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The HVAT has 11 simple questions. It may be self-administered and is available on the Internet: http://www.DHAC.com. The physician may err if his decision in favor of cataract surgery is based only on visual acuity. The HVAT has the potential to guide the decision-making process between patient and physician.

Apparently many respondents chose an unlicensed midwife because they were unable to locate a licensed provider who would attend an out-of-hospital birth. This is consistent with the finding that women attended by unlicensed midwives are more likely to reside in rural counties than their counterparts attended by licensed midwives or certified nursemidwives.Shared religious beliefs was another reason cited for the choice of birth attendant. It was later learned that some unlicensed midwives regard their practice as a ministry to serve fellow churchwomen.That two-thirds of mothers attended by unlicensed midwives paid a fee for service suggests that in most cases this was a professional relationship, not simply one friend helping another. Technically, unlicensed midwives who charge a fee are practicing illegally. However, because they are responding to the needs of particular groups of women, they are likely to continue to practice in spite of legal prohibitions. Legislation prohibiting unlicensed midwives from practicing is rarely enforceable.2 Indeed, the real effect of such legislation has been to force unlicensed midwives to work in secret or to prevent them from seeking education and training.