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As she sits in the State House, Miriam Khalsa, a midwife from Sherborn, glances at her phone. With two clients expected to give birth soon, she is on emergency call. Khalsa, who has been delivering babies since 1981, is one of several midwives urging Massachusetts legislators to pass a bill that would create a state Board of Registration in Midwifery, bringing different types of midwives under one bureaucratic umbrella, and providing more oversight of their work.

"This will help our profession in general be more legitimate. It helps people to understand what midwives do," Khalsa says of the bill, adding, "It would allow us to know that we are practicing legally."

The bill would also bolster consumer access to midwife services. Today, midwives assist only 7 percent of US births. However, midwives are the primary health professionals for over 80 percent of pregnant women in countries like New Zealand and the Netherlands, which boast low maternal and infant mortality rates.

The American Medical Association (AMA) has attacked the bill, calling it too expansive, as it would set separate gynecological standards by licensing a type of midwife (certified professional midwife) that the AMA doesn't recognize because they are "often self taught and in an unregulated apprenticeship-model."

The bill's sponsor, Rep. Kay Khan, D-Newton, considers the legislation necessary for public safety, since certified professional midwives—who are licensed nationally by the North American Registry of Midwives—currently practice in Massachusetts with no oversight. If the bill passes, they would have to apply for licensure and pass a series of requirements to practice legally in the state. "It will give any of the births currently being done more regulation and oversight," Khan says.

Nurse-midwives, the largest group of midwives in the US, are nationally certified registered nurses who complete a midwifery program and practice in hospitals. There are over 400 nurse-midwives assisting births in Massachusetts hospitals, but current regulations prevent them from being independent practitioners.

Massachusetts is one of six states that require midwives to have "physician supervision," meaning midwives can't admit patients to the hospital, serve on major hospital committees, or document either the revenue they generate or their patient outcomes, because they practice under a physician's name.

Peggy Garland, a retired nurse-midwife who worked for 15 years at Boston Medical Center, is now the head of the Massachusetts Coalition for Midwifery.

"If you go to the website of a major Boston hospital and try to search for midwives, '[they're] really hard to find," notes Garland, adding that the lack of data surrounding the contributions of midwives in hospitals keeps them undervalued. "Midwives by and large have to keep their own statistics."

The US has reached a record level of cesarean sections, peaking at 31 percent in 2006. Massachusetts has a 33-percent C-section rate, over twice the rate by the World Health Organization.

Midwives practice a philosophy of nonintervention, letting the physiological birth progress at its own rate. A 2000 analysis of midwifery research, by Jeanne Raisler of the University of Michigan School of Nursing, found that midwives' clients experienced significantly fewer incidents of cesarean birth, low birth weight and neonatal mortality than physician-assisted births.

Gene Declercq, assistant dean of doctoral education and professor of maternal and child health at Boston University School of Public Health, says the research around midwifery care proves it is an excellent option for low-risk mothers. "Research suggests they take more time, and are effective in screening for high risk and referring those clients to obstetricians," he says. "It's the integrated system that makes the most sense."

Barbara Graves, director of the nurse-midwifery education program at Baystate Health, agrees. "I think midwives are the experts in normal birth, and doctors are the experts in problems," she says. "We work together well."

Graves also noted the cost-savings associated with midwives, which is nothing to sneeze at, considering maternity care represents one-fifth of all US health care expenditures. "The cost of midwives is significantly less than physicians. The C-section rate and epidural rate both have costs associated," she says.

Jamaica Plain resident Robin Hutson had a certified professional midwife deliver her first baby in 2002. "I did a lot of research," Hutson says. "After reading all I could, the midwifery model of care just made sense."

Rep. Vincent Pedone, D-Worcester, who has placed a hold on the bill, said he felt more discussion was needed before he could support the legislation. "I have questions regarding the level of protection and safety for child-bearing women in Massachusetts ... My feeling is that the level of education, training and oversight is not adequate for us to give our seal of approval," he says. "It puts both the mother and baby at risk."

Sources within Khan's office say the bill is unlikely to pass before the end of this session, as it would have to go through both chambers by Thursday.

Hey, have you heard about these gas prices? It's some crazy shit. Gas—get this—is expensive. Just ask the Herald. Aside from Turnpike workers who get paid $150,000 a year to sodomize disabled puppies, the cost of refined petroleum is all the paper talks about these days. The issue landed on the tabloid's cover twice last week. On consecutive days. It's enough to drive a bipolar politician to grope at strangers' crotches.

