Objective
To analyze the data available on obstetric complications, maternal deaths, and types of admission in 7 tertiary maternity centers in Cameroon.

Methods
A descriptive retrospective study of all obstetric complications and maternal deaths that occurred in 7 tertiary level maternity hospitals between January 2005 and December 2006. Data were collected using the same registers, file records, and standardized questionnaires.

Results
During the study period there were 34 898 deliveries and 4069 cesareans were performed. There were 11 014 obstetric complications and 249 maternal deaths were recorded, giving an MMR of 713 per 100 000 deliveries. The risk of mortality among women referred to the tertiary level facilities was higher compared with women who were directly admitted to the facilities (odds ratio 3; 95% CI, 2.2–4.0).

Conclusion
The high rates of maternal mortality recorded in tertiary maternity centers among women who were referred reveal the urgent need for interventions to improve the referral system.