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.