A free-standing birth center was established in association with a tertiary care hospital that primarily served an indigent population. Initially, all patient assignments were voluntary. Fifteen months later, a change in policy occurred. In order to reduce the overcrowding in the obstetric suite, the hospital assigned low-risk women to the birth center for maternity care. A study was designed to test the null hypothesis that there would be no difference in outcomes between those who were assigned to the center and those who selected the center for care. One hundred forty-eight women from each group were matched for parity and demographic variables. The outcome results were analyzed and no differences in outcomes were found. The implications for the future of health care for low-risk women of poor socioeconomic status are discussed.