MEDIA FARM KNEW that this presidential election cycle felt miserable, but we couldn't understand why. What was it about watching the electorate dawdling around, weighing the prospect of rewarding a cocksure, near-messianic sense of entitlement against a surrender to craven opportunism, that has made us feel so dead inside?

Now we know. This thing isn't insufferable because it's insufferable. It's insufferable because Hunter S. Thompson isn't around anymore to make it, uh, sufferable. And who do we have to thank for that fact? None other than that pig-fucking imperialist George W. Bush! So says the Phoenix. So it might as well have come from the Pope. "On top of everything else they've blighted over their awful eight-year reign, the Bushies did this: they killed Hunter S. Thompson."

Sweet Jesus, what's a populace to do? Produce searing political commentary and dirty jokes for ourselves? Sit on the couch and watch I Love Money? Scour the country until we find one other person who can write, and worship at that person's feet? How about we just thrash around in the darkness, repeating "Thompson," "Thompson," "Thompson," until the word count machine says it's enough, and we can stop trying to say anything and just put the guy on the cover already?

The piece was the worst kind of bait and switch, because it promised to say something—anything would've done—and only delivered several thousand words of nothingness peppered with flecks of wishful thinking (the Doctor would've found the American Dream in Barack Obama's big, beautiful eyes) and tortured analysis (the Doctor could still shake the world in 2004, even though he was only filing his ESPN.com column every three months, because there weren't any blogs back in 2004; that shit might not have flown today). In the end, this place was "no longer a country for an old man like Thompson."

We'll take a lump of lead to the head now, please. Or maybe 37,000 words devoted to the socio-economic significance of Dunkin' Donuts coffee. Anything. Please. Make it stop.

THE NEW YORK TIMES COMPANY is raising the cover price of its communist newsletter/flagship property, by 25 cents, to $1.50. The move comes not long after a similarly sized price increase for the Globe (one that the Herald roundly mocked, and then matched), and just days after analysts at Standard & Poor's warned that it might downgrade the Times Co.'s stock to junk status. The announcement came as the Times Co. admitted that its earnings were off by nearly 50 percent, that ad revenue in print and online was off 11.8 percent from a year ago, and that June's ads were down 17.8 percent—"a dismal showing," the Times reported, "yet better than average for the industry." We smell an optimistic new slogan. The New York Times: On average, we're less fucked than half our peers!

Also last week, Tribune Company CEO Sam Zell described his industry as being up against "some of the worst advertising numbers in the history of the world." Both the New York Observer and the Columbia Journalism Review took up the charge, with the Observer declaring that 2008 could be the worst year in the history of the modern newspaper business, and CJR retorting that, no, just maybe, there might have been five years when the industry stunk even more strongly of death than it does today.

They included 1957, when Gannett began corporatizing the industry; 1963, when New York's newspaper printers went on strike for four months and the world still managed to get its news; 1982, which marked the launch of USA Today; and 1999, which birthed a seven-toed demon named Craigslist.

And if that's as bad as we've ever had it before, then we're all in deep, deep trouble now.

OR MAYBE NOT! The Economist reported last week that it's only the American newspaper industry dying a slow, awful death. Newspaper sales are up 12 percent in Brazil this year. Sales in India are up 35 percent over the past five years. Ditto for Pakistan, and for China, which has seen recent circulation gains of 20 percent. So you see? Literacy isn't doomed; it just hates America.

Proof that knowing a French word doesn't make you cool

Dear Dig,

Your Bean Counter (7.16.08) on Rep. Marzilli lent credence to his defense that he harassed women due to mental illness. This is a crock of steaming "merde."

You also suggest republicans in the Commonwealth are insensitive to mental health issues. They're calling for Marzilli's ouster because he's accused of serious crimes, not because he is "sick" and can't control his actions.

This neo-liberalism attitude of, "Let's do whatever we want, and let everyone else do what they want," has thrown personal responsibility asunder.

