In order for women to benefit from adequate community-based care during pregnancy, delivery, and the postpartum, health authorities must provide adequate local services with a sufficient number of trained agents to supervise all deliveries, and the communities themselves must strive to prevent maternal deaths. The community should monitor the health of women, assure access to family planning and prenatal care for all women, and make its members aware of warning signs during pregnancy and delivery. Communities need the assistance of a maternity center or hospital for high-risk pregnancies and difficult deliveries if morbidity and mortality are to be avoided. Each delivery should be attended by a trained person who knows when the delivery is excessively protracted and hospitalization is necessary, what to do in case of hemorrhage or poor presentation of the infant, what rules of hygiene to follow, and how to handle other situations that arise during delivery. Women who are healthy and well-nourished before pregnancy have fewer problems during pregnancy and delivery, and family planning allows high-risk pregnancies to be avoided. Regular prenatal care allows high-risk pregnancies to be identified so that the women can be sent to a hospital for delivery. The expectant mother can be given iron supplements, the 2 injections that will protect mother and infant against tetanus, and antimalarial drugs if necessary. Hypertensive women can be identified, and women can be given advice on child care and family planning. Warning signs before pregnancy include pregnancy within the past 2 years, being under 18 or over 35 years old, family size of 4 or more children, birth of a previous infant weighing under 2500 gm at birth, history of difficult delivery or cesarean, previous premature delivery or stillbirth, maternal weight under 38 kg or height under 145 cm, or chronic illness. Warning signs during pregnancy include failure to gain weight, pallor in the interior of the eyelids, and swelling of the legs, arms, or face. 6 signs requiring immediate attention are vaginal bleeding during pregnancy, intense headaches which may signal high blood pressure, significant vomiting, fever, convulsions, and labor of more than 24 hours. The community should try to ensure that each pregnant woman has a delivery kit in her home ready for use so that the delivery can be safely attended at home if necessary. Women and families should know where to seek further assistance if complications or warning signs occur. Communities can organize 2-way communications by telephone or radio with the referral hospital and can ensure that transportation is always available. Communities can also organize their own forms of insurance so that women can pay for emergency medical care.