The New York Times on Monday examined the debate among physicians, legislators, prosecutors, midwives and women over whether home births supervised by midwives who are not licensed doctors or nurses present "grave and unacceptable medical risks." The Times looks at the case of Jennifer Williams, a midwife in Shelbyville, Ind., who conducted the home birth in June 2005 of an infant who died. Williams faces charges of practicing medicine and midwifery without a license but does not face criminal charges of causing or contributing to the infant's death. Indiana and nine other states prohibit the practice of medicine and midwifery by individuals other than licensed doctors and nurses. According to the Midwives Alliance of North America, there are about 3,000 practicing midwives nationwide without formal medical training, and approximately 1,100 midwives are certified by the North American Registry of Midwives, a private agency whose evaluations are recognized by about 20 states. According to the National Center for Health Statistics, about 99% of all births occur in hospitals with nurse midwives participating in about 8% of births. Of the remaining 1% of births, two-thirds occur in homes and one-third occur in free-standing birthing centers. Indiana state Rep. Peggy Welch (D), who has introduced legislation to recognize and regulate non-licensed midwives, said that each year about 1,000 families in the state have home births -- which are legal under current law -- but many physicians and nurses do not to perform home births. Although nurse-midwives in Indiana are permitted to deliver infants at home, most work in hospitals, the Times reports. Stacey Tovino, a professor at the Health Law and Policy Institute at the University of Houston Law Center, said that prosecutions of midwives typically begin when an infant or woman dies, adding, "There has always been a tension between true quality-of-care concerns and anticompetitive concerns." Kevin Burke, president of the Indiana State Medical Association, said that the best environment for labor and delivery is in a hospital or adjoining facility "[b]ecause routine things sometimes become very un-routine." According to Burke, if women prefer a home birth over a hospital setting, "let's make the hospital a more friendly, user-comfortable environment" (Liptak, New York Times, 4/3).