Introduction: Ma'i pālahalaha (infectious disease) shaped new biomedical classification during the complicated history that introduced Native Hawaiians with foreigners from Europe, America and Asia in the 1800's. These unfamiliar illnesses disconnected Hawaiians from their Ka 'Oihana Mauli Ola (traditional Hawaiian health structure). With little immunity to foreign pathogens, Hawaiians experienced severe depopulation (93%) caused by these ma'i pālahalaha. Methods: This research examined the history of infectious diseases in Hawai'i from original documents across multiple archives (N=11). Building on lessons from biomedical science and ethnomedical perspectives, it analyzed specific impact on Native Hawaiian females. Comparative analyses evaluated historical records from concurrent years which outlined traditional health care of Hawaiian women. Findings: A number of associated conditions exacerbated maʻi pālahalaha epidemics in 1848–1849. Of those, abnormal climate variations like seasonal weather shifts, changes in rain patterns, and tropical storm systems near the Hawaiian Islands spread both ko'ohune (bacterial) and mea ho'oma'i (viral infections). In those two years alone, 1/3 of the native population succumbed to maʻi ʻula (measles), kunu kalea (pertussis), hī (dysentery) and palū (influenza). After analyzing historical census and calculating unadjusted mortality rates, deaths exceeded births. Discussion: This research describes female perceptions of illness and disease from a cultural lens and differentiates it from communicable diseases that disrupted their indigenous practices. This paper presents environmental changes in 19th Century Hawai'i with the corresponding rise in infectious diseases rates. Further, it provides two centuries of reflection to encourage public health strategies that improve maternal and child health among indigenous populations today.