Y'all messed up this one but good. Word. EAMONN BOSTON

Bad reviews spark incoherent letters

Hi Dig,I've contemplated writing before. Generally my thoughts were similar to this week's letters (7.16.08). Outraged, confused about you flatly panning an album for what I believed was no reason. I found it hilarious there are still people out there who believe your reviewers HAVE to do anything. The reviews at the bottom aren't really trying to be reviews. They're TRYING to push our buttons, and succeeding. If you don't like reading reviews that bash your favorite artists, I suggest not reading reviews in the Dig. And, really I suggest not reading reviews in general. All the best,

PAUL

VIA EMAIL

Hi Dig,

First time writer to y'all but longtime ... back-to-back weeks of bottom-feeder reviews of the new Girl Talk and Unkle releases (7.2.08 & 7.16.08) a ploy to lavish Debbie Driscoll with more hate mail. The art of sampling, perfected by Pink Floyd, Beastie Boys, DJ Z-Trip, Avalanches and Primo, is not everybody's cup of St. Ides.

Driscoll's ignorance to the art of aural nabbing does not make the Girl Talk CD that good. I've heard his new CD. It's aiight! I also saw him twice last year while on acid and E respectively, and was not moved either time.

Musicians steal. Be it the Rolling Stones or punk-lite bands. If DD wants to miss out on a beautiful scene, that's her problem. Her see no sample, hear no sample, speak no sample. Trashy reviews do not make bad sampling good.

Peace & blessings,

LUGSY

VIA EMAIL

When Arthur Pember first joined the circus, he was shocked by the decorum of his fellow performers.

"I had expected to find myself among a rollicking, roistering set of men, who preferred short pipes and tobies of ale to wine and cigars, and whose dressing-room was a theatrical exhibition of everything that is coarse and objectionable," he writes. "And I had more than a vague suspicion that some of the ladies might be a little loose in their notions of strict propriety."

The year was 1874, and Pember had been conscripted by the Associated Press to go "undercover" as a props manager in the Howe's Great London Circus. His account conjures images long associated with traditional Americana: sprawling tent, vermilion-caked faces, a parade of "painted donkeys" (read: zebras).

But when a cultural tradition remains popular for centuries, it warrants a closer look.

With its origins in the arena sports of ancient Rome, where gladiators battling tigers drew throngs of clamoring citizens—not unlike a modern Ringling Bros. audience—the once-barbaric spectacle didn't become performance art until Philip Astley walked into the ring.

Upon discovering that the combo of centripetal and centrifugal forces helps a rider remain standing on a galloping horse, Astley roped off a field in the shape of a circle to practice his trick riding for small crowds outside London. Later, he added seats to the ring, then a shed to cover the area. Astley is also the man behind the clown; he added joke-telling "jesters," who interacted with the crowd between his equine tricks.

The concept spread to France, Russia and, in 1792, Philadelphia, when an equestrian named John Bill Ricketts added gymnastics and dramatic readings to the billing and took America's first circus on the road. Small, family-owned circuses limped along stateside through the 19th century, mostly in anticipation of being swallowed by larger operations. Menageries were the biggest attractions: On their way to the big top, audiences would walk through a separate tent lined with wagons holding exotic animals like hyenas, ostriches and monkeys. Elephants, giraffes, llamas and zebras roamed freely.

"There is a tremendous amount of work to be done in winter quarters, of which the public knows nothing," explained one animal keeper to W.C. Thompson, author of the 1903 article "On the Road with a Circus." The keeper continues, "... we have to break those beasts so that we can handle them on the road."

Now, the days of animal training "of which the public knows nothing" have given way to the animal rights camp's well-publicized beef with the circus industry, although it's had minimal legislative effect. First passed in 1966, the Animal Welfare Act, enforced by the US Department of Agriculture, leaves legislation on the treatment of animals up to local government, granting traveling circuses the freedom to perform wherever their acts are welcome.

In Massachusetts, the towns of Braintree, Quincy, Revere and Provincetown have banned circuses and other animal acts altogether; the state has banned only animal fighting, like bear-wrestling and bullfighting.

In March, the House rejected a Senate-passed bill prohibiting the use of elephants in traveling circuses. Sen. Robert Hedlund, R-Weymouth, sponsored the bill. "We're up against a special interest that makes a profit," he said in a press release, alluding to the bill's opponents whose districts host the circus when it comes to town.

The bill was initially designed to ban the use of animal-training devices like ankas (aka bullhooks—sharp, cane-like prods) and other practices (like chaining elephants for long periods of time). "It's an archaic, barbaric way of treating an animal," Hedlund said. "But sometimes old ideas die hard on Beacon Hill." Hedlund plans to re-file the bill in the next session.

