A prospective survey was undertaken in 26 practices in Essex to assess the risks associated with a home birth. The 202 women who were booked for a home confinement were compared with a similar group of 185 women who were booked for hospital delivery under consultant care. The principal difference in outcome was the induction rate of 19% in the hospital group compared with 8% in the group booked for delivery at home. A higher rate of episiotomy and second degree tears and more Apgar scores of 7 or below were found in those who were booked for hospital. There were no perinatal deaths in either group. The results of this study showed no evidence of an increased risk associated with home confinements but indicated that there were fewer problems than were encountered in the deliveries in mothers confined in hospital.