Vanuatu is an island nation in the south-west Pacific. Vila Central Hospital (VCH) is the country's major referral hospital. The handwritten labour floor records from VCH between 1979 and 2001 were examined and collated. During this period 28 638 women received care. The mean Caesarean section and instrumental delivery rate were 5.2% (2.1–8.2% per annum) and 1.8% (0.9–3.2% per annum), respectively. The post-partum haemorrhage rate fell from >5% in 1979 to <1% in 2001. The overall hospital maternal mortality rate was 7/10 000. These records represent the largest published series of labour floor data collected from any Pacific island nation.