A midwife is an expert in normal birth. She is trained to keep things normal, and if complications do occur, to recognize and correct them. The most common complications in birth can be safely handled by the midwife. That being said, low-risk women typically have very few complications. If the need for hospital transfer arises, your midwife will facilitate it quickly and efficiently, and stay with you the entire time. Your midwife has working relationships with a variety of health care providers and knows when to transfer your care to one of them. There are many large, well-designed studies that have examined the question of safety of out-of-hospital birth. The results are conclusive. When they compare women without risk-factors, out-of-hospital birth attended by a skilled provider and hospital birth of similar groups have equivalent safety outcomes. If you look at the countries in the world with the lowest infant mortality rates, you see that these countries use midwives and out of hospital birth for low risk women and they do so with excellent outcomes.