**Question:** Denominator of maternal mortality ratio is -

A. Total number of live births
B. Total number of deliveries
C. Total number of pregnant women
D. Total number of stillbirths

**Core Concept:** Maternal mortality ratio (MMR) is a metric used to measure the number of maternal deaths per 100,000 live births in a given population. It helps to track the health system's performance in saving maternal lives. The denominator in calculating MMR represents the number of women who are exposed to the risk of maternal mortality, which is usually referred to as the total number of pregnant women.

**Why the Correct Answer is Right:** The denominator of maternal mortality ratio is C. Total number of pregnant women, as it represents the number of women who are exposed to the risk of maternal mortality. This is crucial for calculating the MMR accurately, as it reflects the population at risk.

**Why Each Wrong Option is Incorrect:**

A. Total number of live births (A) is incorrect because it represents the number of infants born, not the number of women who are potentially exposed to maternal mortality.
B. Total number of deliveries (B) is incorrect because deliveries may include both live births and stillbirths, which are not part of live births.
D. Total number of stillbirths (D) is incorrect because stillbirths do not contribute to maternal mortality; they are separate from maternal deaths.

**Clinical Pearl:** Understanding the concept of Maternal Mortality Ratio and choosing the correct denominator helps in assessing the health system's performance in reducing maternal deaths and improving maternal health outcomes. Improving maternal health requires focusing on reducing maternal deaths, preventing complications, and ensuring appropriate healthcare access for pregnant women.