Nowadays, maternal mortality rate (MMR) in Indonesia is still high. In the period 1992-1997 the MMR was 390 per 100.000 live births. This rate was about 3-6 folds higher than that in South East Asian countries. The primary causes of the MMR were bleeding, gravidarum tocsemia and infection, which infact, could be promptly detected by adequate health-care facilities. The purpose of the study was to explore the background of the high MMR in East Nusa Tenggara province (Kupang and Belu districts). Data were collected through in-depth interview towards the closest persons of the cases including husbands, parents, sisters. brothers. neighbors, traditional birth attendants and midwives. The study revealed that there were difference perceptions about the causes of maternal mortality between health professionals and the community. According to the health professionals the causes of the maternal mortality were bleeding, infection and eclampsia due to delayed health-seeking behavior. Conversely, the community believed that the maternal mortality were due to suspicious matters and faith of God. The study concluded that the background of the perception's differences was social and cultural aspects within the community and the ignorance of the pregnant women and her families about the high risk symptoms of pregnancies.