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Vermont birth certificates and hospital medical charts for 1979 were reviewed to determine whether infants born at home or in hospitals had documentation of prophylaxis against gonococcal ophthalmia neonatorum. Of the 139 home births recorded in 1979, 78 infants (54.0 percent) received no prophylaxis, compared with 97 (1.4 percent) of 7,156 infants born in hospitals (P less than 0.0001). Ophthalmic medications that have not been recommended for use for neonatal prophylaxis were being used in two hospitals in the State. A followup review of 7,668 Vermont birth certificates for 1980 indicated that hospital practices improved in that year, after the hospitals received a reminder on proper prophylactic procedures from the Vermont Department of Health.