Objective: To define clinical demand, personnel needs and medical infrastructure to organize prenatal care in southern Haiti. Design: A house-to-house survey of 3 communities in Saint Louis du Sud, Haiti was conducted in preparation for considering basing deliveries at an infirmary located in Sucrerie Henri. Setting: A house-to-house survey defined in detail the numbers and distribution of pregnant women, site of deliveries and perinatal outcome. Population 1490 individuals in 3186 households with 187 woman declaring current pregnancy were surveyed Methods After engaging the community, surveys were conducted by experienced demographers from the Institut Haitian de l’Enfance. Each dwelling was located by the Global Position System, GPS Main Outcome Measures To assure accuracy of recall the questionnaire focused on location of the dwelling by GPS, current pregnancy, births in the last 30 days and neonatal deaths. Results The recorded neonatal mortality in communes surveyed was 52/1,000 live births for the year preceding the survey. Higher rates were seen in the more inaccessible areas which correlated with areas with a higher percentage of home births. Conclusions: Detailed description of perinatal health needs in a rural community in Haiti, established an association between distance to health care and out-comes. The survey makes a strong argument for establishing the capacity for deliveries at the existing infirmary in Sucrerie Henri as model for improving the outcomes of pregnancy in rural Haiti.