Ebenezer BD, et al. - Researchers investigated the impact of interventions implemented over the past 18 years, in a tertiary center in South India, on the rates of perinatal mortality, birth asphyxia, and cesarean sections. They employed data from perinatal audits, chart reviews, and data recovered from the electronic database. During this time period, interventions implemented were audits and training, obstetric re-organisation, and minor changes in staffing and infrastructure. Outcomes revealed decreased perinatal mortality and rate of babies born with birth asphyxia over the past 18 years, without an increase in the caesarean section rate, in correlation with a policy of rigorous audits of stillbirths and birth asphyxia, electronic fetal monitoring, and the introduction of standardised criteria for trial of scar in a large tertiary hospital in South India, with 14,000 deliveries per year.