Latar Belakang : Angka Kematian Ibu (AKI) di Indonesia tetap tinggi, yaitu sekitar 305 per 100.000 kelahiran hidup (SUPAS 2015). AKI adalah indikator kesehatan ibu, terutama risiko kematian ibu saat hamil dan melahirkan. McCarthy dan Maine menunjukkan tiga faktor yang memengaruhi kematian ibu, yaitu determinan dekat, determinan antara dan determinan jauh. Kabupaten Serang adalah salah satu kabupaten di Provinsi Banten yang memiliki angka kematian ibu masih tinggi, sehingga perlu dikaji faktor-faktor yang berhubungan dengan kematian ibu di kabupaten tersebut. Tujuan : Penelitian dilakukan untuk mengetahui faktor – faktor risiko yang mempengaruhi kematian ibu, yang terdiri dari determinan dekat, determinan antara dan determinan jauh. Metode : Jenis penelitian adalah observasional dengan studi kasus kontrol, dilengkapi dengan kajian kualitatif mengenai kejadian kematian ibu serta upaya penurunan angka kematian ibu di kabupaten Serang. Jumlah sampel 58 kasus dan 116 kontrol. Analisis data dilakukan secara univariat, bivariat dengan chi square test, multivariat dengan metode regresi logistik ganda. Kajian kualitatif dilakukan dengan metode indept/focused interview dan dilakukan analisis secara deskriptif, disajikan dalam bentuk narasi. Hasil : Hasil penelitian menunjukkan bahwa faktor risiko yang mempengaruhi kematian maternal berdasarkan analisis multivariat adalah pemeriksaan antenatal (OR = 0,152; 95% CI : 0,031-0,744; p = 0,020), penolong ANC/persalinan (OR = 3,184; 95% CI : 1,010- 10,037; p = 0,048), jumlah pendapatan keluarga (OR = 342,67; 95% CI : 58,15-2019,18; p = 0,000).Hasil kajian kualitatif menunjukkan bahwa kematian maternal dipengaruhi berbagai faktor seperti keterlambatan rujukan, terutama keterlambatan pertama, rendahnya tingkat pendidikan ibu, rendahnya tingkat pendapatan keluarga dan belum dapat dilaksanakannya Gerakan Sayang Ibu (GSI) secara optimal di seluruh wilayah kecamatan sebagai upaya pemerintah dalam menurunkan kematian ibu. Saran : perlu pengenalan dini tanda – tanda komplikasi dalam kehamilan, persalinan dan nifas, persiapan rujukan, perencanaan kehamilan, pelaksanaan GSI secara optimal.

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Background : The maternal mortality ratio (MMR) in Indonesia remains high, i.e. approximately 305 per 100.000 live birth (SUPAS 2015). MMR is an indicator of mother’s health, especially the risk of being death for a mother while pregnant and delivery. McCarthy and Maine shows three factors that influence maternal mortality, i.e. proximate determinant, intermediate determinant and distant determinant. Serang district is one of district in the province of Banten which have maternal mortality case still high, so it is necessary to study the factors that related to maternal mortality in that district. Objective : The study was carried out to know the factors that related to maternal mortality, which consist of proximate determinant, intermediate determinant and distant determinant. Methods : This was an observational research using case control study, completed with qualitative study about the occurrence of maternal mortality and the effort to decrease MMR in Serang district. Number of samples was 58 cases and 116 controls. Data were analyzed by univariate analysis, bivariate analysis with chi square test, multivariate analysis with multiple logistic regression. Qualitative study was done by the method of indepth/focused interview and were analyzed by descriptive analysis and presented in narration. Result : The result showed that factors that related to maternal mortality according to multivariate analysis were antenatal care (OR = 0,152; 95% CI : 0,031-0,744; p = 0,020), antenatal/maternity helper (OR = 3,184; 95% CI : 1,010-10,037; p = 0,048), family income (OR = 342,67; 95% CI : 58,15-2019,18; p = 0,000). The result of qualitative study showed that many factors that related to maternal mortality like late referral, especially first late referral, low education of the mother, low of family income, and the GSI activities not well done yet in each subdistricts. Suggestion : This research recommended that it is necessary to detect signs of pregnancy complication, delivery complication, and post delivery complication early, referral preparation, pregnancy planning and optimizing GSI activities.