by Ashley Lodato, Bluebird Grain Farms staff writer
photos courtesy of James Hannah Austin V
A childhood spent on a farm normalized the mammalian birth process for James Hannah Austin V, and quite likely planted the seeds for an eventual career in midwifery. Raised on the same Brinklow, MD sheep farm her father grew up on, Austin had a unique upbringing that included a trapeze in the living room and a 15′ pole she and her sister, Marika (who Austin says “was and is my best companion”), would climb to get a quarter at the top. On their birthdays, the Austin sisters got to eat a picnic lunch on the roof of their home. For fun, Austin’s dad would attach a hall carpet to the back of the tractor and the sisters would try to surf it without tumbling off. The family pet was a flying squirrel. Clearly, Austin was not a girl raised to settle into a conventional life and career track.
She is, however, someone who knew all along that she wanted to be a midwife. “I think birth is the neatest thing in the world, and wouldn’t it be rad if we could all do work with what we believe to be the coolest thing in the world?” Austin asks. A logical path might have been to pursue veterinary medicine, but Austin says “I like talking to humans too much.” In college, although she knew midwifery was her goal, she says she “felt too young to be in the room with something as ancient as birth” so she “did a LOT of different things on my way to midwifery.”
“A LOT” is no overstatement; before diving into reproductive healthcare, Austin led international outdoor trips for high schoolers, taught preschool, taught high school Spanish, volunteered as a firefighter and ski patroller, worked in product development, and embedded with a family as an “adventure nanny.” Before becoming a registered nurse, (RN), Austin worked for Synapse Product Development, Clif Bar, and Seattle Farm Tables; after completing her RN certification she treated patients at a residential eating disorder treatment center (The Emily Program), worked at Sea Mar Community Health Center’s Maternity Support Services, and served at Upstream as a trainer for a patient-centered contraceptive counseling model.
Both practical and resourceful, Austin started looking for a job that would guarantee income and experience while she paused her education. Kotzebue, Alaska popped up in her job search. “I’ve always wanted to live and work rurally but Kotzebue kicks beyond rural to remote,” Austin says.
Located on a gravel spit at the end of Baldwin Peninsula about 50km north of the Arctic Circle on Alaska’s western coast, Kotzebue has been inhabited by the Inupiaq people for thousands of years; they called it Qikiqtaġruk–“almost an island.” It’s the hub for the Northwest Arctic Borough, an area the size of Indiana with a population of about 8,000 people (Indiana is home to 6.7 million) living in ten villages that can only be accessed by air, snowmobile in the winter, or boat in the summer. To board the Bering Air aircraft that carries them around the region, James and the other medical staff provide their names and weights–no TSA screening, no liquids confiscation, shoes definitely remain on.
Whereas in her Seattle reproductive healthcare work Austin would don scrubs and clogs, for her Kotzebue medical visits Austin dresses in layers of puffy pants and jackets, climbs into a small plane, and flies low across the landscape, watching the weather closely. Clear skies make a trip uncomplicated, while low visibility or a storm mean that Austin and other providers “might be spending more than the planned time in the village.”
Still, the logistics are extremely difficult, Austin says. “We have to plan our care around flight schedules and when patients need a higher level of care and the weather is bad, we have to wait until it’s safe to get a medevac in to pick them up.”
Catching babies is only part of Austin’s midwifery work, she reminds us. “Midwives are experts in reproductive healthcare from menses to menopause. You’ll hear us called ‘guardians of the normal,’ because we don’t automatically pathologize pregnancy, birth, and the postpartum period. In many other countries midwives manage the majority of uncomplicated pregnancies. In 2021, Certified Nurse-Midwives (CNMs) attended 8% of all deliveries in the United States, up from 3.2% in 1989, so we’re making some progress.”
Despite the limited variety and expense of food available in the local grocery stores, Austin says she trusts the freezer she has filled with game meat and the pantry she has stocked with staples, including her favorite Bluebird Grain Farms organic products: Potlatch Pilaf, Emmer Farro, Einka & French Lentil Blend, and Old World Cereal. “With a pantry full of Bluebird grains and freezer full of game, I know I’m going to be smiling with every meal,” Austin says. She particularly favors the Potlatch Pilaf with elk burger, often making a big pot of it once a week to fuel her through 12+ hour work shift. “The flavor and texture of Bluebird grains is unmatched,” she says.