PIP: This study analyzed reproductive deaths (all deaths from pregnancy-related causes, including abortion and ectopic pregnancy, as well as from causes related to contraception) among women 15-44 years of age in the state of Massachusetts in 1981. Of the 971 deaths recorded in this age group, 14 were classified as reproductive deaths, for an overall reproductive mortality rate of 1.8/10,000 live births (1/100,000 women). 10 of these deaths were pregnancy related, and 4 were due to pregnancy prevention (oral contraception). 4 of the pregnancy-related and 3 of the contraception-related deaths were considered preventable since they occurred in women in whom oral contraception (OC) had been contraindicated. The risks related to OC use were higher than those related to pregnancy for women over 35 years of age, suggesting that the reproductive mortality rate could be reduced by proscribing OC use in women in this age group, especially in women who smoke or have hypertension. It is concluded that the reproductive mortality rate is a better measure of the risk associated with reproduction that the maternal mortality rate, and it is recommended that committees on maternal mortality expand their surveillance to include deaths due to the side effects of contraception.