Hiring a "midwife" who practices outside a hospital can mean many things in Michigan:
She may or may not be licensed
She may or may not have clinical training
She may or may not have a high school diploma or college degree
She may or may not be certified in neonatal resuscitation
She may or may not carry malpractice insurance
She may or may not report her outcomes to the state of Michigan, or anyone else
She may or may not have had previous, preventable infant deaths or birth injuries
She may or may not have strict "risk out" criteria and truly take on only low-risk clients
She may or may not carry and use prescription medications illegally
She may or may not effectively evaluate and appreciate risks
She may or may not believe in "high risk" as being more than a variation of normal
She may or may not transfer your care before it's too late
She will not have all of the tools, medications, resources, and skills at her finger tips to resuscitate your baby if he or she needs it.
Furthermore, given a bad outcome, poor decisions, inadequate skills, mistakes made, red flags missed or flat out ignored, you may or may not be able to hold your midwife accountable...most likely not when there are not standards or regulations by which to do so.
Midwifery can be done responsibly and ethically. Collaborative care is happening in many parts of our country, even some cities in MI. The problem is, that without a defined scope of practice, you don't know what you're getting when you step outside a hospital and into the hands of a midwife.