reclaiming abortion as a sacred practice is through the work of modern-day Indigenous doulas. These doulas are not only supporting families during birth but also helping to reclaim reproductive justice by providing essential abortion care. By integrating traditional knowledge with contemporary practices, they restore cultural values of choice and sovereignty while addressing systemic barriers and trauma.

Modern-day Indigenous doulas are reclaiming reproductive justice by offering vital support to families during birth. These trained professionals provide physical, emotional, and informational care while blending traditional cultural practices like sweetgrass, cedar, and smudging with modern birthing techniques. Their work goes beyond birth support—they challenge colonial systems that have long oppressed Indigenous communities, restoring cultural connections and advocating for health justice. Rooted in the broader framework of reproductive justice, which includes the right to parent in safe and supportive environments, Indigenous doulas help families heal from the impacts of colonialism while celebrating life and community.

For some Indigenous people, abortion can also be a sacred act of healing that transcends the physical process. It is a reclamation of bodily autonomy, offering healing from the historical and ongoing trauma of colonial policies that sought to control Indigenous bodies. Through abortion, Indigenous women have reclaimed their power, resisted systemic oppression, and honored their self-determination.

While Indigenous communities have endured the violent erasure of cultural and spiritual practices, a powerful resurgence in traditional knowledge, especially around reproductive health, is taking root. Across North America, Indigenous people are revitalizing ceremonies like the Ojibwe berry fast and the Hoopa Valley Flower Dance—rites of passage honoring menstruation, bodily autonomy, and connection to the community as acts of decolonization. Similarly, the rise of Indigenous doulas and the resurgence of cultural birthing practices underscore a deep commitment to preserving our ancestral knowledge in the face of ongoing challenges.

Yet, the U.S. Supreme Court’s decision to overturn Roe v. Wade threatens to deepen the inequities Indigenous people face in accessing both Western and traditional reproductive care. For those in states that have banned or severely restricted abortion, and for those who already navigate barriers within reservation-based healthcare, this decision imposes even greater obstacles. It raises urgent questions about how these new restrictions may impact the use of traditional medicinal practices and Indigenous rights to cultural and religious autonomy.

In this time of uncertainty, reclaiming our knowledge and fighting for accessible, culturally rooted reproductive care become acts of both resilience and resistance. As we build a future that honors the sacredness of our bodies, we affirm the right to live and heal on our terms. We carry forward a vision of care, grounded in respect and liberation, that endures despite the barriers we face.

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About the Author

Seren Friskie (She/They) is an Equity & Engagement Specialist at Foundry BC, a Research Associate at the Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), and an Indigenous Wellness Educator, Speaker, and Advocate. With Néhiyaw, Sto:lo, and European heritage, Seren is committed to advancing health equity, social justice, and systems change. Their work includes fostering Black community spaces, expanding gender-affirming care, and advocating for improved mental health services across Turtle Island. Seren lives on the unceded territories of the xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and səlilwətaɬ (Tsleil-Waututh) Nations in so-called “Vancouver, British Columbia”.