A retrospective, community based study on perinatal mortality was performed in a sparsely populated county with decentralized antenatal and maternity care. Neither level of care nor domicile showed any relation to perinatal mortality. A substantial underreporting of perinatal deaths was revealed. Death causes were classified according to the modified Aberdeen classification. One child per 2,000 births is stillborn due to asphyxia during delivery. Maternal age outside the optimal age range for reproduction was a significant risk factor. A suboptimal standard of care was identified in 33% of the perinatal deaths.