EDITOR,—Tom O'Connell reiterates our point that the differences in psychosocial outcomes in our study, although significant, were small. Consequently their importance is uncertain. We will soon begin a two year follow up of women in the antenatal care project to evaluate possible long term effects of reduced schedules of visits on maternal psychological health, the relationship between mother and child, and use of the health service postnatally. We hope that this study will help to clarify the clinical importance of the differences in psychosocial outcome that we found.

O'Connell also questions the generalisability of our findings, given our non-participation …