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The organisation of delivery care engages both professional and laypersons. When the Norwegian princess Märtha Louise in 2005 chose to give birth at home instead of in hospital, the intensity of the debate in media increased. Some professionals claim with great persuasion that among selected low-risk women, birth at home or in small midwifery units is as safe as in larger delivery units in hospitals. The scientific evidence for this statement is, however, weak. The Norwegian National Advisory Committee for Maternal Care is an important contributor to this debate. The Committee should, however, pay more respect to the scientific disagreement within the field.

In 1996 the Norwegian Society of Obstetrics and Gynaecology appointed a committee to investigate and evaluate the situation concerning recruitment to specialist training in obstetrics and gynaecology. The evaluation was based on data from Section of Register and Statistics in the Norwegian Medical Association, "Utvalg for legestillinger"--a committee central in the regulation of number of doctors' positions, and information from a questionnaire sent to all departments of obstetrics and gynaecology in Norway. The availability of doctors is expected to increase from the beginning of the next century. The committee finds no reason to believe that there is a crisis of recruitment to obstetrics and gynaecology compared to other specialities. The increasing number of female trainees has no negative impact on the rate of production of specialists as time from authorization to specialist is shorter for women than for men. Immigration is a factor of uncertain impact, 20% of the trainees are from abroad, a higher number than in any other speciality. The committee has not found any increased flow of specialists from hospitals to private practice during the last two years. The factors of greatest impact on the future need for specialists is above all increase in the number of positions, changes in working hours and age limit for retirement. Today's rate of education of specialists in obstetrics and gynaecology is satisfactory in a situation where balancing loss is sufficient, but too low to cater for any increase in the number of positions.

This paper describes structure, process, results, and evaluation of the Norwegian Society of Gynaecology and Obstetrics' Guidelines in obstetrics. This work, which lasted for 2 1/2 years, involved almost all obstetrical departments in Norway and 1/4 of all members of the Norwegian Society of Gynaecology and Obstetrics. All members of the Norwegian Society of Gynaecology and Obstetrics were invited to answer 24 questions. Of the 63% who replied to the questionnaire, 44% and 48% respectively stated that the Guidelines in obstetrics were very good or good. The introduction of the Guidelines in obstetrics led to changes in routines in more than 70% of the hospitals, and the different categories of hospital physicians changed their routines as well (55-65%). 83% of the heads of the departments stated that the Guidelines in obstetrics served partly or totally as the model for the obstetrical management guidelines. The evaluation and the experience of this quality assessment handbook serve as perspectives for future work.