PIP: The article by Benjamin Sachs and several members of the Family Planning Evaluation Division at the Centers for Disease Control states forcefully that the efforts to improve the health of women in their reproductive years have been extraordinarily effective over the past 25 years and that total deaths among women who are either trying to prevent pregnancy or who are pregnant are dropping markedly. Some journalists appear to have gathered the wrong message from this article. Sachs and his colleagues have shown that there are risks from using contraceptives and that those risks are now almost as great, in terms of absolute numbers, as the risks of pregnancies to American women. That does not mean that oral contraceptives (OCs) are as dangerous as pregnancy. The article should have placed more emphasis on the fact that the excess attributable mortality rate from contraceptives is far lower than the mortality rate attributable to pregnancy. Many important points are made in this article, and the following are directed to family planners: 1) the effort should made to think in terms of "reproductive mortality" rather than simply in terms of maternal mortality, 2) over the next 6 months there will be many questions relating to the safety of providing OCs to teenagers without parental consent, 3) there is a need to recognize that the deaths caused by modern contraceptives center primarily in heavy smokers using OCs in the latter half of the their reproductive life span, and 4) there are women dying of contraceptive complications whose deaths might be prevented if closer attention was paid to the OC danger signals. The concept of reproductive mortality allows epidemiologists, clinicians, and women to put into perspective all the risks of sexual intercourse. Most would argue that the benefits of highly effective contraceptives have exceeded the risks. This is particularly the case if one includes the numerous noncontraceptive benefits of OCs such as prevention of pelvic inflammatory disease, anemia, ovarian and endometrial cancer, and fibrocystic breast disease.