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Dr. Ank de Jonge from the EMGO Institute for Health and Care Research and colleagues wrote a rapid response in the British Medical Journal to the paper by Evers et al. in the BMJ on perinatal mortality and morbidity in the Utrecht region. Evers et al.’s study is the first study in the Netherlands ever to show a higher mortality rate among births that started in primary care compared with secondary care. Ank de Jonge et al., argue that given the limitations of the study, the conclusion that labour starting in primary care carries a higher risk of delivery related perinatal death compared to labour starting in secondary care is premature from a scientific point of view.