This study aimed to determine the MMR in Basra hospitals for 20 years (1983-2002), to determine the main causes of maternal deaths with regards to direct, indirect & fortuitous causes & to verify the impact of major events including wars & sanction on the trend of maternal deaths. This is a retrospective study included all maternal deaths occurred in hospitals as well as deaths recorded in emergency departments, forensic medicine department & statistical units throughout the study period. Detailed information was taken to verify the cause of death in each woman. A total of 206 deaths occurred during the study period, MMR did not run a steady fashion, they showed gradual decline during 1980s. Following the second gulf war, there was considerable increase in MMR with the peak one observed in 1996. There after the ratio decline gradually to pre 2nd war levels. Direct obstetric causes remain the major causes of maternal death throughout the 20 years with, in a decreasing frequency, hemorrhage, sepsis & AFE were the major direct causes. However, indirect causes showed some, but noticeable increment during the sanction years. We concluded that the major political events, including wars that Iraq & Iraqi peoples exposed to had substantial adverse influence on the trends of maternal deaths. Although a direct maternal death outweigh indirect death, however, sanction years caused obvious increment in direct deaths.