Current evidence indicates the critical importance of several factors that contribute to improved perinatal outcomes: a facilitating environment at the place of birth, skilled birth attendance, and the continuum of perinatal care for women and newborns. This level of care is often referred to as "first-level" care, and is most readily provided in birthing centers and primary level health facilities. However, there is a body of evidence that has been compiled over the past several decades that addresses the safety of planned home birth, under circumstances that emulate these elements of "first-level" care. These studies demonstrate a remarkable consistency in the generally favorable results of maternal and neonatal outcomes, both over time and among diverse population groups. These outcomes are also favorable when viewed in comparison to various reference groups (birth center births, planned hospital births, and vital statistics). These data should influence policy in support of planned home birth, including policy that endorses building or sustaining a home birth infrastructure in parallel to the efforts to build capacity for facility-based birth. Such public policy would also be in keeping with the fundamental right of women to have choice in childbirth, particularly when options are equally good.

conducted what became known as the Wedgeport Polio Trial in which the oral trivalent Sabin vaccine was administered to an entire community in Southwest Nova Scotia. The results of the trial were published in this journal in 1962; 1 50 years on the trial is part of Canadian medical history. As CMAJ celebrates one hundred years of publishing medical research in Canada it is interesting to look at the trial from the perspective of the distinguished photojournalist, Bob Brooks, who accompanied the researchers on their rounds in March 1961. Canada experienced great losses from paralytic polio epidemics in the 20th century. By 1934, almost half of Canada's disabled population could be linked to polio and in 1953, the year of the worst outbreak in Canadian history, almost 9000 cases were reported. 2 While the injectable Salk vaccine helped control some of the epidemic, it did not stop all outbreaks, and more aggressive polio immunization campaigns were needed. Connaught Medical Laboratories, now Sanofi Pasteur, had been developing the trivalent Sabin vaccine (available at the time only in the United States), and this prompted field studies in Manitoba, Saskatchewan and Nova Scotia, which were pivotal in encouraging the licensing of the Sabin vaccine in Canada.

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