Home versus hospital confinement.

The case for hospital rather than home delivery has been powerfully argued, especially in and since the Report of the Peel Committee. Nevertheless, evidence of comparison with other countries, notably the Netherlands, suggests the choice is not necessarily simple.Some general practitioner units are now reporting perinatal mortality rates which are consistently lower than those of specialist units, and recent statistical analyses suggest that the presence of more high risk cases in consultant units does not explain this. The only big controlled home-versus-hospital trial did not lead to a significantly lower perinatal mortality rate in the hospital group.The onus of proof now seems to lie with those who advocate 100 per cent hospital confinement.