But what if...
In Massachusetts, nine out of ten intended home births take place at home. Of those who transfer for medical care, the majority do so for non-emergency reasons, particularly for a long labor that would be helped out with an epidural and some rest.
Birth has a wide range of normal. Midwives work with healthy people, healthy pregnancies, and healthy babies because they represent the lowest risk population for whom all the options--including out of hospital birth--should be available (as they are in the United Kingdom, for example). However, we are also trained to manage complications of birth. For example, I carry anti-hemorrhagic medications, equipment to help a baby transition to breathing air, and oxygen. There is an experienced assistant midwife present at the birth who is current in her neonatal resuscitation and CPR certification.
And, if things aren't in the range of normal, then I'll tell you and we'll go to the hospital. I bring your prenatal and labor records, and will stay with you as labor support through your birth, providing postpartum care as normal.