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Recent reductions in infant mortality rates among indigenous women of Alaska are attributed to a policy of requiring women in remote areas relocate to hospitals to await labor. Despite the stress this causes, indigenous women of Alaska are increasingly subjected to healthcare policies that purport to know what is best for them and their infants. In contrast, midwives in areas such as Canada and Australia have helped return birth back to the traditional communities. For indigenous peoples, birth on country provides benefits a hospital setting cannot: elimination of stress from forced separation of families at the time of birth, connection between the land and the people, and preservation of traditional birth wisdom. Equally important are the efforts of Australia and Canada to educate indigenous women to provide midwifery care in their own communities. Similar efforts are needed for the indigenous women of Alaska.