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BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY. 1991 Apr; 98(4):345-8.Discusses dual concerns of the Royal College of Obstetricians and Gynaecologists (RCOG): that a widening gap between obstetric standards in Britain and those in the developing world exists and that the RCOG is unable to meet the needs of Third World doctors who come to the RCOG for postgraduate study. A meeting sponsored by Birthright and held at the Royal College of Obstetricians and Gynaecologists (RCOG) in June 1989 which explored aspects of Third World obstetric care reflects these concerns. The proceedings of the meeting have been published and verbatim recordings of the discussions are available on tape from the RCOG. Reports on maternal mortality/morbidity in the Third World indicate persistence of poor obstetrical practices and of common obstetrical complications. Suggestions for improvement include the redeployment of and the replanning of services within countries and an increase in health education for women. Access to care at the first referral institution level is seen as the key to the improvement of care. Problems of transport and communication create serious obstacles to the link between community care and the first referral institution. The goal of the World Health Organization (WHO) is to cut the Third World maternal mortality in half by the year 2000. To reach this goal WHO plans to field obstetric teams in Latin America, Africa and South Asia; to train nurse-midwives to perform life saving measures on their own initiative; and to employ community resources by training indigenous midwives to function as extensions of the health team. The RCOG will sponsor training designed for doctors who will work in developing countries.