whether in a hospital or a birthing center.. or during a home birth. At a hospital (or a birthing center) support for emergencies may be (should be) close. Most birthing centers I've heard of work in close cooperation with a nearby hospital or OBGYN. I've also read articles (no direct experience) that midwives are also certified and part of that certification is close contact with a physician, just in case things "happen" during birth.
I don't consider midwives, or the reason to want a midwife "wah wah," nor do I consider it "woo, woo"... Women have been helping other women deliver babies for millenia, no men needed or desired, thank you. This woman had 5 pregnancies go awry for whatever reason and came out of the hospital devastated there was no follow up to help her through it, nor through her desire to successfully become a mother. MOTHERS are not held as the most important aspect in today's world. We are only women. ONLY the baby is held up as important. And if there's no baby, no importance. In fact, the more likely the mother is to feel she has failed as a woman, according to today's standards for women. (and thus was it ever)
I had ONE baby. I readily admit she would not have lived had I not been at the hospital with the OB's on call. Things were touch and go for me for days, as well. In fact, in was nearly 3 months later before I could bring my daughter home. But I don't necessarily feel midwives would have been a problem, if they'd been in contact with emergency care, even in my circumstance. I really had no option... not only because this was 40+ years ago, but also because I was military when I gave birth. And I can tell you from personal experience, as good as those OBs were, I didn't really feel supported. In fact, it took two months AFTER I began telling them something was wrong before anyone even listened enough to me to start doing tests on the fetus and amniotic fluid.
I'm all for expanding the role of midwives during pregnancy and birth. If I could have had another child, I personally would have wanted a midwife in close contact with an OB or emergency approved birthing center. But if a pregnancy has preceded successfully for 9 months with no hint of problems, I see no reason not to have a woman-supported birth... be it at home with a doula or at a birthing center. I also feel Insurance should cover midwives as well as death doulas. Not everyone wants their entry and exit from with world to be in accordance with antiseptic hospitals. That's why Hospice was created. But some people have problems with hospice being too associated with a specific hospital or doctor at times. We would prefer to go out on our own terms, and we shouldn't be kept from that because $$$$ and insurance restrictions; both of which favor males over what women, specifically, would want.