Lach, who boards pregnant Marshallese on Kauai and Hawaii until they give birth, said it was no easy feat to fly the women out of Honolulu without proper identification.

"Southern Adoptions took their passports and birth certificates and refused to return them," she wrote. "Kathy Lahr told me she would NOT return them, and that I should 'give the mothers back.'"

Lahr, asked to discuss her operations and Lach's allegations of mistreatment, said: "I don't want the opportunity."

After the women deliver, Adoption Choices tries to enroll some of them in the federally funded Job Corps program, Debo said. A successful job placement spares Adoption Choices the cost of flying the birth mother back to the Marshall Islands.

Island law ignored

A few hundred yards from the Marshall Islands' fledgling central adoption authority, a government official with a direct financial interest in the traffic in babies scoffed when asked whether the new adoption law would have an impact.

"It will affect us, but only if they enforce it," said Lanny, the deputy director of the Marshall Islands Airport Authority, who augments his income by working as Lach's facilitator, shipping pregnant women to Hawaii. "They have a lot of laws they don't enforce."

Lanny said the pregnant women he deals with come from "the poor, the low class" and are given a $100-a-week stipend while in the United States waiting to give birth. Housing is provided free.

He insisted that he never solicits birth mothers, saying, "They call us."

Lanny would not disclose his fee. A rival facilitator, Lina Morris, who arranges for direct adoptions from the Marshalls, said she collected $2,500.

He praised Lach, his associate in Hawaii, as "a very honest person. That's one of the reasons I went to work for her."

Lach, for her part, expressed no concern about the new Marshall Islands law. "It's not aimed at me," she said. "They do not have jurisdiction.

"I realize the government would rather this didn't happen," she added, speculating that the law is "all for show."

Lach, who said she receives $13,500 of the $25,000 fee that adoptive parents pay, contends that her paramount interest is the children. If not for the adoptions she arranges, she said, many of the youngsters she has placed might not be alive.

The infant mortality rate in the Marshall Islands is 38.68 per 1,000 live births, comparable to that in many developing countries. (The rate is 6.69 per 1,000 in the United States.) More than a third of Marshallese children under 5 suffer from vitamin deficiency and malnutrition, according to studies published this year in American health journals.

"I think the people know we do ... the best adoptions in the Marshall Islands," Lanny said. "We make sure [birth mothers] are healthy. We find moms and dads for these poor kids."

Getting Medicaid

When maternity nurses in Hawaii first encountered Marshallese women, they didn't realize they were dealing with foreign nationals because the new mothers were enrolled in Medicaid, said David W. Heywood of Hawaii Pacific Health.

"Only in talking to them does it become clear," he said, adding that the women often are accompanied by a woman from the adoption agency who acts as a translator.

Qualifying Marshallese mothers for Medicaid is an integral part of the adoption agencies' procedures. Marshallese qualify for coverage if a doctor certifies that there is an emergency: A woman about to deliver a baby fits that description.