The director of the state health department said in a letter Monday that the agency will not waver from enforcing rules that govern how midwives do business in South Carolina.

Meanwhile, about 200 supporters of a local natural-birth center rallied at the College of Charleston Monday to affirm their right to have babies without the presence of a doctor.

Catherine Templeton, director of the S.C. Department of Health and Environmental Control, said she expects midwives to follow state law, which is intended protect unborn babies and their mothers. That includes having an “on call” physician close to the birth center in case of a complicated delivery, she said.

State law says, “A physician must be on call and available to provide medical assistance at the birthing center at all times that it is serving the public.”

“The agency has simply requested the documentation that shows the midwife clinics are complying with the law,” Templeton wrote in a letter to Charleston attorney Laura Evans, who has been hired to represent the South Carolina members of the American Association of Birthing Centers. “This is not a reinterpretation of the law, but enforcing of the law.”

The association includes the Charleston Birth Place, whose staff and supporters see no need to call doctors to the center. They say mothers and midwives can decide when they need to go to a hospital. The center is less than five minutes from Trident Hospital in North Charleston.

The Birth Place could lose its license if it does not show proof of contracts with on-call doctors who agree to come to the center when needed. DHEC put the center on notice Saturday that it has 15 days to demonstrate compliance.

Evans, the association’s lawyer, interprets the law differently.

Previously, she said, DHEC required only that doctors be available for phone consultations and that it didn’t matter how far away they were. “On call” didn’t necessarily mean close by, she said.

Part of the problem with the regulation is that it’s hard to find doctors in the Upstate who will sign contracts with birth centers, Evans said.

“DHEC had historically allowed a simple telephone conversation,” she said.

Evans said she will file an injunction on behalf of her clients on Wednesday if DHEC cannot provide more clarification.

An injunction would allow a judge to interpret state law and how it should be enforced.

About 200 supporters of the Charleston Birth Center rallied at the College of Charleston Monday to protest DHEC’s interpretation of the law, and to affirm their right to have babies without the presence of a doctor. They held up signs, took turns speaking and hugged each other in the garden behind the Stern Student Center.

Erin Foushee of West Ashley was holding Sam, who was delivered at the Charleston Birth Place in April 2012, and a hand-lettered sign that said “My body, my birth, my choice.” Her husband Matt stood by her side.

“We felt outraged,” she said of DHEC’s policy on doctors. “Their effort to regulate will just lead more women having their babies at home, and that certainly is not safer than being near a hospital.”

Reach Lauren Sausser at 937-5598.