I N THE past twenty-five years, there has been a definite improvement in the death rate of infants during the first year of life. The mortality at birth and during the neonatal period has remained practically unchanged. As a result of improved prenatal care and supervision some reduction in the neonatal death rate has been achieved. There are still many intrapartum and neonatal deaths due to ill-timed, ill-chosen, and unnecessary operative procedures. Unfortunately there has been in the recent literature an indication of a tendency in the direction of more active operative interference in labor, the wisdom of which can be seriously called into question. A statistical survey of the infant mortality at the Cook County Hospital was made to analyze the results of what may be regarded as a conservative policy in this department with respect to operative procedures including delivery by cesarean section. True conservatism consists as much in the performance of operations properly selected and performed as it does in a well-considered policy of allowing the patient to deliver spontaneously. In a study of infant mortality the question as to whether too many or too few operative deliveries are performed can only be answered by a consideration of the number of infants lost who could have been saved by some operative procedure without undue risk to the mother. Normal deliveries are conducted by the internes under the supervision of the resident physician. Analgesias are rarely used beeaus~ of the expense involved and the limitation of personnel. Inhalation anesthesia is used only when operative procedures require it. Local infiltration with 1~ per cent novocaine is used for the performance of episiotomy and repair of lacerations. Frequently, in selected cases, prudendal nerve block is resorted to, for the performance of simple operative procedures. As in all large charity institutions, Cook County Hospital accepts patients who have had no prenatal care; patients who have been referred from clinics other than that associated with the Hospital, because of complications of pregnancy or labor; and many patients who have been under the care of private physicians or midwives and are admitted to the Hospital as emergencies. This survey covers a four.year period, 1933 to 1936 inclusive, during which time 16,242 babies were delivered, including 184 sets of twins. Of the 16,058 mothers delivered, 10,016 attended the Cook County