Suggested Method of Computing and Standardizing the Maternal Mortality Rate

SINCE the publication of my original paper1 on this subject I have had, from different parts of the world, several letters containing criticisms and suggestions regarding the proposed method of computing and standardizing the maternal death rate. As the method suggested necessarily involves some of the principles of the present method, a good share of the criticisms aimed at me also strike at the method now in vogue of arriving at the maternal death rate. My paper, then, has evidently served a twofold purpose. The present work is the result of an attempt to rewrite the original article in simpler form, using as a guide the material found in those letters which my correspondents have kindly forwarded to me. In the United States for the year 1928 the maternal death rate was 69 per 10,000 live births. For the same year in the Netherlands the rate was 34 per 10,000 live births. Does this mean that the pregnant woman in the United States actually runs double the risk of dying in childbirth of her sister in the Netherlands? Or might the difference in the two rates be due, in some