The death of a mother, fetus, or neonate is tragic whenever it occurs. While relatively rare in the industrialized world, maternal, fetal, and neonatal deaths occur disproportionately in developing countries, where the vast majority of the 515,000 maternal deaths, 4 million late fetal deaths (beyond 22 weeks’ gestation), and 4 million neonatal deaths are conservatively estimated to occur each year. In Eastern Africa, 1 in 11 women dies of pregnancy-related causes, a lifetime risk of maternal death 500 times greater than that faced by women in some industrialized countries. Most maternal, neonatal, and fetal deaths occur between late pregnancy and the end of the first month of the child’s life and many are preventable. Yet this important period has received inadequate attention in the health care programs of most countries. This report reviews the evidence on key interventions that could greatly improve birth outcomes1 in developing countries.