The purpose of this study is to examine the usefulness of two existing obstetric risk assessment instruments in predicting intrapartum complications at term. One tool, although not designed to predict problems in labor, is widely used in general populations. The other tool was specifically designed for use in a free-standing birth center. Neither instrument performed well when applied to a sample of 699 clinic patients at term. This inability to identify those who will need hospital care reinforces the necessity for effective referral and transport mechanisms.