One thing that actually is happening (thank venture capital, ironically) is that dedicated hospitalists are on hand. They work on shifts and are always at the hospital. This means that a doctor doesn't have to worry about whether the choice to go for vaginal birth means they have to come in at 3 am on a Sunday. The guy who ends up doing that is going to be there anyways. The people who think that the 10k or whatever "they" pay means that they own several other human beings for 9 months don't like it, though.