Causes of maternal death at Natalspruit Hospital, Johannesburg, South Africa

Background. Despite increased resources to reduce maternal deaths, South Africa (SA) has an unacceptably high maternal mortality rate (MMR).Objectives. To determine the causes of maternal deaths at Natalspruit Hospital, Johannesburg, SA.Methods. A 2-year retrospective audit of case records was done All maternal deaths from January 2013 to December 2014 were included.Results. There were 20 676 live births and 79 deaths, with a MMR of 382.08/100 000. Forty-four women (56%) were HIV-positive, 14 (21%) died of obstetric haemorrhage and 12 (15%) had hypertensive disorders of pregnancy. Thirty women (38%) had not attended an antenatal clinic. More women died between 16h00 and 08h00 than between 08h00 and 16h00. Most women (88%) had at least one avoidable factor.Conclusions. Natalspruit Hospital has a high MMR. The majority of deaths were HIV-related. There was a high number of women who were unbooked. Most deaths occurred after normal working hours