One of the reasons maternal mortality is so high in the U.S., and why medical costs in general are so high, is because the American Medical Association for the past hundred years has acted as a restrictionist guild. In many industrialized nations, a person can become a doctor 6–8 years after graduating high school. The onerous cost of entry both in time and money to become a gynecologist limits the supply and drives up maternal mortality. We need to make licensing easier in this country.