Columbia -- Ruth Johnson remembers being sent to the pay phone in the middle of the night to call the midwife when her mother's labor pains started.

"I called the midwife. She said she was coming. She never did show up," Johnson said, thinking back to life as a 12-year-old in Barnwell County in the late 1950s.

Before long, Ruth's mother sent her back to the pay phone at the Hilda grocery store. The second time, the midwife admitted she had no intention of coming to help with the birth. "She said, 'Your mama, she owes me $25 for the last baby.' "

And so the baby was born in the family home, without a birth certificate -- a common practice in the 1940s, '50s and '60s in rural South Carolina, but one that is causing problems now for an older generation required to have proof of identification.

Before the government began discouraging midwifery in the 1970s, a lot of women in rural South Carolina didn't go to hospitals to have their babies, either because of the cost, discrimination or culture. Often, the births were unrecorded, whether a midwife was in attendance or not. In some cases, names were misspelled by illiterate midwives or recorded incompletely when parents couldn't settle on a first name right away.

But having no birth certificate, or having one where the name conflicts with other legal documents, can cause problems today proving one's identification -- and getting the photo ID required to get a job, travel, go into public buildings and, in a recent and controversial change in South Carolina, register to vote.

In some cases, people who have never had a problem before must now go to family court to authenticate the names they have used all their lives.

Joseph Williams, a physician who sees mostly elderly patients in Sumter, guessed as many as 20 percent of his 3,000 to 4,000 regular patients have problems with identification. Some only know the year they were born.

"It's extremely common for people who are over 50," said Williams, who is 60. "Record-keeping was poor in our age group."

What happened?

Since the attacks on Sept. 11, 2001, businesses and government agencies increasingly require that people prove who they are using a photo ID.

And a birth certificate is considered the "seed document" for establishing one's identity, making it more important to own -- and protect -- than in years past, said Adam Myrick, a spokesman for the Department of Health and Environmental Control, which oversees the state's vital-records division.

No one knows how many South Carolinians don't have a birth certificate. One indicator may be a tally by the S.C. Election Commission, which shows 178,175 voters do not own a photo ID, according to the latest available figures.

Earlier this year, the General Assembly passed a law requiring voters to show a photo ID -- a driver's license, passport, military ID, new voter registration card or a state-issued ID.

But getting a state-issued ID requires a birth certificate.

For those who don't have a birth certificate, the state's vital-records division requires at least three documents from a list that includes marriage and school records, military and medical records, the birth certificates of siblings and children and voter registration documents.

But there's a hitch.

The name must be identical on each document used as proof of identification: no nicknames, middle initials or other variations.

"The law is very specific: The name has to be the same," said DHEC spokesman Thom Berry. "This is not a South Carolina issue; this is a national issue."

One of the biggest areas of fraud in the country, Berry said, is illegally obtaining a birth certificate.

Berry said DHEC averages about 80 requests a month for delayed birth certificates.

The number spiked after 9/11, when more organizations began requiring birth certificates as positive proof of identification, he said. It has since declined.

The agency responded to 1,488 requests for delayed birth documents in 2005, for example, compared to 960 last year.

"For someone with no birth certificate at all," he said, "it's usually going to require a judge's court order."

But whether people attempt to gather their own historical documents or hire a lawyer to sort through the matter, it's a potentially costly and time-consuming process.

Reconstructing history

Ruth Johnson's brother Willie Jefferson usually signs his name "Willie J. Jefferson." But not always.

The second in a family of eight children, Jefferson was born at home in the summer of 1949 with the help of a midwife. He never had a birth certificate. His mother, Louise Jefferson, recorded the birth in the family Bible.

The lack of a birth certificate wasn't an issue until last month, when Willie Jefferson turned 62 and wanted to apply for retirement benefits. He worked at a palette company for 42 years and planned to draw early Social Security.

Jefferson, who lives in Lexington County, has a Social Security card but no birth certificate to prove he has reached eligible age.

"I didn't know it would be a complication," he said.

And it may not be.

The Social Security Administration, which doesn't require a birth certificate when it assigns numbers, asks for a birth certificate for retirees if age is in question, said Chris Jenkins, a spokesman in Columbia.

But with a policy shift in September 2008, the federal agency began taking people's word if they file online and the birthdate they give at retirement matches the date they gave when they first applied for a Social Security number, he said.

Still, Johnson wants to get her younger brother a birth certificate.

Johnson, 63, a community organizer in lower Richland County, got a copy of his childhood school record from Richland 1, stored on microfilm. ("They put it in a certified, sealed envelope," she said.)

But she ran into problems when she went to get hospital records as a second form of identification. The hospital purges records after 10 years.

Using another accepted document -- a daughter's birth certificate -- became a second stumbling block. Years ago, when his ex-wife filled out the information for their daughter's birth certificate, she listed Jefferson's name as "Willie James Jefferson Jr."

He is not a "Jr."

So for now, at least, the brother and sister have been stymied in their efforts to get Jefferson's delayed birth certificate.

"I'm hoping it'll all work out," Johnson said late last week.

A tough road

For some, getting the document means a trip to court.

Ruben Gray, a retired family court judge in Sumter, is helping 10 people clear up their birth records.

Others have come to him, he said, but he's trying to get the initial cases completed before he takes on more.

It's time-consuming work that requires collecting a variety of documents, many of them difficult to obtain.

He has requested baptismal records and family Bibles, Social Security cards -- even Census records from 1950, 1960 and 1970.

If his clients had to pay for the service, Gray said, it could cost as much as $1,800 to gather documents and pay court and legal fees. He's doing the work as a community service.

Gray said the state should be more flexible about the records it will accept.

"In many instances, we deal with people who've been working for 50 years -- they just don't have a doggone birth certificate," he said. "I have people who have served in the military, with an honorable discharge."

Among Gray's clients are Curtis Rogers, who said he was asked for a photo ID when he applied for a job at a chicken-processing plant. He doesn't have one.

Rogers' birth certificate reads "Baby Boy Montgomery."

Montgomery was his mother's family name, not her married name.

Needless to say, "Baby Boy Montgomery" conflicts with other records, all under the name "Curtis Rogers" -- including his World Trade Center ID, which he was wearing when he escaped the carnage nearly 10 years ago when terrorists flew one airplane, then another, into the towers.