"There's no way a doctor can ever give a woman during pregnancy or labor what a nurse-midwife can give," she said. "Doctors are trained for abnormalities in birth. Nurse-midwives are the artists of normal birth."

When Cybill became pregnant with Clementine in the late 1970s, she found a doctor she liked very much at the University of Tennessee in her hometown of Memphis. He referred her to a birth class taught by nurse-midwives. Cybill liked the nurse-midwives and their approach. As she read about child birth, she drew some conclusions: if a woman was surrounded by caregivers of her own choosing, people she knew well and trusted, mother and baby would fare best. She asked her doctor the likelihood of his being there for the birth. His answer: 90 percent. If she switched to the nurse-midwives, she asked, how likely would one be with her? The answer: 100 percent.

"So right there was the difference," she said. "One of these people who you were so close to, who you saw all through pregnancy, could be with you for the birth. You have more of a chance to build trust."

With her doctor's agreement, Cybill switched to the nurse-midwives. She liked their openness and emphasis on education; she felt well prepared.

"As you learn about what is going to happen to you in birth, or the many different possibilities that can happen, your fear quotient goes down. As you overcome that fear, your chance of discomfort and pain is lessened."

Cybill does not hide the fact that her thirty-one-hour labor was painful, but the nurse-midwives made an immeasurable difference. "I'm sure I would have had a cesarean had I not been with nurse-midwives," she said. "They worked with me so carefully."

After thirty hours, she was exhausted. The nurse-midwives gave her a regional anesthetic so the pain would not sap her strength. As it wore off, she asked for more. It would be Cybill's choice whether to receive more anesthesia, the nurse-midwife explained, but she made clear one possible outcome: it might inhibit Cybill from pushing effectively, making a forceps birth more likely. Between contractions, Cybill asked how close she was to giving birth. The midwife looked at the clock, then 6:20 p.m., and said Cybill would have her baby by seven. Cybill chose to let the anesthesia wear off.

"I trusted her, and I believed in her," Cybill said. "I don't think anybody except the nurse-midwife who had been with me--not just for labor, but for the whole pregnancy, too--could make me feel that much trust. She had been with me through all the pain and difficulty, breathing with me, helping me, supporting me. So when she said, `You can do it,' I believed her."

It was that "leap of faith," Cybill said, that gave her the strength to deliver her baby. Clementine, 8.5 pounds, was born at 6:59. Cybill did not need an episiotomy, and for that she credits the skill of her nurse-midwife.

IT'S A GIRL! AND A BOY!

Like so many other mothers, Cybill Shepherd describes nurse-midwife birth in a hospital as "the best of everything."

"It's the best thing for you and the best thing for your baby,"she says. "You always have the doctor right there and all the emergency things. You don't have to travel somewhere for backup, which you probably won't need. And you have less chance of needing it with a nurse-midwife."

When Cybill became pregnant with twins eight years after the birth of her daughter, she was dismayed to find that nurse-midwives usually do not handle twins. Although twins usually are delivered by cesarean birth in the United States, she shopped until she found a Los Angeles doctor who would let her try to deliver vaginally. He also agreed that two nurse-midwives could be present at the birth to assist her in labor and delivery. He would stand aside, as long as there were no complications. Labor lasted thirteen hours-a difficult time for Cybill, but she had the support she wanted and needed.

"The nurse-midwives stayed in my face with breathing and helping me," she said. "They helped me walk around and gave me enormous support."

The first twin born, Ariel, was a normal head-first delivery into the hands of nurse-midwives. But as Ariel moved through the birth canal, she pushed her twin brother sideways. That's when the doctor got involved. Aware that the complication could call for an immediate cesarean, the doctor, nurse-midwives, and an obstetrical nurse all helped, using their hands, to turn the baby. Zach turned head down and was delivered vaginally six minutes after his sister. "The doctor's training is not to help women through labor; it is to be prepared for complications," Cybill said. "He did his job brilliantly."

Cybill was extremely grateful to have such skilled professionals, who also took into account her desires. They helped her give birth in a way that left her feeling proud and satisfied.

"It was my greatest sense of accomplishment in my life, that feeling after giving birth to twins," she said.

"To have what you want at your birth, that's the safest thing for you and your baby. It allows you to take control so that in that moment of birth when you must lose control, when it's so difficult, you are surrounded by people who can support you not only physically but mentally and emotionally, they almost breathe for you, to keep you breathing."