This study compares 796 pregnancy outcomes at a maternity center (BMC) with 804 hospital (TJUH) pregnancy outcomes. The samples of pregnant women from the participating institutions were matched on sociodemographic characteristics; analysis of outcomes was performed controlling for medical-obstetric risk. Differences between the institutions were found mainly among women with low intrapartum risk. For these women, neonatal morbidity and length of infant nursery stay were lower at BMC IntroductionDuring the past decade, alternative approaches to conventional in-hospital maternity care have increased in number and visibility. Their purpose is to offer parturient women a satisfying birth experience in a safe environment and at lower costs than conventional care. Growing attention to alternative birth settings was recently expressed in the report of the National Academy of Sciences Committee concerning the Assessment of Alternative Birth Settings.' Although the safety of such alternative approaches is of paramount importance and has been the subject of considerable controversy,2 little information is available to allow an objective evaluation of their safety. Published reports on birth centers as well as in-hospital alternatives have been largely descriptive.3-5 Only one published study of an inhospital alternative birthing center included a comparison