Chapel Hill: Opinion

Manju Rajendran: A Piedmont homebirth

Manju Rajendran
Manju Rajendran

Early in my pregnancy my partner and I explored options for giving birth: at the hospital, in a birthing center, some combination. We decided to plan a natural home birth because we wanted to ensure that my body’s innate wisdom about birth would be allowed to guide the process.

I believed that feeling at ease would decrease the likelihood of needing intervention. In familiar space, I hoped to feel free to express my voice or try adventurous positions. I could choose who would be in the room based on criteria like trust, relationship longevity, shared values about birth, and shared politics (such as a commitment to ending racism). I wanted my pregnancy treated like a healthy, natural, wondrous thing, not a medical condition.

For us, home birth was far more affordable than the alternatives. As feminists, it was important to my partner and me that the needs of baby and mother be front and center, rather than the profit motive of the birthing industry. Most of our peers are facing insurmountable debts related to inaccessible education, unaffordable housing, a broken health care system, and other systemic barriers to raising children, and we’ve watched our friends struggle to pay back hospital bills for years after having children. Midwives and doulas work hard to keep safe, choiceful, and pleasurable births accessible to all.

Along the way we learned that many legal barriers have made homebirths difficult to access for North Carolinians who want them. Most paths we found led to Nancy Harman, a longtime certified nurse midwife practicing homebirths through her business, Birthwise of Central NC.

North Carolina is one of a handful of U.S. states that require nurse midwives to be under the supervision of a backing physician; the law has been in place here since 1983, and a change is long overdue. If supervising physicians change their minds, midwives are no longer able to practice above ground and the array of legal options for people giving birth in North Carolina dwindles.

I was at home when my body released the mucus plug that had sealed my cervix. For the next 24 hours I meandered through contractions, stretching, strolling, and sleeping whenever possible.

My doula Alexis Pauline Gumbs, my mother Vimala, and my partner accompanied me through most of this time, helping me move through my pain. With their support I ate meals, breathed deeply, and laughed a lot.

My midwife’s assistant, Joanne, came to check vitals for the baby and me. I called our midwife, Nancy, and my doula, Candor Plaza, with updates and they offered suggestions by phone. That evening after supper, my contractions slowed from about 5 to 7 minutes apart to 8 to 15 minutes apart, and we agreed to call it a night. I sent home my siblings and my doula, but my mother lingered – she had a feeling.

As soon as the house cleared and the sun set, the waves of contractions resurged at a racing tempo. I threw up my supper. My partner drew a warm bath for me, but it made no difference. Before I had recovered from one wave, the next crashed.

My partner set up the birthing tub in the living room while he called the midwife and doulas back. After three hours of active labor I was on my knees in the kitchen answering my body’s strong call to push. The birth team helped me migrate to the living room for more comfort.

I clambered into the birthing tub and crouched in the water, encircled by the light of beeswax candles. The warm buoyancy took the edge off my pain, enough for me to climb on top of the next wave and give another push. Her head emerged from my vagina. I felt like the pain would break me, and so I began calling to my baby, “I love you, I love you, I love you.” Love was a tether to draw her out into the world, to unite our strength in the hardest thing either of us had ever done. And with the third push her body was out.

I heard my midwife’s voice invite me to reach down and catch our baby. I pulled her up from the water and held her while I cried and trembled with happiness and relief.

My partner climbed into the water and held me while my mother called family members to share the news. I moved with the baby onto a bed nearby where my partner cut the umbilical cord. I birthed the placenta. Our midwife Nancy and her assistant Edie moved swiftly and with incredible tenderness through all the tests, clean-up, and aftercare, and we focused on snuggling with our small miracle until dawn.

Azadi Asha was born at 12:26 a.m., 21 inches tall, 6 pounds, 12 ounces, and luminous. Azadi means freedom and Asha means hope, and we know she will live into her name.

Write to Manju Rajendran in c/o The Chapel Hill News at