Umm, heck yeah I support them. I had my first baby in a state that did not license midwives, so my choices were: underground midwife, 5 hour drive to The Farm, a hospital with a CNM who I didn't click with very well, the hospital being the most natural birth friendly BUT had a mandatory nursery stay for the newborn for at least an hour (if pediatrician signs off on it) but usually more like 4 hours. (And, being incredibly active in the birth community had never even HEARD of anyone who successfully fought the policy) or hospitals that were less natural birth friendly but didn't have the unbendable nursery stay policy. I chose the underground midwife. Obviously its not ideal, but I felt it was my best choice. A choice I agonized over for the first 24 weeks or so of my pregnancy (that was when I made my final decision) Underground midwives (at least the ones I knew in that city) weren't underground because they are "unethical and have a high tolerance for risk". Its because they are passionate about offering choices to women in an area that had few choices. They were honest and upfront about what kinds of situations they were and were not comfortable with, safety wise. And when things weren't looking good, they transferred to the hospital, staying with the mother. The biggest risk they face is prosecution, but they stick their necks out to offer women that choice, and yeah, I damn well appreciate them for it! I personally DID transfer, and unfortunately had a c-section (chose the not-very-natural-birth supportive hospital option because at that point I knew I was not getting a natural birth, but wanted to keep my baby with me at all times!) my midwife and her apprentice stayed with me and cooperated with hospital staff, identified themselves as lay midwives, handed over prenatal/labor records. They are actively trying to change the laws to license midwives there, but in the meantime, women deserve a choice somewhere between hospital and UC. I can see how in a location that is openly hostile towards midwives and they're being prosecuted, there's the possibility of it being "less safe" because a midwife's risk tolerance could be stretched thin, delaying transfer with signs of distress to avoid being "caught" at the hospital. I'm sure it happens. Luckily where I used underground midwives, I have not heard of any attempts to prosecute, so that is not hanging over their heads. When there's distress/abnormality, they transfer.