There is little legal experience with home deliveries because very few home
deliveries in the United States are attended or supervised by physicians.
Although there is a small, visible group of middle-class and affluent women
seeking home deliveries, most women delivered at home are poor and would
prefer to be delivered in a hospital by a physician. Once these women are in
labor, they can be brought into the hospital under the antidumping provisions
of the Medicare/Medicaid laws, but they will still be responsible for their
medical bills. These poor women pose a dilemma for physicians because of the
conflict between their desire to help the woman avoid the hospital costs and
the ethical and legal problems in engaging in potentially substandard care.