The Women Having Babies Underground

After two years working in a labor and delivery unit as a surgical tech, Carlie Smith knew she didn’t want to give birth in a hospital. Nearly every night shift she worked was the same: women were wheeled in for cesarean sections following failed 39-week inductions that their bodies and babies weren’t ready for. 

But as a North Carolina resident, Smith didn’t have many options for home birth. North Carolina is one of a dozen states that doesn’t license Certified Professional Midwives, who are direct-entry midwives specializing in out-of-hospital birth. CPMs can face arrest just for practicing in the state.  

So Smith went underground. She found a midwife based in Charlotte, N.C., to attend the birth of her first daughter in August 2022.