An audit of obstetrical practices, defined here as a critical analysis of practices, was accepted by the local authorities and obstetricians/pediatricians of the district of Seine-Saint-Denis (northern Paris, France). The study analyzed all perinatal deaths occurring during a three-year period (the Perinatal Enquiry, 1 Oct. 1989 to 30 Sept. 1992) and subsequently became a permanent tool for critical analysis of obstetrical practices. Bimonthly meetings of obstetricians and pediatricians were held to discuss observed fetal and neonatal deaths. This intervention was associated with a major reduction in perinatal mortality rates after a 10-year period.