Ringling denies accusations that they mistreat their animals, touting their Center for Elephant Conservation, a 200-acre Florida breeding and conservation facility for Asian elephants. Archele Hundley, former Ringling animal trainer, has testified before Congress that she witnessed acts of animal brutality while at Ringling.

"It wasn't just the people, it's Ringling's culture," she tells the Dig. "That's how it's been for hundreds of years, and they don't believe there's any other way to do it."

Most circuses—Cirque de Soleil, the Big Apple—avoid the controversy by focusing on thrills like human catapults and trapeze artists. The Big Apple even contracts their animals, which have separate owners; Ringling owns their animals.

At the Big Apple Circus in Charlestown, R.I., eight costumed poodles performed a conga line right around the ring. The 31-year-old show also features five Arabian stallions, but, as Director of Communications Joel Dein says, "You kind of have to understand horses to fully appreciate the act." (The horses circle the ring, stop on cue, and the same goofball stallion never stops on time—over and over.) The poodle-conga is about as grand as it gets in the way of animals at this circus.

But the Big Apple hasn't always restricted exotic animals from the billing. Until five years ago, three elephants were featured in the show. On the use of bullhooks, Dein says, "I believe at some point they were used as a prod. I've never seen anyone actually stick an animal with a bullhook [in the Big Apple]."

Animal tricks aren't the only big top attraction that doesn't jibe with modern sensibilities. Sideshows, largely popularized by P.T. Barnum (of Barnum & Bailey fame), are now obsolete. They often played to perverse voyeurism and exploitation; "grinders" would ballyhoo the crowds, beckoning them to observe "the wild man" (a hairy, smelly, "uncivilized" man, who was often black), or "the electric woman," who supposedly had a current flowing through her fingertips.

But Barnum also introduced the modern-day, multi-ring format, in which multiple acts performed simultaneously in three, five, and later, up to seven rings (these still cater to contemporary attention spans). Astley's original joke-telling clowns couldn't be heard by the ever-accumulating masses, and soon gave way to mimes; acrobatic stunts grew more daring as big tops became larger, and animals were costumed and trained to perform tricks.

Extravagance and grandeur became watermarks of the American brand of circus, as did monopolies. By the Great Depression, Ringling Bros. had merged with Barnum & Bailey and the American Circus Corporation; independent circuses were nearly extinct.

Only in the past 30 years have they regained popularity. In 1984, a troupe of 20 fire-breathing, stilt-walking Quebec street performers formed Cirque du Soleil. The internationally touring company has since drawn nearly 80 million spectators (close to 10 million in 2007alone); a success story to be sure, but Feld Entertainment, parent company of Ringling Bros., draws 25 million annually.

In 1987, Circus Smirkus became the first Vermont-based touring circus in over 100 years. Founded by Rob Mermin—who honed his big top skills performing in European circuses before he became a director of the Ringling Bros. Barnum & Bailey Clown College—the company "is dedicated to promoting the lifestyle and traditions of the traveling tent circus," according to its website. Its philosophy is didactic, teaching kids the art of performing and joys of traveling as a troupe.

The Big Apple, founded in 1977, also seeks a return to tradition. "The Big Apple Circus is fashioned after classical European circuses," Dein explains. "It's a one-ring circus, as opposed to the Ringling-esque circus of three rings, which is just a massive spectacle. Ours is a very intimate, one-on-one experience. No seat is more than 50 feet from the ring, even though our tent seats 1,700."

Even as smaller circuses cater to a more informed and concerned public, they'll need to compensate in order to compete not only with the revenue-raking Ringling Bros., but with digital entertainment.

"We're going to begin using more contemporary costume and music simply to attract a younger crowd," Dein says of the Big Apple's modern strategy. "Children these days are much more savvy. These days, there's more competition with video games and televisions and iPods, but not a lot of live entertainment for kids to go to. It's difficult to attract attention but stay true to who you are."

Dein's plan seems to be working: The big top at the Charlestown show was packed with families, gaggles of teenagers, and octogenarians like Helen Benford, who says she attended the Big Apple 20 years ago when tickets were $2.50. "It's the only circus I come to," says Benford, who added that she appreciates the intimate atmosphere of a one-ring show. "Who cares what it costs? At my age, you can't take it with you."

Perhaps that sentiment sums up the hundreds-year battle between Ringling and the independents. Smaller circuses have departed from the tradition of excess and mega-mergers that is a purely American creation, returning to the European format that Philip Astley and John Bill Ricketts founded ... with dancing poodles at the helm.

