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Objectives:  Maternal mortality is a crucial indicator of health care provision within a nation, particularly during the periods of instability. This study aimed to assess the maternal mortality ratio in one of the largest hospitals in Baghdad over eight years including the time of the threat of the so-called Islamic State of Syria and Iraq.  Materials and Methods:  A cross-sectional study was undertaken by reviewing the records of mothers who passed away in the hospital from February 2011 to February 2018. The gathered data included the patients’ demographic features as well as obstetrical and medical conditions and causes of death each year.  Results:  During the eight years, the total live births numbered 95 800 while 52 mothers died for a maternal mortality ratio of 58.12 per 105 . Most of the deceased mothers aged between 30 and 39 years ( P  = 0.0015), were multiparous and from rural residence ( P  = 0.000), booked no antenatal care ( P  = 0.0014), and completed delivery via a cesarean section ( P  = 0.0184). The majority died in the postpartum period ( P  = 0.000) within the first 12 hours of admission ( P  = 0.000). Finally, the major presentation and cause of death were often obstetrical hemorrhage.  Conclusions:  The maternal mortality was high and obstetrical hemorrhage was the main cause of death. In addition, the majority of patients died within the first 12 hours of admission, which is attributed to delays in access to the hospital and the lack of needed facilities during that critical period of time.

Maternal Mortality in an Iraqi Tertiary Hospital: Lessons From the Years of the Crisis