Obstetricians and Gynaecologists face a wide variety of challenges: Managing the care of patients of all ages from puberty through menopause and beyond; treating both acute and chronic health conditions; and of course, managing risk through the pregnancy and childbirth process. The United States has a higher ratio of maternal deaths than at least 40 other countries, even though it spends more money per capita for maternity care than any other. The lack of a comprehensive, confidential system of ascertainment of maternal death designed to record and analyze every maternal death continues to subject U.S. women to unnecessary risk of preventable mortality. Maternal deaths must be reviewed to make motherhood safer.