Summaryobjective To determine the risk factors, such as socio-economic background, quality of antenatal care and availability of family planning, responsible for high maternal mortality in Surabaya, Indonesia.methods The study used a case-control design. Descriptive, bivariate and multivariate analyses were carried out, comparing 59 maternal deaths and 177 women survivors in the referral hospital, from 1996 to 1999.results The risk factors for maternal mortality were: living outside of Surabaya [odds ratio (OR) ¼ 11.7, 95% confidence interval (CI) ¼ 5.0-29.2], unemployment (OR ¼ 4.4, 95% CI ¼ 1.7-13.8), unavailability of toilet facilities (OR ¼ 2.9, 95% CI ¼ 1.0-7.7), <4 antenatal visits (OR ¼ 2.5, 95% CI ¼ 1.1-5.5) and initial visit to antenatal care facilities after the fourth month of pregnancy (OR ¼ 3.0, 95% CI ¼ 1.3-7.0). There was no significant association between maternal mortality and the availability of family planning.conclusion Low socio-economic background and the availability of antenatal care have a significant influence on maternal mortality in Surabaya, Indonesia.keywords maternal mortality, socio-economic background, antenatal care, family planning, Surabaya

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