Born before arrival. A study at the New Somerset Hospital, Cape Town

A 3-month prospective study was undertaken to determine the factors which contribute to a baby being born before arrival (BBA) of the mother at hospital. The majority of the mothers of such babies were Black and lived in peri-urban areas of Cape Town. They were of higher parity, had experienced fewer complications during pregnancy, had shorter labours and had previously had more home deliveries than a comparative group of mothers. One-third of the babies were delivered in transit to hospital, and these babies had more major complications and a higher perinatal mortality rate than those born in hospital. The BBA rate of an area serves as an index of the accessibility of perinatal care. This index should be taken into account when reviewing and planning regional perinatal services. We believe that a BBA rate higher than 1,5% is unacceptable and merits investigation.