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The first year of existence of the Peninsula Maternity and Neonatal Service (PMNS) is reviewed. Some 21000 deliveries per annum fall under the Service. The ethnic distribution in 1980 was 27% Black, 69% Coloured and 4% White. The perinatal mortality rates per 1000 births were 31,2 for Blacks, 29,4 for Coloureds and 15,0 for Whites, with an overall perinatal mortality rate for the PMNS of 29,2. The administration of the PMNS is described. The Midwife Obstetric Units are discussed under the following headings: function, workload, advantages, and continuing education. Research opportunities and the main problems in the PMNS are outlined.

The Peninsula Maternity and Neonatal Service (PMNS) was established on 1 January 1980 as a result of the regionalization of obstetric and neonatal services in the Cape Peninsula. Some 20000 deliveries per annum occur in the 5 maternity hospitals and 3 Midwife Obstetric Units (MOUs) under the aegis of the PMNS. As part of the reorganization of the service the booking and referral criteria have been revised, taking into account the function of the Groote Schuur Hospital Maternity Block as the high-risk unit. The concept of risk in perinatology is discussed. The booking and referral criteria are detailed under the headings of booking criteria for hospital and for MOUs and referral criteria from the MOU to hospital -- antenatally, in labour, in the puerperium and for neonatal problems.

A revised scheme of management of the third stage of labour was recently introduced in the Midwife Obstetric Units in Cape Town. Patients received synthetic oxytocin (Syntocinon; Sandoz) 5 IU intramuscularly with the delivery of the anterior shoulder and ergometrine maleate 0.5 mg intramuscularly after delivery of the placenta. A significant decrease in the incidence of postpartum haemorrhage and retained placenta was observed, warranting continuation of the new regimen.