11.   She is a lay midwife, one who came to the birthing room by apprenticeship, rather than by university training, and who specializes in home birth.

12.   She now has a thriving business in a state where lay midwives are legal.

13.   Some prohibit lay midwives from handling breech births, which some doctors believe usually warrant Caesarean sections.

14.   State officials could seek to amend the nurse-midwife law to prohibit lay midwives, Ms. Hess noted in her decision.

15.   That potential, for most doctors, makes a lay midwife, who lacks medical training and works outside the medical system, too big a risk.

16.   While most licensed nurse-midwives do not assist home births, lay midwives specialize in them.

17.   Lay midwives are not certified by the state.

18.   Prosecutors indicated they will retry Yvonne Cryns, whose case has focused attention on the use of what are known as lay midwives.

19.   The case has focused attention on the use of lay midwives.