Confidential Enquiry into Maternal Deaths in the Netherlands, 2006–2018

(Acta Obstet Gynecol Scand. 2022;101:441–449)The national maternal mortality ratio (MMR-quantified maternal deaths during pregnancy through 42 days postpartum per 100,000 live births) is an important metric for evaluating health care trends and allows for learning to improve care and prevent further death. While 90% of maternal deaths occur in low- and middle-income countries, from 1990 to 2015 some high-income countries saw increased MMR over previous decades. In the Netherlands, the rise of known risk factors including chronic hypertension and obesity, changes in national demographics, and reduced underreporting are considered significant contributors to the MMR increased observed from 1982-1992 (9.7 per 100,000 live births) to 1993-2005 (12.1). Further inquiry is necessary to update MMR in the Netherlands and evaluate new trends.