Summaries of papers read at the meeting of the Society for Social Medicine 16 to 18 September 1976

During the decade 1960-69, 33 871 mothers in Newcastle upon Tyne were booked for delivery either in specialist hospitals or at home. Confinements in hospital rose from 45% in 1960-62 to 80% in 1966-69 and at the same time perinatal mortality fell from 36 to 26 per 1000 births. While home bookings fell from 51 % to 23 %, the proportion ofwomen so booked who were eventually transferred to hospital, rose from 13% to 21%. Perinatal mortality from 'obstetrical' causes fell at a greater rate than those from 'environmental' causes. Cases transferred from home to hospital showed a high mortality, which fell steeply from 128 (1960-62) to 54 (1966-69) per 1000 births. There is evidence of improved selection both at booking and at transfer, which probably accounts for the fall in the mortality rate among home deliveries. The above findings cannot be explained by changes in the distribution of social class, parity, age, maternal height, or birth weight nor by selective migration from the city.