Abstract: Klamath women’s health and experiences of pregnancy and childbirth have been dramatically transformed by shifting federal Indian policies that have structured their lives form the nineteenth-century institution of the reservation through the mid-twentieth-century period of termination. Federal policies that may initially appear disconnected from health and health care have devastated the Klamath people’s overall “well-being” in two ways. Federal policies, beginning with the reservation system but also including the later policy of termination, disrupted traditional Klamath birth practices, replacing them with the western medical model of care. After disrupting those traditions, the federal government repeatedly failed to provide both funding for and access to any adequate level of western health care. These continuous failures reflect the ongoing nature of settler colonialism and its impact on Klamath women’s birthing experiences.