The Confidential Enquiries into Maternal Deaths (CEMD) produced triennial reports entitled "Why Mothers Die" from 1952 up to and including the report for 1997/9. Confidential Enquiry into Maternal and Child Health (CEMACH) has not only continued the Why Mothers Die report and the Stillbirth Neonatal and Postnatal Mortality report but also undertakes focused enquiries e.g. The Diabetes Study. This chapter dicusses the main causes for maternal death, fetal and neonatal death, and the recommendations for anaesthesia services from the most recent "Why Mothers Die" (2000-2002) report. The major causes of indirect maternal deaths reported in the last triennium were cardiac, psychiatric and malignancies. Both stillbirth and neonatal mortality rates are higher in women in socially deprived areas and in women of Black or Asian ethnicity. Anaesthetists should be involved in the care of high-risk patients from early in pregnancy and a management plan made for the care of these women.