Objectives: To asses the Maternal Mortality Ratio and the causes of maternal death over a period of three years in one of the rural district of Sindh Province, Pakistan.

Methods: A retrospective analysis of maternal mortality was carried out for a period of 3 years from 2006 to2008 by reviewing the maternal mortality record and statistics of National Programme for Family Planning and Primary Health Care of District Matiary, Sindh Province Pakistan. The information regarding demographic, reproductive parameters and verbal autopsy questions was collected and analyzed by SPSS V 16.

Results: The cumulative MMR was 297/100,000 live births. The direct causes accounted for 58 (80.5%) deaths. The high ratio of maternal mortality was found in women of age 29-39 years and in Para > 4. Thirty five (48.6%) maternal deaths occurred at tertiary care hospitals, while 20 (27.8%) and 16 (22.2%) took place at home and on the way to hospital respectively.

Conclusion: Maternal Mortality in rural areas of Sindh Province Pakistan is still a challenge for the achievement of the Millennium development Goal (MDG).

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