Twenty home birth patients referred for hospital management were reviewed. Eleven mothers were referred in labour and nine infants in the first week after birth. The clinical presentation and neonatal outcome are described. The majority had antenatal factors suggesting increased perinatal risk. Careful patient selection, prompt detection and early referral of complications, and adequate facilities for infant resuscitation should minimise the risks of home birth. More research is required on the population requesting home birth and its outcome.