Two issues are of greatest concern in the evaluation of alternative birth settings: (1) defining which women are at low risk of complications, and (2) identifying appropriate management and cost of low risk deliveries. While several studies have reported the safety and psychic benefits of alternative birth settings in terms of maternal and infant health outcomes, the methods of study have differed sufficiently that the definition of appropriate care remains controversial. It is in this context that the study under review is proposed. The purpose of the study is to describe similarities and differences in management acitivities and patient health outcomes between a traditional labor and delivery setting and a hospital based Birth Center. A historical cohort design of low risk deliveries between 12/1/82 and 11/30/84 at Jefferson Davis Hospital, Houston, Texas, will be performed. The study subjects will be chosen from among those delivering in the Birth Center or the traditional labor and delivery setting who were classified as low obstetrical risk as determined by a POPRAS score of 25 points or less at time of admission for labor and delivery. Subjects will be matched on race, parity, age, date of delivery and utilization of prenatal care. Practice and activity data will be extracted from the medical records of study subjects and linked with maternal and infant health outcomes obtained from the records. Activities surrounding the labor and delivery of a subsample of births selected for record review will be observed and recorded. Cost data will be abstracted form administrative charge slips. Attitudes of patients will be collected using a questionnaire that will form part of the medical record during the latter part of the study period.