This is a description of the process and outcome in the development of a large perinatal database. The database is relatively unique, as it utilizes a convenient paper format for initial data entry that can easily serve, in the absence of a computer, as a very complete obstetric and neonatal medical record. With the addition of a moderately priced microcomputer, the database is converted into a computerized medical record that provides admission notes for the labor suite and the nursery, and discharge summaries for abortion, non-delivery, delivery, newborn nursery, and intensive care nursery admissions. The development of the paper forms, the choice of data-entry clerks over health-care providers for computer input, the design of the software to ease use and economize on storage requirements, and the use of the database in research projects are described.