So if you give birth in Texas unattended, without a hospital, doctor or midwife, how do you get a birth certificate then? I don't see how not being able to get a valid birth certificate from a midwife would discourage women from using midwives, unless the law was worded in such a way as to make it harder to get a birth certificate if you were alone than if there was a midwife present. Something about this just doesn't quite add up.