An excerpt from "Yertle the Turtle" ...

"My throne shall be higher!" his royal voice thundered,

"So pile up more turtles! I want 'bout two hundred!"

"Turtles! More turtles!" he bellowed and brayed.

And the turtles 'way down in the pond were afraid.

They trembled. They shook. But they came. They obeyed.

From all over the pond, they came swimming by dozens.

Whole families of turtles, with uncles and cousins.

And all of them stepped on the head of poor Mack.

One after another, they climbed up the stack.

Then Yertle the Turtle was perched up so high,

He could see forty miles from his throne in the sky!

"Hooray!" shouted Yertle. "I'm the king of the trees!

I'm king of the birds! And I'm king of the bees!

I'm king of the butterflies! King of the air!

Ah, me! What a throne! What a wonderful chair!

I'm Yertle the Turtle! Oh, marvelous me!

For I am the ruler of all that I see!"

Standing at Kenmore Station this past week, I flipped through an issue of Uncanny X-Men from my weekly haul of comic books. The platform wasn't choked with people, so it was easy to hear myself think for once. It was also easy for me to hear the woman next to me scoff at me for flipping through the pages of my comic book.

"Aren't you a little OLD to be reading THAT?" she asked.

I looked up from my brain candy and saw a 40-something standing beside me in a suit with a skirt, sporting gelatinous cankles that oozed out of her too-high heels like super heroine's breasts tend to bulge from too-tight tops.

"No ... I'm not too old."

I continued reading. She grunted. We were done. Still, something was troubling me. I mean, I know I'm 26 and pretty well set in the gray department, but too old for comic books? Comic books are everywhere, and so are the people who appreciate them.

Joss Whedon of Buffy the Vampire Slayer has taken his seven-season long television series to an eighth season, but has done so in comic book form. Pulitzer Prize-winner Michael Chabon helped pen the script for Spider-Man 2. Brian K. Vaughan worked for both DC and Marvel comics and is now a writer on ABC's Lost. The people who write what entertains mainstream America are also reading and writing comic books. No one's bitching about them being too old, or about those shows and movies being targeted at young, upstart whippersnappers. Shoot, Buffy won an Emmy!

I also don't think that millions of dollars in box office sales can be discounted when considering how prevalent comic books are in our culture. Spider-Man, X-Men, Iron Man: All have raked in huge earnings at the box office, and we're not just talking milk money from Mommy and Daddy. Mom and Pops are going to see these movies too, sometimes more than once. Iron Man alone grossed over $102 million opening weekend and Spider-Man made $114.8 million its opening weekend in 2002. It's not just parents and their young children going to see these movies. Everyone's going to see them. My father was stoked for The Dark Knight. Hell, my grandmother enjoyed Spider-Man!

So to better answer that woman's question: Maybe I like to get my superhero fix a little more often than others. Maybe that's why I pick up the pulp version. Maybe I enjoy the splashy artwork. Maybe I like the clever writing and the one-liners that only a great comic book can deliver. Maybe I like the surprise reveal you can only get when you turn a page. But there is a plainer answer to her question, and a better one: No, I'm not too old ... and neither are you.

The Standard-Times' report Sunday on the financial struggles within the gambling industry should give Massachusetts residents and lawmakers pause.

Sometimes power (and the laws that are often used to enforce it) is used for good; too often, it is used for bad; and, unfortunately, sometimes it is used foolishly, and nothing good comes of it. Events unfolded for us in Dartmouth this week that might...

As an independent publisher of a weekly newspaper, I read with great interest the pieces by New Bedford Standard-Times Editor Bob Unger and independent publisher Jim Butler.

I was following the news about Sen. Barack Obama and his campaign trip to the Middle East. I have no idea how a man talks to our troops and generals and still says he is against the war. He wants to pull our troops out before we obtain a victory. We all...

Incident at camp is troubling

Another reason to go vegetarian

Community shares value of good day's work

Her 'View' needs clarification

At a time when so many of us are worried about not only our own futures but the direction of our nation, last week's act of enormous generosity in the global battle against AIDS was an inspirational reminder of the true greatness of the United States.

The United States does not have an effective national energy policy. The "energy crisis," a term used to describe the sticker shock of recent gas and oil prices, has brought this to the attention of most Americans.

Proposed tax