Certain facts pertaining to puerperal mortality in New York City have been presented. It appears that the rate has been decreasing steadily for the past four years while it remained essentially stationary during the preceding thirty-five years. Etiologic or predisposing factors, such as age, race, place and type of delivery, and important causes of death, are reviewed. In addition, statistical data have been presented on some of the prineipal causes of death in New York County, hemorrhage, infection and deaths associated with cesarean section and anesthesia. While it is admitted there are other important causes of death, an attempt has been made to emphasize the leading factors at the expense of omission of other phase of the problem. The following suggestions appear worthy of consideration. 1.1. The puerperal risk involved in the care of underprivileged, elderly, or colored patients is several times greater than that of young, white and the better situated economic group of patients. Lethal complications in the former may be sublethal in the latter. For these reasons such patients demand mature judgment and the best possible care at all times.2.2. The more general adoption of local or regional block and greater restriction in the employment of general anesthesia.3.3. The use of the classical cesarean operation should be limited to patients who are not in labor. The low flap operation is relatively safe during the early hours of labor; however, the dangers increase progressively as labor advances and the use of this procedure after fifteen or more hours of labor is accompanied by an unwarranted risk to the patient.4.4. The employment of blood plasma where whole blood is not immediately available and the exclusion of crystalloid solutions is indicated for the immediate restoration of blood volume following hemorrhage to prevent the development of secondary shock.5.5. Early recognition of the nature of infections and the prompt use of the appropriate sulfonamide drugs in adequate dosage where indicated.6.6. Active participation by general practitioners and specialists in maternal welfare meetings, believing this medium to be the best available and a very satisfactory method of postgraduate instruction.7.7. Assumption of the attitude that every obstetric death involves mistakes in judgment or technique and a constructive attempt to profit from the experience.