We report the first results of the analysis of maternal mortality at the university hospital of Donka, Conakry, Guinée. This paper details the mortality rate [12.47/1,000] in a consultant service which has very limited facilities. It outlines the causes of death, the dramatic circumstances in which the accidents occur and it discusses the notion of responsibility and above all the means to reduce these terrible mortality figures: an increase in primary health care, peripheral obstetrical services, training of health personnel and of traditional birth attendants, as well as education of the population.