Might be expensive, but they could go the route of paying to have a trained transport staff on duty. The Childrens Hospital in the service area of the company I worked for a few years ago did this. They contracted us for one specially outfitted ambulance for neonate transports and an EMT that stayed parked at the hospital. The hospital provided an on call team that included a nurse and respiratory tech that would hop on whenever necessary. I'm sure a similar setup could be done for transporting out of a birthing center. That would solve the problem of maybe an ambulance not being nearby. But yeah, more cost effective to just call for an ambulance if necessary...who cares about the occasional morbidity or mortality right?