ABSTRACT: The medical literature comparing home and hospital obstetric outcomes is reviewed. A home obstetric service with hospital and obstetrician back-up is described, including screening, care during pregnancy and delivery and management of complications. Of 495 women who were accepted for home delivery, 77 miscarried or moved, 49 changed to hospital delivery, 19 had premature labor, and 61 were transferred to the hospital during labor. Maternal and perinatal mortality and morbidity are described. In this well-selected low risk population, careful prenatal and intrapartum care resulted in outcomes which are comparable to those of hospital programs.