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The findings from a case‐control study of perinatal deaths occurring within a health authority during 1982 are described. No clear‐cut picture between cases and controls emerged for a range of social, maternal and access to service variables. The tentative findings suggested that, once mothers were in the health care system, differences in medical practice and attitudes might be related to perinatal outcome. Participant observation led to the identification of problems in communication between the mothers and some members of medical staff. This led to “victim‐blaming” and to mothers′ anxieties not being taken seriously, sometimes with serious consequences. It is suggested that “victim‐blaming” behaviour has its roots in the deep and long‐term processes of medical socialisation. How the range of explanations for inequalities in health, set out in the Black Report, may be implicitly adopted in inconsistent ways in the delivery of health care to this particular group, is illustrated.

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