Objective To analyze the causes and factors associated with maternal death in Changzhou, Jiangsu Province, and explore effective measures to reduce maternal mortality, so as to provide evidence for government’s policy-making.

Methods The data of maternal death surveillance, death cases and audit materials of Changzhou, Jiangsu Province from 2017 to 2022 were collected and analyzed retrospectively. Maternal mortality, cause of death, place of death, changing trends and factors associated with it were analyzed.

Results There were 19 maternal death cases in Changzhou, Jiangsu Province from 2017 to 2022. Maternal mortality rates in the past 6 yeas were 10.00/100 000, 9.48/100 000, 17.14/100 000, 9.30/100 000, 9.77/100 000 and 0/10 000, respectively. The average maternal mortality was 9.54%, being higher than the average level of the whole province and the requirements of the 13th Five-Year Plan. Most deaths could be avoided. The main causes of death were direct obstetric factors. The places of death were mainly at maternal and child health care specialized hospitals and tertiary general hospitals. The ‘three delays’ were mainly medical treatment delay (84.61%), treatment-seeking delay (46.15%) and transportation delay (7.69%). The main factors associated with maternal death were knowledge and skills of health professionals in municipal health care institutions (84.61%) and personal knowledge and skills (69.23%).

Conclusion Maternal mortality in Changzhou, Jiangsu Province shows a downward trend from 2017 to 2022, but the situation is not optimistic. Capacity-building of obstetrics and multidisciplinary collaboration in maternity and child health care specialized hospitals and tertiary general hospitals should be enhanced to improve health professionals’ knowledge and skills, their ability to identify high risks, respond and treat quickly, and hierarchic healthcare should be implemented to reduce maternal mortality.